HomeMy WebLinkAbout014-942-23-2305-SAN-2022-192 _,t` � [�V Department of Safety c°°"ty �
�,• = v I & Professional Services, s�`�'`' Gr — �
, � _ : � Sanitary Pertnit Numbcr(to be filled in by Co.;
� ��, �_ , �j Industry Services Division
�� � , ,�; �- ,,�1 r � 3� , �� . �..,
.,. . �I - �..�
Sanitary Permit Application StateTransactionNumbe= �
In accotdance with SPS 383.21(2),Wis.Adm.Code,submission of this forrn to the appropriate governmentai unit .�
is requircd prior to obtaining a sanitary permit.Note:Application forms for state-owned POW7'S are submitted to Project Address(if different than mailing addr '�j
the Department ot�Safety and Professional Services.Personal information you provide may be used for secondary �1
purposes in accordancc with the Privacy Law,s. l_5.04(I)(m),Stats. ��� ^q�l a"�3:-�3Q,�
I.Application Information-Please Print All Information
PropeRy Owner's Name Parcel#
a� { � B do. Wo.l KK I 3��1 E�;c Ksan 2c►:
Property Owner's Mailing Address PropeRy Location
rl o�$`U t�` _ , '
City,SYate 7ip Code Phone Number
L�jn Id,A.��n � W= ��1e�0 0l S W '/4,�11�_'/�, Section �3 -
IL Type of Building(check all that apply) l.ot# � T a N R 09 �o
�I or 2 family Dwelling-Number ofBedrooms_� Subdivision Name
I31ock tt ^-
❑Public/Commercial-Describe Use
❑City of _ ___-
❑State Owned-[�scribe Use CSM Number ❑Village of
CS M� �+�a� �"I'own of �..Glll`04�___
V•�S • ►l,1
111.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 System p y
❑ Re lacement S stem ❑ Other Modification to Existing System(explain) Additional Pretreatment Unit(explain)
B' ❑ Ho(ding Tank �In-Ground ��,prrd.� ❑ At-Grade ❑ Mound ❑ Individual Site Design ❑Other Type(explain)
(conventional)
��- ❑ Renewal Before ❑ Revision ❑ Change of Plumber .�st Previous Permit Number and Date Issued
❑Transfer to New Owner
Gxpiration "—
IV.Dispersal/Treatment Area and Tank Information: pp (xoy�,q� i,n 9.S x sa 4'f ft 1/
Design Plow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(sfl Dispersal Area Proposed(s� Sys[em Elevation
yso ,. o yso y�s � gy. ga FE
Capaciry in Total #of Manufacturer
�
Tank Infortnation Gallons Gallons Units � � v � ^
New Tanks Existing Tanks � o " � y L c3 c�'e
CGSY�n�DC'� n. U v� � c� w C7 Ci,
Septic or Holding Tank �
� 000 i e r
Dosing Chamber �O� .� �O�
V.Responsibility Statement- 1,the undersigned,assume responsibility for installallon of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Si atur• MP/MPKS Numbcr Business Vhone Number
l3'C tY'w I� �C O C M E � � 7 SO�I I 7 - SS -�I 3
Plumber's Address(Street,Ciry,State,Zip Code)
1.35�� W Froer�e_� Rc1 1-�Qyward, w� stisy3
V L County/Department Use Only
�,Ap � d ❑llisapproved Permi[Fee Date Issued Issuing Agen[Signature �
�,,, $ '�oo�� �� ��a a � �—
❑Owner Given Reason for Denial
Conditions of Appto3'altReasons for Disapproval S-- �--_
��`� �, �;� ���� �?
aa �---1 �� �-�-?,��
��I I N� -...�... �.��_ � ;�
c �;�:
Chk# l�� I A�� 0 5 ZQ22 --
�. ST' � I "- � l � RCpt#t�Q,..w (n1_�rld � �8�3 SAWYER COIJNT'�`
�j ZONl1VG ADMiNISTR/�T ON
Attach ro complete plans for the system and submit to the County onty on paper not less than 8�2 x I 1 inches in size
NO REFJNDS AFTER
M SBD-6398(R.03/22) ISSUE OF PERMIT � g���
� �
GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN
Residential Ap�lica?��or
INDEX AND TITLE PAGE
nerinfo . . _
Project Name: Walkky-Erickson Rd
Owner's Name: Jack&Brenda Walkky
Owner's Address: 73 250th St
Baldwin,WI 54002
roperty Info
Property Address: Erickson Rd(no address yet)
Legal Description: SW NW S 23 T 42 N R 9 W
Township Lenroot County: Sawyer
Subdivision Name:
Lot Numbec 1 Bbck Number. CSM#: 6728
Parcel I.D.Number: 014-942-23 2305 _
Plan Transaction No.
