HomeMy WebLinkAbout002-840-06-5115-SAN-2022-156 '' Department of Safety c°°°r`' �
� = & Professional Services, �
s� - Sanitary Permit mber(to be tilled in by� �
� � Industry Services Division
:,.
(;� "3"1 i 5 � �
Sanitary Permit Application State Transaction Number �
,
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit �� _
is required pnor to obtaining a sanitary permit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing a� (/1
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. �L'u�� �, ` �;c � /
I.Application information-Please Print All Information � IV y Kol
Property Owner's Name Parcel#
C1 i 6oz8E-io(,s11S
h��S �c��.. 1
Property Owner's Mailing Address Property Location
W vlL�rlC•� ��rt'r� I����1 Govt.Lot �
City,State Zip Code Phone Number
�� ��` � )U ���y ��' -33G " U'�Q '/<, '/<, Section ��D
II.Type of Building(check all that apply) Lot� T �10 N R � E
�lor2FamilyDwelling-NumberofBedrooms � 13 SubdivisionName
Btock#
❑Public/Commercial-Describe Use
❑City of
❑State Owned-Describe LJse CSM Number �Village of
:����n�� �G9�� �cTo,�or �ss t-�. �
IlI.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C i
a licable.
`�� New S stem �
� y ❑ Replacement System ❑Other Modificat�on to Existing System(explain) ❑ Additional Pretreatment Unit(explain)
B' ❑ Holding Tank �In-Ground ❑ At-Grade g yp ( p )
❑ Mound ❑ Individual Site Desi n ❑ Other T e ex lain
(conventional)
C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner A '
List Previous Pennit Number and Date Issued
Expiration ►- /v�w
IV.DispersaUTreatment Area and Tank Information:
Design Flow(gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required(sf� Dispersal Area Proposed(s� System Lleyation
�o� O.`l y�S.ld �5'0o i� a3.o,
Capacity in Total #of Manufacturer
Tank lnformation Gallons Gallons Units � ` o 'g �
New Tanks Existing Tanks � c aVi � Y � � �
w U cn � v� w C7 G.
Septic or Holding Tank t D�� �� � � ` �C r, �
/
Dosing Chamber G � � � � (C� r
v
V.Responsibility Statement- t,the undersigned,assu e re ponsibility for iastallation of the P WTS s6own on the attac6ed plans.
Plumber's Name(Print) Plumb 's Sig ature MP/MPRS Number Business Phone Number
J 3�;�;�� �i.�_ �_���3
P ber d ress(Street,City,State,Zi Code)
� ' � �Ci,, tn��(lf►O �� ��3
VL Co nt /Department Use Only
�A dy ❑Disapproved Permit Fee Date Issued Issuing Agent SignaWre
• �O.Owner Giuen Reason for Denial $��'� �'��� �r�.�^�- ,�i�.,���'�
Cond' 'ons of Ap roval/Reasons for Disapproval � � , ���r �''-'ti "�"'
1 1�•j �
� I ...� ��i i � � ,
F�� � � - -- -- - �� �
'� !
� 1� � i.�1�I'� � �0 0�� .�_��� �-- .
e ;
�_-��-� J�� 4 � ��?� .
��� Chk# N S`�3 �,....�.. �-�----------_-----
��- I 10 - , �
^ � + '(^ ;:7r'�t� � L:'\�
�Ut
EtC��'�1i;W v�1u r�1 � NINu�,�;�fti�� �,�i i;ri�;t,iv
Attach to complete plans tor the system and submit to the County only on paper not less than 8 1/2 z �nches in size
sB�-639s�R.o3izz� NO REFJNDS AFTER
IgSUE OF PE�;MIT
;�-�L1
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
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
Manufacturer Tank Specs Soil Evaluation Report&Site Map
Project Name/Description
Gould Conventional With Lift
Owner Name(s): Christian Gould Phone: 651 _336 _8180
Owner Address: 80 ViCtOrla St N St PBuI, MN Z�p; 55104
Project Adaress: 9445N Nyberg Rd Hayward, WI
Govt.Lot: 1/4 of 1/4,Section 06 ,T40 N-R08 E❑or W❑✓
Township: Bass Lake Counry: Sawyer
Project Parcel ID#: 00280065115
Designer Information
Designer Name: Douglas E. Manthey Phone: 715 _739 _6868
Designer Address: PO Box 196 Drummond, WI Zip; 54832
E-I11811: IlOfplfl@S G�CfI@C�flet.112t �, �:i f�,r :a�ov;il stamp.
