HomeMy WebLinkAbout014-941-06-1401-SAN-2023-014 , ���` "'�,� Department of Saf y c°""�' ✓�
�: � t�-'� & Professional Ser� :es � �' -� �'
i=' �,, �� i<� � Sariitary Permit Number(to be filled in by( �
� � � ` Industry ���r�•ices IDi�.ision � �, .
,
� 5 �� � �� ��
Sanitary Permit Applicati�n StateTransactionNumber '�
In accordance with SPS 38321(2),Wis.Adm.Code,submission ofthis form to the appr.�priate� arnmental unit �'- ` �^��`'�✓������ Q
is required prior to obtaining a sanitary permit.Note:Application forms tor state-owne4 POV✓T2 :e subrnitted to Project Address(if different than mailing ad _..
the llepartment of Safety and Professional Services.Personal information you pro��ide i��:ry be ust..t.>r secondary �
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. _� _ _ ��_
I.Applieation Information—Please Print Alt Information _�
Propert�'(hvner's Name -------�---- P�rcel t� C��,l� ��/_'O� " I�� I
-1 1
� vc'�d �N V l�O� "c'� - - -
Property Owner's Mailing Address � PropeRy Location
3
►i�{o( N 1-1 c�r- � � '
Ciry,State � Zip Code I�h�n..Number
�GV�/�c'tl-Ck �� �"'� 1 O � .J i �� '/a, I�C '/4, Section �
,f :_ `- _�
Q.Type of Buildirtg(check�ll that apply) �- �— T �/� N R � E or�1
� 1 or 2 Family Dwelling-Number ofBedrooms_.__� _ Subdivision Name
I31ock# �—
❑Public/Commercial-Describe Use ^
❑City of
❑State Owned-Describe Use CSM Number ❑Village of
r
� �Co���n of ����7:c3L%1
IlI.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C ifi�.
a licable. � �
ti
`�� ❑ New S�stcm �Replacement S}stem ❑ Other I�lodificauoh to}�xisting Sy stem(explain) ❑ Additional Yretreatment Unit(explain)
B' ❑ Holding Tank ❑ In-Ground ❑ At-Grade ,� �Mound ❑ Individual Site Design ❑ Other Type(explain)
(conventional)
ist Previous Permit Number and Date Issued
C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber ❑ Ttan3fAr to New Owner � �
Expiration � 9�—�o��j 3I I g 9
�..�?ls era�all�'reattneut Area and'Tank Intarmation: "+� t
�
Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(sf) Dispersal Area Proposed(s� System Elevation �
6o p l.o bo 0 6 oa 9(�.-7S'
Capacity in Total �t of Manufacturer
�
Tank Information Gallons Gallons Uniu � � U '$ �
New Tanks Existing Tanks � o v 2 y L A �
a U v: �, v: :z C7 G
Septic or Holding Tank j�Z,�y�;} 1 Uvv � 5 �� �y � �
Dosing Chambet �'�L'7 � � (+J�E:.�S r-f�
V.Responsibi[ity Statement-I,the undersigned,assnme responsibility far installation ot the POWTS shown on the attached plans. �
Plumber's N:nne(Yrint) Plumb� 's Sinnature � MP/MPI2S Number Rusiness Phone Numbar �
Jerry Ruid Excavating, LLC �� ��'Z`��,:� 7��_ y�i.z_ �.-��`t
Plu i., t ip Code)
Stone Lake, WI 54876
VL Caun lDepartm�nt Use Oniy �
�.Ap ro ❑Disapproved Permit Pee Date Issued Issuing Agent Signalure
�✓ $ `/�.°° .�.I�� (� � �����,�c`{�t�„��
❑Owner Given Reason for Denial
Conditions of ApprovaUReasons for Disapproval �
� ��
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Attac6 to complete plans for the syst and submit to the County only on paper not less than 8 1/2 x 11 inches in size i-��y q
NO R�FJItiDS AF7FR �
SBD-6398(R.03/22) IS51�����'�'17
� . ek � '� �
Wisconsin Department of Safety and Professional Services ,.�.,� ��%a., Phone: 608-266-2112
Division oflndustry Services %���' '��� Web: http �ids�s ti�i�ov
4822 Madison Yards Way ��=� � � � � "� Email dspc ii:wisconsm.aov
PO Box 7302 (� '` � � '''�
Madison, WI53707 ��p � ; � �,�j T011y EVe1'S, �iOVerr101'
;r,F — ti� Dan Hereth, Secretary
i,�iu .s,.-
February 6, 2023 Conditionally
APPROVED
