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Home My WebLink About014-941-05-5101-SAN-2022-266 ��" "'�. Induslry Services Division County (� 4822 Madison Yards Way SAWYER � ;```�_' = Madison,WI 53705 Sanitary Permit Number(to be filled in by � �. = P.O.Box 7162 / `- ' Madison,Wl 53707-7162 CP 3 � �.s� � '".;;:,�.,,,, Sanitary Permit Application State Transaction Num�r � In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit � is required prior to obtaining a sanitary pertnit.Note:Application forms for state-owned POWTS are submitted to Project Address(if different tfian mailing a � the Depariment of Safety and Professional Services.Personal information you provide may be used for secondary � pucposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. � I.Application Information-Please Print All Information Property Owner's Name Parcel# Peter Mayou O!u` U/�Q� s(0 7 T Property Owner's Mailing Address Property Location 12064N State Hwy 27 Govt.Lot 1 City,State Zip Code Phone Number Hayward,W( 54843 �/,, '/., Section � II.Type of Building(check all that apply) Lot# T N R E of� �1 or 2 Family Dweliing-Number ofBedrooms 3 Subdivision Name Biock# � ❑Public/Commercial-Describe Use ,� ❑City of ❑State Owned-Describe Use CSM Number ❑Village of ,_. �Town of Lenroot [lI.Type of POWTS Permit:(Check either"New"or"ReplacemenY'and ot6er applicable on liae A. Check one box on line B.Comptete line C i a licable. A. ❑ New System �Replaceruent System ❑ Other Modification to Existing System(explain) ❑ Additional Pretreatment Unit(explain) s•�, o,nl B' ❑ Holding Tank �In-Ground ❑At-Grade ❑ Mound ❑ Individual Site Design ❑ Other Type(explain) (conventional) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner ist Previous Permit Number and Date Issued Expiration Q�...1�` �_�'�O v IV.Dispers9U'Treatment Area aad Taak Information: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� Systcm Elevation 450 .� 6y2-y yx Y�F�.sr.,, 89.50 Capacity in Total #of Manufacturer Tank[nformation Gallons Gallons Units p � o � � New Tanks Exisling Tanks � o v � y � � n# a. U 'v� � rn i�, C7 0, Septic or Holdiog Tank 1060 1060 1 'nfilUator Dosing Chatnber V.Responsibility Statement- I,the uodersigned,sssume responsibility for iostallation of the POWTS s6own on the attached plans. Plumber's Name(Print) Plumber's Sign re MP/MPRS Number Business Phone Number Gerald Ercemel � 950111 715-558-1138 Plumber's Address(Street,City,State,Zip Code) 13502W Frcemel Rd Hayward,W1 54843 VI.C untyfDepartment Use Only �A d ❑Disapproved $ertnit Fee Date Issued Issuing Agent Signature ❑Owner Given Reason for Denial �� a�I�-a � Conditions of ApprovaUReasons for Disapproval � a�a�e.__��a-a-��a_ __ _�.�.»� � �j�� f �� `�� ' �� ,��a _� �v�lq _ ___ �;1 f, � � SEP � 1 2022 'J� CS�` �n _ `�� N�_ �!`�Qr_��_�3533 —� .� � oL I�� SAV1iYE�� C�'Oi>',��Y � �- - AnacL to complete plaes fer the system ard sabmit to t6e Counry oely on paper eot kss than 8�rz:11 inches io size ��3 g NO REFUNDS AFTER SBD-6398(R 03/21) IiSUE�F PE�irJ11'f� Peter Mayou Property Owners Name 12064N State Hwy 27 Property Address 014941055101 Tax Parcei Number Sawyer County 1 Gov Lot or Qtr-Qtr/Qtr S5 Section T41N Town R9W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 6 Maintenance Plan 7 Contingency Plan Gerald Froemel Plumber's Name � Plumber's Signature 950111 Plumber's License Number 715-558-1138 Plumber's Phone Number 09/21/22 Date Not an endorsement,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Products Inc.,Skaw PreCast Co.,Huffcutt Concrete Inc.,Zabel Environmental Technology,ITT Industries(Goulds),The Pentair Pump Group(Myers), Infikrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,Simlfech Filter Inc.,Sta-Rite Industries, Page 1 of 7 ow��r: L��. (��(-�!��i C�i�r�51"��t 2 l'�l. �`''�cz�o c-t.. Saw�e r C0.� Le v�ro o'� T�-�'�- 120(o�-f i.) 5"'E- l�}'w� Z-( t�t� C�l�l-�`fl_o5-S/o! 1-�-��,.�c�� `�1 5�a43 5 o S T' u�r� (�D 4 w 'It5-(,3`-F- 31-18 t a-�l-Go� l,� l (D.Ffcc.L. � s�a�e l"_ �-to, �� o io Lo 30 40 Ctu,r41E J l Z y ll� ''a`� ulell V � \ � � E-- 'To ({w�( z�7 �I de<� o �, gv�ioo 0 I � " 3 Z � /►art�oo n��l,�;b6o,� 3'��sns��e 3�' �0.k �(. R3.Oz' � I z. RZ.oB' ' 3 9z.�5� +l p/ ! rv�p/15 f S l/ �; � Z so'��s�S�s�e�• 54,5� i � ra�•�e. SZ.'15'_rd4S�� EsE ST ir�1 q3'-�l�-I` In-Ground Soil Absorption SBD-10705-P (N.01/01) Version 2 • 1 Component Manual Used 3 Number of Bedrooms Percent Slope (%) Depth to Soil Limiting Factor (in.) 0.7 In Situ soil application rate 300 Estimated Wastewater Flow (gpd) 450 Design Wastewater Flow (gpd) 1 Number of System Elevations Ci� n� 89.5 Proposed System Elevation #1 Proposed System Elevation #2 Proposed System Elevation #3 Original Grade #1 92.5 Finished Grade #1 Original Grade #2 Finished Grade #2 Original Grade #3 �i� Finished Grade #3 �x;sT7 l.