HomeMy WebLinkAbout008-937-01-4108-SAN-2023-171 - ` Department of Safety c°°°`y �
�� 0 & Professional Services, �
s Sanitary Permit umber(to be filled in by C
P= Industry Services Division
_ �q3�Y �
State Trdnsaction Number �
Sanitary Permit Application `� ` !
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit �' 7��7�30���v� ,J
is rcquircd prior to obtaining a sanitary permit.Notc:Applicarion forms for state-0wncd POWTS aze submittcd to Projcct Address(if dif7crcnt than mailing a� �
the Department of Safety and Professional Services.Personal infortnation you provide may be used for secondary ZZ�5 N Y �_I
pu�poses in accordance with the Privacy Law,s. 15.04(1)(m),Stats. � ����
I.Applicafion Information-Please Print All Information EXQla�td ws �$
Property Owner's Name Parccl �
t Up�--r.�3-1-C71 - z-I I c7�
Property wner's Mailing Address Property Location
� Govt.Lot
City,State Zip Code Phooe Number
5 � I Z�S 3 f ! 6�q7 _�E'/.,� ve, Section .�. _
II.Type of Building check all that apply) Lot# T 2__N R E or
�L 1 or 2 Family Dwelling-Number ofBedrooms 3 ( Subdivision Name
Block#
❑Public/Commercial-Describe Use
❑City of
❑State Owned-Describe LJse CSM Number ❑Village of
3 g/b 3 a�To�,�f �e�a-her
III.Type of POWTS Permit:(Check either KNew"or�ReplacemenY'and other appiicable on line A. Check one box on line B.Complete line C if
a licable.)
`�� New S stem
�, y ❑ Replacement Systcm ❑ Other Motlification to Existing System(explain) ❑ Additional Pretreatmenl Unit(explain)
B.
❑Holding Tank ❑ In-Ground ❑ At-Grade �Mound ❑ Individual Site Design ❑Other Type(explain)
tional)
C• ❑ Renewal Befo Revision ❑ Chan�e of Plumber ❑Transfer to New Owner ��t Previous Permit Number and Date Issued
Lxpiration �5••0��. � o�3
IV.DispersaUTreatment Area and Tan lnformallon:
Design Flow(gpd) Design Soil Application Ratc(gpd/sfl Dispersal Area Required(s� Dispersal Arca Proposed(st) System Elevation
H5o ,. � .o ZZ5 �S� z . 8��•`1 9'6.� '
Capacity in Total #of Manufacturer
�
Tank Infotmation Gallons Gallons Units � � o ,'o, �
New Tanks Existing Tanks � o � � � p ;y �
a. U in �, c7� i+. V n.
Septic or Holding Tank ,'�O �� ' O� � c�-, �/
aRK�/ �C
Do;ing Chxmber �� �� ��
V.Responsibility Statement-I,the undersigned,assume responsibility for installafion of the POWTS shown on the attached plans.
Plumber's Name(Print) � Plumber's Signaturc MPMPRS humber E3usiness Phone Number
Z1 I 7/S N3 2 0
Plumbcr's Address(Strcc[,Ciry,Statc,Zip Code)
VI.County/Department Use ly
�.A ❑Disapproved Permit Fee Date Issued lssuing Agent Signature
❑Owner Given Reason for Denial $ l�•� � � � I �� ���!-�Ca-x-L�.t�._
ConditionS of-7CppFoval/Reasons for Disapproval
�+ � �7�i.�..._.g�� "3...-�.._._-..._ . � ����� ��
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r�-i .�UL 31 2023 ;-'
�S-r-- a3 _�� -,,t.� ��3� �F , , -__�
�______
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Attach to complete ans for the system and submit to the Couoty only on paper not less than 8 I/2��p��Rji�p�Ciie 1 1 i'a�� '''��- '
W��'�_
SBD-6398(R.03/22) NO REFUhD�qF1'ER
IS��JE OF PER;Ul1T
/r��'_�u�v;-��
Wisconsin Depariment of SaFety and Professional Services �� � ,`�, Pho�e:608-266-2112
Division of Industry Scrviccs � i Wcb:http:�-dsps.wi.�=ov
4822 Madison Yards Way ' � �� � `�� Email:dsusrciiwiscoi�sin.¢��v
PO Box 7302 � �1 ��
' f +f
Madison,wi 53�07 Yx�� a ;�=/ Tony Evers,Governor
� �_-i�i
�,�,, :-��;� Dan Hereth,Secretary
z�xu�n.�>,
Conditionafly
luly 25, 2023 APPROVED
DEPT.OF SAFETY AND PROFESSIONAL
CONDITIONAL APPROVAL SERVICES
DIVISION OF INDUSTRY SERVICE3
PLAN APPROVAL EXPIRE5:2025-7-25 �C,�,,� ����.,/,
.��.,�
Plan Review: PWTS-072301516-C
SEE CORRESPONDENCE
Kurt Brown
233N Hwy 40
Exeland, WI
SITE:
Ausen
2285N Y Road
Sawyer County
Town of Edgewater
NE'/<SE %51 T37 R9W
FOR:
Description: 3 Bedroom-450 GPD—20"to � GeoMat Mound Manual—(May 2022-2027) i
Ilimiting factor—Effluent Filter- i Pressure Distribution Component Manual—Ver. !
