HomeMy WebLinkAbout008-938-33-5105-SAN-2022-267 1
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_"'""'"'`%: Department of Safety c01f�' �.
Sawyer `
;��\�_ ; &Professional Services, Sanitary Permit Number(to be filled in by i �
,J,� �, r= Industry Services Division
��; � (93q � S � �
Sanitary Permit Application State Transaction Number �
In accordance with SPS 383.21(2),Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit � �
is reyuired prior to obtaining a sanitary permit Note Appiication forms for state-owned POWTS are submitted to Project Address(if different than mailing a� �
the Department of Safery and Protessional Services.Personal information yo�provide may be used for secondary
purposes in accordance with the Privacy Law,s-15_04(I)(m),Stats. 2846N County Hwy F
I.Application Information—Please Print All Information
Property ONmer's Name Parcel#
Eric Hayden 0089383355105
Property Owner's Mailing Address Prope�ty Location
N1301 E County Rd.O Govt.Lot i
City,State Zip Code Phone Number
Mondovi WI 54755 '/,, Y,, Section 33
II.Type of Building(check all that apply) Lot# T 38 N R 9 E or w
�1 or 2 Family Dwelling-Number ofBedrooms 3 4 6`���.} �/ Subdivision Name
/
Block#
❑Public/Commercial-Describe Use
�City of
❑State Owned-Describe Use CSM Number ❑Village of
19 1�g ��0.6 �7'own of Edgewater
III.Type of POWTS Permit:(Check either"New"or`Beplacement"and other applicable on line A. Check one box oe line B.Complete line C i
a licable.
'�� �j1ew System ❑ Replacement System g y ( p ( p )
❑Other Modification to Existi❑ S stem ex lain) ❑Additional Pretreaunent Unit ex lain
B' ❑ Holding Tank n-Ground ❑ At-Grade gn ype( p )
❑ Mound ❑ Individual Site Desi ❑ Other T ex lai�
(conventional)
C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Transfer to New Owner �st Previous Permit Number and Date Issued
Expiration
IV.DispersaUTreatment Area and Tank Information:
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(st� Dispersal Area Proposed(s� System EI�vation
450 5 900 918 95.0 ��5�,��� 7
Capacity in Total #of Manufacturer
Tank Information Gallons Cmllons Units � � v �, �
New Tanks Existing Tanks y o � � Y � � `�'
a U v) �v, rii tz. C7 a.
Septic or Holding Tank �pp/3pp 1000 1 Wieser }{
Dosing Chamber
V.Responsibility Statement-I,the undersigned,assume responsibility for installatioo of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Signature � MP/MPRS Number Business Phone Number
Rick Brown ` 2312�1 7]�-419-0739
Plumber's Address(Street,City,State,Zip Code)
PO Box 637 Spooner WI 54868
VI.Co n /Department Use Only
�Ap ,,v /y ❑Disapproved Permit Fee Date Issued Issuing Agent Sienature
�N ❑Owner Given Reason for Deniai $ `"�� � I��I°� ����""-^'-"�
Conditions of ApprovaUReasons for Disapproval
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C S� ��— I q � -�-.,.F:. �,�,,., wo t��_ ,�
Att�ch to complete plans for the system and submit to the County only on paper not less than 8 Ux x 1 mc u in size
yo�oa
SBD-6398(R.03/22)
NO R�FJNDS�F�ER
ISSUE OF PEFit;AtT
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
Component Manual Design Re(erences:
In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
Pg 1 of 4 Index&Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross-Section &Plan View
Pg 4 of 4 Management Plan
Attachments: Enclosures:
POWTS Application for Review
Soil Evaluation Report&Site Map
Project Name/Description
Hayden
Owner Name(s): Eric Hayden Phone: - -
Owner Address: N1301 E County Rd.O M t.��:' vy Zip; 54755
Project Address: 2846N County Rd.F
Govt.Lot: � 1/4 of 1/4,Section 33 ,T 38 N-R 9 E❑or W❑✓
Township: Edgewater County: Sawyer
Project Parcel ID#: 0089383355105
Designer Information
DesignerName: RickBrown Phone: �15 _419 _0739
Designer Address: PO Box 637 Spooner WI Z�P: 54801
E-mail: rickbrown2004@hotmail.com , „
License Number: 231251
Remarks:
�
Signature: �L Date: 9�4�22
Onginal signaNre required on each submitled copy.
i . t
CHECK BOX AS APPIICABLE. � CHECK BOX AS APPLICABLE.
