HomeMy WebLinkAbout010-941-36-1405-SAN-2022-159 �a�*""T"�'�r� Industry Services Division Counry �
�'� � 4822 Madison Yards Way S�� �C' �,
�( t Madison,WI 53705 Sanitary PermitNumber(to be filled in by� �
,� P.O.Box 7302
�'����'� Madison,WI 53707 (s7 �j�j ( j �j
Sanitary Permit Application StateTransactionNumber �
i
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fonn to the appropriate governmental unit " _
is required prior to obtaining a sanitary pemrit Note:Application forms for stateowned POWTS are submitted to Project Address(if different than mailing s �
the Depazvnent of Safety and Professional Services.Personal information you provide may be used for secondary �q�p C'�, N� ,� �
putposes in accordance with ihe Privacy Law,s. 15.04(1)(m),Stats. ��
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Properry Owner's Name Pazcel#
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Property Owner's Mailing Address Property Location
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City,State Zip Code Phone Number
t���"W�rd �� �`� � �t 3 '/., �/., Section 3�c'
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, h�,;.. Lot#
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�1 or 2 Family Dwelling—Number ofBedrooms � � Subdivision Name
Block#
�ublic/Commercial—Describe Use
�Ciry of
❑State Owned—Describe Use CSM Number illage of
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`�' �iew System �teplacement System ❑Other Modification to Existing System(explain) ❑Additional Pretreatment Unit(explain)
LJ
B' �-Iolding Tank �In-Ground �AAt-Grade �Mound Individual Site Design Other Type(explain)
(wnventional)
C• ❑Renewal Before �Revision hange of Plumber �I'ransfer to New Owner ist Previous Permit Number and Date Issued
Expiration ---
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Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation
7sc� � �- �a �� �o� � �t(�.o , � 3,�
Capacity in Total #of Manufacturer
Tank Infoanation Gallons Gallons Units A ` � $ _
New Tanks Exi�g r� w = �, � � � ; �
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Plumber's Name(Print) Plumber's Signat/u�re ^ MP/MI�RS Number Business Phone Number
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Plumber's Address(Street,City,State,Zip Code)
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�° ' .:3 �� � <n ���-r.;-r�r '���.'?�vz, ' "�' aa'M ,.�`. .:r_ .?:.'" �°"r...��£ h ���� �,£^-.,�,�„��.. �*�" �"�:.�,„�,.
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�A� o�ve ❑Disapproved Permit Fee Date Issued Issuing Agent Signature
Q�Owner Given Reason for Denial $ ` a� �I ' I'�""� " �"-
C�D• :2 1 �:.� �'4" > :�.r���:�„u
Con 'tio�o A r v �easo for Disapproval �� �----�,�`
' � � '�_������/����,��^�
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�_ n �ate ------ JUL 1 5 2022 �-:�
CS � �a_ � � � ,k# 3usa _ _ _�
f�t�� ���-,r t�-'� r5^lrviFi��ivi�r.c��c��7;C�����z�;���N
�_ _ _ — _
Attach to complete plans for the system and aubmit to the Coanty only ou paper not less than 8 12 z Il inches ln size
SBD-6398(R.02/22) N�REFJNDS AFTER �,i.��.��,5
13SUE OF PE�sMl7'
PAGE 1 OF 4
In-Ground Gravity P1an
Index & Cover Sfieet
cwi,po.�ern Man�sl oesrgr,Rerero�oes:
Versio��,SBD-10705-P(N.01/01,R.10H2). ..
�,�
Pg 1 of 4 index&Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross-Sedion 8�Plan�ew
Pg 4 of 4 Management Pian
Attaehmerrts:
POWTS .lication for Review
Soil Evaluation Report&Site Ma
Project Name/.Descriptlon
owner Name(s): R raJ�s�( �'��s<v� Phone: -
Own�rAddroa: �N 7�3:3 w M��c�z� c,.��c>d s (��f(4y,,,�,F�Z'ip: S�i Y>4 3
Pro�YCtAddrMs:�`is`Gi1% �0 41c.�'Y � F�l�ly;�s�� �,�-� s t(gq3
tiovl.Lot: 1/4 of 1/4,Sectlon '3� .T �( N-R q E Q or W Q
TOwnihtp: N�'�r �s�c�c_( COuilty: s tw v'r�
ProJeCt Parcel ID#:_o l c����l l 3� �N a S
D�igner Informa�on
���N�: Jerry Ruid Excavating,LLC Phone: 7�_�/g,Z 2�i o�t
D�igner Addross: stone Lake;WI 54s7s Zip: S`(8 7G
E�Ytifl:�C v�G� GBN�vf'�/(C re.N e,G This spau resaved for appmval scamp.