CONDITIONAL APPROVAL DEPT. OF SAFETY AND PROFESSIONAL
PLAN APPROVAL EXPIRES: 2025-2-6 SERVICES
DIVISION OF INDUSTRY SERVICES
Plan Review: PWTS-022300148-C
Keith Stoner �A�'Q �L���
23220 Woodcreek Rd
Siren, WI SEE CORRESPONDENCE
SITE:
Knutson
11901 N Harper Road
Town of Lenroot
Sawyer County
SE % NE % S6-T41N-R9W
FOR:
Description:4 bedroom-600 GPD mound-15"
to limiting factor- Effluent Filter - Mound Component Manual — Ver. 2.1, SBD-
10691-P (S/22-5/27)
Maintenance required. Pressure Distribution Component Manual — Ver.
2.1 (May 2022-2027)
Verify proper dose is achieved and system is not being over dosed.
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative
Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be
constructed and located in accordance with the enclosed approved plans and with any component manual(s)
referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance
with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per
s.145.06, stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
• The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and
removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees
and shrubs flush to the ground and leave stumps. Avoid operating equipment on the
Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid
compaction.
• Components and soil removed from an existing drain field shall be properly disposed of so that there is no
risk to public or environmental health.
• A sanitary permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.19,Wis.Stats.
• Inspection of the private sewage system installation is required.Arrangements for inspection shall be made
with the designated county official in accordance with the provisions of Sec. 145.20(2�(d),Wis.
Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required.
• A copv of the approved plans,specifications and this letter shall be on-site durin�construction and open to
inspection bv authorized representatives of the Department,which mav include local inspectors.
Owner Responsibilities
• The current owner,and each subsequent owner,shall receive a copy of this letter. Owners shall also receive a
copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is
operated and maintained in accordance with this chapter and the approved management plan under s. SPS
383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard,the property owner must follow the contingency plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance.As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building,structure,or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the
address on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and
any others who are responsible for the installation,operation or maintenance of the POWTS.
Sincerely,
J� /�v�vl�y
loshua Rowley
POWTS Plan Reviewer, Division of Industry Services
(715) 634-5124
Joshua.rowlev wiscflnsin.k ov
Fa�e 1 of 7
�TIC��?C �1'tt.� �'1��� ��1�E't
Prc�j�,ct t�amL: T€jdd l�.nutsc�n fieplacenzes�t Mc�ur�d Sy�stestt
Pr���rt���+�ner: "�c�cid K��utscrc�
� l�fl 1 ?�. ���irp�r LL3r.
Flar�ward'Vv'I ��48�3
PFran�: aE 31�_NE 1l�
Section G T41T�i-K�3W
Township. Le�rac�t �.c,unt��: �aw�y��r '
Su�d€4��sivn 1^�arne: �(a Loty�[a
C�mp.#IParcel II?. 57-014-2-41-t19-A6-1 �}4-{�Otl-t}OOOIO
C'C��T`EN��
Conditionally
���; � ������,��r����s�,�et A P P RQV E D
�tt��, ,� P��� �`�� DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
Pa�e: 3 [Vtc�un�i Pl�in V�e��and Ccc>ss S�ct�an �IVISIDN OF INDUSTRY SERVICES
P��e:� Lateral La�'��ut t�rawin� �.�d�.�cQ %���ta.��!
