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Home My WebLink About002-940-21-5416-SAN-2023-145 � �° Industry Services Division County � 4822 Madison Yards Way SAWYER � : .�_' = Madison,WI 53705 Sanitary Permit Number(to be filled'u►by C _ , P.O.Box7162 ,� , ` �S3 � - Madison,WI 53707-7162 � State Transaction Number � Sanitary Permit Application � — In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit �� is required prior to obtaining a sanitary permit Note:Application forms for state�owned POWTS are submitted to Project Address(if different than mailing adc the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary S I S6N Windigo Ln purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. �' S�f I.Application Information-Plexse Print All Informatioo �---- Property Owner's Name paz��q Frank&Diane Dowell 00294021546�• _S-c�// 10 Property Owner's Mailing Address Property Location t1244 Siedschlag Rd c��e�— City,State Zip Code Phone Number Spring Grove,IL 60081 pX„ ,yl�Section 21 _ II.Type of Building(check all t6at apply) Lot# T 40 N R 9 E or W �l or 2 Family Dwelling-Number ofBedrooms 2 � Subdivision Narne Block# ❑Public/Commercial-Describe Use Q City of ❑State Owned-Describe Use CSM Number ❑Village of S ,2�/ � ��O 1�Town of Bass Lake 7•`}0 0 III.Type of POWTS Permit:(Check eit6er"New"or"Replacement"and other applicsble on line A. Check one boa on line B.Complete line C i a licable. `�" �New S stem ( p ) y ❑ Replacement System ❑Other Modification to Existing System(explain) ❑Addidona(Pretreatrnent Unit ex lain B" ❑Holdin Tank �In�'iround ❑ At-Grade ❑Other T e lain g ❑ Mound ❑ Individual Site Design ype( acp ) (conventional) C• ❑Renewal Before ❑ Revision ❑ Change of Plumber ❑Transfer to New Owner �st Previous Perrr►it Number aad D�e Issued Expirazion �� IV.DispersaUTrestment Area and Tank Information: Design Flow(gpd) Design Soil Application Rate(gpd/s� Dispersal Area Required(s� Dispersal Area Proposed(s� System Elevation 300 .7 428.6 4502 89.00/87.00 stepped Capacity in Total #of Manufacturer Tantc Information Gallorrs Galbns Units � � o � � New Tanks Existing Tanks w � y � y a`� v� � o „ � � � � �a a, U ri� H va w C7 p. Septic or Holding Tank 50 50 1 ieser X Dosiag Chamber V.Respensibility Statement-I,the nadersigaed,assame responsibility for insqllatioa of the POWTS shown on the attached plaas. Plumber's Name(Print) Plumber's Signa e MP/MPRS Number Business Phone Number Gerald Froemel �/ �, _�� 95011 I 7I5-558-1138 .,- � U� �� Plumber's Address(Street,City,5hdbe,Zip Code) 13502W Frcemel Rd Hayward,WI 54843 VI.Co n /Department Use Only �Ap 3 ❑Disapproved Permit Fee Date Issued Issuing Agent Signature ,� ❑Owner Given Reason for Denial $-1�•� � I�" � �1 3 '�l�-C�-t�-i Conditions of ApprovaUReasons for Disapproval � �� `� _ ��,�� . � ��3 0 �� ` `!_ _ ° _� ` , �:�� ,. ; �, _ _ _ �.. .. _ _.., �hk# � ��1 � �� ; ' �� JUL t 3 21123 =._�� 5� a-3 � ._ -- - ��S �� -��3. _ _ _�� _--- _,: , ` ;; r��_`i•��Y [.v.vrriCa Hi;.�PVifNISTRNTION Atqch to rnmpkte plaos for the system aad sabmit to ffie Coaaty only on paper not less thae 8 t!2:i l inc6es m size �Li -�� (S A�'V �3- I �I S� N(��1�FUN��AFTER SBD-6398(R.03/211 ��qUE OF PER�IIIT �� Frank � Diane Dowell Property Owners Name 815fiN Windigo Ln Property Address �'1940215407 Tax Parcel Number Sawyer County � � Gov Lot or Qtr-Qtr/Qtr S21 Section T40N Town R9W Range Page Index 1 Property tnformation 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 Dose Tank fi 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 07/13/23 Date Not an endorsement,written or implied for the tollowing companies and produds;DelZotto Concrete,Wieser Concnete Products Inc.,Skaw PreCast Co.,Huffcutt Concxete Inc.,Zabel Environmerrtal Technology,ITT Industries(Goutds},The PeMair Pump Group(Myers},InfiRrator Systems,ADS Products,Polylok Inc.,Orenco