In ex ages _ :
Page 1 Index and title Page 9 Plot plan
Page 2 Data entry Filter specifications
Page 3 GeoMat dist.cell drawings&calculations
Page 4 Lateral and cell cross section
Page 5 Management&contingency
Page 6 Maintenance 8 specifications Pump Specifications
Page 7 Tank cross sections
Page 8 Distribution media
6r�...��0.�.d..,e � Jr-',3?�j//�
r License Number: -4�
Date: OS/02/22 Phone Number �»-�—
��� 7�.�=.s-.sa—ii3�
Signature:.�s✓G�
Designer Stamp: State of Wisconsin Approval Stamp:
Designed Pursuant to the
GeoMat In Ground Component Manual Ver.June 26,2018 Version
Page 1 of 10
In Ground and Dosing Distribution Component Design
Site Mformation
R Residential or Commercial Design N ISD Required?
300.00 Estimated Wastewater Flow(gpd)
7.50 Peaking Factor(e.g. 1.5 = 150%)
450.00 Design Flow(gpd)
0.00 Site Slope (%)
94.92 Prop. System Elevation (ft)
54.00 Depth to Limiting Fac[or(in)
1.00 In-situ Soil Application Rate(gpd/ftZ)
97.25 Lowest Original Grade Ele. In System Area (ft)
97.46 Highest Original Grade Ele. In System Area (ft)
92.75 Limiting Factor Elevation (ft)
1.04 Depth Below Grade
s ribu on ell information
3.25 Cell Width (ft) 2 Number of Cells
2.00 Dispersal Cell Design Loading Rate (gpd/ft2)
2 Influent Wastewater Quality(t or 2)
Distribution Infortnation
E Center or End Manifold, Dist. Box or Drop Box
� Number of Laterals System dosed Y
3.00 Lateral Spacing (ft)
73.40 Forcemain Drainback (gal) Does the forcemain drain back7 Y
0.50 Forcemain Filter Loss (ft)
2.00 Forcemain Diameter(in)
450.00 Forcemain Length (ft)
87.00 Inside Pump Tank Elevation (ft)
3.50 System Head (ft)x 1.3
10.02 Vertical Lift(ft)
6.26 Friction Loss (ft)
2028 Total Dynamic Head (ft) Designer must enter friction �oss and system demand (gpmi
115.40 Minimum Dose Volume (gal)
25.00 System Demand (gpm)
Manufacturer Intortnat on
Treatment Tank I�formation Effluent Filter Information
1000.00 Septic Tank Capacity (gal) Lifetime Filter LLC Filter Manufacturer
Wieser Concrete Products, Inc. Manufacturer LT 1/8 Filter Model Number
Dose Tank Information Galions/lnch Calculator(optionali
602.82 Dose Tank Capaciry (gal) 602.82 Total Tank Capacity(gal)
11.82 Dose Tank Volume(gal/in) 51.00 Total Working Liquid Depth(in)
Wieser Concrete Products, Inc. Manufacturer 11.82 gal/in (enter result in cell DoseTankVolume)
Project: Walkky-Erickson Rd Page 2 of 10
In Ground Plan�ew
Z eev G'veoPvfat
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
•' 00000000000000000000000000000 �g 000000000 :•
•� o°o�o°o°o�o°o°o°o°o°o°a°o�o°o°o°o°o°o°o°o�o°o°o°o°o°o°o�o ��1�Y1L5� o°o°o°o°000000000 �.
0000000000000000000000000000 00000000
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 0000000000 � � � 00000 � � � � 0000000� o � � � 0000000� � o� �
0000000000000000000000000000000000000000000000 •
0000000000000000000000000000000000000000000000 .'
