HomeMy WebLinkAbout002-840-20-5419-SAN-2022-063 _ •"' Industry Services Division County �
� , 4R22 Madison Yards Way Sawyer �
- , _' - Madison,WI 53705 Sanitary Permit Number(to be filled in b '
: - P.O.Box 7302 �y �7 �
Madison,WI 53707 Cp �j� V t0 1
Sanitary Permit Application State Transaction Number N
In accordancc with SPS 3R3.21(�),Wis.Adm.Codc,submission of this fomi to thc appropriatc govcrnmcntal unit �— `
is required pnor to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if difterent than mailing �
the Department of Safety and Professional Services.Personal information you procide may be used for secondary g 120N Ct HW K �
purposes in accordance with the Privacy Law,s. 19.04(I)(m).Stats. y y �
I.Application Information-Please Print All Informarion / ``
Property Owner's Name Parcel# v�+
Michael Horman 002840205409
Property Owner's Mailing Address Propert Location
8120N Cty Hwy K �oYP°;��4
City,State 7_ip Code Phone Number
Spooner WI 54801 '� � � �-j I �O - I(��2 r� �s����on 2°
II.Type of Building(check all that apply) Lot# T40 N R 8 E or W
�(or 2 Family Dwelling-Number ofBedrooms 2 � & 2 Subdivision Name �
Block#
�ublic/Commercial-Describe Use _
�c�cy oe
❑State Owned-Describe Use CSM Number illagc of
17/66 ���-� ❑✓T°"'"�e Bass Lake
Ill.Type of POWTS Permit:(Check either"New"or"Replacement"and o[her applicable on line A. Check one box on line B.Complete line C if
a Iicable.)
A� �7,,e lacement S stem ther Modification to Existin S stem es lain Additional Pretreahnent Unit ex laui
�_ I✓IK P Y � g Y• l P ) ❑ l P )
LJ
B' ❑Holding Tank n-Ground ❑At-Grade �A4ound Individual Site Design Other Type(explain)
conventional)
C• ❑Renewal Before Re ion hange of Plumber �Iransfer to NeH Owner List Previous Permit Numb and Date Issued
�;xpiration �7 "�, j 11 r�IOY �O`I� �
IV.Dispersal/Treatment Area and Tank Information:
Design FIoH(gpd) Design Soil Application Rate(gpd/sf� Dispersal Area Required(st) Dispersal Area Proposed(s� System levation q� Y
300 , , / 8 �, � -��:�.?0 A���
Capacity in fotal #of Manufacturer
�
Tank Infortnation Gallons Gallons Units � � v b„ �
New Tanks Fxisting Tanks � c y � � � � �
0
n. U �n h �n i,. C7 4i.
Scptic or Holding Tank �oOQ ���� 1 Wieser ✓
Doaing Chamber 6�� 60� �' � � �
V.Responsibility Statement- 1,the undersigned,assume resp ibility r installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Signa c MP/MPRS Number Business Phone Number
Dan Burch 253808 715.416.1642
Plumber's Address(Street,City,State,Zip Code)
N5921 County Hwy K Spooner WI 54801
Vl.C nty Department Use Only
�A r ❑Disapproved Permit Fee Date Issued Issuing Agent Signature
��� ❑Owner Given Reason for Denial $ `��� ts� � I�'2 ��`^- ""'"'�I "'' -
S--r�c--_�,
Conditions of Approval/Reasons for Disapproval D '�Gia ' t'i� �!.�• �;
�� �� r`�� �U,-=-
i ;
_ +
� s� �a� o �f z �P� z $ zo2z ; ;.
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. SAV1/�'t:�� ; �
ZONI(vG�Uf��;i�;'��:.-:, ._ _.:�
Attach to comple[e plans for the sy�stem and submit to[he County nnly on paper not less than R V2 x 11 inches in size
SBD-639A(R.02/22) NO REfUNDS AFTER
ISSUE OF PERMIT
GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN
�_ . � :; _
INDEX AND TITLE PAGE
Owner Info
Project Name: Michael Horman GeoMat
Owner's Name: Micahel Horman
Owner's Address: 8120N Cty Hwy K Hayward WI 54843
Property Info
Property Address: Same as above
Legal Description: S 20 T 40 N R 8 W
Township Bass Lake County: Sawyer
Subdivision Name:
Lot Number: 2-Jan Block Number: CSM#: 17/66
Parcel I.D. Number: 2840205409
Plan Transaction No.:
Index Pages
Page 1 Index and title Page 9 Filter specifications
Page 2 Data entry Soil test
Page 3 GeoMat dist. cell drawings &calculations
Page 4 Lateral and cell cross section
Page 5 Management&contingency
Page 6 Maintenance &specifications
Page 7 Distribution media
Page 8 Plot plan
Dan Burch License Number: 253808
__ _ __
Date: 04/28/2 Phone Number: 715.416.1642
Signature:
Designer Stamp: State of Wisconsin Approval Stamp:
Designed Pursuant to the
GeoMat In Ground Component Manual Ver.June 26, 2018 Version
Page 1 of 10
In Ground and Dosing Distribution Component Design
Desiyr� VVorksheet
Site Information __ . :
R Residential or Commercial Design N ISD Required?
