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Home My WebLink About002-121-07-0800-SAN-2022-088 �,,�•"�",�. County �� Safety and Buildings Division sawyer �J��EP - 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in t � '�; s - Madison,WI 53707-7162 � � ^� ��1 �i 5 Sanitary Permit Application State Transaction Nu_m�� In accordance with s. SPS 38321(2),Wis.Adm.Code,submission of this form to the appropriate govemmental � unit is requued prior to obtaining a sanitary pertniL Note:Application forms for state-owned POWTS aze submitted project Address(if different than mailing to the Departrnen[of Safety and Professional Services. Personal information you provide may be used for secondary � u oses in accordance with the Privac Law,s. 15.04 1)m,Stats. �Q�,,,1� O� I. Application Information-Please Print All[nformation P� Property Owner's Name Parcel# Mary Beth Bates 002121070800 Property Owner's Mailing Address Property Location 7768N Grindstone Ave. Govt.Lot City,State Zip Code Phone Number '/,, Ya, Section 30 Hayward,W I 54843 T 4ON; R H W [I.Type of Building(check all that apply) Lot# � 1 or 2 Family Dwelling-Number of Bedrooms 2 Subdivision Name g-12 comm bch Its 8-12 blk 7 Block# � PubliclCommercial-Describe Use � ❑ City of ❑ State Owned-Describe Use CSM Number ❑ Village of � Town of bass lake III.Type of Permit: (Check only one box on line A. Complete line B if applicable) A' � New System � Replacement � TreatrnenUHolding Tank Replacement Only � Other Moditication to Existing System(explain) System B. � Permit � Permit Revision � Change of �Pertnit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner ��\. .� Ex iration �� IV.T e of POWTS S stem/Com onenUDevice: Check all that a I � Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound>24 in.of suitable soil ❑ Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dis ersaUTreatment Area Information: Quick 4 Plus Design Flow(gpd) Design Soil Applicaiion Rate(gpds� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Elevazion 300 .7 428.6 4502 94.25 VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units D i U �, � New Tanks Existing Tanks v c � � � � � � .M1`� U v� "vi r/� ia. O Ls. Septic or Holding Tank '750 750 1 wieser � � � � Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII.Responsibility Statement- l,the undersigned,assume responsibility for installat' o of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's � e MP/MPRS Number Business Phone Number Gerald Froemel � � 950111 715-558-1138 Plumber's Address(Street,City,State,Zip Code) y 13502W Froemel Rd Ha ward,WI 54843 Vlll. o nt /De artment Use Onl � Pertnit Fee Date Issued Issuing Agent Signature �A ro ❑ Disapproved �� - J� -rr— ,�J�� ❑Owner Given Reason for Denial $�� ` I� I a� � �' IX.Conditions of ApprovaUReasons for Disapproval D � �� cs-r �a-c � i ) � Y �� ' , � � J U N 0 1 2022 Attach to complete plans for the system and submit ro the County only on paper not less than 8 tn x 11 inches in size SAWYER CrJUNTY SBD-6398(R. 1 I/1]) NO REFUNDS AFTER ZONING ADMINISI'RATION ISSUE OF PERMIT Mary Beth Bates Property Owners Name 77'68N Grindstone Ave Property Address 6 2121070800 Tax Parcel Number Sawyer County comm bch Its8-12 bik7 Gov Lot or Qtr-Qtr/Qtr S30 Section T40N Town R8W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 Dose Tank 6 Maintenance Plan 7 Contingency Plan County Parcel Listing Gerald Froemel Plumber's Name � Plumber's Signature 950111 Plumber's License Number 715-558-1138 Plumber's Phone Number 06/01/22 Date Not an