� Maintenance required i 2.1 (May 2022-2027) i
; I
'-----------_____— ----— �
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
• If using the existing septic tank,it must be inspected for watertightness and structural soundness,size and
baffles, and must be brought into conformance with the requirements of ch.SPS 383,Wis.Adm. Code.
• The mound 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.
• 12"of sand shall be installed between the contour and the bottom of the GeoMat product.
• Orifice Shields are required.
• 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 aoproved qlans,specifications and this letter shall be on-site durine construction and ooen to
inspection bv authorized reoresentatives 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.
Sinterely,
,J����►,uw/2o�ul�y
Joshua Rowley
POWTS Plan Reviewer,Division of Industry Services
(715)813-9111 loshua.rowlev@wisconsin.�ov
r
GeoMat MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE
Owner Info
Project Name: Wayne and Paula Ausen
� Owner's Name: Wayne Ausen
Owners Address� 1796 235th Ave.
Deer Park. WI 54007
�
Property info
� Property Address: 2285N Y Rd.
i Exeland. WI 54835
f
legal Descripfion�. NE SE S 1 T 37 N R 9 W
Township Edgewater County� Sawyer
Subdivision Name: NA
Lot Number: 3 Block Number. CSM#� 7I308#148:
Parcel I.D. Number 8937014�03
Plan Transaction No.�
� Index Pages
� Page 1 Index and title Page 9 Tank cross sections
f Page 2 Data entry Page t0 Sde Diagram
f Page 3 GeoMat mound drawings
E Page 4 Lateral and dose tank
Page 5 Distribution metlia
Page 6 System maintenance specifications
Page 7 Management and contingency plan
Page 8 Pump curve and specifications
Kurt Brown License Numbec 224281
Date: 07l20/23 Phone Number. 715 943 2988
Signature� i�
Designer St p�. State of Wisconsin Approval Stamp�
co�mao�auy
APPROVED
�EPT.OF SAFETY ANO PROFESSIONAL
SERVICES
DIVISION OF IN�IISTRV SERVICES
Designetl Pursuani to!he o"--""-- '"""7
Synergy Systems LLG.GeoMat Mound Component ManuaL(Edl on 1,2m7),_(N an n
SSWMP Publica6on 9.6 Design of Pressure Distribution Networks f0E6L�ltG+(WIBR�Cdd
Pressure Disiribution Component Manual Ver.2A S8D-10706-P(N.01/01,R. 10/12)
GeoMat Mound Edition 1, 2017 Page 1 of 10
Mound and Pressure Distribution Component Design
Site Information
R Resrdential or Commeraal Design N ISD Required�
300.00 Estimated Wastewater flow(gpd}
1.50 Peaking Factor (e.g 1.5 = 150°h)
450.00 Design Flow(gpd)
12.00 Site Slope(%)
96.30 Installation Contour Line ElevaUon(ft)
20.00 Depth to Limiting Fador(in)
0.60 In-situ Sod Application Rate (gpolfl`)
65.00 Contour Length Avatlable(fl)
Distribution Cell Information
6.50 Cell Width (fl) 45.00 [kksigner Input Cell Length (ft)
2.00 Dispersal Cell Design Loading Rate (gptlltt`) 45.00 Dlspersal Cell Length Required (ft)
2 Influent Wastewater Quality(7 or 2)
Pressure Distribution Information
E Center or End Ma�rfold Are the laterals the highest pomt
2 Number of Laterals in Ihe d�stnbution Y