f'a�e: 5 Fump Clzamber C'ross-S��ctic�n
SEE CORRESPONDENCE
Page: 6 Pump C«rve
Pa�e; 7 M�n�gemer�t and�c�nt�ngene�� I}l�nn
A�C�chm�n#s. �4i1 a�d Sit��valuativn Repc�rt�nd�ombinatioz�Tan�C Cross Sectio�
Nfr�und C'�am#��nent .Manual tJ�ed{�'�rsian 2.1} �May ?022-2(l27)
I'ressure �i�#�abutic�n Cc�rnpc�nent Manual(Version?,2?(:Ma��20?2�ZU27}
I3�:si�et:l�:�ith '. �ton ri�. ��, r 157-t}C17 P`hone: 715-653-2324
��'CH E 5�,�'L
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Pagc,3 of 7
�CjUtlt� ���t'l �1�VJ
` , � , : �
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L
a�+I�ur�d com��nent Dimen:�icsns
A �' k�: 32,5�" I�'����2?�f (�,'�� '12,(�f�'
B 1�' F' ._ t (����i�' L I 2�.1��
[7 2l" G 6" � J L�.t6' V4� �35.21'
�,�t �<ft.sq.}C)��;}��rsal C;e#1 Areu �•s��� �ft�}f3�s�t r�re�Atailnbke
�i.�1 ��P�'��i.ia�ar L,�>adi��,itat� �� {�.�� (�Ct)ItiCl �(�bs<�'s�:I'l�u.�na�t
M�und Crass Sectia� V�ew
A��;regat�Dis}�er�al Ar��
Finishcd Grade 9$.{�{�' —_----:
�� � �
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���}� � � . , � ��is��ersaF C��li � . . � �}7.`?3' ���
.-�' � � �= �. _. � ,'-' '�
. � �• � . -
Lateral
'l�isp�rs�al � � . .. , ; ;. vert
In
C�I!
E(evatior�
� �5.0t3` tft)�'�r�taur�levatioa
l6%0 5ite Slnpe
Shading I�ey
�Tc�psail Cap Detail c�f
"Cvpir;al Dispersat�;ell �—~�ec�textite Fataric
Subsc�il C�p d Cnver
(��ASTM G33 Sand ' ' �' '
Tilled Layer
� t����re�ate
't g�picaet�-�t�ra! �`
Observation Pipe to be cc�r���ructed�3f�" di�un.
pipe�al ovater ti�;ht cap,a tninimurn b" �Ic�t
anchored with 3f8"rebar+��a��ater closet e�ltar. $---- A --�
Revised KES UL9/23 Page 4 of 7
Lateral Layout
End Connection Lateral Layout Diagram
Tum-„p wroau�ai�e o��ieao Laterals centered over the A&B dimension
out plug
�
�2.����E P
.S Laterals and Forec Main ofPVC Sch.40
per SPS Table 38430-5
2.��
�X�
Number of Laterals 2 Orfice Diameter 156/5/32" in.
Lateral Diameter �5 ]o. Orifice Spacing(X) 4.00 �
Lateral Length(P) 96.00' ft Onfices per Lateral 25
ft�i
Lateral Spacing(S) 3.00 fr Ori6ce Density �Z'�� onfce
Lateral Flow Rate 13.50 �m Manifold Length 3.00'
fr.
Cell Flow Rate 27�� gpm Manifold Diameter I.5
in.
System Flow Rate 27.00 gpm Total Dynamic Head 10.10 E�.
Lateral Turn-up Detail
Finished Grade Threaded Clea�out Plug or Ball
6"to 8"diameter Lawn Sprinkler Box Valve
�V
ODO�O�
Long Sweep 90 or Two 45°Bends Same
O O O O O� Diameter as Lateral
�O�O�O �
O O O Distribution Lateral
Note:Lateral ends at last orifice where variable
length to cleanout begins.
