HomeMy WebLinkAbout026-938-08-5210-SAN-2023-037 Department of Safety c°°"ry �
0 + = & Professional Services, SQw�e r Z
t . Sanitary Permit Number(to be filled in by
�'s Industry Services Division � �1 � � �
•-��,;�,,,.,- I
Sanitary Permit Application State Transaction Number W
— �
fn accordance with SPS 383.21(2),Wis.Adm Code,submission of this form to the appropriate govemmenta)unit 0
is required prior to obtaining a sanitary permit.Note:Application forms for state-0wned POWTS are submitted to Project Address(if different than mailing a W
thc Department of Safety and Professional Scrvices.Personal intormation you provide may be used for secondary �
purposes in accordance with the Privacy Law,s. 1�.04(1)(m),Stats. �(�1..�t.��W �n ne�S �..n
I.Application Information-Please Print All Information
Property Owner's Name Parcel#
a o �C C�c�e�l r-r�s ��c oac�- 938� � Sa�O
Property Owners Maihng Addres Pr�opCerp�Location
P 0 13a 1(� 1 �.�--
ca�c.L�c J
City,State Zip Code Phone Number
�'�e �KQ � W 1 ��,.�(� e (� Section �$
IL Type of Building(check all that apply) Lot# T 3g N R C'� W
�I or 2 Famih�Dwelling-Number ofBedrooms 3 � Subdivision Name
Block# `
�Public/Commercial-Describe Use
--- ❑Ciry of -_-_—
❑State Owned-Describe Use CSM Number ❑Village of
cs n # sac�r [�Town of 5�.�c� `aKe _
v. �7 p. �3S
[I1.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on►ine B.Complete line C i
a licable.
'�� �New System p y g y p )
❑ Re lacemen[S stem ❑ Other Modification to Existin S stem(ex lain ❑Additional Pretreatrnent Unit(explain)
B' ❑ Holding Tank Id,In-Ground�C.wr+� ❑ At-Grade
❑ Mound ❑ [ndividual Site Design ❑Other Type(explain)
(conventional)
C• ❑ Renewal Before �Revision ❑ Change of Plumber ist Previous Permit Number and Date Issued
❑Transfer to New Owner
Expiration � _ �8� � � � �0� 1
IV.Dispersal/Treatment Area and Tank Information: � % (� ,,,,,, Ce 1 I o.S +� `13 Pf B kSa)
Dcsign Flow(gpd) Design Soil Application Rate(epd/s� Dispersal Area Reyuired(s� Dispersal Area Proposed(s� System Elevation
I
yS� a.� /i•� aas / yso a�q.s / y5 O `�'SS.
Capaciry in Total #of Manufacwrer �
:,' ~
"Tank Information Gallons Gallons Units � � � � � .
New Tanks Existing Tanks y o ay�, � v ,a co �
a. U v� y �n w C7 fi
Septic or Holding Tank �
�b c�p 1�O O (,J.'e s t r �o�+c re�c
Dosing Chamber �d� --- (�O O
V.Responsibility Statement- I,the undersigned,assume responsibility for installa6on of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Signaturo MP/MYRS Number Business Phonc Number
(�crra.�d A S rec LS Tc �Li/� � a�Co� g'b 7iS-SS8-G y'7 a
Plumber's Address(Stree City,State,'Lip Code)
9 a�s N s�r�� 2� a� 1�4 �,.�a�c�, c,i3� s�-�8 y 3
V1. un /Department Use Only
�A o ❑Disapproved $ermit Fee� Date Issued Issuing Agent Signature -
� ❑Owner Given Reason for Denial �O' ~I�"�1 I�?� `� ���'"""'-_����
Conditions of Approval/Reasons for Disapproval
�1 � � � ul � N � � 3 _ � � � V �
V W V� � �� '�� _:r:s:t:
