HomeMy WebLinkAbout010-941-32-3108-SAN-2023-030 County: �
��p. � Safety and Buildings Division Sawver �
Sp �� 20tW.Washingtonave.,PA.Box7�62 SanitaryPermilNumber(tobe(ill
S Madison,WI 53707-7162 -
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Sanitary Permit Application StateTransaction Number �
rdancc wlth s_comm 83 21(2),W i..Adm.Code submfssion of thfs form to thc approperate govcmmcntal unit fs rcqufr �
ining a sanilen�permiL Notc.Appllcauon fo�.ns fur state-o�cned PON'I S are submitted to department of commerce.Pe ProjeCt Addres5 �
infortnation you providc may bc uscd for sccondan purposcs in accordancc wlth pnvacy lae�,s.15 04(I)(m),Stals. (i/di/ferent than meiling addn �5
I.Application Information-Please Print All Information 16542W US Hwv 63
PropertyOwnersName�. Parcel#p�o-9Y/-3�-,31C
Daniel R Thomoson :44145
Property Owners Mailing Address: Property Location
W5937 Shell Creek Road Govt Lot NE114 �tlq
City,State: Zip Code Phone Number S32 T41N R9W
Minono-WI 54859 0
II.Type of Building(check all that apply) Subdivision Name:
❑� 1 or 2 Family Dwelling-�t of Bedrooms Lot# ._
2 0
❑PubliUCommercial-Desaibe Use Block# —" O ❑Ci�, �Village
❑State Owned-Describe Use CSM Number
Y7 �� 0 ❑� Township
III.Type of Permit:(Check only one box on line A.Complete Line B if Applicable) Havward
A --�Replacement System �Other Modifcation to Ezisting System(explain) ❑Additional Pretreatment Unit
B ❑Holding Tank �In-Ground(Conventionap ❑At-Grade ❑Mound ❑Individual Site Design ❑OtherType(ezplain)
�Permit Renewal Befo�Revision ❑Change of Plumber ❑Transfer to New Owner List previous Permi=Number and Date Issued
C� Ex iration
IV.DispersallTreatment Area Information: 22 �4 Chmbers
Design Flow(gpd) Design Soil Application Rate(gpds� Dispersal Area Required(s� Disp.Area Proposed(s� System Elev.
300 gpd 0.70 gpdsf 428.60 Feet' s -42�8-fwet� 97
Capacity in Gallons Total #of Units Manufacturer Prefab Site Steel/Fiber.
Tank Information New Tank Exist Tank Gallons Concrete Constructed or Plastic
Septic or Holding Tank 1000 1000 Huffcutt X
Dosing Chamber 0,--�"� �- 0 Huffcutt X
V.Responsibility Statement-I e undersigned,ass e res nsibility for instalation of the POWTS shown on the attached plans.
Plumber's Name(print) lumb 5 nat e Jy1P/ ,S Number Buisness Phone Number:
Mark S.Thomoson �-r1�: .� 7598 715I699�081
Plumbers Street Address(Stre , ty„State i C e)
P �Box 657 Ha ard I WI 54843
VIII.County/Department Use Only
�Approv9 �3 Z3❑Dissaproved Permit(Fee: Date Issued-. Issuing Agent Signature
�/ ❑OwnerGiven Reason for Denial 7��� '`��'`���'�' �1�t'i.�+.-�.�j'r-,i-u*-
Conditions of ApprovallReasons for Disapproval
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Attach complete plans(fo the county only)for the system on paper not/ess than 8%x 11 inches in size
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SBD-6398(R03/21)
NO R�FJ�DS AFfER
ISSUEOF�;V;�7
PAGE 1 OF 4
In-Graund Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soii Absarption for POWTS Versian 2.1 (May 2022-2027)
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plo# Plan
Pg 3 of 4 Dispersa( Area �ross-Section & Plan View
Pg 4 of 4 Management Plan
Attachments: Enclosures:
POWTS Applica#ion for Revi�w
Soil Evaluation Report & Site Map
Huffcut Septic Tank S ecs
Project Name / Description
Dan Thompson 1 Conventional
OwnerName(s): Daniel R. Thompson Phone: 715 _699 _4084
owner Address: W5937 Shell Creek Road, Minong, WI Zjp; 54859
Praject Address: 16542 US Hwy 63, Nayward WI 54843
Govt. Lot: NE 1/4 of SE__ 1l4, Section 32 , T�� N-R9 E❑or W �
Township: Hayward co��,�y: Sawyer
Pro�ect Parce� �o #: 01�941323108
Designer Information
Designer Name: Mark S. Thompson Phone: 715 _699 _4081
Designer Address: 12006N US Hwy 63 zip; 54843
E-mail: dighayward 1�1 @gmail.com ; ., � ._ . , �{;; . � �.:,,..:..
License Number: 877598 �;:�,���- -;�, -- _,
`�.,f`���` -C-.=.1���I�'1"'i;
Remarks: ;��� _---� -:u�,�i
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,��r� � 3 �ZQ�3 �,
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�:Ax'�YtR COUNTY
_ ��'-?`ddi�,t�Div11NlS�RA710N
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Signature:���'����' %�'i�` °° ��'� Date: �/13123
riginal si ature equired each submi e opy.
