HomeMy WebLinkAbout002-840-17-5402-SAN-2022-170 <<:,¢':7,> C'OuntV V;
r�---;�T, [ndustr}'Services Division
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"� � �;', 4822 Madison Yards Wa}� S8Wy2f �
i�,`.i � f� �;� Madison,WI �370� Sanitary Permit Number(to be tilled in by C �
= P.O.Box 7302 �
�;'k.;;- _ Madison.WI 53707 t..0 �� � �� �
� Sanitary Permit Application �'"`� `�`°"��`"°"""","eL `'-'
�PwfS-o?�oiS73 -�- '
In accordance�vith SPS 383 21(2)_Wis.Adm Code,submission of this form to the appropriate governmental unit _,
is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project t�ddress(i(�ifferent than mailing ad� �
the Depar[ment o1�Safety and Professional Services.Personal infonnation you provide may be used for secondary ���� ����� �� �.�
purposes in accordance�ro�i[h the Privacy La���,s_ I�_04(1)(m),Stats
L Application Information-Plcase Print All Information
Property Owner's Name Parcel#
CHRISTOPHER W MLEJNEK oo�; -g�(� - �7 -SYo�
Propeny Owner's Mailing Address Property Location
2520 19 1/8 ST c,o�t L�t Prt 4
City,State 7ip Code Phone Number
RICE LAKE, WI 54868 �e� °� se�t��n"—
lI.Type of Building(check all that apply) Lot# � 40 N R 08 E or W
�l or2 Famih�U�cclling-NumberofBedrooms� '� SubdivisionName
[3lock# �
�Public/Commercial-Describe Use
� �City of
�State O�vned-Describe Use CSM Niunber �Village of
-- �ro«n of BASS LAKE ____
t[L Type of POWTS Permit: (Check either"New"or"Replacement"and other applicablc on Iine A. Check one box on line B.Complete Iinc C if
a licable.)
A
�Ne�c Sy�stem �Replacement System �Other;�loditication to L�istine Scstem(explain) �Additional Pretreatment Unit(explain)
GEOMAT 3900
�' �FioldineTank �In-Ground �At-Grade � ❑
✓ Mound Individual Site Desien Other�I�ype(explain)
(comentional)
C. Rene�val Before �Revision �Chanee oi Plwnber �Iranstcrto Ne���O�vner
l.i�t Previous Permit Number and Date Issued
Expiration ��j-��3 9 .36 pg
IV.Dispersal/"trcatment Area and Tank Information:
Desi�n I�lo���(epd) Dcsign Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Arca Proposed(st) System Fle��ation
450 2.00 225 292.50 98.80 cell elv.
Capacity in Total #of Manufacturcr �
Tank Information Gallons Gallons Units � � � � �
New Tanks Exish�g Tanks '� o y � � �
o c� '
� ,n .�
a U ✓: � n u. U n.
Septic or Holding i'ank 2000 2000 1 WIESER CONCRETE ✓ �
Dosing<'han,ber 750 750 1 WIESER CONCRETE �/ � 0 �
V.Responsibility Statcment- 1,the undersigned,assume responsibility for installa6on of the PO��"CS sho��n on the attached plans.
Plumber�s Name(Print) Plum Signature MP/NIPRS Number 13usincss Phone iVwnber
Travis Butterfield 652879 715-634-8176
Plumber's Address(Street.City,State,7ip Code)
14346W St. Rd. 77, Haywa d, WI 54843
VL County/Department Use Only
�,Appr �d ❑ Disapproved Permit Pee Date Issued Issuing Agent Signature
❑O��ner(;iven Reason Yor 1)enial $ ��� � I a��� '.,J�I�L"C����` 1""`
Conditions of Approval/Reasons for Disapproval -- ._
t�ir�isw�
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Chk# I ��� �`��. 2? 2022
C S�T �.oa� - `� l `� � �----�-.- �
RCtlt#. �.� i��%r 1�A ���Cn�� BAWYEFi �:;ti'�`._l;�T`�
^ �I - T
At[ach[o complete plans for[he s}stem and submi[[n the Counh�only on paper nof Iess than S I x mches in size
NO REFJNDS AFTER
sBn-639s�R.oziaa� Is.�,SUE OF PEHMIT
� i� 9
`�FpARTS�F.�,T DIVISION OF INDUSTRY SERVICES
h�r r�\ 2850 MIDWEST DR STE 104
? ��'; .f.
� / �F . ONALASKAWI 54650
:;' � p ,"
S � � Contact Through Relay
i � ' P http://dsps.wi.gov/programs/Default.aspx
1 l �
\yt�� S /-�'/ www.wisconsin.gov
�i.�r(� �-_;��j%
��5'siu�i' Tony Evers - Govemor
Dawn Crim - Secretary
July 19, 2022
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2024-07-19
Plan Review: PWTS-072201573-C
TRAVIS A BUTTERFIELD
14346 W State Road 77
Hayward WI 54843 ��n�;,;on,,,y
APPROVED
:;E�- 0� 5.:°ETY ANO PRO=ESSIONAL
SITE: SER��=ES
Christopher Mlejnek 2nd Home � � �� �= h��5-R� 5=�� ��5
8599N Shady Lane �ir.r,����
Town of Bass Lake
Sawyer County �-` ��P�F��o�:o=���E
P.O. Gov.Y lot 4, S17, T40N, R8W
Total Amount: $250.00
FOR:
Description: Three Bedroom Geomat Mound System\ —Sloping site
GeoMat Mound Component Manual — version 2017, Pressure Distribution Component Manual —
Ver. 2.0, SBD-10706-P (N .01 /01 , R 10/12), 450 GPD, 30" depth to limiting factor, Maintenance
required, Effluent filters, Replacement construction
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
This system is to be constructed and located in accordance with the enclosed approved plans and with
any component manual(s) referenced above. The owner, as defined in chapter 101 .01 (10), Wisconsin
Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department
per s. 145.06, stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with
the requirements of Sec. 145.19, Wis. Stats.
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8
inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If
it rolls into a 1 /4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed .
If the site is too wet to prepare, do not proceed until it dries.
• The proposed pump chamber shall be securely anchored per SPS 383.43(8)(g), Wis. Adm. Code.
• Inspection of the private sewage system installation is required . Arrangements for inspection shall be
made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis.
Stats.
• A state approved effluent filter is required . Maintenance information must be given to the owner of the
tank explaining that periodic cleaning of the filter is required .
• A copv of the approved plans specifications and this letter shall be on-site durinq conshuction and
open to inspection by authorized representatives of the Department which mav indude local
insqectors.
Owner Responsibilities
. The current owner,and each subsequent owner,shall receive a copy of this letter.Owners shall also
receive a copy of the appropriate operation and maintenance manual(s)and be responsibie for
ensuring that POWTS is operated and maintained in accordance with this chapter and the approved
management plan under s.SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a
health hazard,the property owner must follow the contingency plan as described in the approved
plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s)utilized in the POWTS.
