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Home My WebLink About010-841-25-5207-SAN-2022-335 Indushy Services Division C�IY � 4822 Madison Yards Way Sawyer Madison,WI 53705 Sanitary Pemvt Number(to be filled in by � P.O.Box 7162 w Madison,WI 53707-7162 �'��j �I 3 � ot � Sanitary Permit Application StateTransactionNumber r .— w In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fortn to ti►e appropriate governmental tu�it W is required prior to obtaining a sanitary permit Note:Application fortns for state-owned POWTS are submitted to Project Address(if different than mailing a (/1 the DeparUnent of Safety and Professional Services.Personal information you provide may be used for secondary 10197N Comstoc)c Rd purposes in accordance with the Privacy Law,s.15.04(lxm),Stats. I.Application Information-Please Print All Informatioo Property Owner's Name Parcel# EICBS ��p��02�'� J�C-� l O Property Owner's Mailing Address Properiy Location Po Box 1390 Govt.Lot�_ City,State Zip Code Phone Number Hayward,WI 54843 � 11(C, Section 25 II.Type of Buiiding(check all that apply) Lot# T 4t N R 8 E �l or 2 Family Dwelling-Number of Bedrooms 4 � Subdivision Name Bfeek# ❑Public/Commercial-Describe Use �}c,� ❑City of ❑State Owned-Describe Use CSM Number ❑Village of �vaa #�.3 t`� �Town of Havward III.Type of POWTS Permit:(C6eck eit6er"New"or"ReplacemenY'and other applicable on line A. Check one box oo line B.Complete line C i a licable. A. ❑New System �Replaceme►rt System g Y � P ) P ) ❑Other Modification to Existin S stem e�e lain ❑Additional Pretreatrnent Unit(ex lain B' ❑ Holding Tanlc �In-Ground ❑At-Grade ❑ Mound ❑ Individual Site Design ❑Other Type(explain) (conventional) C- ❑ Renewal Before ❑ Revision ❑Change of Plumber ❑Transfer to New Owner �st Previous Permit Number and Date Issued Expiration �- �Q� �I� g� IV.DispersaUTreatment Area and Tank Informstion: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation 600 7 857.1 8753 93 Capacity in Total #of Manufacturer Tank Information Gallons Gallons Units � � U �, � New Tanks Existing Tanks 4 0 _ � � � � `� a U �n � �n c:. U a Septic or Holding Tank ]250 1250 1 ieser Dosing Chamber V.Responsibility Statement- I,the uadersigned,assume responsibility for installatioo of th W'I'S s6owo 0o the attached pl'ns. Plumber's Name(Print) Plumber's Si MP/MPRS Number Business Phone Number Gerald Frcemel � 9501 I1 7I5-558-1138 PlumbePs Address(Street,City,State,Zip Code) 13502W Frcemel Rd Hayward,Wl 54843 Vl.C un /Department Use Only �Ap � ❑Disapproved a��t Fee� Date Issued Issuing Agent�ignature �✓ ❑Owner Given Reason for Denial `�• ,� �"! �� 'C��1 '`'��-^�"`- Conditions of Approval/Reasons for Disapproval � :�:; _►��.�.��.:�_ o� � -� � � �� o . � �I G I �� ;� ..,�c# .�. �ay y NOV 2 1 202Z �J� �a.. - �-� � `''.�.;'i?�1`'1Z:tN ....��r id �"'„� ' y� SAWYER COUNTY INISTRATl�P� Attach W complc#e plaas for the systea�aed wbmit to the Coaety only on paper aot kss thao 8 V2 i(1 inches in size NO R`FJNDS AFTER SBD-6398(R.03/21) I.�.,SUC OF PE�tMIT EICBS Property Owners Name 10197N Comstock Rd Property Address p 10841255207 Tax Parcel Number Sawyer County � 1 Gov Lot or Qtr-Qtr/Qtr S25 Section T41N Town R8W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 Dose Tank 6 Maintenance Plan 7 Contingency Plan County Parcel Listing Gerald Froemel Plumber's Name � Plumber's Signature 950111 Plumber's License Number 715-558-1138 Plumber's Phone Number 11/21/22 Date Not an endorsement,written or implied for the following companies and products;DelZotto Concrete,Wieser Concrete Produds Inc.,Skaw PreCast Co.,Huffcutt Concrete Inc.,Zabel Environmental Technology,ITT Industries(Goulds),The Pentair Pump Group(Myers),Infiltrator Systems,ADS Produds,Polylok Inc.,Orenco Systems Inc.,SimRech Filter Inc.,Sta-Rite Industries, Page 1 of 7 -�� In-Ground Soil Absorption SBD-10705-P(N.01I01)Version ,� Component Manual Used 4 Number of Bedrooms Percent Slope (%) 100 Depth to Soil Limiting Factor(in.) 0.7 In Situ soil application rate 400 Estimated Wastewater Flow (gpd) 600 Design Wastewater Flow (gpd) 1 'Number of System Elevations . 