License Number: MP230722
Remarks:
/ /r
Signature: 4 � Date: 07/18/22
O'inal signature required each submitted copy.
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� L.rN e ?Yber D.
IN-GROUND DOSED-GRAVITY DISPERSAL AREA
Stepped Elevation Trenches with EZ1203HP Bundies
3-ft Trench (down-sizing credit)
I min. 12"
Geotextile � �ryP;�,� TYPICAL TRENCH
Cover
SOIL COVER CROSS SECTION VIEW Provide minimum 3 ft
,z° T (No Scale) separation between trenches.
min.trench � e �
depth 1 L _ — — — J"� �
(bPicaq . . . .
Highest Trench Lowest Trench (as applicable) OBSERVATION PIPE DETAIL
�No s�ia�
S stem Elevations= 93.4 ft; 92'0 ft; ft; ft; ft sorew-rypeor p;n;snaacreae
y Slip Cap Qoosa) (mulchatl&seetled)
4"0 PVC Pipe � Topsoil Cwer
Topol�j�t$�rpdna�e ���� (min.1�oo�)
atarabhve im edg2de
TYPICAL TRENCH (Show location of inlet/outlet pipe connection on plan view.)
(4)1/4"-1/2"X B"Sbfs
PLAN VIEW
(NoScale) 4�� � Observationpipeshallbeinstalletl A��honngDavme Sudaean
atjunction�eN✓aenlwo units. �Q ft
Perforated Lateral Observation Pipe
(typical) (typical) — — (�YPical)
r - - - - - - - - - - �f- - - - - - - - - - - - - - � �
I =_____ _______ '_--__ ___ '_--- � A - 3.0 ft �
� - - - - - - - - - - - - - - �� - - - - - - - - - - - - - - - - - - J cryP��o m
g - 50 ft �i c,�
aY��o O
INSTALL PER TRENCH: EZ1203H Bundle TI
(rypical) �
5 10-ft bundles @ 50 ft� EISA/unit=250 ft� (mfd by Infiltraror Systems, Inc.)
Install pursuant to manufacturefs instructions.
+ 5-ft bundles @ 25 f� EISNunit= ft�
= Proposed EISA per trench = 250 ft� Required Infiltration Area= 42$•6 ft� Distribution Method:
x 2 trenches = Proposed Total EISA = 500 ftz branched manifold �
PAGE40F5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"H Vent Pipe
>10 ft fmm
euilding Elecincal mus�comply with
17'Min.or 2.0 R above SPS 316 and NEC 300
Eslablishetl Plood Eleva�ion Exlend manhole nser as necessary,
(lypical) Wealherproof
Approved Junclion Boz
Vent Cap APPm�ed Locking Manhole
I MPORTANT: with Waming Label Attached
Anchor tank(s)as necessary ��YPI��
pursuant to SPS 383.43(8)(g) —co�a�a 4��M;,,.o�z.o n aeo�e
Esfsblished Flood Elevation
(rypicap
�Airtight Seal �
Finished Gatle 1
Quick Oisconnect I
18"Min.