KES Revised 1/19/23
Page 5 of 7
Combination Tank Component Cross Section
Approved Manhole Covers With Warning Labels
and Locking Device / 4" Min. Above Final Grade
Weather Proof Junction Box
Electric per NEC 300 & SPS.
4" Sch. 40 Verit � 316Al2WAC
> or = to 12" �
Above Final Grade
Disco ect
Altemate Outlet Location
W/Approved 4" Sleeve
Inlet Approved Force Main Diam. = 2 "
Effluent Filter
/7 < or = to 1/8" Weep Hole or Anti Siphon Device
Baffle Particle Size
A
B Pump Off Elev. 92.43'
W LP 1200/800
Wieser C
Tank Mfr. Concrete
D 91.60'
Dose Tank Elev.
Vertical Differencc Betwecn Pump Off and Distribution Pipe = 4.32'
Minimum Rcquircd Supply Pressurc ...................................... = 4.55
30 FT. of Forcc Main x 4.11 Friction Factor/100FT. ... = 1.23
Min. Dose = 88.32 Total Dynamic Head .................... = 10.10'
Max Dose = 120 gals.
Number of Doses ... = 5.65 per Day Gal. Per Day/ #of Doses = 106.31 Gal.
Volumeof Backflow .................................................................... = 4.89 Gal.
TotalDose Volume ..................................................................... =111.20 Gal.
Pump Tank Capacity g00.64 Gallons Dimensions Inches Gallons Note: A two float pump
Pump Tank Volune 22.24 GaUInch p 19 422.56 control switch will be
B 2 44.48 requitred for this
Pump Mfr. Zoeller C 5.00 111.20
Pump Model 151 application
D 10 222.40
Minimum Discharge Ratc = 27.00 GPM
Alarm Mfr. S.J.E. Rhombus Tota1= 36 g00.64
Alarm Model Tank Alert 1
Bed Tank per SPS. 383.45(5)
Anchor Tank as necessary to negate buoyant forces per SPS. 383.43(8)(g).
Note: Pump Controls and Alarm Switch require separate circuits.
� �z��-�
Page �i of 7
'TC�TAL. DYNAl�It� HEAR �
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e�t�� s����� rv�� �r� r �.o e,r� �� a: �, � �o�a
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sr��s� ����E� a�,�a „� � s.a rr� so � 1s � �fl��
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ra�sa �s,n�€� �t�r� �t� � a.s a,��a �o �a � a7 � ��,��
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BN152 Si�i� Aut€� tt5 S 8.5 4110 ' 60 39 18 ' �rse 3
8�152 Si»�se tvaan 2ao t a.3 +�+t0 80 39 t8 " 7.t�r�
IV1''s3 5ingle tVon it5 1 10.� t/2 60 37 17
BNt53 Sirtgte AuYd tt5 �'i 1�7.5 1F? 60 39 18 t 2 oc 3�
�153 �i�g[e Na�t 230 1 5.3 if2 BQ 3T 17 1 2�r 3
BE'f53� S1Rgfe NuR�� 23p ^!� 5,9 td2 � $EI 3� 18 '" 2 tSr�3�
'�BiV attd BE modeis i�ctude a 2U'16 m�P399Yt�adc variable devsi p�mp swit�fi.AQd"rtian�l txaM Ieng2h�'are avail�hte in 25'{8 m1 and 35`(21"m).50'115 m}a�rda ares
�v#iiabie for 23�V units er�ly.
NO7E:Modul t51 has a plastic bsss.Mac�efe T52&t53 ha��cast iron bese.
s�t���to�Gu�r��
7, �or a�tvm�tic,use singi�piggYbadc v�rfab�e tevei fioat switch or doubi�piS�Yback w�riable tevel flQat switt�.
