HomeMy WebLinkAbout024-175-00-0100-SAN-2023-168 ��`""""`' Department of Safety cO°"ry `f'
::,- ,-� �
�_'��,�• = & Professional Services, �`'`"� � �
; � _ = Sanitary Permit Numb (to be filled in by C
,,: `; �_ � Industry Services Division
�°_� .w" (.� 5 I o�� � �; ,
State Transaction Number 1
Sanitary Permit Application �
In accordance with SPS 383.21(2j,Wis.Adm.Code,submission ofthis form to the appropriate govemmental unit �
is required prior to obtaining a sanitary permil Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing add �
the Department of Safet}'and Professional Services.Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law,s. 15.04(I)(m),Stats. ��.{�
L Application Information—Please Print All Information
Property Owner's Name Parcel#
�cce11 ♦ : ll;e, c� Oay- J'�'S' C�O 0100
Property Owners Mailing Address Property Location
� �, N �tr�, a� c.,� Govt.Lot
City,State 7_ip Code Phone Number
� W 0.r C� � W'= S�8 y3 %a, '/<, Section ��o
[L Type of Building(check all that apply) i-a�# T 1 N R O"7 E-er
�Ior2FamilyDwelling-NumberofBedrooms 3 f SubdivisionName
B(ock# T�� E(Z G A T
, 0 PubliclCommercial-Describe Use
❑City of
❑State Owned-Describe Use CSM Number ❑Village of
.�Town of���-�
I11.Type of POWTS Permit:(Check either"New"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C i
a ticable.
A.
❑New System �Replacement System ❑Other Modification to Exis[ing System(explain) ❑Additional Pretreatment Unit(explain)
B' ❑ Holding Tank �In-Ground �jCCr'^4k ❑ At-Grade
❑ Mound ❑ Individual Site Design ❑Other Type(explain)
(comentional)
C• ❑ Renewal Before ❑ Revision ❑ Change of Plumber is[Previous Permit Number and Date[ssued
❑Transfer to New Owner
Expiration S3 �' I � '-j/�q
IV.DispersaUTreatment Area and Tank Informarion:
Design Flow(gpd) Design Soil Application Rate(gpcUs� Dispersal Area Reyuired(s� Dispersal Area Proposed(s� System Elevation
y o �. � ��. o aa i / aas 3 3 � / aa� �a.7S
Capacity in Total #of Manufacturer
Tank Information Gallons Gallons Units � � o � �
New Tanks Existing 1'anks y o v � � � «+ �c�'a
a V v� � v� u- C7 0-
Septic or Holding Tank I O� U � 1�(o� � �n �t �,`�•a}.�S s ' `
1
Dosing Chambcr
V.Responsibility Statement- 1,the undersigned,assume responsibitity for installation of the POWTS shown on the attached plans.
Plumber�s Ndme(Print) Plumbefs Signature MP/MPRS Number Business Phone Number
�.�a r� S x�-►4� S� �� a�G�a8 �.s-sss-Gy'�'J
Plumbers Address(Street,City,State,Zip Code)
01�5'l�( S'�`o•}t �oacl a�7 ci ard 1,.� 2 St'/$�!3
V1.Coun /Department Use Only
�Ap �� ❑Disapproved $ermit Fee Date Issued Issuing Agent Signature
' Cj Owner Given Reason for Denial
ya� � �3� ) a� -�.�U�t+�--
Conditions of ApprovaUReasons for Disapproval
�at� � a 3 � ����� �'
,, � �� � _� D
�I IN�
�hk# :. ���� -� JUL 2 8 2023
Cs 1� �-3- � �� ::�� � �.y�o.