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D
�:hk# a�`+ APR 2 1 2023
CJ� � ( — I�� ) �::�t�_ �_�,+`� ._�._._��.�._.... SAWYER COUNTY
ZONING ADMINISTRATION
Attsch to complete plans for t6e system and submit to the County only on paper not less than S 12 x ll inches in size �--��/
NO R�Ft1NDS AFTER `r
SBD-6398(R.03/22) Icu$uC UF F�'EFi+'1�i1�
GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE
Owner Info
Project Name: Hathaway Lodge LLC -Conners Ln
Owner's Name: Hathaway Lodge LLC (Formerly owned by FAS LLC)
Owner's Address: PO Box 161
Stone Lake, WI 54876
Property Info
Property Address: 16442W Conners Ln
Legal Description: S 8 T 38 N R 9 W
Township Sand Lake County- Sawyer
Subdivision Name:
Lot Number: 1 Block Number: CSM#: 5261
Parcel I.D. Number: 026-938-OS 5210
Plan Transaction No.:
Index Pages
Page 1 Index and title Page 9 Plot plan _
Page 2 Data entry Page 10 Tank Cross Section
Page 3 GeoMat dist. cell drawings 8 calculations Page 11 Pump Curve
Page 4 Lateral and cell cross section
Page 5 Management 8 contingency _
Page 6 Maintenance&specifications
Page 7 Tank cross sections
Page 8 Distribution media
Ronald A Spreckels Jr License Number: 226688
Date: 04/21/23 Phone Number: 715-558-6472
Signature:
Designer S mp: State of Wisconsin Approval Stamp:
Designed Pursuant to the
GeoMat In Ground Component Manual April 2019 Version
Page 1 of 11
In Ground and Dosing Distribution Component Design
Site Information
R ResideMial or Commercial Design N ISD Required?
300.00 Estimated Wastewater Flow(gpd)
1.50 Peaking Factor(e.g. 1.5= 150%)
450.00 Design Flow(gpd)
5.00 Site Slope(%)
95.50 Prop. System Elevation(ft) Sand&Native soil Contour
59.00 Depth to Limiting Factor(in)
. 1.00 In-situ Soil Application Rate(gpd/ft)
96.83 Lowest Original Grade Ele. In System Area(k)
97.50 Highest Original Grade Ele. In System Area(ft)
92.08 Limiting Fador Elevation(ft)
0.50 Depth Below Grade
istribution Cell Information
325 Cell Width (ft) 2 Number of Cells
2.00 Dispersal Cell Design Loading Rate(gpd/ft�)
2 Influent Wastewater Quality(1 or 2)
Distribution Infortnation
E Center or End Manifold, Dist Box or Drop Box
2 Number of Laterals System dosed Y
522 Lateral Spacfng (ft)
4.08 Forcemain Drainback(gal) Does the forcemain drain back? Y _. �,
0.50 Forcemain Filter Loss(ft)
2.00 Forcemain Diameter(in)
25.00 Forcemafn Length(ft)
89.34 Inside Pump Tank Elevation(ft)
3 50 System Head (ft)x 1.3
6.93 Vertical Lift(ft)
1.39 Friction Loss(ft)
12.32 Total Dynamic Head(ft) D ,�.�.:st e^ter tnction loss and systein demand lap❑i`�
49.08 Minfmum Dose Volume(gal)
25.00 System Demand (gpm)
Manufacturer Information
Treatment Tank Information Effluent Filter Infortnation
1000.00 Septic Tank Capacity(gap Potylok Inc./Zabel Existing Fiiter Manufacturer
Wieser Concrete Products, Inc. Manufacturer 3014-525-1/16-10,000 GPD Filter Model Number
Dose Tank Infortnation Gallons/lnch Calculator ��; . .. _..
