HomeMy WebLinkAbout026-939-09-5214-SAN-2022-069 ` Industry Services Division County c ' �
=� , � �_ 4822 Madison Yards Way J(�w e!� �
_ , _ : Madison,WI 53705 Sanitary Permit Number(to be filled in by Co
'. 's ' P.O.Box 7162 A1
Madison,WI 53707-7162 ���� d�� ��
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Sanitary Permit Application StateTransactionNumber �
� a
In accordance with SPS 383.21(2),Wis.Adm.Code,submission oY this form to the appropriate govemmental unit
is required prior to obtaining a sanitary permit.Note:Application fortns for state-owned POWTS aze submitted to Project Address(if different than mailing addr (�`
the Department of Safety and Professional Services.Personal information you provide may be used for secondary �
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. .}-� ��'9i�1/� F/e�r �G LI�
I.Application Information-Please Print All Information �
Property Owner s Name Parcel#
�a •� r,r, La �,C oa`- 439- �4 sa�y
Property Owner's Mailing Address Property Location
n Q yr/�i� Govt.Lot C1
City,State Zip Code Phone Number
L• �Cf�t�r1 e. / �� 8atiay ��a, ��a, SCCtl011 V9
II.Type of Building(check all that apply) Lot# � T_��N R��'or
�1 or 2 Family Dwelling-Number ofBedrooms �/ Subdivision Name
Block#
❑Public/Commercial-Describe Use
❑City of
❑Staie Owned-Describe Use CSM Number ❑Village of
cs�-+� a a o b �rro,�of Sa�,d L a K2
v. 3N . 345
III.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C if
a licable.
`�� �New System p y g y ( p ) ( p )
� Re lacement S stem Other Moditication[o Existin S stem ex lain � Additional Pretreatment Unit ex lain
B' � Holding Tank � In-Ground 0 At-Grade gn yp p )
� Mound 0 Individual Site Desi � Other T e(ex lain
(conventional)
C• 0 Renewal Before Revision � Change of Plumber � Transfer to New Owner
ist Previous PeRnit Number and Date Issued
Expiration —
IV.Dispersal/Treatment Area and Tank Information:
Design�low(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System F.levation
Go c� o•� 8S7 9�8 9�,,50
Capacity in Total #of Manufacturer
Tank[nformation Gallons Gallons Units � � o � u
New Tanks Existing Tanks � o .�' 2 �? � `� `�
��!d n. U ri� �, va w C7 0,
SepticorHoldingTank � as� � � � Cr /_ O�`���
Gor►
Dosing Chamber 7 S'V � ,7 Sv
V.Responsibility Statement- I,the undersigned,assume responsibility for installatioo of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Signature MP/[�1PRS Number Business Phone Number
��d A .�ecKcls.�'� �� aa4�8� ��s- 558-G�i��
Plumber's Address(Stre t,Ciry,SYate,Zip Code)
9aaSN Si-�.+� 2� �� Hayw�d, wr S'�r�y3
VI.C u ty/Department Use Only
S Permit Fee Date Issued Issuing Agent Signaturc
�Ap roved ❑Disapproved $ ��`aD 5(��22 ������
�"�'✓ ❑Owner Given Reason for Denial
Conditions of Approval/Reasons for Disapproval
' � � ����
� � 2 - � D
� �C �� 2 �� � ��AY 0 5 2022
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Z'�.:'�'Jlf�l�'.1{�{� I�lii\�`'1.
Attach to complete plans for the system and submit to the County only on paper not less than 8�/2 x 11 inches io size
SBD-6398(R.03/21) NO REfUNDS AF?ER
ISSUE OF PERMIT
PAG E 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet �
Component Manual Design References:
Version 2.0, SBD-10705-P (N.01/01, R. 10/12), , ,
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross-Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: Enclosures:
Pump Curve POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Lagace - 6794N Fleur De Ln
Owner Name(s): James & Amy Lagace Phone: - -
Owner Address: PO Box 4762 ; Breckenridge, CO Z;P: 80424
Project Address: 6794N Fleur De Ln
Govt. Lot: 2 .1/4 of 1/4, Section 09 , T 39 N-R �9 E ❑or W Q✓
Township: Sand Lake county: Sawyer
Project Parcel I� #: 026-939-09 5214
Designer Information
Designer Name: Ronald A Spreckels Jr Phone: 715 _558 _6472
Designer Address: 9205N State Road 27; Hayward, WI Z;p: 54843
E-mail: ronspreckels@yahoo.com
�icense Number: 226688
Remarks:
Signature: � �/� Date: oY / aa �aa
Original signature required on each submitted copy.
