HomeMy WebLinkAbout010-841-36-5407-SAN-2022-057 �;ts.^"'^_%:_C;, Industry Services Division �County �
l,,D, -- 4822 Madison�'ards Way .faw / �
; s P ; Maclisot� WI 5370$ Sanitary Pcnnit Number(to be filled in by C '
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>\;y `� , Madison,WI 53707-7162 �`�� C;(T1 2 N
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Sanitary Permit Application State Transaction Nurober �
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In accordance with SPS 383.2 I(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit �
is rcquircd priur to obt��ini��g a saoitary pertnit.Note:Application fomvs for state-0wned POWTS are submitted ro Project Adclress(if different than mailing ac �
ihc Dcpamncnt nf Safety aud Professional Services.Pe�onal information you provide may be used for secondary
purposcs in accordancc wich the Privacy Law,s. 15.04(1)(m),Stats.
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L Applitation�lnformatioo�-°PleaseP�u��,lUl��;[r�'oC,i�,1�d�tiP�i, � � '��,.. , ._;;, � 9'1�.j,V R�eb P o,✓ �_----,——--
F'roperty Owner's Namc Parccl#
Jefftlyd J4%Mr Re..+.tes olofr y�31 Syo 7 --- -----
Property Owncr's Maili��g Address PropeRy lLocation
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$a Govc.Loc N _
Ciry,State Zip Code� Phone[�lumber
H4 W /�✓S ,f'1�y �r��Section �+6__--
IL Type of 13uilding(check all�that'ap'ply)�� �' � �-���� T�N R 8' E or� ___
�1 or 2 [�amil}�U«�ellinc-Number ofIIedrooms � � Subdivision Name
Alock#
�Public/Commercial-I�escnbe Use -� �—
❑City of ____
�State Owned- Descnbe l Ise_ - CSVI Number illage of _
^ OT�w���f Htyws�--- _
lII.Type of POWI'S T'ermit: (Check_cither"New"olt$�2ep�a�ement"and o�her aBjii�i��hle on line��.Check une bos on li�e[3:Com�Leic linc C if
a>>licablc.) � � r '� �
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____.—____._-- _ - —' � � _____'__—.--_
A� New S��stcm ��e lacetnent S stem ther Modificatiou to Gxistin S s[em ex lain Additional Pretrearment linit cx lain)
❑ � I Y Itt P Y� ❑� � Y � P ) ❑ (" P
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�� �Holding Tank �In-Ground �At-Grade �Mound Individual Site Design Other Type(cx��lainl
(conventional) �
� � ❑Ren����al Refnrc ��Revision �Change of Plumber �Transfer to New Owner ist Previous Permit Number and Datc Issued
E-�,,��„��,,,� �� -��-a y��l�� ao,
IV.Dispers:il/"freatment Area and Tank Ir►ftiimation;�;;:" -��.y-��!''�� � _„ } �'
�:,.. _ > , .,,�.,�. , .��. ., - ,
Design Flow(gpd) Dcsign Soil Application Rate(�d/s� Dispersal Area R�yuired(sfl Dispersal Area Proposed(s� System El�vation �
600 • 7 857.1 /OfQ q�.n , ql.o' 90.0�
Capacity in Total tJ of Manufacturcr �
l�ank Infonr�ation Gallons Gallons Units � ti o � � �
� New Tanks Ezisting Tanks � o avi � Y � ro �
a. U cn � v� w C7 a
Septic or Holdini�'i:�nk �_-�� ��QO-h g00 �d00 �{ �I, (/ C� x �
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Dosing Chamhcr �' ��� �00 � f�R1✓ � � �
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V.Responsibility Statement- I,the undersigned,assume��responsi6ilily torinstalla6ono!`#,6e��'OWTS�showqon-the,attac�hed'plans.� �
Plumbcr'ti��amc f Print) Plumbet's Signature /MP[ZS Number Business Phonc Number
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Plurnber's Addrec i Strect.C it��.State,Zip Code)
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VI.C uoty/llcpartmcut Use Only _�..,�- �'>`.� �;'`�+.�,�,.;r � _�
�A pro cd � "J I)i������r�vcd Pennit Fce '� Dste Issued� Isswng Agent Signature
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CJOw��erGiveoRcasonforDenial �w,6 � 21 ZZ �'(i�Cil.t-�.e..�-c- �+�r
Conditions of Approval/Reasons for Disapproval
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APR 2 1 2022
SAWYER CC�_i�'�"
Attach to complete plans for the sys[em aod submit lo the Covntc only on paper not less than 8 1R i il inches io�size :''J'd
sB�-639s�a.o3iz>j NO REFUNDS AFTER
ISSUE OF PERMIT
Jeffery & Jaime Romsos Property Owners Name
9925 Richardson Bay RD Property Address
10841365407 Tax Parcel Number
Sawyer County
Prt Govt Lot 4 Legal Description
36 Section
41 N Town
8W Range
Page Index
1 Property information
2 Data Entry
3 Plot Plan
4 Drainfield Cross-Section
5 Tank Information
6 Maintenance Plan
7 Contingency Plan
Bruce Vitcenda Plumber's Name
Plumber's Signature
M.P. 220498 Plumber's License Number
715-943-2382 Plumber's Phone Number
9/20/22 Date
Page of
n- roun oi sorp ion - - �����Ua! Used
N.01/01 Version 2 ..•
4 Number of Bedrooms
10 Percent Siope (%)
100/110 Depth to Soii Limiting Factor (in.)