602.82 Dose Tank Capacity(gal) 60282 Total Tank Capacfty(gal)
�1.82 Dose Tank Volume(gal/in) 51.00 Total Working Liquid Dep[h(in)
�Wieser Concrete Products, Inc. Manufacturer � �1.82� gal/in(enter result in cell DoseTankVolume)
Project: Hathaway Lodge LLC-Conners Ln Page 2 of 11
In Ground Plan View
2 cell Q'veolbfat
R
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— � --
Calculations
I ft A 325 ft Basal Area Required 450 ft�
K 1 ft B 43 ft Basal Area Pro osed 450 ftz
S 1.97ft L 45ft
W 10.47 ft
Basal Area Calculation GeoMat Dispersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
450 1 ga�/sq fuday 450 2.00 gal/sq R/day
Total 450 ft2 Total 225 ftZ
Pro osed 279.5 kz
Number of Cells 2 GeoMat Width 3.25 ft
Cell Length ft Lineal Feet of GeoMat Required 69.2
Min. Cell Len th 34.6 ft Lineal Feet of GeoMat Pro osed 86
Cell S acin 1.97 ft NOTE:Min S dimension = 1'
S stem Elevation 95.5 ft
Limitin Factor 92.08 ft
Se aration 3.42 ft z�M�n
Direetions.
Play with cell '.ergth to g2t deslred cell spacing. length and width_ Remembe�syst�-,� ���-1'�..D i_r '�� qa� Fba� r s
wide It must also Satsiv basai loadin rate and GeoMat cell loadln rate
Project: Hathaway Lodge LLC-Conners Ln Page 3 of 11
End Connection Lateral Layout DWgnm
. �- � � . . . �.
. _ . . . _...:�
Hole spacing is every 1T', 1/2"hole at 4 8 8 O'cicek,statling 4 O'clock 6"hom end and
e O'dock Holes at 12"fmm end. 4"Pertoratetl pipe may be used.
Laleral Spacing 522 R Pipe Diameter 2.00 in
isMbation e ross ction
F;.,;�n�n��a� �`� �� �`Y
. . :._.. - .. Di�b�m
I�.-`.� �� . .�. � � lZ"-az n,vro � L+mdl.exl
0.5 fl -� Smd Co�vi°°°mmead°d
( :.: . _,;•.�.
2 in —► pq�clha - , ^ inu � F�x
Y c � \
. . + PiR 1�_'_. ___'.
Topofgeomattobeator �. _ _ _ � � �� � - � �_GFAMAT
below original grade �� 1 � I � I � �2•'—ASIM;3 c,•� I � I , I � I � I Co��mt
In5lvetw StirLce
- _=___NATIVE.SOIL:._-yy=�
59in y �.,
-------���----- ' c�uF.ar�
Observatlon Pipes
.�+w.�
PmGeJOtlf
12"Min. ' __ ..ew �
42"Max.
sm
ro�in ri���. �, ._i«n.,r
� I �� �
I➢15Y. �
�ng6 � mu.u.
' �., � .
°evr"r __,��..___ r
"`�'"`-`�e�rco;iwx� _ wv.
�'���a�:�','�.
95.5
ProjecC Hathaway Lodge Ll.0-Conners Ln Page 4 of 11
Notes/ Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in accordance with SPS 383,Wfs.Admin.
Code,the in-Ground Soil Absorption Component Manual tor Private Onsfte Wastewater Treatment Systems Version 2.0 SPS-10705-P
(N.01/Ot). GeoMat in ground Component manual Apri12019 Version .
1.This POWTS has been designed to accommodate a maximum daily Flow of 45 gAons of wastewater per day. The quality of
inFluent discharge into the POWTS treatment or dispersal component shall be equal to or less than all of the following.
A monthly average of 30 mg/L fats,ofl and grease
A monthly average of 220 mg/�BOD5
A monthly average of 750 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 and preventative action limits specified in ch.NR 140Tables 1 &2 at a point of standards application,except as provided in DSPS
383.03(4),Wis Admia Code.
2.The owner of this POWTS is responsible for system operation and maintenance.
3.Defects or malfunctions identified during mafntenance described above shall be repaired in conformance with SPS383 Wis.Admin.Code,
and the pertaining county Private Sewage Systems Ordinance. The user's manual,provided to the owner of the POWTS indutles 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.
of Commerce in accordance with SPS.3&4,Wis.Admin_Code.
6.If the POWTS is replaced,or its use discontinued,it shall be abandoned in accordance with SPS 383.33,Wis.Admin.Code.