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1N-GROUND DOSED-GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
�
min.12" TYPICAL TRENCH
SOIL COVER �tyP��l�
CROSS SECTION VIEW
,z^
min.Uench (No Scale)
depth •
(iyplcal) •'. e '
•�'• '
• ,. • . ,a •�
� 34�� •' �, .. .
�ryP�caq :�. . � � Provide minimum 3 ft
w • . a.
' separation between trenches.
System Elevation = 92•50 �
(typical)
Quick4 Standard-W
w/End Ca Observatbn Pipe
(typical) p (Show location of inlet/outlet pipe connection on plan view.) <<yP���� TyPICAL TRENCH
Install per manufacturer's
— — — — — — — — — mstructlons. PLAN V�EW
� a�. — .— -:_- - - - �� - - - - - - - �� — (NoScale)
I �d�w . o�ea�l��������"y� �IIRIe•ee�as�k�e�Ea[e I
��' ~ A= 3.Oft
�:
�r��w.4..r��,`�_�.1��'t� — — — — —�� — — — — — — — �� — — — � ��r�r�+������+,��_r,��J �tYPical)
�
g = 63 ft —� D
�ryp���� Quick4 Standard-W Chamber I'TI
INSTALL PER TRENCH: �ryp���� �''�
(mfd by Infiltrator Systems,Inc.) O
Install pursuant to manufacturer"s instructions.
15 Quick4 Std-W @ 20 ft� EISA/chamber= 300 {�2 TI
+ � Pairs of end caps @ 6 ft2 EISA/pair= 6 ft2 �
= Proposed EISA per trench= 306 {�2 Required Infiltration Area= 85$ ft2 Distribution Method:
x 3 trenches = Proposed Total EISA = 918 �Z branched manifold
�.
PAGE40F5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"0 Vent Pipe
>10 ft from
Building Electrical must comply with
12'Min,or 2.0 ft above SPS 316 and NEC 300
Established Flood Elevation Extend manhole riser as necessary.
(typical) \Neatherproof
Approved Junction Box
Vent Cap Approved Locking Manhole
IMPORTANT: with Waming LabelAttaGted
(lypical)
Anchor tank(s)as necessary Conduil
pursuant to SPS 383.43(8)(g) 4"Min.or 2.0 ft above
Established Flood Elevation
(typical)
�Ainight Seal
Finished Grade �
�uick Disconned
� 18"Min.
CAPACITIES @ 16.12 gal�n �:: � , . . � , ctiP'��>
a. � �
Depth(in) Volume(gal)
A 27.0 435.24 *�
Weep ��Approved Joints with
Hole Approved Pipe 3 ft onto
B 2.0 32.24 q Solid Ground
(typipl)
[C] 7.0 112.84 � '
_Alarm
D 12.0 193.44 �B _o�
I [C, PUMP-OFF
� Pump ELEVATION = 85.00 ft
*Pump Tank Liquid Level = 48 in —°� '
° INSIDE BOTTOM
Force Main Diameter = 2 in Concrete
B'°� ELEVATION = $4.00 ft
. . . . . . : ..
Force Main Length - 150 ft 3"Approved Bedding Material Benealh Tank
Force Main Void Volume = 24.45 gal
C 137'3�
[C] Total Dose Volume TDV = 112.84 gal/dose
(<0.2X design flow+force main void volume)
Vertical Lift= 9'5 ft
O O 'T'Pti N
PUMP TANK: SEPTIC TANK(S):
Volume = 773.76 gal Total Volume = 1250 gal
Manufacturer: W�csc-r' �c�+c�'t-� Manufacturer(s): W�Sc�- Ccs�.c..rc_f-e
Pump Manufacturer: Z oe�\e r"
Install approved effluent filter at the septic tank outlet
Pump Model: J3 t3`� � (�e attached pump curve.) immediately upstream of the pump tank inlet.
Controls/A�arm Manufacturer: S3E (t1,o�l,I�us Filter Manufacturer: L;�,-�;m� �� I}�� ��-C
Controls/Alarm Model: T'a..lL!��,c� C�Z-. Filter Model: LT- �/�
Float switches containing mercury are arohibited.