0000000000000000000000000000000000000000000000
. oo°o° o°o°o�o°o°o°o°o°o°o°o�o°o°o°o°o o°o°o°o°o°o°o°o°o�o°o 0 0°0°0°0°0�0�0°0�0°0�0�0°0°0°0° '
— — � —
3 cu ations _
I ft A 325 ft Basal Area Required 450 ft�
K 1 ft B 50 ft Basal Area Pro osed 475 ftZ
S 1.00 ft L 52 ft
W 9.50 ft
Basal Area Calculation GeoMat Dispersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
450 1 gal/sq ft/day 450 2.00 gal/sq Nday
Total 450 ft� Total 225 ftZ
Pro osed 325 ftz
Number of Celis 2 GeoMat Width 325 ft
Cell Length ft Lineal Feet of GeoMat Required 69.2
Min. Cell Len th 34_6 ft lineal Feet of GeoMat Pro osed 100
Cell Spacin 1.00 ft NOTE:Min S dimension= 1'
S stem Elevation 94.92 ft
Limitin Factor 92.75 ft
Separation 2.17 ft z�Mr�
Directions
Play with cell length to get desired cell spacing. length and width. Remember system SHOULD be !onger than i? is
wide. It must alse Satisf� basal loadin rate and GeoMat cell loadin rate
Project: Walkky-Erickson Rd Page 3 of 10
End Connection lateral Wyout DiaQram
�-
�
Hole spacing is every 17', V2"hole at 4&8 O'Gocic,starting 4 O'clock 6"from end and
8 O'clock Holes a�12"from entl.
Lateral Spacing 3A0 tl Pipe Diameter 4.00 in
. s ... O _ e . O .. .. .. ..... ... . . .. . . ....
97.46 ft � Finished C:nAe �N'� V V'`7 W V
.. :.. Di�Ulbatim
12 a18" xa+rn [a�llevrl
i.oatt — I Co.�rnoommmeea ..
� -. -�`'''.
4 in --► PipCIhL - . '(�zu , :����F�
� �.+ �a i�_.
., ... ' . ' � ,_.�
ToOofgeomattobeato ��. _ -- - • � � �_GEOM�T
below original grade � I � I � I ' 2.��33 c� I i 1 , I � I � 1 Campt�
[aflIIeSve S\aSce
` _____NATIVESOIL-_-_l-�
sa e _. 1�
--�------�__--- � C,-,"ni�qFau
servat on pes . . . .. .. . . . .. ... . .
���
9�.asft "'�°°°�°°
, <•.va.
12"Min. '.... � � \I
48"Max. '�. r
�
T.,an n.Nu. I / \ . .-v.wr
Y?i54. � bm.�aem��
�:r.s �� �
. i.._ _ _ ._ . . . i _
oeaur =4i
c��sermuwa]�� ?re a��.J,
c
�i'13'A4�MUJJ�����''�
9492 ft
ProjecC Walkky-Enckson Rd Page 4 of 10
Notes/ Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in accordance wdh SPS 383,Wis.Admin.
Code,the in-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0 SPS-10705-P
(N.01/O7). GeoMat in ground Component manual Version 1.
1.This POWTS has been designed to accommodate a maximum daily flow of 45QjgRons 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 mglL BODS
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 result in exceeding the enforcement
standards and preventative action limits specified in ch.NR 140Tables 1 &2 at a point of standards application,except as provided in DSPS
383.03(4),WisAdmin.Cotle.
2.The owner of this POWTS is responsible for system operation and maintenance.
3.Defects or malfunctions identifed during maintenance described above shall be repalred in conformance with SPS383 Wis.Admin_Code,
and the pertaining county Private Sewage Systems Ordinance. The user's manual,provided to lhe owner of the POWTS fncludes the names
and telephone numbers of the properly licensed intlividuals to contact for such repairs.
5.No product for chemical or physical restoretion or chemical or physical procedures for POWTS may be used unless approved by the Dept.
of Commerce in accordance with SPS.384,Wis.Admia 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 padicle size less tha�or equal to V8". Pilters should be cleaned once in spnng,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 approzimately at the end of each cell.
