HomeMy WebLinkAbout002-940-04-2215-SAN-2022-281 =,�r^"=*.'si;;. Industry Services Division County (�
`-�' 4822 Madison Yazds Way Sawyer �
�;iV``r= = Madison,WI 53705 Sanitary Permit Number(to be filled in b� �
`. ` �_ � P.O.Box 7302
'''���,...,,,�w ' Madison,WI 53707 � 2j���9� 9J
State Transaction Number �
Sanitary Permit Application �
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fomi to thc appropriate govcrmnental unit �
is c+equired prior to obtaining a sanitary permic Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing e c�-�
the Department of Safety and Professional Services.Personal information you provide may be used for secondary Sommer Ln
purposes in accordance with the Privacy Law,s.15.04(1 xm),Stats.
l.Appti�ation laformatfon—Please Print All Information
Property Owner's Name Parcel#
Sawyer County Housing Authority 002940042215 �,,.�+ � 3
Property Owner's Mailing Address Property Location
PO Box 791 �o,�.,�t
Ciry,State Zip Code Phone Number
Hayward WI 54843 �%, ��., Scction 4
lI.Type of Buiiding(check ail Htat apply) �� �� Lot# T40 N R 9 E or W
�1 or 2 Family Dwelling—Number ofBedrooms 4 � Subdivision Name
Block#
�'ubliclCommercial—Describe Use
aCity of
❑Siste Owned—Describe Use CSM Number illagc of
�ro�,of Bass Lake _
III.Type of POWTS Permit:(Check either"New"or"Replacemeat"aad ot6er aQplicable on line A. Check one boz on line B.Complete llne C i
a licable.
A.
✓�IVew System �eplacement System ❑Other Modification ro E�cistin�Sy�tem(explain) ddirional Pretreatment Unit(explain)
B' ❑fiolding Tank ❑In-Ground �At-Cnade �Mound Individual Site Design Other"l�e(explain)
(conventional)
C. �Renewal Before �Revision hange of Plumber ❑i'ransfer to New Owner �st Previous Permit Number and Date Issued
Expiration
IV.D1 ersaUTreatment Area and Tank Information:
Design Flow(gpd) Desig�Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation
600 .7 858 866 91-95
Capacity in 'fotal #of Manufacturer y �
Tank Information Gallons Cmilons Uniu a � v F � y �
New Tanks Existing Tanks `"�' o :: � �i .�� �
� U �n m �n Gc. C7 �i.
Septic or Holding Tank �2r�� 1250 1 wiese� ✓
Dosing Chamber �
V.Responalbility Statemeat—I,the undersi�►ed,assume r sibility for instatistioa of the POWTS shown on the attached plana
Ptumber's Name(Print) Plumber's Si ce MP/MPRS Number Business Phone Number
Dan Burch 253808 715.416.1642
Plumber's Address(Street,Ciry,State,Zip Code)
N5921 County Hwy K Spooner WI 54801
VI. u /Departmertt Use Only
� ❑Disapproved P��t Fee Date Issued Issuing Agent Signature
❑Ownet Given Reason for Denial $ 1��� I� ' �f a� ���`'u'`�'"�
Condidons af AppmvaUReasons for Disapproval Gl 1 � ���rs r��r-,,,---,
io 1 (n aa ' �
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r v�GI EP � � 2���
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b � 8
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ZONINGA�iV1hV� �,::j;;.}i,�
� Attaeh m complete pl�a�fe Ee sy�tem snd�ubmlt ro the County ooly on paper nM len tpaa 8 In x 11 Inchea in dze
NO R�FJNDS RFTER ����
SBD-b39R(R.02l22) iSSUE OF PERMff
PAGE 1 OF 4
In-Ground Gravtty Plan �
Index � Cover Sheet
�ry�o►►a►,t,�►►u��►�:
i/E'rtg1�� a. 1 2 0 R 1-�a a�
pg� �4 index&Cove�Sheet
Pg 2 oi 4 Plot Plan
Pg 8 of 4 Dispersai Area Croas-Section&Plan View
Pg 4 of 4 ManagemeM Pian
Attachrrronts:
POWTS A .tication for Revf�w
SoN Evaluation R 8�Site Me
Project Name/O�cMption
/ _ /��„o:t-c
owner Nemecs)=��'''�r�C�'f N�,�s,�1� /� pno�.�
ow�sr IWde�s.: (�� Rv� 7 Q� ��
ProJsCt Addross: S „�.•"c`"-�� --
Qpyti�,p� 1/4 of 114,Sectlon K .T K a N-R�E��W�
Towr�hip: 5 ._, Co�MY= �P`w��
Pro�ct Parosl ID#: o� 01 k K Da�l�o� (5
Designsr tnfoematlon
�����; Dan Burch p��; 715 _416 .7642
�ss�Onar Addre� ���Y�K Spooner Wl Zlp; 54801
E�111a11' BU�ti71UR1�1lIC�Qfi1811.001fl This cjwce reservtd far approval sbmp.