,,.qt:.._.__._��_ _._.__.__.__ _�_____ �q�rv'1'G�i Ci�UNTY
Attach to complete plans for the system and submit to the County only on paper not Iess than 8 1/2 x 11 ioches in size '1 ���S
NO RCFUNDS A�TER u�
sB�-639s(x.o3i22� ISSUE OF F'ER�lif
GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE
Owner Info
Project Name: Olson-Loon Bay Ln
Owner's Name: Darrell&Billie Olson
Owners Address: 11122N Loon Bay Ln
Hayward,WI 54843 _ �
Property Info
Property Address: 11122N Loon Bay Ln
Legal Description: S 16 T 41 N R 7 W
Township Round Lake County: Sawyer
Subdivision Name: TIGER CAT
Lot Number: 1 Block Number: CSM#:
Parcel I.D.Number: 024-175-00 0100
Plan Transaction No
Tndex Pages
Page 1 Index and title
Page 2 Data entry
Page 3 GeoMat dist.cell drawings&calculations
Page 4 Lateral and cell cross section
Page 5 Management&contingency
Page 6 Maintenance&specifications
Page 7 Distribution media
Page 8 Plot plan
Ronald A Spreckels Jr License Number: 226688
Date: 07/28/23 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 8
In Ground and Dosing Distribution Component Design
Site Information
R Residential 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)
14.00 Site Slope(%)
92J5 Prop. System Elevation(ft) Sand 8 Native soil Contour
89.00 Depth to Limiting Factor(in)
1.60 In-situ Soil Application Rate(gpd/ft�)
94.50 Lowest Original Grade Ele. In System Area(ft)
96.50 Highest Original Grade Ele. In System Area(ft)
87.08 Limiting Factor Elevation (ft)
2.25 Depth Below Grade
Distribution Cell Information
325 Cell W idth (ft) 2 Number of Cells
2.00 Dispersai Celi 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 Laterais System dosed N
4.25 Lateral Spacing (ft)
Svstern -��r h��.e'7
Manufacturer Infortnation
Treatment Tank Information EfFluent Filter Information
1060.00 Septic Tank Capaciry(gal) Lifetime Filter LLC Filter Manufadurer
Infiltrator Systems Manufacturer LT 1/8 Filter Model Number
Project: Olson-Loon Bay Ln Page 2 of 8
In Ground Plan View
2 cell�neoRRat
R
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. o0000000000000000000000000000000000000000000�0�0°0°0°0�0� o 0 0 0 0 0 0 0
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Calculations
I ft A 325 ft Basal Area Required 28125 ft�
K 1 ft B 35 ft Basal Area Proposed 332.5 ftZ
S 1.00 ft L 37 ft
W 9.50 ft
Basal Area Calculation GeoMa[Dispersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
450 1.6 gausq ruday 450 2.00 gausq ruday
Total 28125 ft2 Total 225 kz
Pro osed 227.5 ftz
Number of Cells 2 GeoMat Width 325 ft
Cell Length ft Lineal Feet of GeoMat Required 692
Min. Cell Len th 34.6 ft Lineal Feet of GeoMat Proposed 70
Cell Spacin 1.00 ft NOTE Min S dimension= 1'
S stem Elevation 92.75 ft
Limiting Factor 87.08 ft
Se aration 5.67 ft 2'htin
Directioas.
Play with cell ie, _. _, � �'�JLC t ��ge �_ ., .
wide. It must _:.:- . ,. -� �a ��,�� ;�-� ,;.:
Project: Olson - Loon Bay Ln Page 3 of 8
End Connection lateral Layaut Diagram
�.
n.:s
Hole spacing is every 12", 1/2"hole at 4 8 B O'clock,starting 4 O'clock 6"from end and
e O'clock Holes at 12"fmm end. 4"Pertorated pipe may be used.
Lateral Spacing 425 ft Pipe Diameter 4" in
uHon ei roas Sectlon
�����n�e c�a� �� ��Y �'"y
- m�m
I���� 1z"�z n.nrn �.� I�ILevd
zzsn — 4
T�.
4"in �► P1peDIL-.�'� '� i.0 \ FIn5ltretYe
. . � PWv '�'_
Top of geomat to be at or ��. _ _ _ - � GFAMAT
below original grade � � � � � I � �2:�ASTM;'-3 c� I i I , I � I � I �
ia5la�tw S1uLce
- __-NATIVE.SOIL=_=__�
89in y
� I ____�___�____ L6".i�7F�
Obsarvation Pipes
w.�*�mw
m...ea.a.