0.7 In Situ soil application rate
400 Estimated Wastewater Ftow (gpd)
600 Design Wastewater Flow (gpd)
3 Number of System Elevations
92 Proposed System Elevation#1
91 Proposed System Elevation #2
90 Proposed System Elevation#3
96.75 Original Grade#1
95.75 Finished Grade#1
95.75 Original Grade#2
94.75 Finished Grade#2
94.75 Original Grade#3
94.75 Finished Grade#3
Skaw 800 Combo tank or ump tank
Orenco 8" Biotube Effluent Filter
BioDiffuser ARC 36 Chamber Type
13 Height of Chamber (in.)
25 sq.ft. per chamber(ESIA)
4.5 sq.ft. per pair of end caps (EISA)
5 laying length of chamber(ft.)
1.17 length of endcap(ft.)
33.75 Chamber width(in.)
3 Rows of Chambers
3 Distance Between Cells (ft.)
14 Number of chambers in first row
14 Number of chambers in second row
14 Number of chambers in third row
42 Proposed Number of Chambers Used
� 857.1 .Minimum Distribution Cell Area Required (sq.ft.)
�� 1063.5 � Distribution Cell Area Proposed (sq.ft.)
Page 2 nf 7
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Cross Section of a Three Cell In.ground Co�nent
Using L.eaching Chambers
Finished Grade 94.75
Original Grade 95.75
Z����� Top of Chamber 92.08
/ �System Elevation 91.00
Finished Grade 95.75 /�
Slope 10% C°�� ef�� � � __/�"'--- __. FinishedGrade 94.75
'`�y �3 Feet
96.75 Original Grade `,t'^` ��;'� �'�� -�;
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%r� �� :C ' ' �. � �
93.08 Top of Chamber ��„- y. ., �� r ��_,�- Original Grade 94.75
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� �•' ' ' 1,'' ' ;�' Top oF Chamber 91.08
, � ...• •. ... .�.�......
92.00 S stem Elevation '� -�.�. ; r ' • • • y
y ' . System Elevation 90.00
.y. ,t. y _ _ .__��-.. F. _ ,.
'.'` ` ��'+�TQP�. f..•� •t ' ' ���
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Qb/RVit1OO�Vl��!E'�b 60 CGO/01CIO��Od CIIppEid Y�ib�VVOd�Ef1�h�O[tb!pRhOCB11R W!.
Dia rams Not To Scale
72.34 feet �
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�` - - — 72.34 feet _ _ _-
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, . ::.� � : ; :: . i 3 feet
.____ _
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- ; ?y�; �_�.. . , n,� � . .:; �. ����:��� ' between cells
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72.34 feet
Observation/Vent Pipes to be located at the ends of the distribution celis.
Page 4 of 7
APQrt+v�d Mc]��n�� i,�vCre Wn.. nv....'--� _.._.