In granting this approval the Division of Industry Services reserves the right to require changes or
additions should conditions arise making them necessary for code compliance.As per state stats
101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe
building,structure,or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at
the address on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the
owner and any others who are responsible for the installation,operation or maintenance of the POWTS.
Sincerely,
v r �/vL�
Gerard M Swim
POWTS Plan Reviewer
WI DSPS-Division of Industry Services
(608)789-7892
�errvswim a wi. ov
GeoMat MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE
Owner Info
Project Name: Mlejnek-Shady Ln ___
Owner's Name: Christopher W Mlejnek
Owner's Address: 2520 19 1/8 St
Rice Lake, W1 54868
Property Info
Property Address: 8599N Shady Ln
Legal Description: S 17 T 40 N R 8 W
Township Bass Lake County: Sawyer
Subdivision Name: P/0 Govt Lot 4
Lot Number: Block Numbec CSM#: _
Parcel I.D. Number: 002�40-17 5402
Plan Transaction No.:
Index Pages
Page 1 Index and title Page 9 Tank cross sections
Page 2 Data entry Page 10 Site Diagram
Page 3 GeoMat mound drawings Attacnmencs: soii Test
Page 4 Lateral and dose tank sanitary permit application
Page 5 Distribution media
Page 6 System maintenance specifications
Page 7 Management and contingency plan
Page 8 Pump curve and specifications
Travis Butt eld License Number: 652879
Date: 07/06/2 Phone Number: 715-634-8176
co,�;�,vo��uy
Signature: APPROVED
Designer Sta State of WisconsiioEPr o=saFerr ANo aROFess�or,a�
SERVICES
orvisior�oF imausrav sePvices
�" "-�
�-.- .,_aRes'�:u�=_n;F
Designed Pursuant to the
Synergy Syslems L.LC.,GeoMat Mound Component Manual(Edition t, 2017), (N.4/17),
SSWMP Publication 9.6 Design of Pressure Distribulion Networks for ST-SAS(01/81)and
Pressure Distribution Component Manual . . . �
fe� C'owTs V�r. �.\ 500 - �o�o(n� Mo.y ao�J
GeoMat Mound Edition 1, 2017 Page 1 of 10
Mound and Pressure Distributian Component Design
Site Information
��� R� Residential or Commercial Oesign N �� ISD Required?
300.00 Estimated Wastewater Flow(gpd)
1.50� Peaking Facbr(e.g. 1.5= 150%)
450.00 Design Flow(gpd)
3.00 Sile Slope(%)
98.80 Installation Contour Line Elevation(ft)
3o.oa Depth to Limiting Factor(in)
0.60 Imsitu Soil Applicalion Rate(gpd/k2)
76.00 Contour Length Available(ft)
Distribution Cell Information
6.50 Cell Widlh(R) 45.00 Designer Input Cell Length(ft)
2.00 Dispersal Cell Design Loading Rate(gpd/ft�) 45.00 Dispersal Cell Length Required(fl)
'�.. 2 InFluent Wastewater Quafry(1 or 2)
Pressure Distribution Information
E Center or End Manifold Are ihe laterels the highest point
2 Number of Laterals in the distribution Y
325 Laleral Spacing(ft) network?
22.35 Forcemain Drainback(gap If N above,enter the elevatlon(ft) �
0.50 Forcemain Filter Loss(k) of the highest point . ��
2.00 Forcemain Diameter(in)
137.00 Forcemain Length(k) Does the forcemain drein back7', Y I
� 9325 Inside Pump Tank Elevaiion(ft)
'��. 0.156 Orifce Diameter(in)(e.g.0.25)
'. 2,00 Orifice Spacing(H)= 6.65 kZ/orifice
4.55 System Head(ft)x 7.3
5.63 Vertical Lifl(ft)
172 Friction Loss(k)
12.40 Total Dynamic Head(k)
28.10 5x Void Volume(gal)
50.45 Minimum Dose Volume(gal)
23.69 System Demand(gpm)
Diameter Selection
Lateral Diameter Selection Manifold Diameter Selectlon
in.dia. o lions choice in.dia. o tions choice
075 � 125 x x �
1.00 '.. 1.50 x '��,
125 x x � 2.00 . ...
1.50 x 3.00 � '��
z.00 X
s.00 X
Manufacturer Information
Treatment Tank Information Effluent Filter Information
2000.00 Septic Tank Capacity(gal) Lifetime Filter LLC Filter Manufacfurer
Wieser Concrete Products, Ina 'Manufacturer LT 1/8 �.Filter Model Number
Dose Tank Information Gallonsllnch Calculator
750.36 Dose Tank Capacity(gal) 750.36 Total Tank Capacity(gal)
� 20.28 Dose Tank Volume(gal/in) 37.00� Total Working Liquid Deplh(in)
',Wieser Concrete Products, Inc. Manufacturer 2028 gal/in(enter result in cell DoseTankVolume)
Project: Mlejnek-Shady Ln Page 2 ot 10
Mound Plan View
— —T
��T 10 f � J
Observation Pipe_� _ I
K—�(, T
�" r, „ I A
W � � �
e '
z
o l
� �
L
Mound Component Dimensions
A 6.50 ft E 2.34 in H 1.00 ft K 6.86 ft
B 45.00 ft F 14.25 in I 10.17 ft L 58.71 ft
D 0.00 in G 0.50 ft J 4.64 ft W 21.31 ft
292.50 (ft�) Dispersal Cell Area 750.00 (ft�) Basal Area Available
10.00 (gpolft) Linear Loading Rate 4.50 (ft) 1/10 B Obs_ Pipe Placement
Mound Cross Section View
GeoMat Dispersal Area
Observation Pipe
12"ASTM C 33 sand as GeoMa[
required for Geo Mat Distribution Cell
componen[ '
GeoMat+12"ASTM C-33 sand
t: H, �
100.99 Finish Grade � ;`�,; Cover Material
99.88 Laterel Invert Elevation �s��� � � �/j>
98.80 DispersalCell � � ,��,�.. Slope 3.0
Elevation ' '� ' '
Contour Elevation 98.80
� �4 i Tilled Area
Forcemain
� In situ soil �
In situ soil
Shading Key
� � Topsoil Cap
z r.—� Subsoil Cap
3 � ASTM C 33 sand (F)
.1 G] ASTM C 33 sand (D)
5 0 Tilled Layer
G �] Geo Mat
See details on page 4 tor number,size, and spacing of laterals.
Project: Mlejnek-Shady Ln Page 3 of 10
End Connectfon Lateral Layout Diagram
-�=Turn•upw7ball valve orcleanout plug �
1st orNice located at I Z '
All oriflces paint down
X
P
Wterals&force maln of PVC Sch 40 ver SPS 7able�84.30-51
_ _ ___-__.. __._.. ._.