endorsement,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Products Inc.,Skaw PreCast Co., Huffcutt Concrete Inc.,Zabel Environmental Technology,ITT Industries(Goulds),The Pentair Pump Group(Myers), Infittrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Sim/Tech Fitter Inc.,Sta-Rite Industries, Page 1 of 7 In-Ground Soil Absorption SBD-10705-P(N.01/01)Version 2.,. Component Manual Used 2 Number o Bedrooms Percent Slope (%) 105 Depth to Soil Limiting Factor(in.) 0.7 In Situ soil application rate 200 Estimated Wastewater Fiow (gpd) 300 Design Wastewater Flow (gpd) 1 Number of System Elevations 9425 Proposed System Elevation#1 Proposed System Elevation #2 Proposed System Elevation #3 Original Grade#1 97.7 Finished Grade #1 Original Grade#2 Finished Grade#2 Original Grade#3 Finished Grade#3 Infiltrator Quick 4 Standard Chamber Type 15 Height�a lmber (in.) 2 sq.ft. per chamber 2 Rows of Chambers 5.1 sq.ft. per pair of end caps 3 Distance Between Cells (ft.) 22 Proposed Number of Chambers Used 428.6 Minimum Distribution Cell Area Required (sq.ft.) 450.2 Distribution Cell Area Proposed (sq.ft.) Wieser 750 Septic Tank ose an (if applicable) Lifetime �'rt�' Effluent Filter "*select only if NOT using combo tank SurFace Depth to System Soil6oring Grade Limiting Lowest Highest Elevation Number Elevation (ft.) Factor(in.) Elevation Elevation Acceptable 1 97.80 105 92.05 96.55 TRUE 2 7.74 1 5 91.99 96.49 TRUE 3 9 . 1 5 92.01 96.51 TRUE 4 � 5 4 Page 2 of 7 o w� L��: (1�Qr'� �e'�'� ,(3GZ�es SC"cw�er C0. _� ��SS �� 'ti �, �-16$ r.� Gr��s�vv1� �4�2. �r�J; DoZ— (z,c -- 0�[— 0�00 f'��wqrd.� WI �`-t�`f3 S' 30 I 4b N R. b S� ��n . `lc5" - b`��'i _ t3�-1s Cowiv►� 3�t,, L�s B- IZ 1311L � (oo' . 3 N � � � � � Scale ( "— 3a � N�� l ,� 0 �0 20 3 0 • �} x --J �. -� Le�� s.-�� tJa Go n-�ovr 5 � � J � � �, �.6� °0 �I w Z � .� o � � o_ � �, s � � � � -� y��1e � o � s o �- � �D6� W � e Bl�l. t 0��To� a� �� g �, a,.�� z, a� .-�� ' � 3 . a� .z� ' •� 56: �5 , 5�s-�'ew� �e�. Qy•zS � ,��a�'�5'f�/�/ � r�.�.g e az. z.s'— a4.s'l �k�� • s.l. i�. } �ss� � Cross Section of a Two Celi In Ground Componen; Using Leachinq Chambers Observotio^/Ve�t Pipes � � _ - - _ - - 97.75 Finished Grade -- � ----_ ----, FinishNd�rade --� Slope _ /I CeN�Seperation I i/ „_�_�) �/ ,?`,� � �/ i ��i %/ , \ ' A1 / /�\ J / �l� ��\ / Onginal GraciQ- ,% �,�y,,'�� f . .Y,�'�� ,.eSriginal Grade 95.50 Top of Chamber ^___ _� ti';�,�' , i � __ �^,��:��Top of Chamber 95.50 , }, • �, 94.25 System Elevation '+. . . .: �� System Elevation 94.25 •. � - � • . - . � ' ',�._�' � .• .l'reotn�ent'pnd'Dtspersol.Zone. ' , � - . , • . , •• •- -••--•__' . . � :.. .. '. �.�.��• � �., limiting Foctor Obse�va;o^/Ve�; pipes to be constucted ond copped w�th opproved moterials for the particulcr use. Diagrams Not To Scale —--- - — ---- - --- — --- -- - _ j� _.. ��_ � / � � �� rwi��ar�,�ri.l��r wr�� 4 _ ---- — ----------- � e s � --__. "'.. .. .. --,.._� \ O O �° O . . . O ,� l./Jr � bservation/Vent Pipes to be located 1/5 to 1/10 the length of the distrution cell measured from the end of the cells Page 4 of 7 Ma Beth Bates 7768N Grindstone Ave 2.12E+09 Number of Bedrooms 2 Septic Tank Wieser 750 Estimated Flow(average)ga��ons�day 0 Effluent Filter Li etime Design Flow(peak),(Estimated x 1.5)gal/day Pump Tank / Soil Application Rate gal/day/ftz 0.7 Pump Type Influent/Effluent Quality Monthly Average Fats, Oil &Grease(FOG) 30 mg/L Biochemical Oxygen Demand (BODS} 220 mg/L otal Suspended Solids (TSS) 150 mg/L �!NOTE!! Servicing frequency 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 ear Pump out contents of