Refer to FM0�77
2. See�M122�for corr�ect modet of simplex cor�irol par+el.
3. See fiM0712 for correct mode!pf dupl�x contro{panet,
"Easy assemhk "
t!P'Tlt}NAL.FUMP STANC�PIN 1tf-�427 � cwmrba,".f��*
� �����a.t
+ Reduces potentiat ala�giag by dabris �
• Replaca�racks or bricic5 under the pump , �
+ Made of durabie,noncprrr�$fve ABS y
• aaises pumP 2"{�aRn}��{F�ai39rr�c�f bagin
• Prc�v�d�s ihe��k�ttty ta r��se Frrtake�*y adtfi���etion��f i�ra"c���° � ,� �
1RPUdfD or 0�154�PVG pipjrt� r
•A'ttaches securely to pump ' _
• Accomr»odat$s sumµ;dewatering and efffuent applicaticsr�� �
NOTE:Rkake su�e ftoat ss free i�om obstructioa. "�`,:t--'""
i�r� 4
.�,������ . All�ins6�i{aHon oi contrvta�,ProCuotiaa d+rvves�and wiring ahpuici��be done by a qu�rli�iad'iicenaed Qig�tti�ien. A.li eie�•ricel and asfe�Y codrs mhauW be
fa7�€rt+esd inclurling tFre.maAt racerzt Nai9anal[iecttieal Cada tNEC1.snd ihe t3acu¢atiq�ai 9afa�ty and HuaCih Aoe{pSHA9.
�C4pyright 2Q'I7 Zaeltsr�'Gq.Atl a3�hfs r�seaved.
�02-7782731 ( 80[3-�28-7$$7 � 3�49Gane i�un ftc�ad ( Lottisviite,K'f dtT211-19fii � zttelterpumps.�am
I�a�e 7 c�f 7 (l c�t 3)
Pri�'at� (3nsite �'4'ast���ter Treatment Sy�t+em Mound
1VIan��ernent Plar�
Pursuar��tt� :4P'i :��3.5� �Vis. �"#ctm, �`udt� eaLh!'rivate C)n�ite Wast�ti�vater'�`r�ati�eni
System (PU4�'TS} Shall Inc�ud� in�c�rmatic�r� an�l procedures for znaintaining the sr;sterrm
v�thin th�paramet�r��f SP� 383 �nd 384, an� th�cc�n�iticans af appr�val by the
departm�nt, a�ent, or gc�v�rnmen#al �it. The��prave� pians a.nd permits ��r t:�� system
wi11 be�led with the caunty zc�ning€�r health�iepartrneni,
'T"his m�ur�a�;ement plan eom�lie�wit��I�S 383.54, Wisc+�nsin Ac�m. Codc,th�Mc�und
Gompar��ni N1an�al �or Private Qn�ite V4Taste�at�r Treatment Systems(Versian�.I�
(Niay 2�'?2-2027�and the Pr��sure I�i�tribtatier�Compe�nent Manual (Versitan?.1}{�Ia�r
��}�2-��27j
Table l: Syst�m I�e�i�n Specificatic�ns
_____�_ _.__._.�e....__�.._.._r __.
S.�ani r Permit Plumber
Number c�f Bedre�c�ms � � _
I�e�si �'kaw{CsP`1�j ��0
Soil Absarptic�n Cam�fl���nt Size (s . ft.} -_� �i(�t�
S� tic T'ank Ca acitv Gal. 120Q
Pum��`��mber C'a�aacit�r C��1. .�.�� S�}0 �.�_.
�° � �c�f Vv`astewatei• �7c�rnestic;
Table 2. Sail Absc�r�tion Carnpon��t—Li��ts �af Reliable �}peraxion
Se tic`I'ank C�m nent ' Soil Abso iic�n Cc�m c��ent
� Desi �'low-Peak (�PII� fi00 6��
_
M�, Influent Particle si�� NA 1/8 �nc�
I�Ia:Kimu�n BC}I� 5 n°� l!� I*�A 2��
Maximum TSS (m= I) NA 15t�
�4�axamurn �C�C� N�. ��
�able 3: Maintenance Sch�dul�
Se tic Tank Ins ct anc�lt�r service once every three ears
(Jutlet �'ilt�r Sh�uld ins ct at the time of tank servicin .