12"Min. I� ' I_.__ a�mmm._\\
ti
42"Max. �
i
sm
r,.a.�rm�a. i � n��.�.
Ti�'ist. � . ,:' �`...., .�
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neanr I_. ._ _ _ _
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'=�r�a-�T"�'
9275 -
Pmjeci: Olson-Loon Bay Ln Page 4 of e
Notes/ Maintenance Requirements
MANAGEMENT PLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in acwrdance with SPS 383,Wia Admin.
Code,the in-Ground Soil Absorption Component Manual for Private Onsfte WastewaterTreatment Systems Version 20 SPS-10705-P
(N.01I01). GeoMat in gmund Component manual April 2079 Version_
t.This POWTS has been designed to accommodate a maximum daily flow of 45Q,7QRons 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 monthty average of 30 mg/L fats,oii and grease
A monthly average of 220 mg/L BODS
A monthty average of 150 mg/L TSS
Wastewater shall not discharge to the POWTS in quantities or qualities that exceed these limits or that resWt in exceeding the enforcement
standards and preventative action limits specifed in ch.NR 140Tables 1 &2 at a point of standards application,ezcept as provided in DSPS
383.03(4),WisAdmia Code.
2.The owner of this POWTS is responsible for system operation and maintenance.
3.Defects or malfunctions identfied during maintenance descnbed above shall be repaired in conformance with SPS383 Wfs.Admin.Code,
and the pertaining county Private Sewage Systems Ordinance. The user's manual,provided lo the owner of the POWTS includes the names
and telephone numbers of the properly licensed fndividuals to wntact 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.364,Wis.Admia Code.
6.If the POWTS is replaced,or its use discontfnued,it shall be abandoned in accordance with SPS 383.33,Wis.Admin.Code.
NOTES
Two Effluent Filters to be fnstalled where possible 7 to be installed in ST,and or 1 in pump tank in
order to insure particle size less than or equal to 7/8". Filters should be cleaned once in spring,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 approximatety at the end of each ceIL
The plumber,or county shall see to d 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,eledncal outage causes the dose tank to fill,the homeowner should see to it lhat
the effluent level in the tank is brought down gradualty and not all dosed to the system at once. One large dose wuld 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 rerety ovedoaded. LE.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 stmclural failure resulting in cracks or leaks in the tank must be corrected by replacement of the septic tank component.
Leaks in the joints between manhole risers or covers shall be repaired by repiacing faulty seals with appmved materials to make joints water-
tight.
B.Outlet Filtec The outlet filter shall be replaced or repafred when it is either no longer capable of preventfng the discharge of particles larger
than t/8 fnch or when it has become permanently degraded by clogging so as to interfere with the design Flow out of the septic tank.
G Dosing chamber and pump.The dosing chamber shall be replaced if any structural failure is found.Leaks in joints belween manhole
risers or covers shall be repaired by replacing taulty seals with approved materials to make joints water-tight.The pump and controls shall be
replaced when they are no longer capable of functioning according to the design plan.
D. Pressure Distribution Piping.Partfal clogging of the distribution nelwork may resWt in unduly long dosing cycles.The ends of the
distribution laterals may be ezposed and the threaded end caps removed.The piping can Ce disconnected on the outlet end of the pump.
The distribution piping may then be back flushed to cleanse any accumulated matter from the piping.It is recommended 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 heatth hazard
created by the effluent.AII failures created by surface discharge shall immediately be reported to the appropriate county.The pump shall
then be fmmediately disconneded to prevent further discharge to the ground sudace via the soil absorption cell.The existing septic tank and
dosfng chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorption cell can be achieved.The
replacement shall be initiated only after any necessary plan approvals have been obtained from the
appropriate plan review authority and the required sanitary pertnR is obtamed from the county.