Numher of Laterals 2 Orifice Diameter 0.156 in
Lateral Diameter 125 in Orifice Spacing(X) 2.10 ft
Lateral Length(P) 4455 k Orifices per Lateral 22
Lateral End(Z) 0.45 ft Orifice Densi�y 6.65 ft�/orifce
Lateral Spacing(S) 3.25 ft Manifold Length 3.25 k
Lateral Flow Rate 11.85 gpm Manitold Diameter 7.25 in
System Flow Rate 23.69 gpm Forcemain Velocity 2.42 fVsec
Dose Tank Informatian
Iu��Aiugcnver��itl�oamingL�b.L ` �
Io.Ainy Jcricc nnA wmar iipM.cal
J"vcnmdCnve . '
IJaclii�ulla�z
in \bClnu
1 til S L[�2i\\\C�-
.y:_ I . Lni.L.J<r.We . �:1-! . ui. _. dl�:"�. yll-
�� —Ui9ro�mcct �
A anmm�� p � ' o ��tr�l p�
\Vires 1 f I Iriv so�vice I II �(�f m�.. i i_ry(1 �
_. _ -. .. . . _ I � � .Olu il 61 d
� �
„*,i1LIr �II � / 'opkr1j11 ,li Farcemaindiameler
�"Inki 1511 li 2 10.
I ' ��
❑�, iri
�nd
A. �icli16•��Au I�nw
i ��v..�ri��n.�„�„�
Sim/TechFilter '�I M'°"da"'° i
STF100 1/16 Illigb��'atcralann��N =
B" �I ��
� PwnpUnPlont�l(1 ui
,I � �-- PumpottolevationQt)
vl
� Pump01719nat''I'��'�Pwnp Hi 94.25
D �i==�
�i���i I Dosetankelevalion�8)
.... . ��� ~— 93.25
Nilliil!li�ii i � : ll.��.�;��s!!�,�,+,,���..�:»�.::,.. ! 1,!s;;� , :i Li;:i i:�!;IlE.�!
Dimension Inches Gallons Wieser Concrele Products,Inc.
A 20.5� 415.99 Ca aci 750.36
B 2.00 40.56 Volume 20.28 gal/inch
C 2.49 50.45
D � 12.00 243.36
Total 37.00 750.36
Filter Manufacturer Sim/Tech Filter
FilterModelNumber ��STF700 1It6 ___j
Alarm Manufacturer SJE Rhombus .��
Alarm Model Number�AB '�.
Pump ManufacWrer Zoeller Company . __ _. . �
Pump Model Number BN 98 '�,
Pump Must Deliver 23.69 gpm af 12.40 ft TDH
Project: Mlejnek-Shady Ln Page 4 of 10
GeoMat Distribution Cell Media Layout
6.50 Cell Width(tt) 1.63 Sidewall to Lateral(ft)
Distribution Cell Cross-section Arrangements
Q- _ Q
Component Legend
� Dislribution Pipe With Pressure Lateral L.J Orifice Shield
� Turnup Enclosure ————— Pressure Laleral
GeoMat is covered wilh appmved geotezlile tabric as per the their product approval.
Distribution Cell Plan View Layout-Typical
6.50 Cell Wid[h-A(ft) 45.00 Cell Length-B(ft)
�..,� .� � � , � � � � �. � � �.. �. �.. �.
�. � �. � .� � � ..� � � � . � � �
Typical Dispersal Cell
Sand Pill Recommended Distribution La[eral
� �O�ifice Shield
Pipe Dia. - Approved InFiltrative Fabric
I, " ' ' �' r..: i., __..
I . . . ' .c%;.c�i.tnCn1.. . . GeoMa[
y� . . —. . . Component
I . i - �.iecnnc�r ��i�.. .
� I Infiltra[ive5urfaw/PlowLayer
� L'.i.:&:a:t�ue
Observation Pipes Shading Key
�Wat<rTl¢h[�
� r.� Topsoil Cap
TolletFlange � <'mm � „ 2 � Subsoil Cap
Pebar -� � ASTM C 33 SBnd (F)
��� J � pSTM C 33 sand (D)
�.Mi� EI m.e.n.e I CI 5 0 Tilled Layer
�d/e�o I' M'"
,-�"1 .a (, � Geo Mat
�— I
' I;/C"ii�y.:'
�it(61e'.SIpCF,fr�U��. ' _ .
'IYA:IId";Ihdu'hr6r.�n;. ,
See tletails on page 4 for number,size,an0 s0acing oF laterals.
Projecl: Mlejnek-Shady Ln Page 5 of 10
Mound System Maintenance and Operation Specifications
Service Provider's Name.Travis Butterfield Phone 715-634-8176
POWTS Regulator's Name Saw er County SPIA - Zoning Administration _� PhoneC(715) 634-8288
System Flow and Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 300 gpd Maximum BOD5 30 mg/L
Septic Tank Capacity gal Maximum TSS 30 mg/L
Soil Absorption Component Size 292.5 ftz Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Inspect and clean as necessary at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test periodicall
Pressure System Laterals should be flushed and pressure tested every 3 years
Mound Ins ect for ponding and seepage once every 3 years _ _ _
Other
Miscellaneous Construction and Materials Standards
1 . Observation pipes are slotted and materials conform to Table SPS 384.30-1 , have a watertight cap and are secured in as
shown in the Synergy Systems GeoMat Mound Component Manual Version 1, 2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component
Manual Version 1 , 2017. Media is covered with an approved geotextile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost
penetration.
Lateral Turn-up Detail
6-8" Diameter Finished ; Threaded Cleanout
�, c Lawn Sprinkler Grade � Plug or Ball Valve
Box
� Lateral Ends at La � �
j :
�stOrifice Where
Long Sweep 90 or Two 45
�Degree Bends Same
Diameter as Lateral
. . ' ' ''. y G �� r�� �.V
I
'I.:Iti 1 1 ..:`'.
... �- �� �����' � . .
� Distnbution Lateral �� Lateral Cleanout
1 .4 Feet
Project: Page 6 of 10
Notes/ Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in accordance with SPS 383,Wis.Admin.
Code,the in-Ground Soii Absorption Component Manual for Private Onsite WastewaterTreatment Systems Version 2.0 SPS-10705-P
(N.01/01). GeoMat in ground Component manual Version 1.
1.This POWTS has been designed to accommodate a maximum daily flow of 450�1ons of wastewater per day. The quality of influent
discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following.
A monthly average of 30 mg/L fats,oil and grease
A monthly average of 220 mg/L BOD5
A monthly average of 150 mg/L TSS
Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that resuR in exceeding the enforcement
standards and preventative action limits specified in ch.NR 140Tables 1 &2 ai a point of standards application,except as provided in DSPS
383.03(4),Wis Admin.Code.