3.25 Lateral Spacing (fl) nefwork7
3.59 Forcemain Drainbadc (gal} If N above, enter the elevatio� (ft1
0.60 Forcemain Filter Loss (ft) of the highest point
2.00 Forcemain Diameter(in)
22.00 Forcemain Length (ft) Qoes the foroamaln drain badc9 Y
90.78 Inside Pump Tank Eleva�ion (ft)
0.'188 Orifice Diameter{in) (e.g 025)
2.50 OriSce Spacing(fq = 8 13 it'/onfice
3.25 System Head (ft)x 1 3
5.93 VerUcal Ltft (ft)
0.27 Fncfion Loss(ft)
9.96 Total Dynamic Head (fl)
40.55 Sx Void Volume (galy
44 14 Minimum Dose Volume(gal)
23.59 System Demand(gpm)
Diameter Selection
Lateral Diameter Selection Manifold Diameter Selection
in. dia o tlons choiCe in dia o tions choice
0.75 1.25 x
1 00 1 50 x x
1.25 2 pp
150 x x 3.00
2 00 x
3.00 x
Manufacturerinformation
Treatrnent Tank Infortnation Efiluent Filtar Information
t000 OQ Septic Tank Capacity(gall Lifet�me Fiiter LLC Fllter Manufadurer
Skaw Precast Manufaclurer LT V8 Filter Model Number
Dose Tank Informatlon Gallons/lnch Calculator
64200 Dose Tank Capacity (gal) Total Tank Capacity (gal)
16.47 Dose Tank Volume (gaI/m) Total WorVcing Liquid Depth (in)
Skaw Precast Manufacturer �� gaUn (enter resWt in cell DoseTankVolume)
Pro�ect: Wayne and Paula Ausen Page 2 of 10
Mound Plan View
—t
�� ,�i '°.; � .. �bsetvatlo�PPe���� ��Q-��.. jJ
K � —T
� A
W I I —�
� B �
�.��. � . .. I
LJ
� . .... ��.� ... .� .� .. . .... ...... �
L
Mound Component Dimensions
A 6.50 ft E 73.36 in H 1_00 ft K 8.80 ft
B 45 00 ft F 14 50 in I '13 23 ft L 62 59 ft
D 4.00 in G 0 50 ft J 4 50 ft W 24 23 R
292.50(fl')Dispersal Cell Area 88770 (f[�)Basal Area Available
10 00(gpd/ft)Linear Loading Rate 4 50 (ft)1/10 B Obs.Pipe Placement
Mound Cross Section View
GeoMat Dispersal Area
Observation Pipe
12"AS7M C 33 sand as GeoMat
required for Geo Mat Distribu[ion Cell
component � GeoMat+12"ASTM C33 sand
H G
98.84 Finish Grade - Cover Material
97.71 Lateral Invett Eleva[ion f
96.63 Dispersal Cell . � E . p � Slope 12.0
Elevation �
Contour Elevation 96.30
Tilled Area
Forcemain
In situ soil�
In situ soil
Shading Key
1 � Topso�l Cap
+� Subsoil Cap
�� ASTM C 33 sand(F)
�� ASTM C 33 sand (D)
� 0 Tllled LaYe�
i�� Geo Mat
See details on page 4 tor numbar,size,and spacing of laterals.
Project: Wayne and Paula Ausen Page 3 of 10
End Connection Lateral Layout Diagram
� •=Turn-up w/bail valve or cleanout plug
� ist orfffce located at Z�
__-_______.__._.._-_.__ ._. _ _ _, . _ _. �__.,
All oriflces point down
x
-- P— _—
Laterals&force main of VVC Sch 40 per SPS Table 384.30-51
Number of Laterals 2 Orifice Diameter 0.188 in
Lateral Diameter L50 in Orifice Spacing (X) 2 60 ft
Lateral Length (P} 44.60 ft Onfices per Lateral 18
Latera! End (Z) 0 40 ft Orifice Densiry 8.13 ft�lorifice
Lateral Spacing (S) 325 ft Manifold Length 3 25 k
Lateral Flow Rate 11 80 gpm Man�fold Diameter 1 50 in
System Fiow Rate 23.59 gpm Forcemain Velocity 2.47 ft/sec
Dose Tank Information
1 ii:.i��tl:o�:� ��ilti�u:�m�.i�._ '.,7�.1
I��.:w�g dc�i.c:npt��:i�rr I-:��I�t .i.�. !