CAPACITIES @ see chart gaVin � . _ �tyP'�'>
Depth (in) Volume (gal) • a �
A 1 S 214 — 'r \`
Hole Appmved P pe 3 fl n�o
B 2.� `L6 q Solid Ground
� (typirap
[C] 6 74
_Alarm
D 18 161 -Bi—�— �� _o„
� [c� PUMP-OFF
* 44 � P°`"P —orr ELEVATION = 82�2 ft
Pump Tank Liquid Level = in
° INSIDE BOTTOM
Force Main Diameter = 2 in c°""�`e
� B�°°k ELEVATION = $��� ft
Force Main Length = 135 ft 3""PPro°�da�aa'^9^^a'e"a'e�°ea'nTa°k
Force Main Void Volume = 22 gal
[C] Total Dose Volume TDV = 82 gal/dose
�
(<0.2X design flow+force main void volume)
Vertical Lift = �2'2 ft
PUMP TANK: SEPTIC TANK(S):
Volume = 540 gal Total Volume = 1060 gal
Manufacture Infiltrator Manufacturer(s): Infiltrator
Pump Manufacturer: Goulds
Install approved effluent filter at the septic tank outlet
Pump Model: EPO 411 immediatel u stream of the um tank inlet.
(See atlached pump curve.) Y P P P
Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Orenco
Controls/Alarm Model: SJE1025830
Filter Model: 146
Float switches containinq mercury are prohibited.
(� GOULDS PUMPS Submersible
�_ -� Effluent Pump
r--� -
l � � i
;
��
:
> -y : : � � � 1 EP04
EP05
� -_
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing
following uses: lubrication and efficient improved performance. construction.
heat transfer. ■ Casin and Base: Ru ed
• Effluent systems 9 9q
• Homes Available for automatic and thermoplastic design provides AGENCY LISTING
• Farms superior strength and corrosion
mdlludl0pefdtiO�. AUto- $A' Canadian5tandardsAssaiation
• Heavy duty sump matic models include resistance.
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron
• Dewatering assembled and preset at the for efficient heat transfer, Goulds Pumps is I50 9001 Registered.
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover: Thermoplastic
• Solids handling capability: FEATURES cover with integral handle and
float switch attachment points.
3/a" maximum. ■ EP04 Impeller: Thermoplas- � power Cable: Severe duty
�,,.1 • Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: 1'/z" NPT. seal protedion.
• Mechanical seaL• carbon-
rota ry/ce ra m i c-stat i o na ry,
BUNA-N elastomers.
• Temperature:
104°F (40�C) continuous
140°F (60°C) intermittent. METERs FEEr . - --_-- ,.__ ___._ __._ _�_
� -__ __.._ ,__�__._ ______,__ --_-.
• Fasteners: 300 series �o ,
_ . _ � -
_ _ --
� --
stainless steel. 9 � � �
_ __ ___ .
- _
• Capable of running 30 � � . ���-� � --- �^� --►��--5 GPM - - f
dry without damage to ,-_ _._ _ F __
, ; �
-
�
8 � � � zs�
_- - - �
components. � � _ �
2s'�"- .._._._____1_ -._ _ _._ _ .____i
0 7 I i___._ --�_ — ,_ + , —
Motor: , __. __. . .- -, ;
¢ , _ .. .. � , i
-
, -
__ _.__ __--- --
_ ; : _ � -- -
; ; r � , ;
• EP04 Single phase: 0.4 HP, u 6 Zo;� �- -.-������--; � � __. T__.___1_� ��
115 or 230 V, 60 Hz, 1550 Q ' ; ' ' _ . i_ __ ;__ � �
�- - _ -- ' -- _ -
- _.. -, _ __ -- - --
RPM, built in overload with > 5 i � � ' �
automatig repet. F 4 `---- -- I -----�----�---�--_�__ ;��____ _;._____._ _�_
o �5, �_ — �
• EP05 Sin le hase: 0.5 HP a �- -ePos �
- -
� -- - !