2.The owner of this POWTS is responsible for system operation and maintenance.
3.Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis.Admin.Code,
and the pertaining county Private Sewage Systems Ordinance. The user's manual,provided to the owner of the POWTS includes the names
and telephone numbers of the properly licensed individuais to contact for such repairs.
5. No product for chemicai or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept.
of Commerce in accordance with SPS.384,Wis.Admin.Code.
6.If the POWTS is replaced,or its use discontinued,it shall be abandoned in accordance with SPS 383.33,Wis.Admin.Code.
NOTES
Two Effluent Filters to be installed where possible 1 to be installed in ST,and or 1 in pump tank in
order to insure particle size less than or equai to 1/8". Filters shouid be cleaned once in spring,and once in fall. Also, strainers in sinks in
the building shall be maintained,so that solids and fats are minimized to flow into system.
A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each ceiL
The plumber,or county shall see to it that a copy of these plans including this page, maintenance folder, and maintenance agreement is
given to the homeowner.
This system may contain a dose chamber. If a pump,fioat,electrical outage causes the dose tank to fill,the homeowner should see to it that
the effluent level in the tank is brought down gradually and not all dosed to the system at once. One large dose could cause damage.
Contact a pumper or your installer if this problem occurs.
The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. LE.spread laundry
out over time,not 6 loads in 2 hours,while everybody showers,and uses the toilet,ETC.
CONTINGENCY PLAN FOR COMPONENT FAILURE
A.Septic Tank.Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component.
Leaks in the joints between manhole risers or covers shall be repaired by replacing faulty seals with aoproved materials to make joints water-
tight.
B.Outlet Filter.The outlet fiiter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger
than 1/8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank.
C.Dosing chamber and pump.The dosing chamber shall be replaced if any structural failure is found. Leaks in joints between manhole
risers or covers shall be repaired by replacing faulty seals with approved materials to make joints water-tighL The pump and controls shall be
replaced when they are no longer capable o#functioning according to the design plan.
D.Pressure Distribution Piping. Partial ciogging of the distribution network may result in unduly long dosing cycles.The ends of the
distribution laterais may be exposed and the threaded end caps removed The pipiny can be disconnected on the outlet end of the pump.
The distribulion piping may then be back flushed to cleanse any accumulated matter from the piping- it is recommended that the dosing
chamber then be pumped by a licensed piumber.
E.Soil F�bsorption CeIL The discharge of sewage or wastewater to the ground surface is strictly prohibited due to the human health hazard
created by the effiuent.All failures created by surface discharge shall immediately be reported to the appropriate county The pump shall
then be immediately disconnected to prevent further discharge to the ground surface via the soil absorption cell.The existing septic tank and
dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved.The
replacement shall be initiated only after any necessary plan approvals have been obtained from the
appropriate plan review authority and the required sanitary permit is obtained from the couniy.
Project: (y� ��� �y K Page `1�f 10
�J
� TOTAL DYNAMIC HEAD/FLOW
� w PUMP PERFORMANCE CURVE PER MINUTE
MODEL 98 EFFLUENTAND DEWATERING �„ r
ZS MODEL 98 � I '�°
Feet Meters GaL LAers
0 5 1.5 72 273 �
"�6 20 10 3.0 61 231 .y. . .l.
x
� 15 4.6 45 170
� 20 7.1 25 95
o y Shu4oXHead: 23ft(7.Om) i ,. „�
FJ¢, ooes�i i �a.11�.N
10 i
� i i
2 �
5 �
i
0 i
10 40 50 60 70 80 !
GALLONS a3,(�T �i �
LITERS �
0 80 160 240 � �
FLOW PER MINUTE � �
l'�'. ".(C'O.' ;fl.'°;"f; '11_ �P'LIC:A'11fJRl":3 6M1oz
�OiJ>ll1:1�I A i _I.Y d ,f. _F L I� /1 �
• Eleclrical altemators,for duplex systems,are available and • Variable level float switches are available for controlling singie
supplied with an alarm and three phase systems
� Mechanical alternators,for duplex syslems,are available ° Double piggyback variable level iloa[switches are available for
with or without alarm switches variable level long cycle controls
= Referto FM1922 and FM0806 fortemperalures above 130°F
98 Series Control Selectlon
Motlel Volts-Ph Mode Amps Simplex Duplex
M98 115 1 Auto 9.4 1 4
N98 115 1 Non 9.4 2of3 4
�ee zso i nmo a.� i a "Easy assembly"
E98 230 1 Non 4.7 2of3 4 (pump80ischarqepipe
nolinGUGetl.�
:si:i_�:c��iora c,uin�
i.Integral float operated mechanical switch,no external conVol required.
2.For aulomatic use single piggyback variable level float switch or double
piggyback variable level float switch.Refer to FM0477.
3.See FM7228 for correcl model of simplez control panel.
4.See FM0712 for correct model of duplex control panel or FM1663 tor a �
residentia�a�ternarorsystem. UP`fIONAL.f UMP sinr�u"IN 10-2421
�Reduces polen(ial dogging by debris.
For Information on addiGonal Zceller producls refer to catalog on Pggyback VariaMe Level 'ReplaCes rocks or bncks under Ihe pump.
Sxilches,FM0477;Electrical Altemator,FM04B6;Mechaniral Altemalor,FM0495;Sumpl �Made o(durable,noncorrosive ABS.
Sewage Basins,FM0487;Single Phase Simplex Pump Control,FM1596;Alarm Systems, �Raises pump 2'off boltom oi basin.
FM0732. •Provides the ability to raise intake by adding sections of 1%'
A CAUTION or 2'PVC piping.
�Altaches securely�o pump.
nu in,t:�li.iU��,o�controis,pmtect�on de�i�es ana v�idng;howd ne done i�y� �Accommodates sump,dewa(ering and efFluent applications.
quali(ieA licensed elecirician.All eleclrical aod safery coAes should he followed NOTE:Make surelloalisiree fromobsWction.
inchitlin�ihe most recenl Naiim�al[Iectrical Code(NC:C)anA the Occupalional
Satety and flenllli Acl(OSHn).
�ES�FZV� a't�7W�FtE.�C7 !)�:�11Q,f�
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
_ ____ __ ____
���/��'7 /�/�p MAILTO:P0.BOX1W47
Z e ,��I,L.f'��W�ii�/V e / LouisvAle.KY 40256-0J47 / Menulactuers ol..
