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Home My WebLink About008-937-19-5222-SAN-2022-122 . . , � .+�"�rr`!�S-t t}' `�' 1�� . Industry Services Division Coun Sawyer ��` 0 �� 1400 E Washington Ave Sanitary Permit Number(to be filled in by � a �,SPS r� P.O. Box 7162 —� �*.� ;.,' Madison,WI 53707-7162 � ^ '� � ��;�.. � 3 � 1 �� i ; Sanitary Permit Application State Transaction N_=mber In accordance with SPS 38321(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit � is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing � the Department of Safery and Professional Servies. Personal information you provide may be used for secondary � u ses in accordance with the Privac Law,s.15.04(1 (m),Stats. W@St fZOblfl Lfl. 1. A lication Information-Please Print All Information Property Owner's Name Parcel# Stacy Wiemeri Rev Trust 008937195222 I'roperty Owner's Mailing Address Property Location S7256 Sunrise Dr. co�.t,ot 2 City,State Zip Code Yhone Number , , /., /., Section 19 Fall Creek WI 54742 (circle one) T 37 N; R y E or W IL�'ype of Building(check all that apply) Lot# �1 or 2 Family Dwelling-Number of Bedrooms 3 4 Subdivision Name Block# ❑Public/Commercial-Describe Use ❑ City of ❑State Owned-Describe Use CSM Number ❑ Village of 12/175#2938 C�Town of Edgewater [IL Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ' �1}'New System ❑ Replacement System ❑TreatmendHolding Tank Replacement Only ❑Other Modification to Existing System(explain) B• ❑ Permit Renewal ❑ Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner � 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 ersal/Creatment Area Information: Design Flow(gpd) Design Soil Application Rate(gpds� Dispersal Area Required(s� Dispersal Area Proposed(st) System Elevation 450 .7 643 650 96.0 VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units � � o'a„ � New Tanks E�cisting Tanks � o � � y N `� � � 0. U v� m v� cr. C7 G. Septic or Holding Tank .�QOO `.F ;„ 1 i �3,• X (� Dosing Chamber V I1.Responsibility Statement-I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Si tur � MP/MPRS Number Business Phone Number Rick Brown �, ` ��—.---� 231251 7ig 419-0739 Plumber's Address(Street,City,State,Zip Code) PO Box 637 Spooner WI 54801 VI11. ou /De artmeot Use Ool �.Ap ❑ Disapproved Permit Fee Date Issued tssuing Agent Signature , ❑O er Given Reason for Denial $�l�D.� {D i.�� I �-J '��,�,t,�-�-�-��c.�1�'•-''�'-Y IX.Conditions of Approval%Reasons for Disapproval �� ( �� c�' V� � � '� � Attach to complete plens for the system and submit to the County only on paper not less than 8 112 x 11 inch ' ��_, ��,_.�,^�,—� � i i�, l,,;��. ��'�� :; r�'-n su�,r�;� � � , `_1 `�.::i�� \u �+'1,�; SBD-6398(R0313) NO REFUNDS AFTER � ,��;,/ ISSUEOF PERMIT �UP'� �� Z��Z � Sr;'JU�E� C:t�l:��s Y LON'stvC,AD►UP�!`:!STP�A1'IrJN Chambers Cover Page Page 1 of 6 Project Name: Wiemeri Rev Trust Owner's Name: Stacy Wiemeri Rev Trust Owner's Address: 57256 Sunrise Dr. Fall Creek WI 54742 Legal Description: Gov lot 2 Sec 19 Town 37 Range 9W Township: Edgewater County: Sawyer Subdivision: CSM 12/175 # 2938 Lot Number: 4 Block: Parcel ID Number: 008937195222 Table of Contents Page 1 Cover Page Page 2 Soil Absorption System Cross Section Page 3 Management and Contingency Plan Page 4 Tank Cross Section Page 5 Filter Cross Section Page 6 Plot Map Total Number of Pages 6 Designer Name: Rick Brown License Number: 231251 Phone Number: 715-419-0739 . ' ; _ t/ �' �� . �/ Date: .