115 V or 230V, 60 Hz, 1550 ° � � ' '
3 i o;--------- - --� _._ , � ;
-- � �. � : _�. �,
RPM, built in overload with ; "i f , " �
_._ � I ,_ _ --- � - EP04 .._ i____ __. _ - - - j
automatic reset. Z � ;
f -- -- .. ....__._ .._ _.
• Power cord: 10 foot s;-------� ; �; _._ .... !_. _ _.__�
standard length, 16/3 i ;_ . � : ' � '
, , -- _-
. -- - - -- ; - �
-- - _.._ ;
JTOW with three prong : ,
grounding plug. Optional 20 0 00---_.�_... 10 -_._--- zo ___ __.__.-30 _------__ __._! _�__.___ _
`--- __
�----..
foot length, 16/3 SJTW with 40 50 GpM
three prong grounding pfug ,
(standard on EP05). � � 4 6 $ �o �z m3/h
cAracrry
Goulds Pumps
O 2002 Goulds Pumps ��� ITT Industries
Effective September, 2002
B3871 �
LIFTING STRAP
(IYPICAI)
I TANKTOP CONTINUOUS
� HALF GASKET
A A� TANK
0 � INTERIOR SEAM CLIP
(�)
� �
61� ALIGNMENT
�1567] DOWEL(22) TANK BOTTOM
` 0 • EXTERIOR HALF
! WIDTH
O$ MID-HEIGHT SEAM SECTION DETAII
64.9[1648]EXTERIOR LENGTH
o roP view
�
oVi 24[610j ACCESS OPENING WITH LOCKING LID
w
i
w
O g ��,
0
�
� �
� / o
a�
c
3
0
a
U
� TOTALVOLUME �6
a�i 552 GAL[2,090 L] [1387]
(� EXTERIOR
o HEIGHT \
� $ iY /
SEAM CLIP
0 0.2[S]WAIL (TYPICAL)
� THICKNESS
�
�
� �
o LIFTING STRAP
; SECTION A-A' END VIEW (TYPICAL)
� ISOMETRIC VIEW
�
�
6
C
U
�
�
O
d`
i
N
� NOTES:
3 1. ALL DRAWING DIMENSIONS IN INCHES[MILLIMETERS]OR AS NOTED. �N�M���
Z 2. EXTERIOR OF ACCESS OPENING LID INCLUDES THE FOLLOWING WARNING IN ENGLISH, ����
y FRENCH&SPANISH: "DANGER DO NOT ENTER:POISON GASES."
� 3 7ANK MARKINGS WILL iNCLUDE:MANUFACTURER NAME,MODEL NUMBER,UQUID CAPACITY, Infilirator SysTems Inc.
o DATE OF MANUFACTURE CODE,MAXIMUM BURIAL DEPTH,INLET,AND OUTLET 4 Busine55 Park Rd. Old$qybrook,CT 06475