NOTES
Two Effluent Filters to be installed where possible 1 to be installed in ST,and or 1 in pump tank in
order to fnsure particle size less than or equal to 1/S". Filters should be cleaned once in spnng,and once in fall. Also,strainers in sinks in
the building shall be maintained,so that solids and fats are minimized to flow into system
A minimum of 2 observation pipes per cell shall be installed. These pipes shall be located approximately at the end of each cell.
The plumber,or county shall see to it that a copy of these plans 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 the dose tank to fill,the homeowner should see to it that
the effluent level in the tank is brought down gradually and not all dosed to the system at once. One large dose could cause damage.
Contact a pumper or your installer if this problem occurs.
The homeowner is responsible for formulating 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 everybody showers,and uses the toilet,ETC.
CONTINGENCY PLAN FOR COMPONENT FAILURE
A. Septic Tank.Any structural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank wmponent.
Leaks in the joints between manhole risers or covers shall be repaired by replacing faWty seals with approved materials to make joints 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 permanently degraded by clogging so as to interfere with the design flow out of the septic tank.
C.Dosing chamber and pump-The dosing chamber shall be replaced if any stmdural failure is found.Leaks fn joints between manhole
risers or covers shait be repaired by replacing faulty seals wi[h approved materials to make joints water-tight The pump and contmis shall be
replaced when they are no longer capable of functioning according to the design plan.
D. Pressure Distribution Piping.Partial clogging of the distribution network may resuK in unduly long dosing cycles.The ends of the
distribution laterals may be ezposed and the threaded end caps removed.The piping can be disconnected on the outlet end of the pump.
The distribution piping may then 6e back flushed to cleanse any accumulated matter from the piping-It is rewmmended that the dosing
chamber then be pumped by a licensed plumber.
E.Soil Absorption CeIL The dfscharge 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 surtace discharge shall immediately be reported to the appropriate county.The pump shall
then be immediately disconnected to preven[further discharge to the ground surface via the soll absorption cell.The existing septic tank and
dosing chamber shall be used as a temporary holding tank untll the necessary repafrs to the soil absorption cell ran be achieved.The
replacement shall be initiated only after any necessary plan approvals have been obtained from the
appropriate plan review authonty and the required sanitary pertnit is obtained from the county.
Project: Hathaway Lodge LLC -Conners Ln Page 5 of 11
In Ground System Maintenance and Operation Specifications
Service Provider's Name Ronald A Spreckels Jr Phone (715) 558-6472
POWTS Regulator's Name Sawyer County SPIA-Zoning Administration Phone (715)634-8288
Svstem Flow and Load Paremeters
Design Flow-Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 300 gpd Maximum BODS 30 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 139.75 ft Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform t0E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Ins ect and/or service once eve 3 ears
Effluent Filter Ins ect and clean as necessa at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test eriodicall
Pressure System Laterals should be flushed and ressure tested eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Ma[erials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-t, have a watertight cap
and are secured in as shown in the GeoMat In Ground Component Manual Ver.April 2019.
2. Dispersal cell media conforms to GeoMat produds approved for use wdh the GeoMat In Ground Component
Manual Ver April 2019. Media is covered with an approved geoteutile 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-S"Diameter Finished Threaded Cleanout
Lawn Sprinkler 6rade \ Plug or Ball Valve
Box \
y- Vent if i ' ot Dosed
� Lateral Ends at Last Onfice where
- Long Sweep 90 or Two
�45 Degree Bends Same
� Diameteras Lateral
�� � ��Distribution Lateral ��� Lateral Cleanout �
95.5 Feet
Project: Hathaway Lodge LLC-Conners Ln Page 6 of 11
PAGE �(OF �
GRAVITY-DOSED � "f '�
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"9 Venl Pipe
>70 fl fmm
Building ElecMcal musl compty wi1M1
12"Min.or 2A ft above SPS 316 and NEC 300
Es�ablished Flood Hevalion Wealherproof Eniend manhole nser as necessary_
(ryP���� Junctian Box
Approved qpp���Locking Manhole
VentCap ��hWamin LabelAl�ached
IMPORTANT: //////���''' 9
Anchor tank(s)as necessary / �ryP���
pursuant to SPS 383.43(8)(g) �ndU�� �
/ 4"Min.or 20 fl above
Eslablished Fbod ElevaOan
(typiral)
�AiM1ight Seal _ �I/
Finished Grade 1
Quick Disconnect I
18"Min.
