HomeMy WebLinkAbout026-939-14-5114-SAN-2022-280 " ` ` Industry Services Division County �
4822 Madison Yards Way Sawyer
�_ ; Madison,WI 53705 Sanitary Permit Number(to be filled in by
�= P.O.Box 7302 � 3 q a c� �
Madison,Wl 53707 �
State Transaction Number �
Sanitary Permit Application �
In accordancc with SPS 3R3.21(2),Wis.Adm.Code,submission of this form to thc appropriatc govcmmcntal unit �
is required prior[o obtaining a sanitary permit.Note:Application foRns for state-owned POWTS are submitted to Project Address(if different than mailing� �
the Department of Safery and Professional Services.Personal information you provide may be used for secondary 6182 N Breez Pt LN
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. y
I.Application Information-Please Print All lnformation
Property Ow ner's Name Parcel#
Joseph Jacobson 026939145114
Property Owner's Mailing Address Property Location
2182 St Clair Ave �"� �
Govt.Lot
City,State Zip Code Phone Number
St Paul MN 55105 �f(_� Scction 14
II.Type of Building(check all that apply) Lot it T 39 N R 9 E or ti'
�l or 2 Family Dwelling-Number of Hedrooms 4 �. Subdivision Name
Block#
�ublic/Commercial-Describe Use
�City of
❑State Owned-Describe Use CSM Number illagc of
I�c� ���u �Tow�,of Sand Lake
I
❑i.Type of POWTS Permit:(Check either"New"or"ReplacemenN'and other applicable on line A. Check one box on Iine B.Complete line C if
a licable.
A.
�✓ New System �eplacement System ther Modification to Existing System(explain) ❑Additional Pretreahnent Unit(explaui)
B' ❑Holding Tank In-Ground �At-Grade �Mound [ndividual Site Design �/Other Type(explain)
onventional) eoMat
C• ❑Renewal Before �Revision 'hange of Plumber �iransfer to Neti Owner List Previous Permit Number and Date lssued
Expiration
IV.Dispersal/Treatment Area and Tank Information:
Design Elow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(sfl System Ele ation
600 1.0 600 600 95.5 `�H.S"�
Capacity in Ibtal #of Manufactuter
Tank Information Gallons Gallons Units D � U '�„ � ;
New Tanks Existing Tanks y o Y 2 v � � �
� U in �, in i�. C7 P.
Scptic or Nolding Tank 1250 1250 1 wieser ✓
Dosing Chambcr � �
V.Responsibility Statement- 1,the undersigned,assume respon ility or stallaHon of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Si�mat MPiMPRS Number Business Phone Number
Dan Burch 253808 715.416.1642
Plumber's Address(Street,City,State,7ip Code)
N5921 County Hwy K Spooner WI 54801
VI.C un /Department Use Only
�A rove ❑Disapproved Permit Fee Date Issued Issuing Agent Signature
/�,�� $ y� � � ��$�a�- ,v�,��.��-.�
7J"` ❑Owner Given Reason for Denial �
Conditions of Approval/Reasons for Disapproval � � ?``'�
D �, ��
�'' � °I� a8�2a ��,.; ;i
� �►�G �� � SEP 2 0 2022 �--��'
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CS � �p� � ' �� 1-� ZONfNG FsD�r!I�� �;��-, r_���
�
Attach to cnmplete plans for the s}st and submit to the Counry only on paper nM leas then R v2 x t 1 inches in size ��� 1 `
SBD-639R(R.02/22) NO REFJNDS AFTER
1SSUE OF PEFiMl7
GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DE IGN
Residenba�Apphcabon
INDEX AND TITLE PAGE
wner Info
Project Name Jacobson GeoMat
Owner's Name Joseph Jacobson
Owner's Address: 2182 St Clair Ave St Paul MN 55105
Property Info
Property Address: 6182 Breezy Point LN
Legal Description: S 14 T 39 N R 9 W
Township Sand Lake County: Sawyer
Subdivision Name:
Lot Number: 4 Block Number CSM#: �/379#152�
Parcel I.D.Number: 26939145114
Plan Transaction No.:
Index Pages
Page 1 Index and title Page 9 Filter specifications
Page 2 Data entry Soil test
Page 3 GeoMat dist.cell drawings&calculations
Page 4 Lateral and cell cross section
Page 5 Management&contingency
Page 6 Maintenance&specifcations
Page 7 Distribution media
Page 8 Plot plan
Dan Burch License Number: 253808
Date: 09/20/22 Phone Number: 715.416.1642
Signature:
Designer Stamp: State of Wisconsin Approval Stamp:
Designed Pursuant fo the
GeoMat In Ground Component Manual Ver.June 26,2018 Version
Page 1 of 10
In Ground and Dosing Distribution Component Design
DeSlts',3 UVOf S�S�leeY
ite Information
R Residential or Commercial Design N ISD Required?
