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Home My WebLink About012-740-36-2203-SAN-2022-130 `�`�"''�: Indushy Services Division County SAWYER � ,1 4822 Madison Yards Way � : ,�_' - MadiSon,WI 53705 Sanitary Permit Number(to be fiiled in by( � : P.O.Box 7162 Madison,WI 53707-7162 r� 3 q � a�� Sanitary Permit Application state Transaction tvumber � In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofihis form to the appropriate govemmental unit � is requited prior to obtaining a sanitary permit.Note:Appiication forms for state-owned POWTS are submitted to Project Address(if different than mailing ad w 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. SQ�_ I.Application Information-Please Print All Information Property Owner's Name Parcel# JOHN TRAXLER 12740362205 Property Owner's Mailing Address Property Location 10208W BIG MUSKY RD Govt.Lot 1 SCc. 3S City,State Zip Code Phone Number HAYWARD, WI 54843 �y,, (l�✓ %, Section 36 II.Type of Building(check all that apply) Lot# I� T 40 N R 7 E or W � 1 or 2 Family Dwe(ling-Number ofBedrooms 4 Subdivision Name ✓ Block# ❑Public/Commercial-Describe Use _ ❑Ciry of ❑Staie Owned-Describe Use CSM Number ❑Village of �3��$ �3i,3,.2 D�l Town of 1��7�� III.Type of POWTS Permit:(C6eck either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C i a ticable. A Y I� P Y S Y � p ) P ) ❑ New S stem e lacement S stem ❑Other Modification to Existin S stem ex lain ❑ Additional Pretreatment Unii(ex lain M�� 0�� B' ❑ Holding Tank �In-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑Other Type(explain) (conventio�al) C• ❑Renewal Before ❑ Revision ❑Change of Plumber ❑ Transfer to New Owner �st Previous Permit Number and Date[ssued 9-097 5/13/99 Expiration IV.Disperss�UTreatment Area aod Tank Information: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area PFe�e�(sf System F,levation 600 7 85714 EXISTING �bi1 EXISTING 963 .7 Capacity in Total #of Manufacturer Tank Infocmation Gallons Gallons Units � U v � � New Tanks E�sting Tar�ks v o �; " y y c� � a U 'v� � rn i.�. c7 a. Septic or Holding i'ank ]250 1250 1 IESER Dosiug Chamber V.Responsibility Statement- I,t6e undersigned,assume responsibility for iostallation of the POW"fS s6own on the attached plans. Plumber's Name(Print) Plumber's S g ure � MP/MPRS Number Business Phone Number GERALD FROEMF,L �� 950111 715-558-1138 /�� Plumber's Address(Street,City,State,Zip Code) 13502W FROEMEL RD HAYWARD, WI 54843 VI.Cou ty/Department Use Only � Permit Fee Date Issued Issuing Agent Signature �A o e ❑Disapproved f `�/� � � � � a ❑Owner Given Reason for Denial $��'ao � I� "�`� 1��`�'�� Conditions of ApprovaUReasons for Disappmval r , 1` �i'�C��1�`��it. - i {i ' ,�R i - ,-- IL,`__, � 'r l � �� r' � ST a-� - 10 � ��'�(� :��'�; � : ` C �� z�� `�� I � � �. __ � � �� ._ �Av'1�`��i L��a;�iTY ATIQ�1 Aktach to tomplete plans for the system and submit to the County only on paper not less thae 8 t/2:11 inches in size NO REFUNDS AFTER SBD-6398(R.03/21) ISSUE OF PERMIT John Traxler Property Owners Name 10208W Big Musky Rd Property Address 12740362205 Tax Parcel Number Counry 1 Gov Lot or Qtr-Qtr/Qtr S36 Section T40N Town R7W Range Pagelndex 1 Property Information 2 Data Entry 3 Plot Plan ction 6 Maintenance Plan 7 Contingency Plan Gerald Froemel Plumber's Name � �G�� Plumber's Signature 950111 Piumber's License Number 71 -558-1138 Plumber's Phone Number 06/3 /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 Ina,Zabel Environmental Technology,ITT Industries(GoukJs),The Pentair Pump Group(Myers),InfiRretor Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,SimlTech FiRer inc.,Sta-Rite Industries. Page 1 of 7 In-Ground Soil Absorption SBD-10705-P (N.01/01) Version 2�I Component Manual Used 4 Number of Bedrooms Percent Siope (%) Depth to Soil Limiting Factor (in.) In Situ soil application rate 400 Estimated Wastewater Flow (gpd) 600 Design Wastewater Flow (gpd) 1 ,Number of System Elevations 96. Proposed System Elevation #1 Proposed System Elevation #2 Proposed System Elevation #3 W`Original Grade #1 99.8 Finished Grade #1 ��' Original Grade #2 Finished Grade #2 Original Grade #3 ..._� �.-�v_, �..��--�� Finished Grade #3 Infiltrator Quick 4 Standard ` Chamber Type 15 H��' ht of Chamber�(in.)�� 20 sq.ft. per chamber o � hambers 5.1 sq.ft. per pair of end caps � ist n etween Cells (ft.) 22 Propos Number of Chambers Used #DIV/0! Minimum Distribution Cell Area Required (sq.ft.) #DIV/O! Distribution Cell Area Proposed (sq.ft.) Wieser 1250LP 4Septic Tank ose an (if applicable) �r Lifetime �V �� :Effluent Filter '"select only if NOT using combo tank Soil Boring Surface Depth to Lowest Highest System Number Grade Limiting Elevation Elevation Elevation Elevation (ft.) Factor (in.) Acceptable 1 1 0.90 10 94.90 99.65 TRUE 2 3.00 -1 .25 FALSE 3 3.00 -1 .25 FALSE 4 5 _ ,...