^nd LCckinq nevi�e / 4" Min AbOve c:.,�� r.�de
�
i �� Weother Proof .iunction 6ox
� \\ � E�eCtriC �t�.r NEC 300 dC COMM
4' Sch. 40 Vent � // +g.?g We�
> or = to 12` L
Above Final Grade \�1
I
Discon
Altemate Outlet Locotio�
W/Approved 4" Sleeve
iniet 2 inch forcemain
� Orenco 8"Biotube A
Baffle eep Hole or Anti Siphon Device
B
C
Skaw 800 I D
14 Vertical Difference Between Pump Off and Inlet to Chamber
�y 190 Length of Forcemain(ft.) Inches Gallons
2 Forcemain Diameter(in.) A 23.4 487.7
0.92 Friction Factor per 100ft. B 2 41.7
1.75 Friction Loss C 6.3 131.0
15.75 Total Dynamic Head D 10.0 208.3
TOTAL 41.7 868.6
6 Number of Doses per Day
100 Gallons per pose(Not to exceed 20%of Daily Design Flow}
30.97 Votume of Forcemain Backflow
130.97 Total Dose Volume
�`� � `� PUMP PERFORMANCE CURVE
800 Pump Tank Capacity(Gallons) Mo�E�s8
20.83 Pump Tank Volume (Gallons/Inch) I -
41.7 Liquid Level (in) I �
Zoeller 98 Pump Type = '�, `0
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IS -}
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SJE Rhombus-Tank Alert 1 Alarm ,_ ' I
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�o �n �o ao so eo �a �,�.
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LTtF�- ,��i H�l tg0 24(� -___
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Jeffe 8�Jaime Romsos
9925 Richardson Ba RD
1.08E+10
Number of Bedrooms 4 Combo or Pur Skaw 800
Estimated Flow(average)gallons/day 400 Effluent Filter Orenco 8" Biotube
Design Flow(peak), (Estimated x 1.5)gal/day 600
Soil Ap lication Rate al/da /ftZ 0.7
Influent/ Effluent Quali Monthl Average
Fats, Oil &Grease(FOG 30 mgl�
Biochemical Ox en Demand BODS� 220 mg/L
otal Suspended Solids (TSS) 150 mg/L
Servicing ftequency of 12 months or less requires the
Management Plan be recorded with the Register of Deeds.
Maintenance Schedule
Service Event Service Frequency
Inspect condition of tank(s) At least once every 3 Year(s)
Pum out contents of tank s When combined sludge and scum = 1/3 of tank volume
Inspect dispersal cell(s) At Ieast once every 3 Year(s)
Clean effluent filter At least once every 3 Year(s)
InspecUtest pump and alarm At least once every 3 Year(s)
Maintenance Instructions
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses
or certifications:Master Pfumber, Master Plumber Restricted Sewer, POWTS Maintainer, Septage Servicing
Operator. Tank inspection must include a visual inspection of the tank(s)to identify any missing or broken
hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for
any backup or ponding of effluent on the ground surface. The dispersat cell(s) shall be visually inspected to
check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground
surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tank volume,
the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in
accordance with ch. NR 113, Wisconsin Administrative Code.
A service report shall be provided to the Sawyer County Zoning Dept within 30 days
of any service event.
Start-Up and Operation
For new construction, prior to use of the POWTS check treatment tank(s)for the presence of painting
products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s).
If high concentrations are detected have the contents of the tank removed by a licensed Septage Service
Operator.
System start-up shall not occur when soil conditions are frozen at the infiltrative surFace.
Page 6 of 7
i �
I Do not drive or park vehicles over tanks and dispersat cefls.
�
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong
' the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, denta�
floss, diapers, disinfectants, fat, foundation drain (sump pump)water, gasoline, grease, oil, painting products,
pesticides, sanitary napkins, tampons, and water softener brine.
j Abandonment
! When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure
� that the system is properly and safely abandoned in compliance with Wisconsin Administrative Code SPS
� 383.33;
-All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
i -The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
j -After pumping, all tanks and pits shall be excavated and removed or their covers removed and the voidspace
ifilled with soil, gravel or another inert solid material.
I
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'i Continqencv Plan
IIf the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide a
code compliant replacement system: (Check One)
�The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil
and site evaluation shall be performed to locate a suitable replacement area. If no replacement area is available
! a holding tank may be installed to replace the failed POWTS.
�I �A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil
absorption system. The replacement area should be protected from disturbance and compaction and should no
' be infringed upon by required setbacks from existing and proposed structures, lot lines and wells. Failure to
', protect the replacements area will result in the need for a new soil and site evaluation to establish a su�able
� replacement area. Replacement systems must comply with the rules in effect at that time.