� SNIPTO:3649 Cene Run Road
Louirvilk.NY40Tfl-796f Q��rrPue+asSxce/939�
www.zoeller.com �%/PI/MP!O. (�1J7F�(�1J1�800)fi�&PUMV
OO Copyright 2072 Zoeller Co.All rights reserved. g�F ��
—-- Pa9� _ —
�x � s � i � G 7'� ��G WLP2000— MR ��
��,��, �,��y �5� � �S �, � o �d ,�g T�.�t� � TANK SPECIFICATI �NS �
� O O
o a
164" DIMENSIONS: �' � 6I
WALL: 3'� a a �j-1
BOTTOM: SEPTIC 3"
HEAVY DUTY 5" (ADD 2,800 LBS.) o �
COVER: 6 ' d
MANHOLE: 24" I.D. PRECAST CONCRETE RISER -°
- HEIGHT: 53" O.D. �` �
LENGTH: 164" O.D.
w
WIDTH: 96" O.D. Q w Q
4" CAST-A-SEAL 4" CAST-A-SEAL BELOW INLET: 41" O.D. � � �
LIQUID LEVEL: 36"
260 LBS. �
WEIGHT: BOTTOM 11, o
�Zq.° COVER 8,170 LBS. W }
� INLET AND OUTLET: � Q �
°' S'�� 4� CAST-A-SEAL 800T OR EQUAL � �
m Q �
FILTER OR BAFFLE INLET AND OUTLET BAFFLE AND FILTER: � w
WISCONSIN, SEE DETAIL #10 0 0 �
(OTHER STATES SEE CHART)
�, o
LIQUID CAPACITY: 56.27 GAL/IN �
n
�— �
u�
LOADING DESIGN: 8' 0" UNSATURATED SOIL W g
�
� Y �
TOP VIEW HOLDING TANK: C � �
OUTLET HOLE PLUGGED � o 0�0
ACTUAL CAPACITY: 2,138 GALLONS
� � �
MN TANKS: N
WILL HAVE ONE VENT OVER OUT�ET "�
AND WILL HAVE TWO VENTS IN COVER OVER INLET W � �
� � 3 p
Q � TANK CAN BE USED AS: �, N �
� SEPTIC/ HOLDING/ PUMP OR SIPHON — �
COVER: MIX DESIGN #8 (NO FIBER) � 3
,, TANK: MIX DESIGN #9 (SMALL FIBER)
INLET
_ _ _ - OUTLET CUSTOMIZED TANKS: �
N � � FOR CUSTOM TANKS CONTACT WIESER CONCRETE a o
t� � O U � � � U ' � Z •
� 3" ? � M a. - °i o a Q
� � o � �
0
JOB INFORMATION : a � o
CUSTOMER: 3 W �
;,� PUMP PAD � w
JOB NAME: �
SIDE VIEW DATE NEEDED: SHEET N0.
APPROVED BY: ,�
APPROVAL DATE: OF
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � �
WLP750-MR
TANK SPECIFICATIONS
� °�� �
DIMENSIONS: d a
WALL: 2 1/2" y"
BOTTOM: 3" � a ��
COVER: 4'
MANHOLE: 24" I.D. PRECAST CONCRETE RISER � J
HEIGHT: DOME COVER 61" O.D. ii �,
_____ FLAT COVER 53 1/4" O.D. �. �
� \ OUTSIDE DIAMETER: 84" O.D. (1.,
/ BELOW INLET: 42" O.D. J � �
4" CAST-A-SEAL\ 4" CAST-A-SEAL LIQUID LEVEL: 37" � � o
WEIGHT: 6,150 LBS. �
�24 INLET AND OUTLET: �
�. o
o� �. 4" CAST-A-SEAL BOOT OR EQl3AL N
jY� GASKET, CAST-A-SEAL BOOT OR EQUAL N �
\ _ �
FILTER OR INLET AND OUTLET BAFFLE AND FILTER: ''
BAFFLE WISCONSIN, SEE DETAIL #10 m � �
� / . (OTHER STATES SEE CHART) � � ,�;
` � J
LIQUtD CAPACITY: 20.28 GAL/IN � � ``
W �
HOLDING TANK: �
ACTUAL CAPACITY: 790 GALLONS M' '�
TOP VIEW OUTLET HOLE PLUGGED � �
LOADING DESIGN: 8� 0" UNSATURATED SOIL C� � cfl
� o �
MN TANKS: �
WILL HAVE ONE VENT OVER OUTLET � o �
I
AND WILL HAVE TWO VENTS IN COVER OVER INLET � � �
N
OPTIONAL FLAT COVER TANK CAN BE USED AS: � o �
� IS AVAILABLE FOR EXCHANGE SEPTIC/ HOLDING/ PUMP OR SIPHON � � �
FOR DOME COVER. W = pp
COVER: MIX DESIGN #8 (NO FIBER) e �
�' TANK: MIX DESIGN #10 (STRUCTURAL FiBER) �
� �
INLET - _ OUTLET CUSTOMIZED TANKS: 3
- FOR CUSTOM TANKS CONTACT WIESER CONCRETE
c� d. a m Nq O
U M U - J
� �„ d - r+�j a _ � Q ON
2� � <r � �r . � � �
o Q Q
� � �
� PUMP PAD JOB INFORMATION : � � o
CUSTOMER: w 5
� w
JOB NAME: �
SID E VIE W DATE NEEDED:
SHEET N0.
APPROVED BY: ,�
APPROVAL DATE: OF/
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � �
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Wiswnsin Departmenl of Commercc SOIL EVALUATION REPORT Page�o� �
Division ol Salcry and Buildmgs —
in accortlance wilh Comm 85.Wis. Adm. Code �
County �
Attach wmplete site plan on paper nol less than 8 72 x 17 inches in size.Plan must 1'"��v- �=
inGude,but not limited to:vetlical and honzontal mference Oo�nt(BM1t�,tlirection and Parcei I.D. -. , � l�
percent slope,scale or tlimensions,norlh arrow, and location antl tllstance to nearesl roatl. :;�.�� �'�; - -.� �(! ',1
Please prinY all in(ormation. rteviewed by Dale
Personal inlortnation you provide may be used lor secontlary,urpeses(Pnvacy La..�,s 15 Dd(t)(m)) (� I �0-�-�
PropertyOwner �;,r� Lc,.,��.:� PropertyLora,1tion
� I I I��CU t� ..� 5����4!�;« GovL Lot T 1/4' 1f4 S I � T �y N R S �i(orrWj
Property Owners Mailing Address r,;`.- ��; �r-� ,- Lot� Block z Subd.Name or CSM.
� 1'� S� (t iwo� ..� ] — —, —
City Stale Zip Cotle Phane Numb�r �City n.]Vi!lape �Town Near=st Road
E/,;, �..,- s.t». tG�r� I�f4��-y7oy I�Atis LAkC -.
I C c.�.�„ �=
Q-��������� Use:� Residenhal/Number of betlrooms j Code denved tlesign Oow raic Y��� GPD
J[]Replacement n,T_.:�-a.semmercial_.Doccrihe;
Parent matarial /a/�o,., �
/ Sa,wii Flood Plain elevation II applica6le ���e... � Cu�.1 I.�_ft.