�..�.�... Page 2 of 7 � SITE PLAN ELEVATIONS JOHN AND HEIDI TRAXLER BM=700-0',TOP OF IRON LOT STAKE(GROUND LEVEL) N ONE SOIL BORING WAS CONDUCTED FOR THE PURPOSE OF RELOCATING THE EXISTING B-1 =100.9' SCALE: '1"=40' SEPTIC TANK DUE TO A PROPOSED u ADDITION TO THE HOUSE. FLOWAGE=57.0' � � BOTTOM OF DRAINFIELD=93.15' SLOPE u�+� B_� 0� ^_ BIG MUSKY RD � I I I I � I � �_ __: HOUSE eK��r M DR.WAY J(N 10208W CHIPPEWA t FLOWAGE O WELL � � � t JO3� N;`' '+ seyra �,1.. BM Ta. u IzsZ� �.�Qst� L;�a-f;w r��r�/ /veY✓ CH.. ,rc i o /S� loc� � o�srol� oF l�� SeTL4�k � '4��' ` .�,/�f�ys�i�i John Traxler 10208W Bi Musk Rd 1.27E+10 Number of Bedrooms 4 Septic Tank Wieser 1250LP EStifllBfCd FIOW(average)gallons/day 4 Effluent Filter Li etime Design Flow(peak),(Estimated x t.5)gauday Pump Tank # /A Soil Application Rate gal/day/it� Pump Type Influent/ Effluent Quality Monthl Average Fats, Oil & Grease (FOG) 30 mg/L Biochemical Oxygen Demand (BODs) 220 mg/L Total Suspended Solids (TSS) 150 mg/L ,,,�pr�_,; 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+Year Pum out contents of tank(s When combined slud e 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 ceils shall be made by an individual carrying one ot 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) shaif be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surtace. The ponding of effluent on the ground surface may indicate a failing condition and requires lfie immediate notification of the local regulatory authority. When the combined accumulation of siudge and scum in any tank equals 113 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 Oceration 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 cells. Reduction or elimination of the following from the wastewater stream may improve the pertormance 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 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 shail 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. Continqencv 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 soii and site evaluation shall be pertormed to locate a suitable replacement area. If no replacement area is availabie 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 repiacement 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. ��UVARNING!! 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 cott Poppe Phone# 715-558-11 8 Phone# 5 4��f� �� _ �� POWTS Maintainer Local Regulatory Authority Name 'Jays Septic Agency #N/A Phone# 15-558-11 Phone# #N/A Page 7 of 7 //F':�-= `` ,� PRIVATE ONSITE WASTE TREATMENT county *µ�, `\�� SYSTEMS '� } `� S awyer � �SP �"r �� s��' ( POWTS) "°'Fss'—°V,•='/ INSPECTION REPORT sanitary Permit No: Safety and Buiidings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� 3� Personal infonnation you provide may be used Por secondary purposes[Privacy Law,s. 15.04(1)(m}] Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: •�o'�tY1 , Cd.�C\2.(�— N�n r-- Insp BM Elev: BM Description: Parcel Tax No: �,O�.c�' .o�(1p� l��.S�� O�o2� / C�—'Je�'��3 TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,,,� 2 L f' Benchmark �op,o� Dosing Aeration Bldg. Sewer 9 S�� Holding St/Ht Inlet 55",(Y ` TANK SETBACK INFORMATION St/Ht Outlet 4y,�z' TANK TO P/L WELL BLDG vENr ro ROAD Dt Inlet AIRINTAKE Septic �-�o� 33 � .iS' ¢s' � NA Dt Bottom Dosing NA Instaliation Contour Aeration NA Header/Man. qy.�$� Hoiding Dist.Pipe PUMP/SIPHON INFORMATION Infittrative Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS `N L #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate INFORMATION P I L Bitlg Well Waters °� GP ❑ Chamber Model Number: ❑ EZFIow CELL TO ❑ Mound o Other - — - - —- - —._ - -- — - DISTRIBUTION SYSTEM X Pressure Systems Only Header/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 I Cell Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��l�� (l�l a-� � �.w s T, a��, �ri�fi°�y �l�s Plan revision required?O Yes O No � �,�, �l �� _ / -� � �' � --(� Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A�OITIDNAL COMMENTS AND SKETCH SANITAAY PEAMIT NIJMBER: �'2—I 3c� __ �✓ �i��`^i�, `I `ov"4�tL-�J , �l� �_ l- � . ��- � , -;-- . - - - _ .--- - j - - . ___� . 5 _ . _ _ , . . . � .� �„�<<�fi� _ -� _ � � . , Y � - -- . .__ , � ; � t , _ .: _: . .___ . _.:. ._ , �, S . , , __ ; � - --- - __ - ' ; y,/�L , �. � ._ ___ . . __ �')..��, . . : _i. .__ i__ . t __ ___. , ,.. ,_ _ �(r �� S,� , ; ; . ,. . :_..__ __ __ .; �� f/o' �,S� � ^ � , Yo 1 ( ��,�. � i �� I � 33 � ��. � �� r 8' � � I I ��'�' I � _ � � I � c q ��o��$� I �— ^9 $jg u��s�y � . �s��-r=--- l ( V�" �