� Signature: � Design Methods Used '9n-ground Soil Absorption component Manual for Private Onsite Wastewater Treatment Systems" (Version�) SBD-10705-P (N.O1/O1 R.10/12). ., �� 1 Soil Absoratton Svstem Cross Section ss i g 4'Scheduie 40 Flnal Grade PVC Vem Pipe �_ s�o ft Wtth Vent Cep Leadiirg � Ctrember ♦_ ss.o ft � System Elevatlon s � g 3 g Soll Absomtlon Svstem Plan View i ft �_� I .�_.ft VeM Or Observation Pipe L�ching Trench 1 � Chambers \ 4"Dia. Trench 2 Header Leachina Chambar Soeciflcatlons NlanufacturerAnd Model I11fIItrBtOf QUICk 4 EISA Rating Zo sq ft per chamber Soil Application Rete � gpd/�q ft a5o gpd Design Flow+ .� Soil Application Rate t zo EISA=az Chambers 2 rows of chambers each. ; Page z of ' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of_ FILE INFORMATION Y TEM PE IF CAT N Owner l� r � f�„ ; r .._ t. - Tank Manufacturer: , , � � ; �� ■ NA � Permit# ■ Septic O Dose O Holding Volume: /,; �-,. (gal) pA Tank Manufac[urer: ■ NA Number of Bedrooms: '' LI NA U Septic O Dose �7 Holding Volume: (gap Number of Public Facility Units: U NA Vertical Distance Tank Bottom(s)to Service Pad: (R) Es[imated(average)Flow: ^ t?,; (gal/day) Honzontal Distance Tank(s)to Service Pad: (ft) Specific servicing mechaniCS mu5t be provided if verti[a�is>15 feet or Design (peak)Flow=(estimated x 1.5): i_/ ':� (gal/day) If horizontal is>150 feet.Specifc instruRions to be provided on back. In Situ Soil Application Rate: , 7 (gal/day/ft) Effluent Filter Manufacturer: r'.> /��/�,/i � NA Standard (Domestic)InfluenUEffluent Monthly averege Effluent Filter ModeC J/ - !—�� Fats,Oil&Grease(FOG) 5.30 mg/L pump ManufaCturer Biochemical Oxygen Demand(BODS) s220 mg/L U NA ■ NA Total Sus ended Solids TSS s150 m /L Pump Model: High Strength InfluenUEffluent Monthly averege Pretreatmenl Unit (FOG) >30 mg/L Manufacturer: (BODs) >220 mg/L 7 NA ■ NA TSS >150 m /L J Mechanical Aeration CJ Pea[Filter ❑ Disinfection 7 Wetland Pretreated Effluent Monthly average � Sand Gravel Filter ■ Other: (eoo5) s3o mq/� Soil Absorytion System (T55) s30 mg/L U NA Fecal Colifortn eometric mean s10` � In-Ground(gravity) ■ In-Ground(pressure) ■ NA Y8 in dia. LJ NA J At-Grade '�I Mound { Maximum EfFluent Particle Size � orip-�ine , .Other. Other: � Nq Other. U NA NAN HED LE Service Event Service Frequency F Pump out contents of tank(s) en combined sludge and sam equals one-third!3)of tank volume ❑ When the high water alarm is activated Inspect condition of tank(s) At least once every: 7 u month(s) (Maximum 3 years) ❑ NA � year(s) Inspect dispersal cell(s) At least once every: i � y ar(sjs� (Maximum 3 years) CJ NA Clean effluentflter At least once every: J ;� year(sjs� J NA Inspect pump, pump controls 8 alarm At least once every: , month(s) J NA .J ear(5) Flush laterals and pressure test At least once every: o month � NA O year(sj(s) other: At least once every: ❑ month(s) u NA ❑ ear s O[her: ■ NA MAINTENANCE INSTRUCTIONS Inspedions of tanks and soil absorption systems shall be made by an individual rarrying one of the following licenses or certifcations: Master Plumber, Master Plumber Restricted Sewer, POWiS Inspector, POWiS Maintainer or Septage Servicing Operetor(pumper). Tank inspections must inGude 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 a check for any back up or ponding of effluent on the ground surface.The soil absorp[ion system 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 notifcation of the local regulatory authonty. When the combined accumulation of sludge and scum in any