I
� � A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may be
'I installed to replace the failed POWTS.
f
Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do not enter a
' septic, pump or other treatment tank under any circumstances. Death may resuti. Rescue of a person from the
interior of a tank may be difficult or impossible.
POWTS Installer Septic Pumper
Name Bruce Vitcenda Name Northwest Sanitary
Phone# 715-943-2382 Phone# 715-943-2650
I POWTS Maintainer Local Regulatory Authority
!;Name Northwest Sanitary Agency Sawyer County Zoning
I Phone# 715-943-2650 Phone# 715-634-8288
7of7
BAFFLE
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i � WARNING DEATH MAY OCCUR!F TANK IS ENTERED
� O � WlTHOU7PROPEREQUIPMENT
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�\ � 57,20 56,00 89,20 94.00
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56.70
61.7�
TOP VfEW OF MANHOLE COVER
67.75
FItTER
� 12.00 �
3.00
� 25.5Q
4.00 T
� * 23.50
� �27.00� 27.00� 23.50
5T�24 00 24.00� 25.15
� �--,s.00—� �.00 TOP VlEW OF TANK (TAPERED)
--�-2.00
INL� ' , i � i
/ � OUTLET� i sicnweoo �
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9.00 � J�--59.23
4 INCN PRESS ` 2��� 18.00 > pRE S �i i
SEAL GASKET
1NSTALLED S�� i I
WNEN POURED GASKET i i
�BAFFLE ' '
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300� SECTION i/IEW OF TANKAND COVER 30o OUTLET END VIEW OF TANK
Mode1/Vumber: ��� SKAW PRE-CAST � �
Phone: 715 967-2277
Approved for: SEPTIC, SIPHON, HOLDING, OR PUMP
n e �m. u et im. 26255 105th Street, New Auburn Toll Free: 1-800-924-8625
Weight Liq. Depth Gal./In. Max. Cap. Wisconsin 54757 Fax: (715) 967-2707
79301bs. 46.7" 44.7" 41.70" 19.18 800 gal. www.skawprecast.com
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Oftice of �UN 2 7 ZOZZ ��
Sawyer County Zoning and SA�yER GpU!��`�! ,
Conservation Administration zo�e�►c AVM►n�sT�''�'`�"
10610 Main Street. Suite 49
Hayward, WI 54843
TeL (71�)634-8288
Fax: (715)638-3277
� UI2L:http:/isawyercountygov.or�
Gmail: zonin .g sec(��sawyercountygov•or�
Toll Free: Courthouse/Generai Information
1-877-699-4]10
Sawyer County Zoning and Sanitation "As - Built" Form
Property Owner's Name cT�� 0 0
Fire Number and Road Name _�q,�,�ii/__���{��/�[p�/ �1�
Plumber's Name �Ji{v��l/$'1Ct,✓��I_
Date of Installation �0 '.2�
County Sanitary Permit Number ��(�,�7
12 Digit Parcel Number ��_�y/3L.�ye�
Description and Elevation of Benchmark Zn /�t7ii� 1j�yJfo/'A►i�if/✓C�.65
Tank Manufacturer and Capacity Sk�t�,/_ �roo _ _
Setback-Tank to Nearest Lot Line _ 3� " _
Setback-Tank to Nearest Well 7,f'�
Setback-Tank to Building _ �� �
Cell Width �
--�----- _ _
Cell Length _70'— Ls'- 6S�
Number of Celis _�____ __
Setback-Cell to Nearest Lot Line ��'___ __ ___
Setback-Cell to Nearest Well 7� __ __
Setback-Cell to Building (,0'__
Setback-Cell to Navigable Water �90��
Make and Model of Dispersal Unit A!(L_}�___
Make and Model of Filter _�IfC T�',�__ _
Make and Model of Pump __2 Ot /e! _—____--___
. � - Please complete other side -
ccf�S-BUllt PlOt PIaIl"
� . Elevation Data �
, Benchmark �,� f;,, . � Please include the followin�:
Building Sewer _ /y.s"
Tank In _ /y.[' � Location of observation and vent pipes
Tank Out � Feet of risers used on tank(s)
Dose Tank In iy.�� � Location of benchmark and North arrow
Dose Tank Bottom �j.,�� � Location of all components
Header or Manifold 3,y' • L,ength of pipe between components
Distribution Pipe _ � Number of chamber units in each cell
System Elevation ��=�l=�a' � Location of well, lot lines and roacl
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