Qwnee information� � BM=10d� Toq of concrete slab on the N comer of Bfdg Pg 2 of d
tYame: Daniel R Thompson
Location: 16542W US Hwy 63 B1 = 99.fl4
Township: Hayward g2� gg.pg
County Sawver g3= 9$.7g
Lot#: 0 Lake= 0
Huffcutt 1000 Gal Se tic Tank w/ Flter weu
2 Rows af 11 each Infiitrata 4 t e drainfield material ��
Abandon House
�o^�
��
B3 B.�'1� Driveway �
J
�
62 B1 1 Bedrflom House
0 40 80 X: ' �
„
� M : r S hompso
N � �_.��77s9s
���=ao� 715/634-3139
Septic Tank(s)Manufscturer
IN-GRUUND GRAVITY DISPERSAL AREA Huffcut
Uniform Elevation Trenches with Quick4 Standard-W Chambers SepticTank(s)Volume(s):
3-ft Trench (down-sizing credit) �oaa ga, gal
gal gal
Effluent Filter Manufacturer:
� , ..................
Best
..._.. . ..
Effluent Filfer Model#: �F ��
—min.12��
S01L COVER f�YP�caI)
12..
m�n hench
depth •
«p��a�> ��� � � TYPICAL TRENCH
__ ... ,_ __ . . , , .a�4�.a CRQSS SECTION VIEW
�.�-- 34 , �°� � � (No Scale�
(�YPica!) ..a . .
o . a,. , e.
. � " Provide minimum 3 ft
System Elevation = �� ft separation between trenches.
(typical)
Quick4 Standard-W
w/End Cap (Show location of inlet/ out{ef pipe connection on plan view.) Obse�t�pio�n�)ipe TYPICAL TRENCH
(typical) Install per manufacture�'s PLAN VIEW
instructions.
(No Scale)
�� �-��,�������<'e�"m�'�����`T _ � .r�� T - - - � ._._ � ..�/� - - - ���k����'�����+r�r���',��
�� � °� � � � � ,�.a� : ��i A t�p �) _
���'�,�-��,�����,�'�v����ci�i��— — — — ��?��� �u.���-����'���,��";��'�� ical �
— —�� - - - - — — — ��— ._ r. ..�. ._._ � _ _ —.
�.. g - 44 ft •`� tTl
(typical} Quick4 Standard-W Chamber W
INSTALL PER TRENCH: (typica�) �
(mfd by Infiltrator 5ystems,I�c.) �
Install pursuant to manufacturer's instru�tians.
� � Quick4 Std-W @ 20 ft� ElSA(chamber= �20 ftz �'
+ �� Pairs of end caps @ 6 ft2 EISA/pair= �'�'..._E_, ft7 `��2���
= Proposed EISA per trench= ��'�O ft2 Required Infiltration Area= � ft2 Distributian Method:
y branched manifold
x � trenches = Proposed Total EISA = � ft2
F���ET�
PAGE 4 OF 4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system shall be respo�sible 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.
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 Disnersal Area Operatinq Limits:
Design Flow= 300 gpd; BODS<_220 mgL"'; TSS<_150 mgL''; FOG<_30 mgL"'
Inspection Checklist INSPECT EVERY 3 YEARS
c type of use
o age of system
" nuisance factors{i.e.odors,user complaints,etc.)
o mechanical malfunction(i.e.,pumps,valves,switches,floats,etc.)
o material fatigue(i.e.,ieaks,breaks,corrosion,etc.)
o sotids 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.)
c extent of ponding in distnbution cell prior to dosing
� dosing irregularities-if applicabie(i.e.,pump re-cycling,float switch settings,etc.)
o electrical components-if appGcable(i.e.,wiring,connections,switches,controls,timers,alarms,etc.)
o distribution lateral or laterai 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 tank(s)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(1l3)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(s)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 Wisc.Admin.Code. Report any component failure or maltunction to:
Name of individual or company: MaPI( S. TIlOCT1pS011 Phone: 7�5.699.4OH�
�oca1 govemment unit: SaWYer COLItIt)/ZOtllilg Phone: 7�5.�34'.HZSH
�o�a�go�emment unit address: 10610 Main St. #49 Nayward, WI Z�P: 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.
Continqencv Plan
In the event that any failed treatment component of this POWTS cannot be repaired,it shall be repiaced 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 dispersai component in a pre-determined area of suitabie soils.
�stem Abandonment
If use of this POWTS is discontinued,it shall be abandoned in accordance with SPS 383.33,Wisc.Admin.Code.
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� PR�JECT� 4154 123rd STREET ���a N.P.C.A. CERTIFlED PLANT
� HUFFCUTT CHIPPEVA FALLS, VI 54729 ���� �
� 1,000 GAL. L�W PROFILE ����
N P U M P, S E P T I C, (7 1 5) 7 2 3-7 4 4 6 * (8 0 0) 9 2 4-1 5 1 6 ���� M E M B E R O F:
❑R HOLDING TANK C 0 A C R E T E. �n Ci FAX (715) 723-7111 � www.huffcutt.com ���o NAiIONAL dc IMSCONSN PRECAST CONCREIE ASSOqAl10NS