❑ SOlL EVALUATION o s��e: 40 40� so 80 �SYSTEM PAGE 2 OF 4
SITE MAP PL�T PLAN
PROJECT NAME: �ia �9�d� 10z DESIGN FLOW: 45O GPD
Eric Hayden Attach design flow caiculations for commerciai plans.
PROJECT ADDRESS: 2846N COUlltx HWy F N Pipe Matedal / ASTM Standard (Tabies 384.30.3 8 384.3�-5)
Santtary Sewer. 4 /
BM Symbol: � BM Elevatlon: 100 FZ Force Maln: /
BM pescdptror,: top of 3/4 property pin
Indicata nonh by IMPORTANT:
Slope GradieM(°�) � We11 Symbd (if appiicable): Q drawing an artow Show ground elevallon contours at suitable intervais.
of Tested Area: on ihe approprtte Mne,
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Septic Tank(s)ManufacNrec
IN-GROUND GRAVITY DISPERSAL AREA Wieser
Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s)Vdume(s):
3-ft Trench (down-sizing credit) �000 gal �� gal gal
Effluent Filter Manufacturer:
Polulock
I
Etn�e�c F���e�nnoaei u: PL-525
mm.ir
SOIL COVER (tvp�wp
iz^
min.trench
c�'rv°�� • TYPICAL TRENCH
CROSS SECTION VIEW
F �,�p a�> (No Scale)
� • •.�' • Provide minimum 3 ft
System Elevation=95.0 ft separetion belween trenches.
(typical)
Quick4 Standard-W
w/endCap O�servalbnPlpe TYPICALTRENCH
(typicap (Show location of inlet/outlet pipe connection on plan view.) (Hv��i)
�nscan e�ma�ur�m�rs pLAN VIEW
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,°°u°�s (No Scale)
�s�,
�....—..r...e-------��-------��--- Fat. rt�se si ,
— — —
�uuul,ut�'_�_���. �i r�rif����iii� A Mv�) �
-----��-------��-- � D
� B- so ft �; m
(rypicaq �Quick4 Standard-W Chamber W
RYPical) O
INSTALL PER TRENCH: �mra ny mnu�a�o�sYs��„s,i��.� �
Instau pursuant to manufacturers instructbns. �
15 Quick4 Std-W @ 20 fl'EISA/chamber= 300 g�
+ 2 Pairs of end caps @ 6 fl'EISA/pair= 6•0 ft'
=Proposed EISA per trench= 306 g' Required Infiltration Area= 900 ft' DISt�lbutlOn MethOd:
x 3 trenches=Proposed Total EISA= 9�8 n' branched manifold
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PAGE 4 OF 4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382384,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 Operatinca Limits:
Design Flow= 450 ypd; BODs� 220 mgL''; TSS <_ 150 mgL''; FOG <_ 30 mgL"'
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance fadors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches,floats, etc.)
o material fatigue(i.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s)and any distribution appurtenance(s) (i.e., distribution/drop boxes)
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities-if applicable (i.e., pump re-cycling, float switch settings, etc.)
o electrical components-if applicable (i.e.,wiring, connections, switches, controls, timers, alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure—compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tanklsl 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 cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance repoRs shall be submitted to the praper local government unit in accordance with
SPS 383.55 Wisc.Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Ken WaY Phone: 715-234-7677
Local government unit: SBWye� COUflty Z011lllg Phone: 715-634-8288
Local government unit address: 1061 O M8i11 St. SUit2 #�49 H8yW8Pd WI ZiP 54843
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1),Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383,Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 354,Wisc. Admin. Code.
Contingencv Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
Svstem Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33,Wisc. Admin. Code.