200.00 Estimated Wastewater Flow(gpd)
1.50 Peaking Factor(e.g. 1.5= 150%)
300.00 Design Flow(gpd)
0.00 Site Slope(%)
97.40 Prop. System Elevation (ft)
44.00 Depth to Limiting Factor(in)
1.60 In-situ Soil Application Rate(gpd/ft2)
98.80 Lowest Original Grade Ele. In System Area (ft)
99.50 Highest Original Grade Ele. In System Area(ft)
95.10 Limiting Factor Elevation (ft)
0.60 Depth Below Grade
Distribution Cell Information
3.25 Cell Width (ft) 1 Number of Cells
2.00 Dispersal Cell Design Loading Rate (gpd/ftZ)
2 Influent Wastewater Quality(1 or 2)
Distribution information
E Center or End Manifold, Dist. Box or Drop Box
_ __ ,
1 Number of Laterals System dosed N N
0.00 Lateral Spacing(ft) �
System not dosed
Manufacturer Information
Treatment Tank Information Effluent Filter Information
1 J.;!.;�'��� Septic Tank Capacity(gal) Polylok Inc./Zabel Filter Manufacturer
Wieser Concrete Products, Inc. Manufacturer 3014-525-1/16-10,000 GPD 'Filter Model Number
-��c � Si-� 1J
Project: Michael Horman GeoMat Page 2 of 10
In Ground Plan View
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Calculations
I O�ft A 325 ft Basal Area Required 187.5 ft`
K 1 ft B 40 ft Basal Area Proposed 210 ftz
S O.00ft L 42ft
. W 525 ft
Basal Area Calculation GeoMat Dispersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
300 1.6 gal/sq fvday 300 2.00 gal/sq fvday
Total 187.5 ft2 Total 150 ftZ
Proposed 130 ftZ
Number of Cells 1 GeoMat Width 3.25 ft
Cell Length ft Lineal Feet of GeoMat Required 46.2
Min. Cell Len th 46.2 ft Lineal Feet of GeoMat Proposed 40
Cell Spacing 0.00 ft NOTE:Min S dimension= 1'
S stem Elevation 97.4 ft
Limitin Factor 95.1 ft
Separation 2.3 ft 2�Min
Directions:
Play with cell length to get desired cell spacing, length and width. Remember system SHOULD be longer than it is
wide. It must also Satisfy basal loading rate and GeoMat cell loading rate.
Project: Michael Horman GeoMat Page 3 of 10
End Connection Lateral Layout Diagram
-�
Hole spacing is every 12",1/2"hole at 4&8 O'Gock,starting 4 O'clock 6"from end and
8 O'clock Holes at 12"from end.
Lateral Spacing 0.00 ft Pipe Diameter 4.00 in
Dist bu on ell ross ection
99.5 ft � Finished GrnAc �`t'� `t Y`� W�1'
I ,` '. •.�- '''•.: ,` ` 12"-48" .BaetfiG'. (,�DCtILevC�
0.6 ft— S�mdC°Ktte°°mmmd°d
� � �;� ��`�,• -- � ms�
4 Ift y Pj�G DjL......�'� . ' I�u _ . . '. .�
• ,� P;a �'_- � ,�F�ie
. . . ._._, .
Top of geomat to be at �. • • - GFA MAT
or below original grade � � � , � I � , I � I � I � Componmt
I I I , I 2 AS'IM 33..+n i Infiltrative S�ufsa
_ -�--NATIVE_SOtIr= -'
__�__����� � �....� L��F�coor
44 ft y
servation pes
���
99.5 f F�'°°°a"°°
I �•a�n:
12"Min.
48"Max. I
I
sroo
Tuilc�Planec �i / \ Rcbar
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OP�pT� -t �_ ' �€� - _
TATCR���;�i�ii'�iii': ^IKmD1�Re' ,I�i�i;ii��ii';�i'ii�,i��������iii
'�i� '�I�� il���
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Project: Michael Horman GeoMat Page 4 of 10
Notes/ Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in accordance with SPS 383,Wis.Admin.
Code,the in-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0 SPS-10705-P
(N.01/01). GeoMat in ground Component manual Version 1.