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,Float,electrical outage causes the dose tank to f II,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. I.E.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 fn 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 approved materials to make joints water-
tight
B.Outlet Filter.The outlet filter 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 bewme 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-tight.The pump and controls shall be
replacetl when they are no longer wpable of functioning accortling to the design plan.
D. Pressure Distribution Piping.PaAial clogging of the distribution network may resWt in unduly long dosing cycles.The ends of the
. -.. _ ���seJ and the threaded end caps removed.The piping can be disconnected on the outlet end of the pump.
The u��i��bution 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 licensetl plumber.
E.Sofl Absorption CeIL The discharge of sewage or wastewater to the gmund surface is strictly prohibited due to the human health hazard
created by the effluent.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 surtace via the soil absorption cell.The existing septic tank and
__cir.y c`:.a�ber 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 onty after any necessary plan approvals have been obtained from the
appropriate plan review authority antl the required sanitary permit is obtained from the county.
Project: Walkky- Erickson Rd Page 5 of 10
In Ground System Maintenance and Operatfon Specifications
Service Provider's Name Gerald Froemel Phone 715-558-1138
POWTS Regulator's Name Sawyer County SPIA-Zoning Administration Phone (715)634-8288
Svstem Flow and Load Pareme[ers
Design Flow-Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 300 gpd Maximum BODS 30 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 162.5 ft Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform t0E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Ins ed and/or service once eve 3 ears
Effluent Filter Ins ect and clean as necessa at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test eriodicall
Pressure System Laterals should be flushed and ressure tested eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Materials Standards
t. Observation pipes are slotted and materials confonn to Table SPS 384.30-1, have a watertight cap
and are secured in as shown in the GeoMat In Ground Component Manual Ver. March 20, 2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the GeoMat In Ground Component
Manual Ver. March 20,2017. 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. Scarification of basal area is accomplished with a rake or other tool.
5. All disturbed areas will be seeded and mulched to prevent soil erosion and help reduce trost penetration.
Laterel Turn-up Detail
6-8"Diameter Finished Threaded Cleanout
�. Lawn Sprinkler Grade \ Plug or Ball Valve
Box \
�
� Lateral Ends at Las[Orifire Where
Long Sweep 90 or Two
��45 Degree Bends Same
Diameter as Laterel
. i,- -.r,,.
Distribution Laterel Lateral Cleanout
94.92 Feet
Projed: Walkky-Erickson Rd Page 6 of 10
PAGE * OF �
GRAVITY-DOSED ? ��
SEPTIC / PUMP TANK SPECIFICATIONS
,.,OVentPi� (No Scale)
>10ftfrom
Building Eleclnfal must compty with
'12'Min.or 20 ft above COMM i6 and NEC 300
Eslablished Floo�Elevation Weatherpraof E�.ientl manhole nser as necessary-
(lYPicap Juriclion Box
Approved qpp��Ey Locking Manhole
IMPORTANT: Veo1�P ���h Waming l.abel Aitached
Anchor tank(s)as necessary (�YP��I�
pursuant to SPS 383.43(8)(g) —co�d�a
4"Min_or 20 fl above
Established Flood Elevation
(typiral)
�Airtighl5eal '
Finished Grade
" �uick DisconneG
18"Min.
CAPACITIES @ ���82 gal/in y . (`Y�"a�>
Depth(in) Vo I) • a �
1
A 26.6 314.41 'k �weeP �—APP�o�ed�o�����n
''�Hole APPmved Pipe 3 fl mto
Liquid sord c�a�a
B 2.� 11.82 A peP(h '. Force Main (�vvi�)
� Filter*
[C] 14.4 122.93
�Alartn - '�nstall and maintain pursuant
D 12.0 141.84 -B�--� II o„ to manufacmrer's instruceons.
� � PUMP-OFF
�c �j1 � PumP orr ELEVATION = 88�00 ft
Pump Tank Liquid Level = in
�
° INSIDE BOTTOM
Force Main Diameter= 2 in c°""a`e
B1oa1c ELEVATION = 87�00 ft
3"Approved Bedding Matenal Benealh Tank
Force Main Length = 4�
Force Main Void Volume = 73.35 9al
[C] Total Dose Volume (TDV) = 122.93 galldose
��
(<02X design Flow+force main void volume)
Vertical Lift = 9'33 ft
PUMP TANK: SEPTIC TANK(S):
Volume = 6�2.82 gal Total Volume = 1000 gal
Manufacture Ser Concrete Inc Manufacturer(s): Wieser Concrete Inc
Pump Manufacturer: Liberty
Install approved force main filter pursuant to
Pump ModeL 283 ��a„a�n�P„mPG1Ne.> manufacturer's instructions.