400.00 Estimated Wastewater Flow (gpd)
1.50 Peaking Factor (e.g. 1 .5 = 150%)
600.00 Design Flow (gpd)
0.00 Site Slope (%)
94.50 Prop. System Elevation (ft)
54.00 Depth to �imiting Factor (in)
1.00 In-situ Soi► Application Rate (gpd/ft2)
97.00 Lowest Original Grade Ele. In System Area (ft)
� 98.00 Highest Original Grade Ele. In System Area (ft)
92.50 Limiting Factor Elevation (ft)
2.00 Depth Below Grade
Distribution Ceil Information
3.25 Cell Width (ft) 2 Number of Cells
2.00 Dispersal Cell Design Loading Rate (gpd/ft2)
2 Influent Wastewater Quality (1 or 2)
Distribution Information
E Center or End Manifold, Dist. Box or Drop Box
� Number of Laterals System dosed N
7.52 Lateral Spacing (ft)
System not dosed
Manufacturer Information
Treatment Tank Information Effluent Filter Information
1250.00 Septic Tank Capacity (gal) Polylok Inc./Zabel Filter Manufacturer
Wieser Concrete Products, Inc. Manufacturer 3014-525-1/16-10,000 GPD Filter Model Number
Project: Jacobson GeoMat Page 2 of 10
In Ground Plan View
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Calculations
I ft A 325 ft Basal Area Required 600 ft`
K 1 ft B 47 ft Basal Area Proposed 600 ft2
S 427 ft L 49 ft
w �2.��n
Basal Area Calculation GeoMat Dispersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
600 1 gal/sq iutlay 600 2.00 gal/sq tuday
Total 600 ft2 Total 300 ft2
Proposed 305.5 ft2
Number of Cells 2 GeoMat Width 325 ft
Cell Length ft Lineal Feet of GeoMat Required 92.3
Min.Cell Len th 462 ft Lineal Feet of GeoMat Pro osed 94
Cell Spacing 427 ft NOTE:Min S dimension=1'
S stem Elevation 94.5 ft
Limitin Factor 92.5 ft
Separation 2 ft z•n�tin
Directions�
Play with cell length to get desired cell spacing.length and width. Remember system SHOULD be longer than it is
wide. It must also Satisfy basal loading rate and GeoMat cell loading rate.
Project: Jacobson GeoMat Page 3 of 10
End Connection Lateral Layout Diagram
- - -- -� - - -- - —
a.;ka.
�d
Hole spacing is every 12" , 1/2" hole at 4 & 8 O'Gock, starting 4 O'clock 6"from end and
8 O'clock Holes at 12"from end.
Lateral Spacing 7.52 ft Pipe Diameter 4.00 in
D�stribut on Ce f Cross Section
� �CD�Y �Y�Y ��Y
�� 98 ft � �inisMd(�nAc .
( ,� .' .''- ,�, ..''�,`' • 12"_48" ..Hse►fiq~ �.,.. � TJ9�l.eY�
,
�. Z n — S�d Corut�eeammmded . _ .
� ^ --T .
4 in —► �D1L � . • :, •�tXv � ' . ' ' /F��� vG
� • . �.� Pipr i�.__ - —
Top of geomat to be at �. _ � GFA MAT
or below originai grade � ^ � I 2•ASTM 33 c,n � � � , � � � i � �
I I I . I � ���S�
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G�. � ' ��-.
bservation Pipes
W+.,,�.o�
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''�. 4'Nin Di�
12" Min. ,
48" Mvc.
' sfou
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Project: Jacobson GeoMat Page 4 of 10
Notes/Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWiS)has been designed,and is to be installed and maintained in accordance with SPS 383,Wis.Admin.
Code,the in-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treaiment Systems Version 2.0 SPS-10705-P
(N.01/Ot)_ GeoMat in ground Component manual Version 1.