CAPACITIES @ 11.82 galfin � cryP'���
Depth(in) Volume (gal) • a �
A 33.00 390.10 —* weev ��—nPP�o�ee�om�s�m
I Hole Appmved Pipe 3 fl onlo
B 2.0 23.64 A sord c�o��a
� (typical)
[C] 4.0 47.24
—nia�
D 12.0 141 .84 B I�—o�
�� PUMP-OFF
* 51 � PumP —� ELEVATION = 90.34 g
Pump Tank Liquid Level = in �
° INSIDE BOTTOM
Force Main Diameter = 2 in c°"Ce`e
� 8�0� ELEVATION = 89•34 ft
3"Appmved Bedding Malenal Beneath Tank
Force Main Length = � 2�ft
Force Main Void Volume = 4•24 gal
[C] Total Dose Volume (TDV) = 47.24 gal/dose
(<�w+force main void volume)
Vertical Lift = 6.41 ft
PUMP TANK: SEPTIC TANK(S):
Volume = 602.82 gal Total Volume = 1000 gal
Manufacture ser Concrete Inc Manufacturer(s Concrete Inc
Pump Manufacturer: Liberty
install approved effluent filter at the septic tank outlet
Pump Model: 253 immediatel�upstream of the �umo tank inlet.,
(See atlached pump curve.)
Controls(Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Lifetime Filter LLC
Controls/Alarm Model: PS Patrol Filter Model: LT-1/8
Float switches containinq mercury are orohibited.
f . I
GeoMat DisMbutlon Cell Msdia Layout
325 Cell Witlth(ft) 2.63 Sidewall to Lateral(ft)
Distribution Cell Cross-section Arrangements
....._... � . . ... _. _ S _ . .... . . � . . . . .
omponent Legend � �� - � � �� � �� � ���
O Distribution Pipe
GeoMat is coveretl with approvetl geoteMile tabnc as per ihe their protluct appmval.
Distribution Cell Plan View Layout-Typical ,
325 Cell WiAth-A(k) 43.00 Celt Length-B(ft)
� � � � � �� � � �� � � � �� � ���.
� � � � � � � � � � � � � � ��
� �� � 1 ispersal Cell
F:�:�hed C�rnAc �`� ` ��v W�
��
I CAa�aeammeoded'�:
12 42 �' B"�f9 , IJ9vill.evd
� _T ;
ApC Dj� - � ���u u ` F�51tr�aw
. ._+ P�Cc '�__
-����._ '_�� . - -- . �_GEAMAT
� � � � � � � 2•ASTM 33°»-� 1 � I , I � I � I �
� —==J — — ——_— ———_ _ Infitiniive SurSce
ey I _ -_NATIVE SOIL-__Ji=�
1 f__ _ _ _ _ � �__�___ � L'�s.+.i�RF�a
1
See tlelails on page 4 for n�m�er,size,a�spacing of lalerals.
Project HaMaway Lodge LLC-Conners Ln Page e of 11
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GALLONSPER MINUTE
�250_P 1 Rl/l7/201 R C��Copyright 2018 Liberty Pumps Inc. AlI rights rescrved. Specifications subject to change without notice.
. Pumps�
_� W1000/600-MR
y 14��. TANK SPECIFICATIONS � �
o �
DIMENSIONS: a a
� WALL• 2 1�2�� �
80TTOM: 3" �
COVER; 5"
MANHOIE: 24" I.D. PRECAST CONCRETE RISER �i
C � � HEIGHT: 69 1/2" O.D. 'i�
/ \ LENGTH: 114 7/8�� O.D.
WIDTH: 93" O.D. p
BELOW INLET: 57" O.D. ��
LIQUID LEVEL: 51" N�o
� mz4"� � � WEIGHT: 12,380 LBS.