Project: Olson - Loon Bay Ln Page 5 of 8
In C3round System Maintenance and Operation Specifications
Service Provider's Name Ronald A Spreckels Jr Phone (715) 558-6472
POWTS Regulators Name Sawyer County SPIA-Zoning Administration Phone (715)634-8288
Svstem Flow and Load Parameters
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 1060 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 113.75 ftZ Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service Frequencv
Septic and Pump Tank Inspect andlor 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 erfodicall
Pressure System Laterals should be flushed and pressure tested eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, 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 products approved for use with 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 Turn-up Detail
6-8"Diameter Finished Threaded Cleanout
Lawn Sprinkler Grade \ Plug or Ball Valve
Box \
y Vent if i � ot Dosed
: � Lateral Ends at Last Orifice Where
� Long Sweep 90 or Two
�45 Degree Bends Same
Diameter as Lateral
r
� Distribu[ion Lateral � Lateral Cleanout
92.75 Feet
Projed: Olson-�oon Bay Ln Page 6 of 8
GsoMst DbMbutlon Cell Media Layout
325 Cell Witlth(ft� 2.63 Sitlewall to Lateral(ft)
Distribution Cell Crosssection Arrengements
.. ... � _. _ S _ . __...fl .
0 DiSldbulion Pipe
GeoMat is covered with approvetl geoteutile fabric as per the their product approval.
Distribution Cell Plan View Layout•Typical
3 25 Cell WiMh-A(ft) 35.00 Cell Length-B(k)
� � � � � .� � � �� � � �� � � ��;
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Typieal Dispenal Cell � �
F:njcl.'.1[':r�A� �✓Y ��v W Y
-. . • �ISQiblmm
12 -02�� �.` Aaelfe �-. JJ4Sf�[lVt�
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r �' �/ T �I� IL�hfhVC
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� � � � � � � 2'ASTM_33 °a' � i � ' � ' � � I SnfiltxativeSurfice
e�y =-�_IVATIVE SOIL-�=_=y�
I I�_ - - " - - -��_�___ �_ LT�6F�
I
See details on page 6 for num�er,size,arM spaciig of latxals.
Project: Olson-Loon Bay Ln Page 7 oF 8
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� `"T"``�; PRIVATE ONSITE WASTE TREATMENT County
��� � SYSTEMS
��-;,���P s ��' S awyer
�_ ;,' ( POWTS)
' '"��' INSPECTION REPORT sanitary Pe�mit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION 2 3^ ` �,�
Personal infonnation 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#:
�a�c-L`` d-��1\�e.�s�ti, �v�� �k.� .—
Insp BM Elev: BM Description: Parcel Tax No:
loD� o �a ��_ a�.`l- ��S`-ao-o�oo
TANK INFORMA ION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic ^ �p`D Benchmark pp ,o
Dosing
Aeration Bldg. Sewer,�r �,� '
Holding St/Ht Inlet �
TANK SETBACK INFORMATION St/Ht Outlet �, 3 �
TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet
AIR INTAKE
Septic -�-�b� _ a �.ct� ,} � NA Dt Bottom
Dosing NA Installation
Contour
Aeration NA Header/Man. `�6 � t
Holding Dist. Pipe
PUMP 151PHON INFORMATION Infiltrative
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:
SETBACK OHWM of Nav � Conv � Aggregate
INFORMATION P/L Bldg Well Waters o GP ❑ Chamber Model Number:
❑ EZFIow
CELL TO ❑ Mound o Other
-_ __- --- --- -- - -- — _ ._. _
DISTRIBUTION SYSTEM X Pressure Systems Only
—_ __ - ----- ---—— ------—
Header/Manifoid Distribution Pipe(s) ! X Hole Size X Hole Observation Pipes ��
Length Dia Length Dia Spac Spacing ❑Yes ❑ No �
--
___-- —
SOIL COVER
_ --- — --__-- —
Depth Over �epth Over i Depth of � Seeded/Sodded � Mulched �
Cell Center Cell Edges �, Topsail __ _ ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
��,s��� ���i ��-3
�E,S`�, .c�p�. a,,� Cha ��1 �p�-�
�, � �
Plan revision required?�Yes 0 No � I � �
03; l� 2 '� �� __'; � �
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
AOOITIONAL COMMENTS�ETCH
SANITARY PEAMIT NUMBEA:_.___ bg
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