Pum �hamber �I.nsp�ct�t every scpti�t�nk s+�rv�cin�.
Soil abs� tior� Cc�m}�nent �lush laterals�very 18 months,
Page 7'of 7(1 Qf3�
�e�tic fi�nk
T'he septic tank shali be maintained t�y an indiv�cival c;ertified to service septic tan�under sec.
?8 i.��, Stats, The cQntent�c�f ihe septic tank sliall t>e disposed of in acct�rdance v��ith NR 1�3,
Wis,Adm.Code(Servicing �ep#ic ar H�1din�T�n1cs,Putnping Chamb�rs,Grea�Interce�t�rs,
Seepag�Beds, Seepage Pits,Seepage Trenches,Privies,ar Pc�rta6le Res�ms),
`The op�ratin�condition af the �ptic tank and c�u�t�t�)ter shalt be assessed by ins�section ge�
Table 3 af the mainienance sch�ule. Tl���utiet�l�r shall t�cteaned�nece�sar,�to ensure
pmper operatian. The fitter cartrid�e shouid not be removed unless provisions at�e made to�tain
s�lids in the t�nk that may�Ia�t�h offthe filter when rema�ed from its�nclosure. if the filter is
equip�d with an aJarm,the���er sh�((be�rvir�d"af the alarm is actrvated�c�ntinuc�usly.
Intermit�e�t tilter alarms rnay indicate sur�e f(c��rs�r an rm�ending cor�tinuc�us alarm. The:�eptic
tank shatl have its cantents rernaved when the valurt�e af sct�m and sludge in the�nk exce�:ds 113
the liquid�c�lume c�fth�tan�C. Ifthe contents ofthc tarsk are n��rem�v�d at the tim�t�f an
sss�ssment,m�inte,n�nce persor�n�l�hall advise the t�wner af�v�en th�next servic�needs te�be
performed tc�mainiain less than tna�cimum scuEn and slud�e��;�:umulaiic�n in the ta��k.
Pump Ch�mber
T'h�e pump chamber alsc�requires monitc�ring ana sh�u(d be ins�ted w�aen the sep�ic tank
receives inspee,tican or the time�fproblem,complair�i c�r faii�r�.Inspectian shaul�i inelude
checkin�ct�e dose rate,volum�and�requency.
Warning, The dc�s�chamt�er may fill due ta f[Qtiv��ntinuing durin�pump malfunction or p�wer
�aaaiage�. Une larpe das�when the pc��ver com�s c+���r whc;n the gu►np��repaired rr�ay�aus���
tlispersaJ�}ist�em�o hav�prc�btems. In t�tis situatio�,th�pump c�tamber shc�ulci be purn�et�by a
lic�nsed pumper be�are pump cyciing begins or other measures shall be used ta dose the
campc�nent with crniy the pruper amaunt�f influe�tt. This may� inciude manual aperation oftl�e
pump c�ntrc�ls unt�l such time th�e pump�hamber ha�r�e�ched i�s narm�l l�vel.
Septic tank,�nd Purxxp cl�amber ri�r�,aeesess riser�and cc��er��hc�utd be inspect�d f�r wa#er
tight����s and sauncf��;ss, Acc�ss+apenir��s u�ed Fc�r servi.ce and a�sessrn�nt shall �seal�d
w�aterti�t upon th�ee�rnpte�ic�n of seruice, Any c�pening de�med unso�d,detecti�r�,or subje�t to
failure must be re�Iaced. �'xpt>seti access c�penings�reater t�an 8-inches in diamet�r�hall b�
�ecur�k�y�e�"fe�t�ve loekir���evir�t�preve�t a�cid�ntai�ar unauth�►rized en#ry��tta�tank
Warning: No one sh�ruld enter a septie or ather tr�tment on c��lding#�nk for any reason without
be�n�ict full compliance��ith O"�HA standards f�r enterin�a c�anfined space. °I'l�e atmas�he�
within th��ptic or�thet trea�tnent nn c�al�in�tank may cont�in letFt�t���es,and rescue c�fa
person frc�m the int�ri�r af the tank may be difficu[�t or impc�ssible.