License Number. 2 ��-`� ��
R�narks:
Signature: �,�-�, �� Date: �—i 3 -Z 2.
.i�,r.r.a�r.a on..a,ammMoea covy.
CHECK BOX AS APPLIC/1BLE CXECK BOX 0.S APPLICq91.E.
� SOIL EVALUATION o s�1e: �`+0' � � � SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
� ( PRQIECTNAME: �o, oesicN�av: 7SO cPo
_ t"L e X(l/+'� Attach design flow calculations for commeraal plans.
PROJECTADDRESS: 1 ISO N ?-�w�/ E Pipe Matanal I ASTM Standa�ables 384.303&3&t.303)
BMSymhd: � BMDer�lon: IO� �
N Sanitary5ewer. 4 n �'VL/ S�� �l0
ern oeacdpnon: ��lt w ��I�R���nn� IC-��•f-�C�PP�'_- Force Meln: 'z C� PUG/ 5�� �t U
Slope GratllM(%) �naimte rmrth b� IMPORTANT:
�T��: wmi SymDd(Mappoeabte): � dmving en m�wv Show ground alevation contours at euitable interrals.
on Na epproprile 0m.
� - �18. �
��9� .�3 � ���_
3- �t S�o 5
C'�e�cc�
�-1 o�s e_. �'S o`k= 1-�d r��,
�
�e.-i� 13Grk Sd.o-� i
Sys�e.,-, �6 - 93 i
�roP-e�`FY L�,.�eS
+SO
�a, 11 -Fd r�e-c`t'
s�eq�1C S , ! � � 3
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2
A
Jerry Ruid Excavating, LLC
W208 County HWY q
Stone Lake, W� 54g76
c � �—
/yIr'�S ' ' `'-2 YE>;1
��
RExe3t PAan
� SeptleTWcp)MaN�ch+er
IN-GROUND GRAVITY DISPERSALAREA w��5er
Uniform Elevation Trenches with Quick4 Standard-W Chambers s.,�T.��.��.c.r.
3-ft Trench (down-sizing credit) j5��, ��r�,� _�, _,�
r EMuerrt Flifer A1nAscErter
�..F t't"I:rC�
� �`f" U>
EfRweR Fllmr Matld#
mn.iz
SOIL COVER ��m�
ir
mm.oma
ca on •` TYPICALTRENCH
''d ;.: CROSS SECTION VIEW
F'—� (No Scale)
� . Prwide minimum 3R
3ystam Elevatlon=_ft ��tlD"��^��•
(ba��0
w�a smnasm-w
w/ErqCap O°°°"'°""Pb° TYPICALTRENCH
(�,Pi�) (Show loptlon M InIM/outlet Pipe connectlon on plan view.) i�ii���� PLAN VIEW
1ifQUCtlp' (NO Scale)
r -----�f-------�f----
_ IA=��� -�
L ------yf--------yf---- — �
s= �'� g �i m
RraKa9 puickasrarMarawcrremoar W
INSTALL PER TRENCH: ��I� O
(rtMU M Infllhvfu ey�bit�R M1ic) T
C� ImdtWrs+m�tbmwiuhcWMelnL�utlbm. A
�8 �uick4 Sttl-W�20 fF EISAlchamber= 3�= ft'
+ � Peirs M end raps�61t�EISFVpair= � ft
=Proposetl EISA pertranch= 3�� ft' Required Infiltratlon Area= �d 7Z tt' Distribution Method:
x � trenches =ProDosed Tohal EISA= ��`!�? t� L�n;�C,��
�
PAGE50F6
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale) � •
4"0 Vent Pipe .