ControislAlarm Manufacturer: SJE Rhombus Filter Manufacturer: Simtech
Controls/Alarm Model: Tank Alert EZ
Filter Model: STF-100
Float switches containinq mercury are prohibited.
GeoMat Distributlon Celi Medfa Layout
3 25 Cell Witlth(ft) 2.63 Sitlewall to Lateral((t)
Distribution Cell Cross-section Arrangements
__ _ p _ __ fl _ _ _
_ s _
B � . .end . . .
O Distnbution Pipe
GeoMat is coveretl wilh approved geoteutile faDric as per the lheir product approval.
Distribution Cell Plan View Layout-Typical
325 Cell WiAth-A(ft) 50.00 Cell Leng[h-B(ft)
� � �. � � ` .� � �� � � .�. � � ���
� � � �... � � _. �� ��:
:.. . .� �.. _. . .. .. . .. .. _ _. . ._ _._ ��.o."c c.� .. _. ._�-_.
. . . .. . . .P Ca Perse . .. �
FeeLheA(irnAe �v ��v WY
� '_.' . . `._. DssQ131[bm
SmCCo.a- -- -
12 a8"�� °i1rn -. IatcilI.evel
I _T.. '
f
pipe p�a - � '�u�,. \ , F�
. .. ' P�K "__
-_ _— _��'FAMAT
� � � � � � � 2'ASIM_33°�' � � � � � ' � ' � Ia5luarive Surfice
� - ---NATIVE.SOIL-__J�J�
� I-�== - - -� ���_____ --- T.ri+aFactQ
See tletails on page 4 for number,s¢e,anU spacirg W laterals.
Project: Walkky-EnCksOn Rd Pa9e 8 Of 10
� I�o� P �.A rJ
�7c,� er: Leq� ( ..,
Kc�s�ihe M. Boeckw�4hn- � IDrciSSe�r ,j�,.,.�er co.� Levlc-ooT Lw�.
fZ9pI -1 �`' S-I-. Piwf : Oly -4'�z - 23 — z3o5
D Ss�o � t,�7 I Sy�S� Sw�N W ,� Z3 T 4zr.S �. 04w
5�'�'c : a h E�(`ic�So,� � -i�etso,.i (��L� L o-� 1 CS F-� ZS'�(6� � 6'IZ3
f So� �
Sca� (' -5D'
Er,�,./�roN in 50:� �'es'f' acew o�t,�� �
2d
7�
e .o � �o w so
BMl00�i na:�� (Z:�bo„� 3',�� Wes� sd� S��N�aPle
si. ti,.���
Z G,.Zs�
3. 4'7.46'
�+
.S So.�S
� P(f� -f-o des��v� Sewc.r sys�e.+� w.�-�
(�jeo �'14'�' + vl-�p�n d C-=+3 Sa�c(
,r �, Frccvvia:..� ��e,,., (.�o.�� fo
� S�sfe�.-i "F 45Y�'
3
; _ � ln%etl -�o w,�-E- Code s{-6ks
;,o I
� ► L � � Qr�il dY'��e�,.7c�`-' ^{'U b� GOKs'{r�cTe�
l
wes�- a.,, -1 t.}o��-h o� rzc�e�r ,
� � � 9 l. lo ' a.
O 1
n
�„pn��t�� @ GS� 1U00�CnUO�jG1. 'PreF-�.b CcmCrt�C.
��T��NV41� A CCm1bi'n0.�'2n'1 St��riG /�r�^� �Al{
1�tny5ofk �( Maa¢ c.R p �z�ab Co�ncr�el-e by
W �Y D C✓�C o.�e K�t I.,e w I
^GT 'i 'o ,JC.�m,�,Ce� STF1U0 F•' 1�u' a^G�
4"Wc Sc1�Yo
A� r - �e�nvW� � !,1 b[�+y a93 '� vrn
_ f
L T J /, ,2�
G /
pro� bld>s:�� :��id���
1
� `�/�s�����/
J
�
-� �J�
- �a9e 9 �� ��
� �qQ,Q, d_ cr C` -.-1-0
J
F ,
� �
I�ber Pum s• �_
p
V �, ; I:i
�'�
.