General comments ��
antlrecommendafions: S��c S..,R.SIr �,.,- •a Vv�s ��.:......,-, �>7.�r:., ;�" ila..,. ..,n S .�.J �t-✓..
���,.� l,�+ �f;�, .:7��- y'!- 3, -
� Bonng tt ❑ Boring
� pi� Grountl suAace elev. `%�� ��� fL Deplh to limi6ng factor _5� in.
Soil ApphCation Rale
Honzon Deplh Dominant Color Redox Descriplion Texture Struclure Consistence Boundary Roots GPD/tN
in. Munsell �u.Sz. Cont Color Gr. Sz.Sh. •Eff�1 'EFY'2
� C- �J� . � — / "� �� J '
L'/ l � T i .L .�.'� C ? a�-�� `! . �
�-. � 7.S ,.y�4 — �5 5' .H.� .�?/r-�� . S �
3 �/- �s' > '/1 — s � .s�� _�� � ,-- S i
, / . S � y� c t. � s�. , ,. .
'f J'J'yS `( t.,� 7. S- . '`�= � :,. � � /� i
C.G� 57,. S/= M.-.sT -,
S ys-G� S °%( s y/� . „�,,,�i �- — - L �
�.
x > 5 �: �'_ S � . , x S
� Boring# ❑ Boring
�, p�� Ground suAace elev. ��1 �`� fl. Depth to limiting faclor .5 v� in.
Soil Application Rate
Honzon Deplh DominantColor RedoxDescnption Texlure SWcture Consistence Boundary Roots GPD/N'
in. Munsell Qu.Sz. ConL Cobr Gr,Sz. Sh. 'Eftttt 'Etf#2
� G -� �-.tj�t — �' � � i n , ,J � , Jr_/., . � �
� y- •� , � `'�� — S r� �• : _�' -�., . 5
, s �
3 I,�-.z� c ,� /� — -.> �, �..., ' c s �,:�/,„ - 5 . 'r
CL., 7 .:y.� s o .>a�.s,- -� � /' , _S
3u -S N 3� s, ,� r� s :,< < � 1�, i
k �/�, r S "
'Etfluenl X1 =BODs>30<220 mglL antl TSS>30<150 mgiL •EHluent d2=80D,<30 mglL antl TSS<30 mg4
C5T Name(Please Print) C` I / �e . �--- CST Number
�G'i` { 1�1,�,.��1' � �♦ ��qs."// ����/%C�
Adtlress � Date Evalualion Contluctetl Tetephone Number
�SC�% .���.7.r� /'+✓ �Crn.4./ G��,2 S�L�-0 �- �� - ��� / - �.J- �S i�5
: L .7,
PropertyOwner O�! I �CUM9� ParcellDri Page a o( 3
� Boring# ❑ Borinq
� p�� Ground surface elev.9b'.�g, Depth b limiting factar o�l in.
Sofi Applica4on Rate
Horizon �eptl� Dominant Cotor ' ReOox Dascriplion TezWre Swcture Conststence Bountlary Roots GPD/R'
in. Munsell Qu.Sz. ConL Color Gc Sz.Sh. 'Eff#t 'ENp2
l D-!� /U � z — „� S � �s -/„ . ,G
a2 d-/8 5,,, �/d — s s ,.- ,� , s . f
3 -a �•s�S — S S � l� _s �
- v 7_s,.6f�( c�� 7.s s� S s �c-(' 9I . s _y.
S. , '�� C.t1 S n- s M�+isT _ _
3I C S�a .P . S - /'
❑ Boring p ❑ Boring
❑ p�t Ground surface elev. fl. pepih to Ilmitlng factor in.
Soll Appiiptlon Rate
Horizon Depth DominantColor RedoxDescript�on Texture SWdure Consistence Boundary Roots GPDifI'
in. Munsell pu.Sz. Conl Color Gr.Sz.Sh. •Eff#1 'Eff#2
� C S S ... /tv` �✓
C�' 2 NG -v o-, 7�� !! ,i r
� Bodng# ❑ Borinp � .
❑ Plt Grovnd aurfaee elay. fl. Dapth to Ilmitlnp factor In.
Soil Applicatlon Rale
Horizon Depth DominantCola RedoxDeseription Textura SWcture Consistence Boundary Roo1s GPDlk'
!n. Munsell �u.Sz. ConL Color Gr. Sz Sh. •E(M!7 'Effp2
'E(fluent#1 =BODs>30<220 mg/L and TSS>30�150 mg�L 'EHtuent#2=BOD�<30 mg/L and TSS<30 mplL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance lo access servicu or
need meterial in an alternate foimat,pleue coniact the depanment at 608-266-3 i51 or TTY 608-264-8777.
SBDBJ)0(R.6N0)
- r- � �
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.
_,G�� OCUMENT NO. STATE BAR OF WI9CON9IN FORM 1—IB82 *��e er�ci xuuvm ro�e�co�oiea o�+..
FiD'" �� WARRANTY oEED Vol. 359 Page 18�
aL� A�qLt�c1 Otllo�)
3 0 3 0 9 0 d�—.------- --— :,��..� ��a �.,y as
—�'— ��---°�--- --_- Recelved Tw Recoril
This Deed, m.ae netaeen ...Anita M. Neuman
.......___....................._... ..........._......................................_._.__.--_......
_ ...._ ... ..._ ._ . _................ ............. JUF! 18 1990
......_..................................__.__........_..__.._........._..._ ..........� Grantoq a0 ��/
a�a_.W�,1.�7.?!!l..M....Neuman......._._.....__....._................___.......---- �t •� � T' .N.nna Rewroe<
_............ .........................._............._.... ..........................._........_......_.. In Ya1 ofRecords Paga
_........................._..._....._._.._..._.__. .._..................................� Grantee, nfai oe
. . ...........................____._.__............_._...............
W1E71838 0C11, That ehe eaid Crancor,ta a valunble o aideret�on Of
$1.Q0_and other good and valuab�e consfcferation --_____—_---
. .. . .................. ... . .......... _......................_..._......._..._... -
conveya to Grentee[he fallowing dacribed reel mtate in .......Sa47x0I S Jun iRS'Opj TO
. .. . ......__....
County, Stete of Wieconsin: � A ��� / �
Cl.e ____ v
✓That part of Government Lot Four (4) , Section �
Seventeen (17) , Townahip Forty (40) North, TaxParevlNo:...................................