>tOflhom
euilding Electncel must mmply xith
12'Min.or 2.0 ft abwe SPS 376 and NEC 300
Eslabiished Flootl Elevation W��QR�f EMend manhole nser as necessary.
�ryP�m�� APP�,� Junction Boz
Vent Cap APP�`�Lodcing Manhole
IMPORTANT: w�m wam��9�abei a�acned
(bPinp
Anchor tank(s)as necessary
( )(9) Canduit
pursu2nt to SPS 383.43 B 4•Min.or 2.0 fl ahove
Eslahlished Flood Elevation
(ryp�mp
�Airtight Seal �
Finished Gratle
Ouick Disconne�i
� 18"Min.
CAPACITIES @ �5 gaUn �%� � , y .:� � ' ' �ryP��'>
- ` 1Depth(in) Volume(gal)
—7kT
A I Weep Approved Joints wiN
Hole Apprwed Pipe 3 fl onlo
B 2.� SC7 A � S(IYPGca�nd
[C] (�.o �sc� � :
_Alarm
D C. c� j56 -Bi—�— —o�
� [c� PUMP-0FF
*Pump Tank Liquid Level = �� in � PumP —a' ELEVATION = �C�•`-� ft
Force Main Diameter= �" in D �nctele WSIDE BOTTOM
� B�°� ELEVATION = =z:.� ft
. , , _
Force Main Length = 1 Zv R 3"Approved Bedding Matenal Beneath Tank
Vertical Head = �� ft
Force Main Void Volume = 1`Z:5� gal
+ Min. Supply Head = 2� S ft
[C] Total Dose Volume TDV = �S�j gai/dose �
� + FM Friction Loss = 1• � ft
(5X total laterel void volume<TDV<02X design flow)
+(force main d2inback volume) + Fitting Loss` = C� ft
�(min.supply head x 0.3)�
MIN. PUMP DISCHARGE RATE = z5 gpm = TOTAL DYNAMIC HEAD = �`Z 5 ft
� �
', PUMP TANK: SEPTIC TANK(S):
Volume = `lS�gal Total Volume = �SE3�gal
Manufacturer. � '�S�C` Manufacturer(s): w����
' Pump ManuTacturer: z ��-lf e.r
Install approved effluent filter at the seotic tank outlet
' Pump Model: �5 � (c„�yaHachetl pumpcurve.) immediately upstream of the oumo tank inlet
' Controls/Alarm Manufacturer: s � S �+ `
Filter Manufacturer: �� }e Tr:�� �.
I Controls/Alarm Model: i�1 N �/ �
I Filter Model: ��� �',
I Fioat switches containing mercury are orohibited.
. C.'.r, i ..�.`�� .
� i
�V,r! ;
Li�. , .
�..� " �..� �
� � � PU�1P �'EP�� RI�Af� CE CCJRVE
z ; �
��D�� � 51 /� �21� 53
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12 _� �� - -----, . � 1
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o � 35 �
W 1� � 15�
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x �0 �
1C� ��J 3 �'� �C� ��� �0 �0 8� 9f� 100
GALl.C7�i5
LITERS 0 40 80 i2G 160 2C�� 2�{� 28� 32� �60
FLOI��! PE� (�t1J��iJ i� +ai;a���,
�lft�xl'iltS'1a�tt' r���tf�: ia'cl r�.7ru"�����r ����<� � �rst«nt%n�f�r`�,. � .�II��.. ..,,. , . ,�.. . . ., .r'. ... . .. . .. . � ' o , . ; •. �.,, �. , .,.