°' TY� � � INLET AND OURET: N
4" CAST-A-SEAL B00T OR EQUAL
FILTER OR GASKET, CAST-A-SEAL B00T OR EQUAL � a �
� �
\ BAFFLE / INLET AND OUTLET BAFFLE AND FILTER; m =
� � � WISCONSIN, SEE DETAII /�10 � ' �
._ (OTHER STATES SEE CHART)
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LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC) � �
11.82 GAL/IN (PUMP) W�
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TOP VIEW LOADING DESIGN: 8' 0�� UNSATURATED SOIL �y,��
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MN TANKS: ���p
WILL HAVE ONE VENT OVER OUTLET C��
AND WILL HAVE TWO VENTS IN COVER OVER INLET p z�
N Q 4" VENT TANK CAN BE USED AS: �a�
a� �
� SEPTIC/SEPTIC, SEPTIC/PUMP � N
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�n OR SEPTIC/SIPHON W� I
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COVER: MIX DESIGN �y8 (NO FIBER) ���
WLET TANK: MIX DESIGN #10 (STRUCTURAL FIBER) _�
-- OUTLET
CUSTOMIZED TANKS: �M
FOR CUSTOM TANKS CONTACT WIESER CONCRETE 3
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JOB INFORMATION: g F o
� PUMP PAD 3 w �
CUSTOMER: �
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JOB NAME: �
SIDE VIEW DATE NEEDED:
SHEET N0.
APPROVED BY: q
APPROVAL DATE: I OF/
TANKS ARE MANUFAC111RED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS � �
/�""T"E�><,. PRIVATE ONSITE WASTE TREATMENT county
i j 7�o$p \�j�� SYSTEMS Sawyer
`\����% ( POWTS)
��\S='°�°'y/ INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION � � �3 �
Pe�sonal infonnation you provide may be used for secondary purposes [ Privacy Caw, s. 15.04 (1)(m) ]
Permit Holder's Name: ❑ City ❑ Village �Town of: State Plan Transaction ID#:
et�Pf v"a � �_ �" L� �af�1o� �K-�--
Insp B Elev: BM Description: Parcel Tax No:
�oo .o " N�; ( � R�l�.�-, i .. �7 `' �,.11,,;�- �P,1�.�._. a�� -�'38- os - 5�-�a
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic w�,�.�— — � Oo�o Benchmark �pp,o �
Dosing —�„�bn dpo
Aeration Bidg. Sewer q�{,�'� �
Holtling St / Ht Inlet �3.�Y�
TANK SETBACK INFORMATION St / Ht Outlet q3, CY �
TANK TO PIL WELL BLDG vENr ro ROAD Dt Inlet
AIR INTAKE
Septic �co` N /{ a-�6� +tS � NA Dt Bottom �'1, 3 y �
Dosing � �� K « NA Installation
Contour
Aeration NA Header/ Man.
Holding Dist. Pipe ,�S-'
PUMP 151PHON INFORMATION infitrative
Surface �'�S �
Manufacturer �,� Demand Final Grade
Model Number �S- GPM `� C-33 9'(o.S �
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L �2�'� Dia �" Dist. To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W �d, � L �{S # of Cells � Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav � Conv ❑ Aggregate ���q
INFORMATION P / L Bltlg Well Waters � IGP ❑ Chamber
❑ AG ❑ EZFIow Model Number:
CELL TO � N .� � ❑ Mound �c Other � �e ( I S x`f3 �
-- -- --- ----
DISTRIBUTION SYSTEM X Pressure Systems Only
- -_ _ - --- — —
�Header / Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipe�
Length _ Dia Length Dia Spac Spacing ❑ Yes ❑ No
SOIL COVER
- — ---- ---- - - -
Depth Over Depth Over Depth of Seeded / Sodded Mulched �
-----
Cell Center Cell Edges �Topsoil _ ❑ Yes ❑ No � ❑ Yes ❑ No
— -___ — -
COMMENTS: (Include code discrepancies, persons present, etc.)
� ' � a t,3� ��5� � �Q/J i 1 ��( ��� 3
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Plan revision required?� Yes ❑ No �
3 c �-3 �.: � 6� � 1� —�
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710 (R.3/01)
AODITIDNAL COMMENTS ANO SKETCH
SANITARY PERMIT NUMBER: �_� 3�_
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