Range Eight (8) West, described as followe:
Commencing at the Northeast corner of said Lot 4; thence West
on the North line of said Lot 9 a distance o£ 1962 feet to
an iron pipe, and the place o£ beginning; thence continuing
west on eaid North line to an iron pipe on the water's edge
of Grindstone Creek; thence Southwesterly and along the water's
edge of said creek, 341 feet to an iron pipe at the water's
edge on the East shore of Grindstone Lake; thence Southerly
along the water's edge 100 feet to an iron pipe; thence N 65°
30' E, a distance of 418 feet to an iron pipe at the Westerly
right-of-way of a present and existing road, and 92.5 feet
from the point of beginning; thence North and along the Weat
right-of-way of said road, 92.5 feet to the place of beginning.
(CONTINUED ON REVERSE)
Thie ..13 IIOt homrstead property.
(le) (la not)
Taðer with ell and einguler the hereditemenb end eppurlenanco LhereunW belonSing;
p„� Anita M. Neuman
.............................._.._...._......,....... .._. ...._............_..........,..._......_........................._..
wnCrenG tAet the title Is good, indefeaeible In Iee elmplv end froe und clear o(encumErnncce except
(None)
end will wernnt end defend t�e enme.
nama en�a .....14th----------._--.._........ aer ot ............_June......._._.._..-----------__.......� �s.90_.
................._..._............_.........:�..)_.r..........._BEAL) ..._.�irWfa�- i/ .../.(.`46.a.Rr!..........._(SEAL)
. i.
.. . .._._._..
Anita M. Neuman
• ..._......................_.........................__...._... . . • ._._......_._._....._..._.__....._.....__........_...
......._.................._....�............._.........:..........ISEAL) ......_......._._...._._....................................._(SEAL)
' .................................................................. •..............................____.......__.........._.....
A9T8SNTICATION ACHNOWLED6MENT
9le�atare(a) ........___-__'................._...................._ 9TATE OF WISCONSIN
� �.
-...............................---------------............._...._..... Suneau
......................................Cauntr. 14 th
outhenticeted Lhia ........day of_........._.._........., 18._... Persanell cama hefore me [hja ................day ot
Y
............June..................... �e.90.. eha ebove r.amed
......................._..........__................._..........__.,...... Anita M. Neuman
•.............................................................................. ................................................................................
TITLE;ME�IHER 3TATE BAR OF WISCONSIN
_.__......."'_'.._""_"'__".........................................
([(no4................_.................._..................... .........
authorized bY 4 708.08.Wu.Statal . ......................................................"""' '
^^....^ ��W e ti���....�} who ex the
fo �ne a le e�the eame
n����.�.,���,.�.��,.,.� ... �'�..
; �
Vol. 359 Page 185
And further that the eaid Grantor, Eor a valuable aoneideration
or 41.00 anA othar gooG nnG valuabla aoneideretion� oonveye �
to the Grantee the following described real estate in Juneau
County, State of Wisconsin, to-wit:
Lote one (1) and Two (2) in Block Eleven (11) of Whicher's
Addition to the Village, now City, of Elroy, Juneau County,
Wisconsin, except a parcel of land located in the Southweat
4uarter of the Northwest Quarter (SW� NW;) of Section
Thirty-three (33) , and the Southeast Quarter of the Northeast
Quarter (SW} NEj) of Section Thirty-two (32) , Township
Fifteen (15) North, Range Two (2) East, City of Elroy,
which is bounded by a line described as follows: Commencing
at the Northweat corner of Section 33; thence S 0° 19'
93" E, 1328.59 feet along the west line of said Section
33 to the Northwest corner of the SW� NW} of said Section
33; thence S 04° 35' 44" E, S1fi.17 feet to the ooint of
beginning; thence along the arc of a curve concave to
the northeast, radiue 738.50 feet (the chord of which
bears S 25° 26' S4" E, 204.75 £eet) a diatance of 205.41
feet to a point 20 feet Southwesterly and perpendicular
to the centerline of a spur track of the Chicago, Milwaukee,
St. Paul S Pacific Railroad Company; thence 5 33° 25'
E, 53.63 feet oarallel with said spur track; thence S
56" 41' W, 109.64 feet along the Northwesterly side of
Juneau Street extended to a point on the Southwesterly
right-of-way line of the Chicago, Milwaukee, St. Paul
s Pacific Aailroad property; thence N 33° 23' W, 320.51
. feet along said right-of-way to a point on the easterly
right-of-way of Second Main Street; thence N 0° 19' 43"
W, 180.49 feet along said right-of-way; thence 5 43° 95'
11" E, 219.08 feet to the point of beginning.
EXEMPT: Sectio❑ 77.2515)
218952
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:.\`:�,���i���:\:..,_ Departmen[of Safe[y and Professional5ervices
/-i � -'��r\ Division of IndustryServices
� I `�!�� Plumbing Product Review
U
`^, j �S �;� 4822 Madison vards Way
\ P � P.O.Box 7162
j, ` S Madison,Wismnsin 53707-7162
�y �—�y:� Phone 60&266d112
J ��Lss�pua��` Webhl[o://d;us.wi.eov
Email dsps@wisconsin.gov
Governor Tony Evers Dawn[rim,Secretary TTV:ContactThrough Nelay
May 31,2022
Dept.of Safety and Professional Services
Bureau of Technical Services
Division of Industry Services
Brad Johnson-Section Chief
4822 Madison Yards Way
Madison WI 53705
Re: Description: POWTS Componen[Manual
Manufac[urer. Dept.of Safety and Professional Services
Product Name: Pressure Distribution Component Manual for POWTS(Version 2.1);(May 2022-2027)
Model Number(s�: v.2.1
eSLA PTO No.: PP-091800089-PTOVPCR
The specifications and/or plans for this plumbing product have been reviewed and determined to comply with chapters SPS
382 through 384,Wisconsin Administra[ive Code,and Chapters 145 and 160,Wisconsin Statu[es.
The Department here6y issues an approval based on the Wisco�sin Statutes and the Wisconsin Administrative Code. This
approval is valid until the end of May 2027.
This approval is contingent upon compliance with the foliowing stipulation(s):
1. A copy of this approval letter sha�l be submi[ted with all plans using[he Pressure Dis[ribution Component Manual for
POWTS(Version 2.1�;(May 2022-2027)
Plans submitted without a copy of this approval letter may he denied.
2. This approval recognizes that POWTS systems designed,instalied and maintained in accordance with this manual will
provide treatment and dispersal of domestic wastewater that is acceptable in the content of ch.383 Wis.Adm.Code.
3. Systems ins[alled in accordance with this POWTS Component Manual shall use wastewater tanks approved by the
depar[ment. If a given tank is approved and meets the published specifications contained in the manual,then
redundant approval of the tank is not required. The installation shall not compromise the structural integri[y of the
tank.
4. Systems installed in accordance with this POWTS Component Manual shall be instailed,maintained and used in strict
accordance with[he manufacturer's published instructions,Chapters 381-387 Wis.Adm.Code and this product
approval. If there is a conflict between the manufacturer's ins[ructions and the Wis.Adm.Code or this Plumbing
Product Approval,then[he Wis.Adm.Code and this Plumbing Product Approval shall take precedence.