PAGE� OF �K
In-ground Dosed-Gravity Management Pian � s
IMPORTANT:
The owner of this in-ground dosed-gravity system shall be responsible for its perpetual operation and maintenance
pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this
system shall be considered a human health hazard if not maintained in accordance with this approved management
plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operatinq Limits:
Design Flow= 600 gpd; BODS 5 220 mgL"'; TSS 5150 mgL''; FOG <_30 mgL"'
Inspection Checklist tNSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
o material fatigue (i.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s)and any distribution appurtenance(s) (i.e.,distribution/drop boxes)
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities- if applicable (i.e., pump re-cycling,float switch settings, etc.)
o electrical components-if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure—compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s)shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats.when the volume of solids in the tank(s)exceeds one-third (1/3)the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113,Wisc. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: ROtIaIC� A Spf@CIC@IS .JI' Phone: 7� 5-55H-6472
�ocal government unit: S8W)/@1" COUCIt�/ ZOtllllg Phone: 7�5-634-H25O
�o�a� 9o�ernment�nit address: 10610 Mair� St, Ste 49; Hayward, WI Z�P: 54843
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384,Wisc. Admin. Code.
Continqencv Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
Svstem Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
� TOTAL DYNAMIC HEAD/FLOW -
� W PUMP PERFORMANCE CURVE PER MINUTE �
MODEL 98 EFFLUENTAND DEWATERING 3,� � 61/4
25 MODEL 98 `�
Feet Meters Gal. Liters 37�
0 5 1.5 72 273 �
w g 20 10 3.0 61 231 y— i_
_
� 15 4.6 45 170 4
a 15 20 7.1 25 95
r 4 Shut-off Head: 23 ft.(7.Om) ' i
� . I ,.,ax,,.,n.rm.
� 009971 II I
� ,�j' I i
2
5 - i
i
i
0 �z�ns i
10 20 � 30 40 50 60 70 80 !
GALLONS � �
i
LITERS i a2ir�2
0 80 160 240 ^ i �
FLOW PER MINUTE �
SK7102
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Electrical alternators,for duplex systems,are availabfe and • Variable level float switches are available for controlling single
supplied with an alarm and three phase systems
• Mechanical alternators,for duplex systems, are available • Double piggyback variable level float switches are available for
with or without alarm switches variable level long cycle controls
• Refer to FM1922 and FM0806 for temperatures above 130°F
98 Series Control Selection
Model Volts-Ph Mode Amps Simplex Duplex
M98 115 1 Auto 9.4 1 4
N96 115 1 Non 9.4 2 or 3 4
D98 Zso i ,a�to a.� � a "Easy assembly"
E98 230 1 Non 4.7 2 or 3 4 (pump 8 discharge pipe
natinGuded.)
SELECTION GUIDE
1.Integral float operated mechanical switch,no external control required.
2.For automatic use single piggyback variable level float switch or double
piggyback variable level float switch.Refer to FM0477.
3.See FM1228 for correct model of simplex control panel.
4.See FM0712 for correct model of duplex control panel or FM1663 for a OPTIONAL PUMP STAND PIN 10-2421
residential alternator system.
• Reduces potential clogging by debris.
For information on additional Zceller products refer to catalog on Piggybadc Variable Level • Replaces rocks or bricks under the pump.
Switches, FM0477; Electricat Altemator,FM0486;Mechanical ARemator,FM0495; Sumpl • Made of dUrable,nonCofrosive ABS.
Sewage Basins,FM0487;Single Phase Simplex Pump Control,FM1596;Alarm Systems, • Raises pump 2"off bOttom of basin.
FM0732. • Provides the ability to raise intake by adding sections of 1 Yz"
A CAUTION or 2"PVC piping.
• Attaches securely to pump.
Aii installation of controls, protection devices and wiring should be done by a • Accommodates sump,dewatering and effluent applications.
qualified licensed electrician. All electrical and safety codes should be followed NOTE:Make sure float is free from obstruction.
including the most recent National Electrical Code(NEC)and the Occupational
Safety and Health Act(OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
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MAIL T0:F0.80X 16347
Z ���/ Louisville,KY 40256-0347 Manu(acturers of..
0 ( SHIP T0: 3649 Cane Run Road
� Louisville,icv aozn-�ss� Q��n.pUMPB SNCE��J�/ "
www.zoeller.com PUMP !O. (�Z)��8-2731•1(800)928-PUMP
FAX(502)774-3624
O Copyright 2012 Zoeller Co.All rights reserved.