93 Proposed System Elevation#1 Proposed System Elevation#2 Proposed System Elevation#3 °Original Grade#1 96 �Finished Grade#1 �Original Grade#2 'Finished Grade#2 Original Grade#3 Finished Grade#3 Infiltrator Quick 4 Standard s Chamber Type 15 Height of Chamber(in.) 20 sq.ft. per chamber 3 Rows of Chambers 5.1 sq.ft. per pair of end caps 3 Distance Befinreen Cells (ft.) 43 �Proposed Number of Chambers Used 857.1 Minimum Distribution Cell Area Required (sq.ft.) 875.3 Distribution Cell Area Proposed (sq.ft.) Wieser 1250 Septic Tank ose an (if applicable) Lifetime 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 95.75 100 90.42 94.50 TRUE 2 96.87 108 90.87 95.62 TRUE 3 96.73 108 90.73 95.48 TRUE 4 5 � Page 2 of 7 o��e�-- : L.ec� E T 6 RevOGa�b��Tttis�- S4w�f2r �v � �'a�wc�r� T�'� �O '$x l 3Q p t -P c u�1. 4� p�o_ S`i,1— z S ,5 zb—( t��w��, �l s`i 843 S Zs- -1- � L ►J � o S w S�Te: JblQl nJ ��.,��,��C,. �. �-t�'�' 1.- C5� [ll�Z t� �3[� z �� o� �� e � � t,s� �� I = y,Q� � Ve r� S'�� o �o s, 3e y,b �� 6� � `� � �� r � a Qy S8� B/`1!�o� 0 o d �� y �� J`4�e � ,��7 .� ro �I � • � �f.�y�iir � � � � Brl�oo T'o p � I�t'X t�"x �' os��Qa,.-�' �� a r .�o r o u er{�,�� c�� .��. �1��25 t �.° z. �t6•S�' 3. t6.�3 ' ° Z S�� s sF.el. q3` N ti �- �o �`1►� -�-e�� e q�'� �3.S` � C�c:�r> Se; �ir�r� of r �.�:, C;�'' Ir �;r,:,,;� d Cc^�� N- . 1��; r� Lecch na �rcrn�e•�_ Ccsr�vc;+�o^�'+.'�•�t P�nes /� � � � 96.00 Finished Grade � '� --- - �� Finishea Grade -- /' Slope �% � � Celi Seperation / T�, 3 ,� t �� ,. � � }��}\ p' , /��,\`? Orginal Gradz �7`� `�� y%' I��;�` ' .�riginal Grade 94.25 Top of Chamber ____ _�`��' ��' ��__y _ 'Top of Chamber 94.25 93.00 System Elevation ( _Y__ �.'�• . . , �� ('/ �,,� _ System Elevation 93.00 •• • .• .,�fP_u???'1:��.�1�'Q'�ve`sa'.1{>;c•. : . . ./ .. _••_�~ .•' " ' •' `� �• •. .._ •. -..- -•- •� . �it� `CCtCr ��!�Se�v:., o^/'✓e�: �e5 t�, bt Cci�s•uC'�d G^� .U{.,^,e:, w f• :��over, mC._'ia`� f,r,r t�e pa+tl....l�. ,,,e Diagrams Not To Scale __ '� : �--- ; ; _ � , - 4 � i �:�:._-__ .. � �d�;�',.,; . bservation/Vent Pipes to be located 1/5 to 1/10 the length of the distnition cell measured from the end of the cells Page 4 of 7 EICBS 10197N Comstock Rd 1.08E+10 Number of Bedrooms 4 Septic Tank Wieser 1250 Estimated Fiow(average)ga��ons/day 400 Effluent Filter Lifetime D8Si9f1 FIOW(peak),(Estimated x 1.5)gaVday 600 Pump Tank #N/A Soil Application Rate gaUday/ft 0.7 Pump Type Influent I Effluent Qual' Monthl Averege Fats,Oil 8 Grease FOG) 30 mg/L Biochemical Oxygen Demand(BODs� 220 mglL otal Suspended Solids(TSS) 150 mg/L ':NCTE'� Servicing frequency of 12 months or less requires the � Management Plan be recorded wi[h the Register of Deeds. Maintenance Schedule Service Event Service Frequency Inspect condition of tank(s) At least once every 3 Year 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 effluent filter At least once every 3 Year Inspect pump,pump controls&alarm 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 surtace. 