Tank abartdonment shall be�c�c�rda�ce+��v�th SPS.�83.��, 1�J`is Adm.��ade w�he� tF�e t.�nk is�ci
ionger used a5 a Pt7W"T�comp�anenx.
Page 7 nf 7 {1 c�f 3j
�rail �b�r�t�on C.c�n��mn�nt
T'h�sc�il aF��c�rpt'st�n ecsa�p�ner�t s�;rvin�?fihis stt`��cture is c�e�igtsecl to aec�pt dt�me�t'sc wastt;va�at�r
frc�n�a r�sidecitial Eac:il`sty. '�`hc limats c��'c,per�t��a�ro c�fthi�cc-�rr�pc+rtent are�hc���n i��'abt�2.
The[ange��i�y of a�c�il absacptic�n com�+�nent ciepends�rc;attv an prc�p�z�and timely maintenance,
and system us���ithin c�r belc�� the Iizr�iis of"r+�li�ble�per�tic�n> rCi�c�d w�t�r c�nservatic�n
pra�ices by�11 oc��pants and�he inst�l lation of��at��cesnservin�plumbing�iatur�s are��y
fac�tQrs in e��i�ding the��s�fu1 life�f this corr�pc�ner�t.
Th���sfl�l absc�rp�ion Gc�nYpo���nt`s op�c�taaa�must be a��essed t���ir�sp�cta�n at least once ever�3 -
year�. �.ateral turn up�are prc��rid��d at the ends of t�e laterals far the purpase c��'fTushin�t�e lines
af any solids. Flushing th�se 1is�es sh�uld [�dune every l 8 rnc�nths, `�l�e inspectior�sFtal! �netude
reccrr�iing I���els uf p�sndin,�, if any, i�elte�b�ervation�iges,�nd visua!inspeclion f�r any
�vid�nce of aur�a�e dischar��frc�m th�compcznent, C)n�t�eply slopir��sites,areas o�'er�sic�n
sh4uld be idet�tified and repctirrted ta the owJner for re�air. The surface discharge nf d�mestic
wa�tewater r�r sewa�e from the systezn is pres�tabited�nd eonsidered a hum�n health hazard.
Traffic arcaund c�r vv�er#ha sail at�sorption c�tt��n�nt shau}d he avc�ided p�rticularty ciurin�
winter months. T�e cc�mpaction ar remc,val Qf snow e��er aver ihe ccsm{�nent may lead to
hydrarsli�#`ail�re!��°f'reezan�. Tta'►�ty�p�c�f�'�ilatrre is usuallv ter�zporacy,but i�d�#�icult crr
irnpt�ssible tr�repair uritil w•�:�ther cc�r�ciiti+���s€mprc�u�. in�;e�e�al,sc�il�ompactic�n ovs�r this
cc���nent�cvil]r�duce dit�usion�f€���t�;en in�o ihe soil ancf di�persal cell,whi��may�lead to
m�r�;int+ense,and�$rlier,�tc���;ing c�f t�r;�oii:
Pl�ting Qf deep mc�t�d tre�s ar�d shr€�bs direc��y aver�r within l0 feet of the c�mpanent shoutd
be avc�ided since r�t intrusivrs intc�tlte com�n�ni ma�r c�bstru�t wast��;ater flc��v.