� 4- MAXIMUM BURIAL DEPTH IS 48 in[1219 mm]. (800)221-4436
5. MINIMUM BURIAL DEPTH IS 6 in[152 mm].
� 6. TANK IS FOR NON-TRAFFIC APPLICATIONS. IM-54O
L 7. NOMINAL WALL THICKNESS IS 020 in[5 mm]. PUfllp�$�phOfl TQn�(COn�9U�Ut�On
v
C Dwwn by: EMB Checked by: DJL Date: OS-30-13
� Scale: Not to scale Drawing: IM-540-VA SheeT: I of I
' Table 2:Nominal Volume Chart
Liquid height above Liquid volume in tank at indicated height(measured from tank bottom to liquid surtace)�
tank bottom�
IM-540 IM-1060 IM-1530
in cm
� U.S.Gal LRers U.S.Gal Liters . U. .Gal Liters
1 3 3 11 3 11 1 4
2 5 8 30 13 49 34 128
3 S �4 53 28 10fi 51 192
4 10 21 80 46 174 68 256
5 13 29 109 65 246 94 357
6 15 37 141 86 326 122 463
7 16 46 173 107 405 152 573
8 20 55 207 129 488 180 681
9 23 64 243 152 575 212 602
10 25 74 279 176 666 245 928
11 28 84 317 200 757 280 1.061
12 30 94 356 225 852 312 1,182
13 33 105 396 251 950 351 1,326
14 36 �16 437 277 1,049 387 1,463
15 38 127 480 303 1,147 422 1,597
16 40 138 523 330 1.249 464 1,756
17 43 150 566 357 1,351 500 1 892
18 46 161 611 384 1.454 537 2,034
19 48 173 656 411 1,556 575 2,17�
20 50 186 702 438 1,658 614 2,322
21 53 198 749 465 1,760 652 2,468
22 56 210 796 493 1,866 690 2,612
23 58 223 843 521 1,972 729 2,758
24 61 235 891 549 2 078 I70 2,914
25 64 248 940 577 2,184 808 3,058
26 66 261 988 605 2,290 847 3,208
27 69 274 1,038 633 2,396 687 3,356
2g 71 287 1,088 6fi2 2 506 928 3,513
29 74 300 1,137 691 2.616 968 3665
30 76 313 1,185 719 2,722 1.007 3,874
31 79 326 '1,233 747 2,828 1,048 3,966
32 81 338 1 281 775 2 934 1 087 4113
33 84 35� 1.328 802 3,036 7126 4,262
34 86 363 1,375 830 3,142 1165 4,410
35 89 375 1,42� 857 3,244 1204 4,557
36 91 387 1 466 884 3 346 1,242 4,701
37 94 399 1,51� 911 3,449 1.280 4,846
3g g7 411 1,555 938 3,551 1,318 4,988
39 99 422 1,598 965 3,653 7,355 5,131
40 102 433 7,640 992 3,755 1393 5,2�2
41 104 444 1,687 1018 3854 1,430 5,412
42 107 455 1722 7.044 3,952 7,466 5,550
43 109 465 1,761 1,069 4047 1,502 5,685
44 112 475 1.799 1 094 4,141 1.537 5 817
45 114 485 1,836 1,118 4,232 1,572 5,950
qg �77 4g4 1,871 1,142 4.323 7604 6,070
47 119 503 1,905 1,165 4,410 1638 6201
48 122 512 1938 1,187 4,493 1,667 6,310
4g 124 520 1.970 1,208 4,573 1,697 6422
50 127 528 1,999 1 228 4 648 1.724 6.527
57 130 535 2,027 7 247 4,720 1 749 6 621
52 132 542 2,050 1265 4,789 1,766 6,684
53 135 547 2077 1,278 4,838 1,777 6,726
54 137 551' 2,087 1287 4,872 1,785' fi,758
1.Liquid height measured from lowermost inside surtace at bottom of corrugation in tank to the liquid surface elevation.
2.To determine liquid volume between Ilquid heights,subtract the Table 2 volume indicated for the upper and lower heights.Example:IM-1060
volume between 50 in(127 cm)and 40 in(102 cm)=1,228 gal(4,648 L)-992 9al(3,755)L=236 gal(893 L).
3.The total capacity of the IM-540 tank is 552 gallons;the total capacity of the IM-1530 tank is 1,787 gallons.