• • , • ,,�'�- ,; �
��,
' � - - � --
;
• - - -
• • • .
LITERS PER MINUTE
0 50 100 150 200 250
40 �2
i
10
�
�
30
i
I
---�--
i $
-�--
�
�
F w
w � W
LL �
Z !� I 2
W 20 I I ' 6 W
I
--t—
� f�"
I 4
-- - i
10 '
2
p 0
0 10 20 30 40 50 60 70
GALLONS PER MINUTE
� ° b�y
280 Pl RO10/7;2015 C`Copyright 2015 Liberty Pumps Inc. All rights rescrved. Specifications subject to change wi[hout notice.
�
-'���""'"`�'�- PRIVATE ONSITE WASTE TREATMENT �ounty
�.:, :�-.
„��
�-r': o ��', SYSTEMS SaWyer
-�',�Sps � � ( POWTS)
��: , `—, ;� ,
�'`�F�----;<r
�'s'��'-�^� '' INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION ,�� ..— �� �
Personal infonnation you provide may be used for secondary purposes [ Privacy Law, s. 15.04 (1)(m) ]
Permit Holder's Name: ❑ City ❑ Village � Town of: State Plan Transaction ID#:
`Sa�k �f--�re� WG��. ��o� '—
insp BM Elev: BM Description: Parcel Tax No:
�c� ,o ' Iv�a, \ �- �'�1�� 3` � w. s:� �� 8" � ,�`T o� y � �Ya - �3 -�3�5'
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic �,,,� - f po'o Benchmark (oa.a'
Dosing ^ �„�.,� (�vt� L
Aeration Bldg. Sewer �?.7S
Holding St I Ht Inlet 6�•33 '
TANK SETBACK INFORMATION St I Ht outlet �,�g'
TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet
AIR INTAKE
Septic ��o� N �, NA Dt Bottom �� .p Q �
Dosing h �, T �, Nq Installation
Contour
Aeration NA Header! Man.
Holding Dist. Pipe 56. � �
PUMP 151PHON INFORMATION Infiltrative
Surface �7Y•`�� �
Manufacturer � Demand Final Grade
Model Number � GPM c'3 `�S9 �
TDH �� Lift Friction Loss Sys Head TDH Ft
Forcemain L � �� Dia � " Dist. To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W q,s L ` # of Cells ) Type of System Distribution Media Manufacturer:
� Conv ❑ Aggregate /n�
SETBACK P I L Bldg Well OHWM of Nav � IGP c Chamber ea ►' ►(R
INFORMATION Waters � AG � EZFIow Model Number:
CELL TO S r- t� � _ �aD ' ❑ Mound � Other
- - — _ _ _ _- -- - -- -- -—
DISTRIBUTION SYSTEM X Pressure Systems Only
Hea�der I Manifold Distgbution Pipe(s) --- p �X Hole Size - XP oleg Observation Pipes �
Len th Dia Len th Dia S ac I S acin O Yes ❑ No
SOIL COVER
De th Over De th Over ; Depth of Seeded / Sodded Mulchetl
Ceil Center �Cel�l Edges I, Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
���-e� ���3�a�
� ��a`�
Plan revision required?0 Yes ❑ No � � i � i 6� � �
(7 3 6� 02� ---��- -- —J �
L _
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710 (R.3/01)
ADOITI�NAL COMMENTS ANO SKETCH
SANITARY PERMIT NUMBER: �--�_�_____
�'Nels�..., l�l,c�.�
/ �? \� o�-t� .
�� Qa .� [�
/ /
/ -
�
b`
��-sP
w� ol��P � ��
�s�°��:� �°f L
� ���
�
�
xr �
4�
I �
�O
�
� C� �,���ll� 3.�s'',c us�
�j� �f3m.
\�'� qs�
�--- �, �, �( �
��
r
-__ �� �,2t�s�., �d .