1.This POWTS has been designed to accommodate a mazimum daiy flow of 60Q�ons of wastewater per day.The quality of
influent discharge into the POWTS heatment or dispersal component shall be equal to or less than all of the following.
A monthty averege of 30 mg/�fats,oil and grease
A monthly average of 220 mg/L 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 antl preventative action limits specifed in ch.NR 140Tables 1&2 at a point of standards application,ezcept as provided in DSPS
383.03(4),Wis Admin.Cade.
2.The owner of this POWTS is responsibie for system operation and maintenance.
3.Defects or malfunctions identifed during maintenance described above shall be repaired in conformance with SP5383 Wis.Admia Code,
and the pertaining counry 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 individuals to contact for such repairs.
5.No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Dept.
ot Commerce in accordance with SPS.384,Wis.Admin.Code.
6.If the POWTS is replaced,or its use discontinued,it shail be abandoned in accordance with SPS 383.33,Wis.Admin.Code.
NOTES
Two Effluent Filters to be installed where possible 1 to be installetl in ST,antl or 1 in pump tank in
order to insure particle size less than or equai to 1/8". Filters should be deaned once in spring,antl once in falL Also,strainers in sinks in
the building shall be maintained,so that solids and fats are minimizetl to flow into system.
A minimum of 2 observation pipes per ce�l shall be installed.These pipes shall be located approximately at the end of each cell.
The plumber,or county shail see to it that a copy of these pians 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 ihe dose tank to fll,the homeowner should see to it that
the effluent level in the tank is brought down qradually and not all tlosed to the system at once. One large dose could cause damage.
Contact a pumper or your installer if this problem occurs.
The homeowner is responsibie for tormulating 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 everybotly showers,and uses the toilet,ETC.
CONTINGENCY PLAN FOR COMPONENT FAILURE
A.Septic Tank.Any stmctural failure resulting in cracks or leaks in the tank must be correctetl by replacement of the septic tank component.
Leaks in the joints beriveen manhole risers or covers shall be repaired by replacing faulty seals with approved materials ro makejoints water-
tight.
B.Outlet Filtec 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 become permanenily tlegraded 6y clogging so as to intertere with the design flow out of the septic tank.
C.Dosing chamber and pump.The dosing chamber shatl be replaced if any stmcWral failure is found.leaks in joints behveen 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
replaced when they are no longer capable of 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 Ihe
distribution laterals may be exposed and the threaded end caps removed.The piping can be disconneded on the outlet end of the pump.
The distribution piping may then be back flushed to deanse any accumulated matter from the piping.It is recommended that the dosing
chamberthen be pumped by a licensed plumber.
E.Soif Absorption Cell.The discharge of sewage or wastewater to the ground 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 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 county.
Project: Jacobson GeoMat Page 5 of 10
In Ground System Maintenance and Operation Specifications
Service Provider's Name Dan Burch Phone 715.416.7642
POWTS RegulatoYs Name Sawyer County SPIA-Zoning Administration Phone (715)634-8288
Svstem Flow and Load Parameters
Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in
EstimatedFlow-Average 400 gpd MaximumBODS 30 mg/L
Septic Tank Capacity 7250 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 152.75 ft� Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service Freauencv
Septic and Pump Tank Ins ed and/or service once eve 3 ears
Effluent Filter Inspect and clean as necessa at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test periodicall
Pressure System Laterals should be flushed and pressure tested eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
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 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 geote�Rile 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 frost penetration.
Lateral Tum-up Detail
6-8"Diameter Finished Thr2ad2d Clednout
Lawn Sprinkler Grade \ Plug or Ball Valve
Box \
�I
lateral Ends at Last Orifice Where
Long Sweep 90 or Two
��45 Degree Bends Same
Diameter as Lateral
Distribution Lateral Lateral Cleanout
94.5 Feet
Project: Jacobson GeoMat Page 6 of 10
GeoMat Distribution Cell Media Layout
3.25 Cell Width (ft) 2.63 Sidewall to Lateral (ft)
Distribution Cell Cross-section Arrangements
Q _ S _ � e_ ��:.,�
omponen en � _ _ _ .
O Distribution Pipe
GeoMat is covered with approved geotextile fabric as per the their product approvai.