��;� �rG�d� trator Quick 4 Standard Chamber Type 1 Height of Chamber (in.) 20 s 2 R f Chambers 5.1 sq.ft. per pair of end caps 3 Distance s (ft.) 22 Pr umber ambers Used 6 Minimum Distribution Cell uired (sq.ft.) RROR Distribution Cell Area Proposed (sq.ft. Infiltrator 1060 sSeptic Tank ose an (if applicable) Lifetime ��LL :Effluent Filter ""`select only if NOT using combo tank Surface Depth to System Soil Boring Grade Limiting Lowest Highest Elevation Number Elevation (ft.) Factor (in.) Elevation Elevation Acceptable 1 93.02 96.02 91 .77 FALSE 2 92.08 95.08 90.83 FALSE 3 9 .75 95.75 91 .50 FALSE 4 5 Page 2 of 7 Peter Ma ou 12064N State Hwy 27 1.49E+10 Number of Bedrooms 3 Septic Tank Infiltrator 1060 Est'tmated Flow(average)gal�ons�day Effluent Filter Li etime D8Si9n FIOW(peak),(Estimated x 7.5)gaVday 450 Pump Tank #N/A Soil Application Rate gal/daylftZ 0.7 Pump Type I�fluent/Effluent Qual' Monthl Average Fats,Oil&Grease(FOG) 30 mg/L Biochemical Oxygen Demand(BODS> 220 mg/L otal Suspended Solids(TSS) 150 mg/L '!N OTE!! Servicing frequency of 12 montFis or less requires the Management Plan be recorded with the Register of Deeds. Maintenance Schedule Service Event Service Frequency Inspect condition of tank(s) At least once every ear Pum out contents of tank(s) When combined slud e and scum=1!3 of tank volume Inspect dispersal cell(s) At least once every 3 Year Clean effiuent filter At least once every 3 Year Inspect pump,pump controls&aiarm At least once every Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:Master Plumber,Master Plumber Restricted Sewer,POWTS Maintainer,Septage Servicing Operator. Tank inspection must include a visual inspection of the tank(s)to identify any missing or broken hardware,identify any cracks or leaks,measure the volume of combined sludge and scum and to check for any backup or ponding of effluent on the ground surface. The dispersal cell(s)shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a tailing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of siudge and scum in any tank equals 1/3 or more of the tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch.NR 113,Wisconsin Administrative Code. A service report shall be provided to the County Zoning Department within 30 days of any service event. Start-Uo and Operetion For new construction,prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatment process and I or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank removed by a licensed Septage Service Operator. System start-up shaii not occur when soil conditions are frozen at the infiltrative surtace. Page 6 of 7 Do not drive or park vehicles over tanks and dispersal cells. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fat, foundation drain (sump pump)water, gasoline, grease, oil, painting products, pesticides, sanitary napkins, tampons, and water softener brine. Abandonment When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with Wisconsin Administrative Code SPS 383.33; -All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. -The contents of all tanks and pits shali be removed and properly disposed of by a Septage Servicing Operator. -After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. Continaencv Plan If the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide a code compliant replacement system: (Check One) " The site has not been evaluated to identi(y a suitable replacement area. .Upon failure of the POWTS a soil and site evaluation shall be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be instailed to repiace the failed POWTS. A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area shouid be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed sWctures, lot lines and wells. Failure to protect the replacements area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Repiacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may be installed to replace the failed POWTS. ,n Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do not enter a septic, pump or other treatment tank under any circumstances. Death may result. Rescue of a person from the interior of a tank may be difficult or impossible. POWTS Installer Septic Pumper Name Gerald Froemei Name s,Scott Poppe Phone# 715-558-1138 Phone# '(715)'634 1450 POWI'S Maintainer Local Regulatory Authority Name Jays Septic Agency Sawyer ounty Zoning Phone# 715-55 -1 Phone# 715-634-8288 Page 7 of 7