,
LIFTING STRAP RISER CONNECTION 1.5[38]
(TYPICAL) B (TYPICAL) ACCESS PORT RIM CONTINUOUS
TANK TOP ELASTOMERIC
FLEXIBLE ELASTO- LID HALF GASKET
MERIC GASKET
(TYPICAL) TANK
INTERIOR SEAM CLIP
A p' �sa�
O O INLET! ALIGNMENT
O O OUTLET �OWEL(34) TANK BOTTOM
�' ° c' `� ° �' TANK TEE HALF
62.2 (INLET
�p �p [1580] INTERIOR SHOWN)
EXTERIOR
WIDTH
O PIPE PENETRATION OS MID-HEIGHT SEAM
SECTION DETAIL SECTION DETAII
�
N LIFTING LUG B�
o (TYPICAL)
o ----- 127A [3226] EXTERIOR LENGTH -- - I TANK EXTERIOR LIDUID DEPTH 44.0 �1118) - --
v �LENGTH �Z�.a I32261 TOTAL CAPACITY � 128�GAL[4872 L]
a TOP VIEW INVERT DROP 3.0[76]
m WIDTH 62.2(1580] — WORKING VOLUME 1094 GAL[4141 L]
� I HEIGHT 54•7[1389] FREEBOARD 10.2[260]
O
U
p 0 4(102] 0 24[610J ACCESS OPENINGS WITH LOCKING LIDS(2)
� PVC OR ABS 0 4 [102)PVC OR
�NLET TEE 10.2[260)FREEBOARD
o ABS OUTLET TEE OUTLET —
<o
0
� INLET 16. %
y AIR SPACE OUTLET
� 3.0 = -- PER 0.2[5]WALL
� P [76� CODE THICKNESS
U �'7
� PER CODE �.0 � $ [1389] FIBER-
�� ���t8j EHEIGHTR GLASS
LI�UID 2 [51] X 2 [51] SUPPORT
o DEPTH FIBERGLASS SEAM CLIP
� SUPPORT (TYPICAL)
y (TYPICAL)
F LIFTING STRAP
9 (TYPICAL)
m
v
� SECTION A - A' END VIEW SECTION B - B'
�
0
�
d
�
N
Y
C
N
u��i ISOMETRIC
� � " VIEW
� o \ .
O
K
� NOTES: � 8 � ^
. ;_R����t��
N 1. ALL DRAWING DIMENSIONS IN INCHES [MILLIMETERS] OR AS NOTED. S � ianks
0
; 2. EXTERIOR OF ACCESS OPENING LID INCLUDES THE FOLLOWING WARNING IN ENGLISH,
Z FRENCH &SPANISH: "DANGER DO NOT ENTER: POISON GASES." ' , INFILTRATOR WATER TECHNOLOGIES
m 3. TANK MARKINGS WILL INCLUDE: MANUFACTURER NAME, MODEL NUMBER, LIQUID , � 4 Business Park Rd. Old Saybrook,CT 06475
� CAPACITY, DATE OF MANUFACTURE, MAXIMUM BURIAL DEPTH, INLET,AND OUTLET. ' (800)221-4436
�
y 4. MAXIMUM BURIAL DEPTH IS 48 in (1219 mmj.
� 5. MINIMUM BURfAL DEPTH IS 6 in [152 mm]. SIDE INLET/ INFILTRATOR IM-1060 TANK
� 6. TANK IS FOR NON-TRAFFIC APPLICATIONS. OUTLET(TYP.) 1-COMPARTMENT CONFIGUR,4TION
� 7. AIRSPACE IS 16.5%.
L 8. OUTLET TEE IS COMPATIBLE WITH AN EFFLUENT FILTER.
� 9. INTERIOR LENGTH TO WIDTH RATIO IS 2.3:1 (118.8-INCH LENGTH/517-INCH WIDTH =2.3). Drawn by: EMB Da�e: 08/05/2013
(7 Scale:r+oT To scn�e CheGced by: DFH SheeC 1 of 1
PAGES OFS'
In-ground Dosed-Gravity Management Plan
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 Operatina Limits:
Design Flow= 300 gpd; BODS<_220 mgL"'; TSS 5150 mgL"'; FOG<_30 mgL''
Inspection Checklist INSPECT 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 adivities,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 Seotic 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(1l3)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(sl 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 individuat or company: NOf PII12S PIUCTII�IIIg Phone: 715-73J-6H68
Local govemment unit: SaW)/Ef COUCIt�/ZOCllllg Phone: 7�5-634-828H
�oca�9o�e��ment�nit add�ess: 10610 Main 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.