treatment tank equals one-third(%)or more of the tank volume,the entire contenis of the tank shall be removed by a Septage Servicing Operator(pumper)and disposed of in accordance with chapter NR 113, Wisconsin AdminisiraBve Code. All other services, including but not limited to the servicing of efFluent flters,mechanical or pressurized components, pretreatment units, and any servicing at intervals of_12 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005(02/OS) Page of_ START UP.AND OPERATION For new construction, prior to use of the POWiS check treatment tank(s)for the presence of painting produds, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not dnve or park vehicles over tanks or the soil absorption system. Do not dnve or paric over, or othenvise disturb or compact,the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the Ireatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants,fats,foundation drain (sump pump)discharge,fruit and vegetable peelings,gasoline, greases, herbicides, meat screps, medications,oils, painting produds,pesticides, sanitary napkins,solvenls,tampons, and water softener bnne discharge. 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 sately abandoned in compliance with s. Comm 83.33,Wsconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems 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(pumper). • After pumping, all tanks and pits shall be excavaled and removed or their covers removed and the void space flled with soil, gravel or another inert solid material. CONttNGENCY PLAN If the POWiS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: � 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 structure, lot lines and wells. Failure to protect the replacement 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 the time of their permit issuance. u A suitable replacement area is not available due ro setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWiS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. J Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARm TREATMENT 7ANK5, PUMP TANKS,AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK 4„SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT.ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITlONALIN5TRUCTIONS: POWTS INSTALLER POWTS MAINTAINER Name �� ,�� (� , :, I Name �, , .. Phone t� ! y' 1 " 1 i' Phone � " � ' / / �� / SEPTAGE SERVICING OPERATOR(PUMPERI LOCAL REGULATORY AUTHORITY Name Name �� , � Phone Phone '. - � ' ,:�i This document was draRed by the staffs of the Green Lake, Marquette and Waushara County POWTS regula[ory agencies in compliance wi[h sections Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1),(Z)&(3),Wisconsin Administrative Code. WLP1000—MR TANK SPECIFICATIONS � � � o o a 104" DIMENSIONS a � WALL: 2 1�2� a a BOTTOM: SEPTIC 3" 0 COVER: 4" � � � � MANHOLE: 24" I.D. PRECAST CONCRETE RISER i� /i�� HEIGHT: FLAT COVER 53 1/4" O.D. � �/ \� LENGhI: 104" O.D. � �� 4" CAST-A-SEAL �� 4" CAST-A-SEAL `MDhi: 86" O.D. w .� BELOW INLET: 42" O.D. N p o ' � '� LIQUID LEVEL: 36" � m24 � WEIGHT: 6,790 LBS. °J TYP � INLET AND OUILET: a o �\ ' FILiER OR\ � 4" CAST-A-SEAL BOOT OR E�UAL �' o �i \ BAFFLE % GASKET, CAST-A-SEAL 800T OR EQUAL r � � m o �� j INLET AND OUTLET BAFFLE AND FILiER: � � � �_ _ _��' WISCONSIN, SEE DETAIL (�10 a k' � - - (OTHER STAlES SEE CHART) o o � 0 LIQUID CAPACIN: 27.83 GAL/IN W ,'�. HOLDING TANK: ~ �' TOP VIEW OUTLET HOLE PLUGGED � � ACTUAL CAPACIN: 1,085 GALLONS .