C�ntin�enc r�.,,i'lan
In the case raf'septic c�r dose tank campanent dama�e.measur��shall be taken to repair or replace
the tanks to'there ari�inai c�peratin�cc�nditio�. Upc�n f�ilure c�fthe distribution cell cc�mpsanent�
the�vstem sl��l�be i�spected to determine�h�cause c�f failur�. Bas�ci crn the tacatian caf the
failure difterent reYnedies ap�ly. Steps ta4cen tca repair thc mauncfs lea�y toe slcape might be the
pla��:ment�ddi�ivn�l �1[a[c�n�the do�vn sla�tc�. F`�ilure w+it�in the di�pet�sal area itsel�';may
invc�[v�tl�e remova�cafia bicr�nat,��h��h vv�su�t�r�quir�c[eani�t�or repl�cern�nt c�f#he distribution
network as well as repiacing the rack and cic�g�e+d portions ofthe sand fiti.
Compc►nent Cl�wn�rs Coutact List
�� _ __..___
J� Ruid (715)49?-�409
Saw er Count Lonin 7]5) &34-82$$
W�eser Crancrete Prc�ducts M�iden Rc��k WI 8{�U)647-'?311
S�e tic 1'um r ��c�ti Pc� e {7�5�63�-7279
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"�''E` ; PRIVATE ONSITE WASTE TREATMENT County
, ,.
'�-��$ ��, SYSTEMS SaWyer
� P ' ( POWTS)
=��� � S �.�
\ti�F_____<;:�,,
F'=s'��='�='" INSPECTION REPORT sanitary Perrnit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION � � _ C� ( Y
Personal infonnaYion you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)]
Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#:
n �k �So v� �`^��"pl��Ol�g-L
Insp BM Elev: BM Description: Parcel Tax No:
o�-a' N��� �-��O�,o� �. �`' DQ�t P�u�,'1�- a�`1 _�Y r_66 - ��o �
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic Q,K� 5���,�/ ��p Benchmark ��.o�
Dosin9 p e.w c� Wi�as�eT I�o ($oo ST'o tiT � , I S-t
Aeration Bldg. Sewer
Holding St/Ht Inlet �,�,5' I
TANK SETBACK INFORMATION St I Ht Outlet 9 Y•
TANK TO P/L WELL BLDG vENr ro ROAD Dt Inlet
AIR INTAKE
Septic .}�' .�.�� +�va ��ss� NA Dt Bottom q� 8 `
Dosing � � � � NA Installation
�a� �� �(w Contour
Aeration NA Header/Man.
Holding Dist. Pipe
PUMP 1�IPHON INFORMATION Infiltrative ,
Surface �6 'g
Manufacturer �� Demand Final Grade
Model Number SI GPM
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L 23` Dia �. `� Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS �N � L �p #of Cells ( Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav ° Conv � Aggregate
INFORMATION P/L Bldg Well Waters � IGP ❑ Chamber
❑ AG ❑ EZFIow Model Number:
CELL TO _��� �}(� �'�.�` j� Mound. o Other
- ---- -� ---
_.__ — -- - — - -- --- --
DISTRIBUTION SYSTEM X Pressure Systems Only
-- - ----__ --------.
Header/Man�fold ti Distribution Pipe(s) ,, � .X Hole Size X Ho e` Observation Pipe�l
Length� Dia �•S _ 1_Length��` Dia� Spac�� � �Spacing �'es ❑ No
SOIL COVER J
- -- _ __— - — - —
Depth Over ,� Depth Over �" �� , Depth of / �� Seeded I Sodded ^! Mulched
Cell Center �� Cell Edges l� ! Topsoil_ b � J�"Yes ❑ No l !�Yes ❑ N�
COMMENTS: (Include code tliscrepancies, persons present, etc.)
�'��((�,� �13 f 2 3
Plan revision re uired?❑Yes❑ No �� �� �� I • � II ��� � � �
q � I � i
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AOOITIONAL COMMENTS ANO ySKETCH �_
SANITARY PERMIT NUMBER. �?J^0I I �� �
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