Systems Inc.,SimlTech Filter Inc.,Sta-Rite Industries, Page 1 of 7 nna �� -a� In-Ground Soil Absorytion SBD-1070�P(N.01/01)Versi�2�� Component Manual Used 2 Number of Bedrooms 5 Percent Slope (%) 108 �Depth to Soil Limiting Factor(in.) 0.7 .In Situ soil application rate 200 Estimated Wastewater Flow(gpd) 300 �Design Wastewater Flow (gpd) 2 ;Number of System Elevations 89 Proposed System Elevation#1 87 Proposed System Elevation#2 Proposed System Elevation#3 Original Grade#1 92 'Finished Grade#1 'Original Grade#2 90 =Finished Grade#2 "bOriginal Grade#3 �� Finished Grade#3 Infiltrator Quick 4 Standard � Chamber Type 15 Height of Chamber (in.) 20 sq.ft. per chamber 2 Rows of Chambers 5.1 sq.ft. per pair of end caps 3 � =Distance Between Cells (ft.) 22 ;Proposed Number of Chambers Used 428.6 Minimum Distribution Cell Area Required (sq.ft.) 450.2 Distribution Cell Area Proposed (sq.ft.) Wieser 750 ,Septic Tank ose an (if applicable); �� Lifetime �w ;Effluent Filter *'select only if NOT using combo tank Soil Boring Surface Depth to Lowest Highest System Number Grade Limiting Elevation Elevation Elevation Elevation (ft.) Factor (in.) Acceptable � 3.00 -1.25 FALSE 2 3.00 -1.25 FALSE 3 3.00 -1.25 FALSE 4 5 Page 2 of 7 '1 ��,;:~,_�: � . ��, . �- � � � � � , y�. ` -�- `"'� ��t` i �/i�—_%`__ `✓�:':.L:2 �. �C'tCeJ�;'C-•er `�i Vrz55 i._C�;i� �C.:�� tii ?j-;��' Ste,c'±.5c.in't�� `�ct . �Cl�i1. bOZ. � -r(�� - 2( — S�fc;-T L. i �,t S ��'L vt,� '�7 (^FJ ti 2. � L L o ��j � J 2 � ^ d--�p N !� C��t..�J r 5��'. �t s(o� t/�.%:�,��`�� L o�- � LS Yl. S"�3 2(o � ! b b$ � - � � , � ; 4 -��a�� o l: � � �� ; � � � !44C2 �- � ,i � .� � � ,� � a � , � �. ---� �— � 1 G k � i � � � � ��. : ; � ! �. i � .� � ,\ � �I � ^� ! ,1 n � � �;. � , A �'75 i ;6^ ��' ;; � � �� ` �v ,�J'C�'tL i ' �� ';;� �`,;! .� � �1 i ;;:� �'! —1 3 � (i g �5 �G \\ s � j p.�� f \ \ \ � p [0 20 36 �La ,; � � 1 �� ° �,` o � � � � °�\� � '� �,P'�� ` \�' � ��, tib� �� .�5 � � , �- � , .�o�� `, �� ` ` �, oa ` / 1� l ' \ , � 1 � , �B� da� 1 �, ' � l9p• ��` if c . � rc � 3t-'t ico, lyc�i�,�'� ��a;•� Z �,� l�o 5,�� (� oQ�� i �Z Z3� 1 z �z 3� 3.��.73 ` r c a T b � 50� !`'j �1 ��eb- t�a �� ev, �A��r�- ��;� « L.c��.� �`1S` , � 5 s Z� � L a c-q,-��o,� o�- �.o wt.e a-f�r o x�w�a,�-P � ��l( -�o Cm�I� sfbk5 _��--�_ � �-� - =i' � ��5�� Cross Sectior of a Two Cel! In Ground Ccmpcnent Using Leaching Chambers observatio^/ve•,t Pipes � \ 92.00 Finished Grade � �-� � j -- � — Finishetl Grade-� 90.00 Slope 5°h � Celi��§�eperatlon � ..___._.� \+,L�/J' �T��^� Orginal Grede -, ��y�` , �� ,,Pfrginal Grade 9025 Top of Chamber � ��"��,'� I �_ ___ _.'�Top of Chamber 88.25 „ - ,,. 89.00 System Elevation '+• .. ,: �' '" System Elevation 87.00 . •.-'.Yreatrne�t'pnd'D1ype�sal.Lo�c� ' . ' _. _ '.._•• , ' , ' . ._..—_� �. Ur.�dtlny Factor Obse�va:��o-�/Vea: pipes to be wnstucte0 and capped w-th app.oved materiols for the porticular use. Dia rams Not To Scale -- — - - — —� I �� : �� i S _ — — - -- � �_ _ _ � II � �� ea a .--- . .. ... _� � m�w�s.�w��`�'�_. � bservation/Vent Pipes to be located 1/5 to t/10 the length of the distrution cell measured from the end of the cells Page 4 of 7 Frank& Diane Doweil 8156N Windi o Ln 2.94E+09 Number ot Bedrooms 2 Septic Tank Wieser 750 EStimated Flow(average)gallons/day 200 Effluent Filter Lifetime D@Sign FIOW(peak), (Estimated x 1.5)gaVday 300 Pump Tank � #N/A Soil Application Rate gaUday/ftz 0.7 Pump Type Influent/Effluent Qual' Month Average Fats, Oil 8 Grease (FOG 30 mg/L Biochemical Oxygen Demand (BODs) 220 mg/L otal Suspended Solids (TSS) 150 mg/L 0 Servicing frequency of 12 monUis or less requires the �� Management Plan be recorded wdh the Regisfer of Deeds. Maintenance Schedule Service Event Service Frequency Inspect condition of tank(s) At least once every 3 Year � Pump out contents of tank(s When combined slud e and scum = 1!3 of tank volume Inspect dispersal ceil(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 Irestructions 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 identiTy 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 surface. The dispersal cell(s)shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effiuent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condfion and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals 1/3 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 Administrative Code. A service report shall be provided to the County Zoning Department within 30 days of any service event. Start-Up and Oceration For new construction, prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatrnent 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 shart-up shall not occur when soil conditions are frozen at the infiltrative surface. Page 6 of 7 Do not drive or park vehicles over tanks and dispersai celis. Reduction or elimination of the folbwing from the wastewater stream may improve the perfortnance and prolong the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, 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 permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with 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 Plan 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 shail be performed to locate a suitabie replacement area. If no 2placement area is available a holding tank may be installed to replace the failed 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 wetls_ Failure to protect the reptacements area will result 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. i�WARNlNG'� 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 resutt. Rescue of a person from the interior of a tank may be difficult or impossible. POVYTS Installer Septic Pumper Name Gerald Frcemel Name ;Scott 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# 715-634-8288 Page 7 of 7 ="�'""—``;;��i, PRIVATE ONSITE WASTE TREATMENT county ,� �;�� SP ,��, SYSTEMS Sawyer �� s � ( POWTS) \\H �-r!, "F ' INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION o2 3— I�S Personal inYonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(I)(m)] Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: ��1��- �;u,,,�. ��...�.�\ 8.� s t�k� �— Insp BM Elev: BM Descriptio�: Parcei Tax No: � oo-� ` �a;l �,��. 2'y� I/�s,�. ��.'�Gk o�� -aY�..a� ^�!(� TANK INFORMATION ELEVATION DATA b�r'• TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,,ie�t' 7 � Benchmark �oa,o � Dosing Aeration Bltlg. Sewer �q.'�� Holding St 1 Ht Inlet q, Y ' TANK SETBACK INFORMATION St/Ht Outlet $9, ( ' TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic �h�o N g� .}g ` NA Dt Bottom Dosing NA Installation Contour Aeration NA Header I Man. �•?S Holding Dist. Pipe PUMP 151PHON INFORMATION Infiltrative �5..� Surface �• 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 � L � #of Cells Type of System Distribution Media Manufacturer: R� Conv ❑ Aggregate ��( SETBACK P I L Bldg Well OHWM of Nav � �GP (� Chamber ' INFORMATION Waters c AG ❑ EZFIow Model Number: CELL TO � ' ❑ Mound o Other -- �" - —��--- N�-�_ �---- - ------- — —Q��----___ DISTRIBUTION SYSTEM X Pressure Systems Only � — � pO X Hole Size X Hole Observation Pipes - - I Header/Manifold Distribution Pi e s � Length Dia Length Dia Spac ' j Spacing ❑Yes ❑ No I 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.) ��..�(I� ��-��l a3 - - - — - __ Plan revision required?� Yes 0 No �3, �l �J� _ / , �e�� \ __ l�v _ __. Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AODITI�NAL COMMENTS AND SKETCH SANITAAY PERMIT NUMBEA:___�3 _ � �S __ � �� 3 � a-Z �j�-� - �,25\ I � x � �{- � � `� � I �. 4� r. 8, � �'�� v \ .� ,�� ` '� s v��p�, � ��'' v 3 � 1�4 � � • ` � , � / � �� >` `� � '� ! �� Q �� 3 / 6� � � / �G � / �� o� � ��