1.This POWTS has been designed to accommodate a maximum daily flow of 30Q�1 ons of wastewater per day. The quality of
influent discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following.
A monthly average of 30 mg/L fats,oil and grease
A monthly average of 220 mglL BODS
A monthly average of 150 mg/L TSS
Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement
standards and preventative action limits specified in ch.NR 140Tables 1 &2 at a point of standards application,except as provided in DSPS
383.03(4),WisAdmin.Code.
2.The owner of this POWTS is responsible for system operation and maintenance.
3.Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis.Admin.Code,
and the peRaining county Private Sewage Systems Ordinance. The user's manual,provided to the owner of the POWTS includes the names
and telephone numbers of the properly licensed individuals to contact for such repairs.
5.No product for chemical or physicai restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept.
of Commerce in accordance with SPS.384,Wis.Admin.Code.
6.If the POWTS is replaced,or its use discontinued,it shall be abandoned in accordance with SPS 383.33,Wis.Admin.Code.
NOTES
Two Effluent Filters to be installed where possible 1 to be installed in ST,and or 1 in pump tank in
order to insure particle size less than or equal to 1/8". Filters should be cleaned once in spring,and once in fall. Also,strainers in sinks in
the building shall be maintained,so that solids and fats are minimized to flow into system.
A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell.
The plumber,or county shall see to it that a copy of these plans including this page,maintenance folder,and maintenance agreement is
given to the homeowner.
This system may contain a dose chamber. If a pump,float,electricai outage causes the dose tank to fill,the homeowner should see to it that
the effluent level in the tank is brought down gradually and not all dosed to the system at once. One large dose could cause damage.
Contact a pumper or your installer if this problem occurs.
The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. I.E.spread laundry
out over time,not 6 loads in 2 hours,while everybody showers,and uses the toilet,ETC.
CONTINGENCY PLAN FOR COMPONENT FAILURE
A. Septic Tank.Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component.
Leaks in the joints between manhole risers or covers shall be repaired by replacing faulty seals with approved materiais to make joints water-
tight.
B.Outlet Filter.The outlet filter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger
than 1/8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank.
C.Dosing chamber and pump.The dosing chamber shall be replaced if any structural failure is found. Leaks in joints between manhole risers
or covers shall be repaired by replacing faulty seals with approved materials to make joints water-tight.The pump and controls shall be
replaced when they are no longer capable of functioning according to the design plan.
D.Pressure Distribution Piping.PaRial clogging of the distribution network may result in unduly long dosing cycles.The ends of the
distribution laterals may be exposed and the threaded end caps removed.The piping can be disconnected on the outlet end of the pump.
The distribution piping may then be back flushed to cleanse any accumulated matter from the piping.It is recommended that the dosing
chamber then be pumped by a licensed plumber.
E.Soil Absorption Cell.The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard
created by the effluent.All failures created by surface discharge shall immediately be reported to the appropriate county.The pump shall then
be immediately disconnected to prevent further discharge to the ground surface via the soil absorption cell.The existing septic tank and
dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved.The
replacement shall be initiated only after any necessary plan approvals have been obtained from the
appropriate plan review authority and the required sanitary permit is obtained from the county.
Project: Michael Horman GeoMat Page 5 of 10
In Ground System Maintenance and Operation Specifications
Service Provider's Name Dan Burch Phone 715.416.1642
POWTS Regulator's Name Washburn County SPIA-Zoning Department Phone (715)468-4690
Svstem Flow and load Parameters
Design Flow-Peak 300 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 200 gpd Maximum BODS 30 mg/L
Septic Tank Capacity 1.66666667 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 130 ft2 Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service Frequencv
Septic and Pump Tank Inspect and/or service once eve 3 years
Effluent Filter Inspect and clean as necessary at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test periodicaliy
Pressure System Laterals should be flushed and pressure tested eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
_ __ ___�
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap
and are secured in as shown in the GeoMat In Ground Component Manual Ver. March 20,2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the GeoMat In Ground Component
Manual Ver. March 20,2017. Media is covered with an approved geotextile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 384,Wis.Adm.Code.
4. Scarification of basal area is accomplished with a rake or other tool.
5. All disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration.
Lateral Turn-up Detail
6-8"�iameter Finished Threaded Cleanout
Lawn Sprinkler Grade \ Plug or Bali Valve
Box \
�
lateral Ends at Last Orifice Where
Long Sweep 90 or Two
�45 Degree Bends Same
Diameter as Lateral
��Distribution Lateral �� Lateral Cleanout
97.4 Feet
Project: Michael Horman GeoMat Page 6 of 10
GeoMat Distribution Celi Media Layout
3.25 Cell Width(ft) 2.63 Sidewall to Lateral(ft)
Distribution Cell Cross-section Arrangements
___ _ �l�J' __ . . _
omponen egen _ __
O Distribution Pipe
GeoMat is covered with approved geotextile fabric as per the their product approval.