Distribution Cell Plan View Layout - Typical
3.25 Cell Width -A(ft) 47.00 Cell Length -B (ft)
End Connection Lateral Laycut Diagram
_ _
i �I�� Iwl�� r� rY� �� �r�� ��� �� ��� W� �� ir•�
�� T� ��� �
. yp ca " spersa e
�:niehnrl [;r;�Ac � `+ ` ` `� `� ` �`
( ,; .. ' . . . . _ `. .�� -� '.`..� QJi�1bOU00
�•- -' . ^- .,.`',`,''�, .. '�. -. . .BackfiO� j.i0C1E11.EYt�
� ' • „ '. ' . " ' . ' 12"-48�� .
S�d Co�ec�eeommmded . ' .
� , : .
.� __T. .. : '� �
pipe Di�,' � " t�u ' .� : ' .� Fabrie
, • .. • � N� �:__: --
� 1�. _ � - . ,- ^ . � GFAMAT
� � � ^ � I � 2•AS.I?,� 33 oxi I � I , I � I � I �
� — = _ — _ — = = = = = = - = - - - - = InfiltrativeSurfaee
� _ _ _ _ -NATIVE.SOIL= _ = _ - � �
_ � _ � � � � � � .� .._ � ._ � _. � L�^.rtaP Faaar
,�--
See details on page 4 for number, size, and spacing of laterals.
Project: Jacobson GeoMat Page 7 of 10
� CMECN BO%AS MM/CABIE. CHECK BOX N• 6�.�
0✓ SOIL EVALUATION o S�'��?�40' � � Q✓ SYSTEM PAGE 2 OF
SITE MAP PLOT PIAN
PROJECT NAME: oesicrr Fl.ow: 600 cPo
Jacobson GeoMat 10� Atlech tleslpn 1bw celpdetfons fw comrtrerdal plenn.
Pao.�cr nnoaess: 6182N Breezy Pt LN Plpe Meterlal I ASTM S�deM(Tables 384.30.3 8 38430-6)
BM syirod:$ BM Davatbn 100 N sennary s�wec SCh 40 PVC �
� Face MWrc I
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SAWYER COi;'�STY "�� ��
ZONWGAUMIh.15?'��,4C;ON I o
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��'`'"'-"`� PRIVATE ONSITE WASTE TREATMENT co�nty
i' � ��;��..
�;�'o$ ��K�� SYSTEMS Sawyer
�\���� ps ��' ( POWTS)
�(JFI�_- \'��`/
'�"—'"``"`'' INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION �� � �._g�
Personal infonnation you provide may be used for secondary purposes[Pnvacy Law,s. 15.04(1)(m)]
Permit Holder's Name: ❑City ❑ Village f�'Town of: State Pla�Transaction ID#:
�as�2 �u co�So� h La� �
Insp BM Elev: BM Description: Parcel Tax No:
��•a, 1U9r\ i �1 �7 tr �G�� �� +��3 ` ���'_' ��
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic �,�,; � ��j Benchmark � v�
Dosing
Aeration Bldg. Sewer q'�,o�
Hoitling St/Ht inlet q(,,��
TANK SETBACK INFORMATION St/Ht Outlet ,-5S'
TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet
AIR INTAKE
Septic p r� ��� � p' NA Dt Bottom
Dosing NA installation
Contour
Aeration NA Header/Man.
Holding Dist.Pipe (� p�
�
PUMP 1 SIPHON INFORMATION Infiltrative �
Surface �Y•S
Manufacturer Demand Final Grade
Model Number GPM C 3 9 �.S�
TDH Lift Friction Loss Sys Head " TDH Ft
Forcemain L Dia Dist. To Well
DISPERSAL CELL INFORMATION R „
DIMENSIONS W.� � � l o,� #of Cells � Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav � Conv ❑ Aggregate ��� �q�
INFORMATION P I L Bldg Well Waters � �GP ❑ Chamber
❑ AG ❑ EZFIow Model Number:
CELLTO fi�o` �a` � �i ❑ Mound � Other
DISTRIBUTION SYSTEM x Pressure Systems Oniy
Header/Manifold Distnbution Pipe(s) --- ', X Hole Size X Hole Observation Pipes
Length Dia Length _ _ Dia Spac �� Spacing ❑Yes ❑ No�
SOIL COVER
Depth Over Depth Over Depth of Seeded/Sodded Mulchetl �
Cell Center Cell Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present,etc.)
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Plan revision required7�Yes ❑ No
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Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AOOITI�NAL COMMENTS AN� SKETCH
SANITAAY PEAMIT NUMBER:�--28a ___
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