Ucsnss Numbsr. 25��
Ramwrlcs:
s��ature: � �
�a�: q a 7-�a
CNECK BOX AS APPUG�BtE. CNECK BOX Ab APPl1CA8LE.
� SOIL EVALUATION o 5��� �30' 45 � �✓ SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN
PROJECTNAME: Tbf DE310NFLOW: BOO GPo
Sawyer County Duplex AttsCh design fiow calculations for commercial plens.
PRQIECTAWRESS: SOfi1R16f LN Pipe MateAal I ASTM St2�tlarC(Tablea 384,903$384.3Q5)
sh�svmbw. � eht�evawn: 1� � N senxrysewer. SCh40PVC �
foroe e.laire /
BM���, naii in power pole
� G�� % im�enmtnby IMPORTANT:
ope 4 ) we�i symoa(rcappncedet O a�ewW.n mwr Shaw gfourxf etevatlon contours at suliable intehals.
m Tuteenroe: on Ms■vP�M�,.
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Septic Tank(s) Manufacturer:
IN-GROUND GRAVITY DISPERSAL AREA wieser
Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s)Volume(s):
3-ft Trench (down-sizing credit) 1250 gal gal gal gaI
Effluent Filter Manufacturer.
Polvlok
�
Effluent Filter Model #: 525
� min. 12"
SOIL COVER ��P��I�
12"
min. trench
depth
�aP���� ��� < � TYPICAL TRENCH
--_ __ __-- .- ,. .. . .�.�a� . a. CROSS SECTION VIEW
�-- 34° ` . .� �� � � (No Scale)
(h'pical) •;'a .
.r . a ,. . e.
. " Provide minimum 3 ft
System Elevation - 94 ft separation between trenches.
(rypical)
Quick4 Standard-W
w/ End Cap Observa[ion Pipe TYPICAL TRENCH
{typical) (Show location of inlet / outlet pipe connection on plan view.) (typical)
Install per manufacturer's PLAN VIEW
ir�structions.
(No Scale)
r-- ��� —.� ,� �,.— � - - - --��- - - - - - - - �f- - - - - -� — — - -�
�;� „ � ��, �A = 3.Oft
� �— —� � � � ` —'— — — — — — — — — — — — — — y— �_� w— J �tYPical) �
�� �� �
�r g = 175 ft —� T
1 � 1
(typical) Quick4 Standard-W Chamber W
INSTALL PER TRENCH: �tYp���� �
(mfd by Infiltrator Systems, Inc.) �
Install pursuant to manufacturer's instructions. �
43 Quick4 Std-W @ 20 ft� EISA/chamber = 860 ft2
+ � Pairs of end caps @ 6 ftZ EISA/pair = 6 ftz
= Proposed EISA per trench = 866 ft2 Required Infiltration Area = $5$ ftz Distributian Method:
x � trenches = Proposed Total EISA = 866 ft2
•��M
W1250—MR
TANK SPECIFICATIONS � o �
o a
8'-8'� a �
DIMENSIONS: � o
WALL: 2 7/16" a a
4" CAST-A-SEAL 4" CAST-A-SEAL BOTTOM: 3"
COVER: 5"
-____ MANHOLE: 24" I.D. PRECAST CONCRETE RISER Q
��,-� ` HEIGHT: 64 1/2' �
-;\\
�i'� ���� LENGTH: 8'-8" >
�� �� WIDTH: 7'-2" �
ii�_ 2�` �� BELOW INLET: 53"
� i �� ���lQ' �ij`�\ 1 UQUID LEVEL: 47" o
`j � � WEIGHT: 7,220 �BS. � � o
r
II U �
�+� �--'� �� �%��� INLET AND OUTLET: � 3 0 0
�� // 4" CAST-A-SEAL BOOT OR EQUAL GASKET � m o N
�� FILTER OR //. o .-
��� BAFFLE ��� � 3 �,; ;
�\�\ �� INLET AND OUTLET BAFFLE AND FILTER: Q Q � w
,;� WISCONSIN, SEE OETAIL #10 � a o �
\ -------� (OTHER STATES SEE CHART) �' o
�
�
LIQUID CAPACITY: 26.81 GAL/IN W �
TOP VIEW � �
HOLDING TANK:
OUTLET HOLE PLUGGED V � �
ACTUAL CAPACITY: 1,340 GALLONS � � �
� o I
� LOADING DESIGN: 8�-0" UNSATURATED SOIL Q �n
� � N
c� TANK CAN BE USED AS: � o j�
� SEP11C / HOLDING / PUMP OR SIPHON W ,. o
� �i = �
-- COVER: MIX DESIGN #8 (NO FIBER) �
-___ ____ �_ TANK: MIX DESIGN #10 (STRUCTURAL FIBER) � �
INLET - OUTLET CUSTOMIZED TANKS: � 3
_ � i FOR CUSTOM TANKS CONTACT WiESER CONCRETE
i � i
� a � � �-�, � 00 c¢�
�� I - co F a
`° ,,f `r i � `n � �� o J
Q
I I � �
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2�„ l - -------�=^=J o �
REVIEWED BY c�v U
;.� PUMP PAD REVIEW DATE 3 �
w
DRAWINGS SUBMITTED N
SIDE VIEW FOR APPROVAL
APPROVED BY: SHEET N0.