IJ..Iii:.dM�.n �r� l'.i t.:ll n�.i '
:n�w+\It �ir.i
:md�i'�:1 n'r 11.�C
��, .. . . . I�oi.Iw�J(iraJc .. , .. . �. . . .
I � Ui;.i�nu:cl�
I1 tL_ . � rnP'�•. , iy...�,r_Jb.dl�ah.
� A1nc. l :.c�: l IccU�:�.nunr . � ,•. .�u•• -P.�adm
� cllin nii,c�utd�n.d
�
I l�pl'.,c�.J��41kt FOfCC1I1W11 d18fOB2H(
I L�I.i 1'�:I I. .
� � 2 I�.
Ru.. .i, �i � �� � �_ ��.itt;i,:i p�p:o.�
.irJ v..iLi � ,.�..�i,.,.���., �„ i�
q, �s;�t,� •_.�.ti.•� ,�,.
Sim/fech Fllter ��� ,. � �� i114
S7f 100 1/16 ���_„ ��.�;.� .�!ai,���-,
g • �
{'ilul��111�1�I��al
� �— Pump df ebvalion(1q
�� I'unq�lll l�lu:�t• �. �.
pn.ul` 9�]8
D
� ��...� �_Doae lank elevation(R)
. .� , . . . �.;:�:��.�.;" lirit�l��,��. iin�lcri,w6. . _.. :: . . _. ' 9078
� Dfinenswn Inches Gallons Skaw Precast
� A 22.30 367.28 Ca aci 642.00
� � B 2.00 32_84 Volume 16.47 gaUinch
C 2.68 44.14
D 12.00 197.64
Total 38.88 642.00
Fflter ManufaCturer Sim i Tech Filter
Filter Model Number STF 100 1/t6
Alarm Manufacturer SJE Rhombus
Alarm Model Number AB
Pump Manufacturer Zoelier Company
Aump Model Number 53
Pump Must Deliver 23.59 gpm at 9.96 ft TDH �
Project: Wayne and Paula Ausen Page 4 of 10
c.�oMr<ono-�e�ew�cen r.�a;a�,yo„i —
�_.._;r.aiw�mnlnl f..-�ig±ismewsnm�nor,��:n; —
i Distrib�kion Cell Cross-sectlon Arta�pemeM9
ComponBntlAgerM
� o�si�c�wn Pwe�nr v�e+ame�am�a -...
. iurnup Er�rJovwa ----- .rwa.+e.�nrerT.
ifNAY:9 GmeIM Htr MM��'Siea��M hG�1[at ON UN Men MaEud aVGrni
omnewon cmi vwn vie++�ayou�-Typ+wi
, E50 GenWIMn-AIRI [ <500 G11LengN�Bln1
�_�����..�.�.�.��—��� �
�._�_����.���_�_�._.__a
Typital Oispersal Cell
�s.,m ru a.r�,..�,e.o as�.a�c�.ai«rn
.__���i- o.,w.,.>nN.e
h>Pa npC�wuC�M�p.naw aab�i
I - ��_-_ _
';. �roM,.