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 failing condifion and requires the immediate notification of the local regulatory authority. When the combi�ed accumulation of sludge and scum in any tank equals 1l3 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 AdminisVative Code. A service report shall be provided to the County Zoning Department within 30 days of any service event. Start-Uo and Oceration For new construction,prior to use of the POWTS check treatment tank(s)tor the presence of painting products or other chemicals that may impede the treatment process and/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 shall not occur when soil conditions are frozen at the infiltrative surface. Page 6 of 7 Do not drive or park vehiGes over fanks and dispersal cells. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS:andbiotics, baby wipes, ciga2tte butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfecfants, 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 permanentty taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance wifh 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 shall 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 Ptan 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 identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation shall be perfortned to locate a suitable replacement area. If no replacement area is available a holding tank may be installed to replace the tailed POWTS. A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infinged upon by required setbacks from existing and proposed structures, lot lines and wells. Failure to protect the replacements area wili resuR in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement 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. �!WARNWG!! 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 Frcemel Name ott Poppe Phone# 715-558-1138 Phone# (715)634-1450 POWTS Maintainer Local Regulatory Authority Name Jays Septic Agency Sawyer County Zoning Phone# 715-558-1138 Phone# 715�34-8288 Page 7 of 7 ` "''"�r PRIVATE ONSITE WASTE TREATMENT co�nty �ri`��Q��g �`� SYSTEMS � P$ ( POWTS) Sawyer \\kU t��T/P i;;; INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �� S Personal infonnation you provide may be used for secondary puiposes[Privacy Law,s. 15.04(1)(m)J Permit Holder's Name: ❑City ❑ Village � Town of: State Plan Transaction ID#: �'1�CQS �ay,,.iQ� — Insp BM Elev: BM Description: Parcel Tax No: f �l�O.tS o,�'"' ,�S ��CC O�o " �Y�^.�5�-Sota� TANK I FORMAT ON ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,,,i�r �2� Benchmark �d.o ' Dosing Aeration Bldg. Sewer �j�i ' Holding St/Ht Inlet q3,8 ' TANK SETBACK INFORMATION St I Ht Outlet �3, �, ' TANK TO P/L WELL BLDG vE"T To ROAD Dt Inlet AIR INTAKE Septic �-(S'� -}�s` � .�-�' � NA DtBottom Dosing NA Installation Contour Aeration NA Header/Man. 9 y. S' Holding Dist. Pipe PUMP/SIPHON INFORMATION �nfiltrative ► Surface 5'��S Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORM TION DIMENSIONS �N ,3 � yy 6Y 6 #of Cells 3 Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate �� INFORMATION P�L Bltlg Well Waters o GP � Chamber Model Number: ❑ EZFIow CELL TO 'f-�" ^�-(p' .�-�j _ ❑ Mound ❑ Other 4�� ------ DISTRIBUTION SYSTEM x Pressure Systems On►y Header/Manifold Distribution Pi e s X Hole Size X Hole Observation Pipe� Length Dia Length pO Dia Spac , j Spacing ❑Yes ❑ No ; - — -- _ - — — --� SOIL COVER -- ----— _-- - Depth Over Depth Over I Depth of — � Seeded I Sodded � Mulched � Cell Center Cell Edges j Topsoil ❑Yes ❑ No ❑Yes ❑ PJo COMMENTS: (include code discrepancies, persons present, etc.) �".1,,,�(� /.�� t T �� S7"�P7' '��a�j �3 .� � � --- -_ ___—._—_-_ � Plan revision re uired?❑Yes ❑ No �� ' �� q jva a� �Y � � �� / _ _ i � Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) ADOITIONAI COMMENTS AN� SKETCH SANITARY PERMIT NUMBER;____��-�3S_,__ �.� ��,� �,�,�, � � ' Q�� — , �b� �L� �-S�-� K� •�b� ;�_------ , C�� a�n, , S' �a ,�1,� 1 y �� k�� '� �� SP. , � S , t �S' � "l.6 � � �� ±3'�' a oa��, S�`�e � ��w� � ��a�� a �—