APPROVAL DATE: � �
OF
PRODUCTS NEEDED BY: / �
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
PAGE40F4
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 382-384,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.
Furthertnore,all inspection and maintenance activities shall be pertormed by a registered POWTS Maintainer in
accordance with SPS 383.52(3),Wisc.Admin.Code.
Maximum Disqersai Area Operatina Limits:
Design Fiow= � 9Pd: BODS<_220 mgL''; TSS 5150 mgL"'; FOG 5 30 mgL"'
Inspection Checkiist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors(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 treaVnent tank(s)and any distribution appurtenance(s)(i.e.,distribution/drop boxes)
o neglect or improper use(i.e.,exceeding design capaci5es,prohibited adivities,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 electricai 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 effiuent or sewage back-up into structure served
Maintenance Checkiist MAINTAIN EVERY 3 YEARS(or when necessary)
o Seotic and dose tank(sl 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-thlyd(1/3)the iiquid volume of the tank(s)or
as required by tocal ordinance. Disposal of contents shall be pursuant to NR 113,Wisc.Admin.Code.
o Effluent fliterlsl 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 reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wlsc.Admin.Code. Report any component failure or malfunctfon to:
Name of individual or company: Dafl BUfCII Phone: 715.416.1642
�ocal government unit: SaWYef COUtlty ZOnitlg Phone: �15.634.8288
l.ocal govemment unit address: 1061 O M81f1 St. #49 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 384,Wisc.Admin.Code.
Contins�encv 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 shail be abandoned in accordance with SPS 383.33,Wisc.Admin.Code.
'"'"'�T`-'�``���� PRIVATE ONSITE WASTE TREATMENT �ounty
i��% -�
»/�� ��;��
r�� � ��� sYSTEMs Sawyer
'����1 �P�s ���; ( POWTS)
�ryU,L_�N/
�Zs�'�'-�"=' 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[Privacy Law,s. I5.04(1)(m)J
Permit Holder's Name: �M� �3 ❑Gity ❑ Village �Town of: State Plan Transaction ID#:
/� � f A 1' _ �
C..o�,n 1�1�`-�S� C� o� S �AY�--
insp BM Elev: BM D cription: Parcel Tax No:
�� .o� 1Jr � o��- Q�� oo�r9Yo- o y-a-2�S-
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic (,�„��� � � Benchmark �bo.o'
Dosing
Aeration Bldg. Sewer QS ys '
Holding St l Ht Inlet q� 2�-�
TANK SETBACK INFORMATION St/Ht Outlet �Y.� '
TANK TO P/L WELL BLDG vENrro ROAD Dt Inlet
AIR INTAKE
Septic �y� n, �o� �o� NA Dt Bottom
Dosing NA Installation
Contour
Aeration NA Header/Man. �y.-� '
Holding Dist.Pipe
PUMP 151PHON INFORMATION Infiltrative ,
Su rface �'3•7
Manufacturer Demand Final Grade
Model Number GPM
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L Dia Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W 3� L $' p/ #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav � Conv ❑ Aggregate '�,��I
INFORMATION P/L Bldg Well i/yaters ❑ AG � Chamber Model Number: ,
❑ EZFIow
CELL TO �,S ` ❑ Other
%�-'S N 1J --- ❑. _ Mound _____ _�Y,l—
DISTRIBUTION SYSTEM X Pressure Systems Only
_ __ -- —
Header/Manifoltl Distribution Pipe(s) X Hole Size X Hole Observation Pipes
( Length Dia Length Dia Spac Spacing ❑Yes ❑ No
----
------- — --
SOIL COVE
— --
De th Over De th Over —� De th of Seeded/Sodded Mulched
Cell Center �Cel�l Edges I Topsoil ____ _� ❑Yes ❑ No ❑Yes ❑ PJo
COMMENTS: (Include code discrepancies, persons present,etc.)
����� �< <gr��
__
03- l,� ��� ��
Plan revision required?�Yes ❑ No �_'j (o �3 � v"
1 � �--- ------ ____
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
A�OITIONAL COMMENTS ANO SKETCH
SANITAAY PERMIT Nl1MBEA: oZ� -i�$I
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