Distribution Cell Plan View Layout-Typicai
3.25 Cell Width-A(ft) 40.00 Cell Length-B(ft)
End Connection Lateral Layout Diagram
� � � � � � � � �.
_ _ _p ca persa e
Finishcd Gradc r'�'Y \`Y�!'`�" w'�Y
� ,'� •�•.~-- ��.•'..���• � . 12��_48"L. Backfill�` LiL�taII,CYC�
&md Cara 7e0ommtaded '
Pi�cDia .. �i��, . F�fiftr�v°
. _� N� �__: ..�
.'�• -- - - ' � GFAMAT
� � � � � � � 2'ASTM 33 8� � i � � � ' � ' I Iafilt:ative Siuface
�' I _ -NATIVE.SOIL=� _--
vJ =--���- -- _J -___"_�=�
!——.� ��——. _. L�n.ivap,Fata
�— � _
See details on page 4 for number,size,and spacing of laterals.
Project: Michael Horman GeoMat Page 7 of 10
�- .
CHECK BOX AS APPLICAB�E. CHECK BOX AS APPLICABLE. _
❑✓ SOIL EVALUATION o s`�1e: 30 30 as so 0 SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
PROJECT NAME: "r" �5Z DESIGN FLOW: 3OO GPD
Horman Geomat Attach design flow calculations for commercial plans.
PROJECT ADDRESS: 8�ZON Ct�/ HW)/K Pipe Material/ASTM Standard(Tables 384.30-3&384.30-5)
N sanitary sewe�: SCh 40 PVC �
BM Symbol: � BM Elevation: ��� FT Force Main: /
BM Description: S�ab
I�dicate north by IMPORTANT:
Slope Gradient(%) Well Symbol(if applicable): � drawing an arrow Show ground elevation contours at suitable intervals.
of Tested Afee: � on the approprite lirre. ,
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� �f`�� PRIVATE ONSITE WASTE TREATMENT county
;�J=��o ,I\\r� SYSTEMS
s ,t.
� �� P�'�� ( POWTS) Sawyer
�� ��
�';'""-=•/ INSPECTION REPORT sanitary Permit tvo:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION �.�, rOC73
Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)]
Permit Holder's Name: ❑City ❑ Village l�Town of: State Plan Transaction ID#:
��'ri�la�l ��rMaa1 D�� - �'(� — oZ0—S'�{O� —
Insp BM Elev: BM Description: Parcel Tax No:
coo.a� s1�1� s� �31 ada_ $�a - �o-s-�o�
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic ,,,�� • �,,,;e�..¢�--. �oov Benchmark (Oa,d�
Dosing ^.�,,,,,bo (,00
Aeration Bldg. Sewer --
Holding St/Ht Inlet 9 q�YS�
TANK SETBACK INFORMATION St I Ht outlet qQ,i.S �
TANK TO P/L WELL BLDG VENT TO ROAD Dt inlet
AIR INTAKE
Septic -1-5� ,r�po' io �o ' NA Dt Bottom
Dosing N N w ,, NA Installation
Contour
Aeration NA Header/Man.
Holding Dist. Pipe
PUMP I SIPHON INFORMATION Infiltrative Q..� Y i
Surface
Manufacturer Demand Final Grade
Model Number GPM o4{�uv� 4�,o �
TDH Lift Friction Loss Sys Head TDH Ft C33 �t'$. `(
Forcemain L Dia Dist. To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W ,�s'` L ' #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav f� Conv ❑ Aggregate �e��a.�-
INFORMATION P I� Bldg Well Waters o GP ❑ Chamber Model Number:
❑ EZFIow
CELL TO } � _ �-lpf �}-(Ob� �"IOb r ❑ Mound � Other —
DISTRIBUTION SYSTEM X Pressure Systems Only
— — - -
Header I Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes
Length Dia Length Dia Spac Spacing ❑Yes ❑ No
SOIL COVER
Depth Over Depth Over Depth of Seeded/Sodded Mulched
Cell Center Cell Edges Topsoil __ ❑Yes ❑ No ❑Yes ❑ Na�
COMMENTS: (Inclutle code discrepancies, persons present,etc.)
,��,.�'�I(� ����I�Z
�` G���fi
Plan revision required?❑ Yes❑ No o� a� �3 � (� �� J� ��,o
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AOOITIONAL COMMENTS AN� SKETCH
SANITAAY PEAMIT NUMBEA: �v2—OC�3
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