5. Complete operetion and maintenance instructions POWTS systems designed in accordante with this manual shall be
provided to each system owner and remain onsite.
6. Systems designed in accordance with this manual shall be installed by persons holding the proper license or
registration in accordance with Wis.Stats.4 145.
7. Drain,was[e and vent piping used to install these systems shall conform to s.SPS 38430(1),(2)and(3)Wis.Adm.
Code.
Dept. of Safety and Professional Services
May 31, 7_07_2
Pa�e 2 of Z
eSLA PTO No.: PP-091800089-PTOVPCR
ft. ❑eanouts shall be installed in drain piping associated with the installation of these systems in accordance with s.SPS
38235 Wis.Adm.Code.
9. Commercial food processing,food production,food service, restaurants,taverns and similar establishments which
-may generate greases,fats,oils orsimilar substances;shall havestate-approved grease'mterceptors installed
upstream of POWTS systems designed in accordance with this manual in acwrdance with s.SPS 38234 Wis.Adm.
Code.
10. DSPS VOWTS plan approval shall be obtained from the department's Private Sewage Section,or the appropriate agent
county,for
a. each installation of POWTS systems designed in accordance with this manual;and
b. high-strength and/or commercial POWTS systems designed in accordance with this manua�.
11. A sanitary permit shall be obtained, in accordance wich s."SPS 38321 Wis.Adm.Code,from the county, or other local
authority having jurisdiclion,for each proposed installation of systems designed in acmrdance with this manual.
12. A mmpieLe and acceptable soil evaluation report, conforming to s.SPS 385.40 Wis.Adm.Code,shall be performed for
all proposed rystems designed in accordance with this manual.
Technical notations:
a. This approval supersedes the approval issued September 11,2018 under product file no.20180223.
he department is in no way endorsing this product or any advertising and is not responsiblc for any situation which may result
from its use.
Sincerely,
Brad Johnson—Section Chief
Department of Safety and Professional Services � .
6ureau ofTechnical Services . � . �-
Division of industry Services
Phone: 920 492-5605 �
Email: 6radlevJohnson��VJisconsin.gov_
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7128122,&27 AM Real Property Lis[ing Page
Real Estate Sawyer County Property Listing PropertyStatus: Curtent
Today's Date: 7/28/202Z Created On: 2/6/2007 7:55:05 AM
�Description Updated: 2/27/2020 � Ownership Updated: 2/27/2020
TaxID: 2179 CHRISTOPHER W MLEJNEK RICELAKE WI
PIN: 57-002-2-40-08-17-5 OS-004-000020
Legacy PIN: 002840175402 Billing Address: Mailing Address:
Map ID: :4.2 CHRISTOPHER W MLE]NEK CHRIS70PHER W MLEINEK
Municipality: (002)TOWN OF BA55 LAKE 2520 19 1/8 ST 2520 19 1/8 ST
STR: 517 T40N R08W RICE tAKE WI 54868 RICE LAKE WI 54868
Descrip[ion: PRT GOVT LOT 4 m
Recorded Acres: 0.680 r Site Address ' indicates Private Road
Calculated Acres: 1.912 8599N SHADY W * HAYWARD 54843
Lottery Claims: 0
First Dollar. Yes 1..� Property Assessment Updated: 9/13/2012
Waterbody: Grindstone Creek 2022 Assessment Detail
Grindstone Lake
Zoning: (RRl) Residential/Recreational One �ode Acres Land Imp.
ESN: 445 G1-RESIDENTIAL 0.680 252,000 85,300
2-Year Comparison 2021 2022 Change
�� Tax Districts Updated: 2/6/2007 Land: 252,000 252,000 0.0%
1 State of Wisconsin Improved: 85,300 85,300 0.0%
57 Sawyer County Total: 337,300 337,300 0.0°/o
002 Town of Bass Lake
SR478 Hayward Community School District
001700 Technical College
Property History
, N/A_... ._ . .
. Recorded Documentr Updated: 9/13/2021
QUIT CLAIM DEED
Date Recorded: 4/16/2021 431257
DESIGNATION OP TOD BENEFICIARY
Date Recorded: 9/10/2021 4346D2
WARRANTY DEED
Date Recorded: 12/12/2008 357295
hrips://tas.sawyercountygov.orglsystemlframes.asp?uname=Enc+Wellauer 1l1
Oftice of �-��
� �
Sawyer County Zoning and /,`��?���
Conservation Administration <�; ���
10610 Main Street, Suite 49 ✓ �
Hayward, WI 54843 �N p r_��
Fa.Y:(715)G38 8�88 z��/s���'�R ����j� 0
URL:http:/,lsa��.ycrcountti'��ov.� '�iy�ti�O�N
EmaiL•z_onine.sec�u sawyercounty�ov.or�� ST��Y
--�----
Toll Free:Courthouse/General Information �
1-877-699-4110
Sawyer County Zoning and Sanitation "As - Built" Form
Property Owner's Name �,��c3 /b��r' �L eJ n��e
Fire Number and Road Name � �f�9 g 's�"`�`, �'�
Plumber's Name ��r`1✓�3 ��`^ ' ' " ���
Date of Installation �� � ^ �'a �'�i3 � �"'�
County Sanitary Permit Number a a � � 70
12 Digit Parcel Number # �p a 'gY0 — / � — s S�`�a
Desci•iption and Elevation of Benchmark h��' � 02 Y � �''�- �L �O�' `� New
Tank Manufactu►•er and Capacity Px�S��j a�O G4 � ��`'�� �� ���'� ���
G����I�
Setback-Tank to Nearest Lot Line 7s (
t
Setback-Tank to Nearest Well �
---- -�— —
Setback-Tank to Building _ �
Cell Width � � °�'�
Cell Length �S
Number of Ceils _ � __ ___
�
Setback-Cell to Nearest Lot Line �S
(
Setback-Cell to Nearest Well ��
---- �
Setback-Cell to Building _ / 3� _ ____
Setback-Cell to Navigable Water _�DO �
Make and Model of Dispersal Unit ��o �- �
Make and Model of Filter � z de�l P�'
Make and Model of Pump _ __/l� �g
- Please complete othet� side -
"As-Built Plot Plan"
Elevation Data
Benchmark /o��� Please include the followin�:
Building Sewei� ��y �
Tank In 6 �� k • Location of observation and vent pipes
Tank Out � 6`` � Feet of riseis used on tank(s)
Dose Tanlc In C� � � "' • Location of benchinai•k and North arrow
Dose Tank Bottom o `/v" • Location of all components
Header or Manifold . S • Length of pipe between components '
Distribution Pipe �l o • Number of chamber units in each cell
System Elevation ��o • Location of well, lot lines and i•oad �
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