tank(s) When combined sludge and scum = 1/3 of tank volume Inspect dispersal cell(s) At least once every 3 Year Clean effluent filter At least once every ear Inspect pump, pump controls &alarm At least once every Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:Master Plumber, 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 dispersal 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 County Zoning Department 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 Do not drive or park vehicles over tanks and dispersal celis. 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, dental floss, diapers, disinfectants, fat, foundation drain (sump pump)water, gasoline, grease, oil, painting products, pesticides, sanitary napkins, tampons, and water softener brine. Abandonment When the POWTS fails and/or is permanentty 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. -The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. -After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. Continpency Plan If 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. ` 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 not 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 suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may be installed to replace the failed POWTS. ��WARNING!! 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 result. Rescue of a person from the interior of a tank may be difficult or impossible. POWTS Installer Septic Pumper Name Gerald Froemel Name Scott Poppe Phone# 7 5- 5 -1 Phone# ( 4- 45 POWTS Maintainer Local Regulatory Authority Name Jays Septic Agency Sawyer County Zoning Phone# 715-55 -1138 Phone# 715-634-8288 Page 7 of 7 /�' "�`�,,, PRIVATE ONSITE WASTE TREATMENT county ,,�� ;��$ : SYSTEMS SaWyer P ( POWTS) ;�, s � \\T�_�� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �.� — O� Personal infonnation you provide may be used for seco�dary purposes[Privacy Law,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: �a c � �-r�te'S Q,55 �r�- .— Insp BM Elev: BM Description: Parcel Tax No: lc�o•�` c� �•e.� t�o�-121 --d7—G$� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic N,l��' —�� Benchmark p�„o � Dosing Aeration Bltlg. Sewer `t�•3 ' Holding St I Ht Inlet �6.1` TANK SETBACK INFORMATION St/Ht Outlet �(,, ( � TANK TO P/L WELL BLDG VENT TO ROAD Dt Inlet AIR WTAKE Septic .��.5` —�� .Y�j � NA Dt Bottom Dosing NA Installation Contour Aeration NA Header l Man. �`,J•3' Holding Dist. Pipe PUMP 151PHON INFORMATION Infiltrative � , Surface Y�3 Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist. To Well DISPERSAL CELL INFOR ATION DIMENSIONS W ,3� � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate �..�I INFORMATION P�L Bldg Weli �raters o GP f� Chamber Model Number: , o EZFIow CELLTO ��..�j� + � k� /li A ❑ Mound o Other �� -- -- 'T--- --- DISTRIBUTION SYSTEM X Pressure Systems Only _ __--- - --- -- Header/Manifold Distribution Pipe(s) ' X Hole Size X Hole Observation Pipes Length Dia _ Length Dia Spac I Spacing ❑Yes ❑ No � SOIL COVER --- - ---- - --- - --- - Depth Over Depth Over ! Depth of Seeded I Sodded Mulchetl Cell Center Cell Etlges j Topsoil _ __ �Yes ❑ No ❑Yes ❑ fvo COMMENTS: (Include code discrepancies,persons present,etc.) ��ll� � (7 ��.� ---, -� Plan revision required?�Yes❑ No v�� C��l� �� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A�OITIONAL COMMENTS ANO SKETCH SANITARY PERMIT NUMB`R:__��$ _ �l�. � �D' C�'�QVF�I\ v �� , y W�� y 1� � �p ,1_ y' �"7 �wr+.92 � �o b ,3�e�ra a4�� d�, � a 3 � `C � -fl�'�� -�--- � � �� ,ur�.�� --- � � �