�. �� o LOADING DESIGN: 8' 0" UNSATURATED SOIL C °� � �t w p i � � TANK CAN BE USED AS: 'C�1' a � � SEPTIC/ HOLDING/ PUMP OR SIPHON � � N N COVER: MIX DESIGN /8 NO FIBER) � a TANK: MIX DESIGN //10 �STRUCNRAL FIBER) W � I O � CUSTOMIZED TANKS: W � � FOR CUSTOM TANKS CONTACT WIESER CONCRETE � � INLET - — � - OUTLET � 3 �' P � . � a 2�" �� "�� n � ¢ I � _ •� _ _.r - _f- -"J. p Z O � O U M PUMP PAD � a DRAWINGS SUBMITTED N SIDE VIEW FOR APPROVAL APPROVED BY: SHEET N0. APPROVAL DATE: �I PRODUCTS NEEDED BY: I OF � TANKS ARE MANUFACTURED TO MEET OR EXCEED AS1b1 C-1227 REQUIREMENTS � � 2.00 �- \��_ // - -- --- I 5.1 cm' — 11 �.� ��\\� y� 1 2 A �� _�� T �� — � '� a �� ' �� (�;� � ��'•,�� - ACCEPTS 6" SCHD 40 �� `� �'��`' � � ��' 14.34 �-- :� _ l � � � � FOR INLET EXTENSION � ' �� --� � � � � � �� 11 .59 �� I C36.4 cm 1 �. �� -� , � OUTSIDE DIAMETER �� ,.� � �;' � - OUTLET BUSHING ACCEPTS '�29•4 cm � �I� �il,, �1 � ACCEPTS 4" SCHD 40 SOCKET ��' �� '� ' 4" SCHD 40 & 6" SCHD 40 �� `� �� '� � I� OPTIONAL BUSHING �;, , �� ,;� ,''��` `� �', 8.10 � ' '� � ;� � �� ' �,' _ � ., �,� C20.6 cm 1 �� (FOR 4" THIN WALL PIPE) � �� 1 s ,� � � � � /� �,'. �` � �� - i = - � � ! PART N0. 30142-R , � ��i � � � �� I� . �, ��' , � � ,, � �` - '�� y � � �� '�� ', � . J � , j OR � �� _- � I �, , i I U � � � ' 1 I _ _ � (FOR 110 MM. PIPE) �� I - i � _" ��II, I� � 'I ', � ; �%" - `; 10,52 � PART N0. 30142-EUR �� _�� , �� / ,� � � � ,� � � � , .► __ ��26.7cm1 �� ; � �-i , \� � � i � ,, � �. � - � '� ` ,I`. � L � ' , - � , '�"�� - — - _ _ __r � � , �� `,� " t � � �� _ �� , � �� , �, � �_ � _.., --� � � � - 1�— 11 �L ` _ �� ' � � 5.23 � � , , I \ �\. �� \\, I/,�,. ' � j�" � �:I :\\\ �\.. �I II I I . "�� y.l i� e/'"�� \,\\ ��_.. ..� �J.J C.m I � rewiu�ar�a�m�n wm. � G �� l �I � l � a �-n' ,��.. I� � � � � � � / � � �� i�� rmm�rr �� 'i� ap � ,J; � �� i✓ '' � . ;'I i ��__ '.u,.� . _ . .. . .� m r `�� -�� ` � ��. �/, ... I�'. 1. �1 \\\� l ', // ' ��/ I ,\.' �'I ��Ili r � ,,I �� j I $�Vil�f Mt� kGr3;ae�d231 � II ��p i I �'� � � . I: � �� ,f��f��67L�u�8.��l�l�s I ' ' �� - � A� � �i II ' LIQUID LEVEL i ` " - � %� �� __ ,Y � �.v�- � � � � _ - I � i� �� '. .,� )urttto.rlatSleavam \ � . � — Z . — �r.-G' i � ✓ RN�N YM I I 1 � 1,_� _ _J i n2 xn.4� I '�. I�\ 1 1� `I�� i � , A � J, I I � ' I I � a I I I� �A � � �i � y, " � - � � �; � �� I � I \` `. �� I �-_� I ii � � �, � I � � �� \� � I: �, ;\ ..�,\ i I�� , ' , II, 'I ,, �I ��--i-� z � , i � � � �� %� C� � . � "% � ' � �. , �. �� ,A� �� /.,= � � I, �'� _ ; .. i � ° I � I _ , � � � � . �� '' , I � � � �' RETAINING CLIPS a „ , ,; PREVENT FILTER ' '� 33.02 ; � yl' �__.}_ ' ' 83.9 cm I i '! FROM FLOATING , � �,� , ,.! , , ; � �� ..� � , — ---- -- , i � -� _- -___ � �� ' \�, � 18.31 I `�� '� � �, �,- - ��' � :� �,. — ,, PL-525 -625 FILTER HOUSING � . �'�, ' as.5 cm- , ,— -> � _ � - �� _ _ _. _ _ � � � � _ PART N0. - 30142-525 � _ � � _� t _ ° _ � MATERIAL - �� ' � �' � �� ;-- � , � ; �� HOUSING - POLYPROPYLENE J : � � L' ' , ,�� ' OUTLET BUSHING - PVC I �� __ � � I � i 6.5" BALL - HDPE � � �� °' � ,� - ' �'�� -- --- _ _ 1 s��y ��.,. � �� - � 19-37E � o� � ` SITE PLAN �� f �� C� (�'� �'� �� l � fiU .�� _ , �-, �� : > 1 �J 1�`'i y� si d� �.�� n� ��.�' � �� i, � � 9 g 5 1� � ��,� -� � -� ��y (�� Cr l�^-- , � d v ��. -�, ��s � ' �,�'� � ,t�� . �� y � � / , ,..�, �---� � , LEGEND � f - 7o cJ' ]"=40, ��r ��Ov- �� BM Bench Mark EL 100.0 S 1 /�� G/l>._..l /,�,Q�v�—��D %.�.0 Q Boring B1= 9�.f B2= �7 ) B3= �i7_� Rick Brown 231251 I_" fs-- l�y �_1� .