WLP1585/950
,5�-3��� TANK SPECIFICATIONS o �
a �
��� DIMENSIONS: � o
WALL: 3• a a
�--------------------�i ir----------� BOTTOM: 5"
Y I i I i Y COVER: 6" ,;;
� 4" CAST-A-SEAL �����4" CAST-A-SEAL � MANHOLE: 24" I.D. PRECAST CONCRETE RISER a
i i i i i i HEIGHT: 56" o
��a� LENG7H: 15'-3 3/8"
>
���-�� ��'yQ. ��-���i i i ��-�� WIDTH: 8'-5 3/8" �
� i ��� i BELOW INLET: 45'
� � i � i � � LIQUID LEVEL• 38" �
� � ,�� � � ��� �� �� WEIGHT: BOTTOM 15,977 LBS. � a o �
i � I I I I � I COVER 9,300 LBS. �� � � i
' FILiER OR i i I I v I � o �
� BAFFLE II'll � ° INLET AND OUTLET: � m o a
, i i i i i � i 4" CAST-A-SEAL BOOT OR EQUAL GASKET J 3 � 3
� I I I I � a a t-- i.i
r--------------------����-----------� INLET AND OUTLET BAFFLE AND FlLTER: N � o �
WISCONSIN, SEE DETAIL �10 W o
(OTHER STATES SEE CHART) � a
TOP VIEW LJQUID CAPACITY: 41.67 GAL/IN (SEPTIC) � �
25.00 GAL/IN (PUMP) � ��
LOADING DESIGN: 8'-0" UNSATlJRA1ED SOIL O � �
� o I
TANK CAN BE USED AS: < 'n
� N
�w SEP11C/SEP71C, SEP11C/PUMP, � �
a� OR SEPTIC/SIPHON � } o
c7 4" VENT � 3 �
� COVER: MIX DESIGN �8 (NO FlBER) _
� ' TANK: MIX DESIGN �!9 (SMALL FlBER) �1 �
� 7
�� �
--- . . , _ , --- . _� CUSTOMIZED TANKS: � 3
INLET ---- � ---- � ---- FOR CUSTOM TANKS CONTACT WIESER CONCRE7E
� � �.�� -
OU TLET
� 1. ! - � I - cn
� � � I - - -� � I I � a ' � �
�n a, � � ao I�.I "� � - J
� � � � '`� � ,� � U � a` M � a
I I � � � � �
�3„ �� � �=d. l, a, z
I .I Q
'�--,-�—1------ --- ---�--J .L�--------� � �
. . . . , - . ao
REVIEWED BY � v
�n REVIEW DATE � W
DRAWINGS SUBMITTED N
SIDE VIEW FOR APPROVAL
APPROVED BY: SHEET NO.
APPROVAL DATE: � �
OF
PRODUCTS NEEDED BY: / �
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
PAGE40F4
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 Oneratinq Limits:
Design Flow= 7�c> gpd; BODS<_220 mgL"'; TSS<_150 mgL''; FOG<_30 mgL''
Inseection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance fac[ors(i.e.odors,user complaints,eta)
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 exterd of ponding in distribution cell prior to dosing.,,r-
o dosing irregularities-if applicable(i.e.,pump re-cycling„fJo,at 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�VERI(µ3 YEARS(or when necessary)
o Seotic and dose tank(sl 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(sl shall be inspected every 3 years and shall be cieaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period wiil 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: ��=�'Y'/ 1�� �� Phone: 7i S ' `-t4�- 2 Yo l
Local government unit: 5 C Z Phone: 7 is (�3`I���[`�F
Local government unit address: ��-�G r���n� S�� 1—�i Y��K'� �-�-- ZIP: S `��`� j
Any defective part of this systeni shzll be repaii�r�i,r�:�.iac, . �r removr;d pursuant to SPS 383.51 (1),Wisc.Admin.
Code.Repair or replacement of failed or maltEmct�,:ni.:^ ., -�crr its shnlf comply with SPS 383,Wisc.Admin.Code.
No product for chemical or physir.al restorati:�n o1!ne P`1N ; t•:�sed unless approved by the department in
accordance with SPS 384,Wisc.Admin.Cocl�
Continaencv Plan
In the event that any failed treatment compore+�;�,f Y�s f<�'4:�:: ;�r��t L^�repaired,it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and., ,:r� A I�;led in-ground dispersal component may be
abandoned and replaced by a code-complyin�i dispe��al c�.+����oa it in a pre-determined area of suitable soils.
Svstem Abandonment
If use of this POWTS is discontinued,it sh�l"b��aGandor��d in ac �ra::nce with SPS 383.33,Wisc.Admin.Code.
Reset P��s