�. ' —� Cur�Oa+�M
��n.,.:rv,wnx./mw.i.mm�
oeaerv�uoo a�ao� ShaOing Koy
o•s ,��� ' Y�usoil Cap
•'�`�� .� ".. . .� Subsuil CTU
�\ ,,,:.,.�I '� nSTM C 33 sunU(Pj
�"^'� -1� nSTM C 33 sai+G (D1
/•.���n � :� Tilled L.�y�r
—i��.`�,e. ..,1 i ��S f_ e�� 6ec Mai
i� _...TJ
1
.,ee eee.��,wa..s.�•ee�.+�x H...r�a �«•
r�m�.+. wm���a v,��a.��„a� c,ya t oi,o
�
_ _ __-----�
Mound System Maintenance and Operation Specifications
Sernce Prowdefs NBnW fi�.ata� `.'.e6a�c: S,e�vxe pz�^�_ �:�5 A�'�� ;:�a
rr,�,�i i S Rer,Wa:ofs u9me „awyer i,nunh�S.antt:ar�y 3r,U��n�rrc r-4trine 7tb 33a 52$S
Svskem �low arttl l.oad Parametets
� �
�flsign fbw � PEak tl5Q �gpr; :;ar.,mur.: infiuent Pariira� g�p i!8 In
Estimatec��low - Average 3i?c7 gpd Max�m�m Bt�CS� 30 mglL
Sepdr, Tank Capa�ty ?Q3P ;�a! htaxvnum 7SS 3�J mgfi.
Sal Atisorption Component S+za' 292 5 �f{' Maxxnum rt�G 10 mglL
7ype of�PJasiewater �onsesi�c ' Maximum Fecai Coir!orm t0E4 efiVtDO ml.
Srtrvfce Frequencv
Sept�c anrS Pump Tank tns eci a:�d'or service once ev�ry 3 yc�ars �
Ft[iuent Fi{iF� �nspea and cJean a� necessary a; ieast cs,�ev�ry 3 years ,
Pump artd Co�ttrols Teat qi�cn 2vrrV 3 veefs '— �
Atarm 5howa test penod�catl
�.----_...___._._—__�`_
Pressure Systemi l ate:�ts .<.A;:dd be fi;±st�ad anG ressure lested evE*y 3 years
Mound� IF�s� �er:t icr po!:Uiny and �repege bnce every S years
Miacolianoous Consiruction and M�tariais Standarts
t O�servat�un pipes are slotted ana materiais canfcxm�0 72Dfa SFS 384 30-' have a rratsRight .ap ant!are secure�in as
shown in the Synsrgy Systems �eoMat hloun� Cnmpanenl 0.lanuat Vets+on � 2G7.'
2 Dispersal c•xIV med�a contom�s to GeoMat woGuCls approvad tpr use vinfl the Synetgy SyaEems GeoMai N{ound Cw^ponent
Manuai Ve.rsion '. 2917. MFedia is covered w�th an app{ovEtf g�otextite fabrtt.;
3 Ali gravlty and pressore p�ping niatena�s contonn la the regui.*emen;s�n 5?S 38�t,YVis.Adm. CoCe
4 Tillaye of the ^asal ares i; axomp�lshea with a mold board nr chise!plow
5. The mourd si�uc[ure a,d uther dis!urtsad areas wili 5e seedetl a�d mukheC to prevent sat erosfnn an6 he;p sedur.e frosT
pbnetraUcm
' Lateral Tum-up�etalt
:;�5" Dia+netei � F��s� Tb�e.�ded Cleanout
t nwn Sprinkler Grade +, Plug or Ball Valve
d�z `�\_
..`\ ''. � ; l/
:.eier;�l FrWt�t LXsi 4nfKr Whr�c ``� �+_,�...---"
- ; ,s_� ,�..
- - ------ - ---- -` y ` � Lang Sweep 90 or 1wo
r _ , .
_--------_ ,e,_...__. ..'j.�,_ --. ------- ` _,�45 Degree Sends Same
Diameicr as laterat
I
;
i
a- --- - _ . .�... Y„t _�i
Distnbut�r,n La,er,;I Laterai Cleartout �
2 7 ,=ee:
;'ro;ec' 1,�ayr.e an,^, +'3+;:a ausei�
�']t�4 (: :71 -�n
1
!
P�lound System TYlanagement P#an
9c�rsuant to 5PS 383.54.Wis.Adm.CodF
ulRPr31
.. _ _ �.;na�.��ti:.uF�?::+Iec�,.acrt��..�n_�vnti:S�S 3E2�&t Wis Adm CoCe,arw!shal!mamtair.�tl m acCon7ar.ce'++V.��hi wmpottcrt;
y manua�s[Sy:�e�gy�Sy.tems i�i: 3ecma?M�urb i,�mp[nsent!1Ranual versbr 1.201;.Prersure DlStnp�t�on Comoonent idanuai Vzr t 0
� SBL�•tO7G+E-�+N Utm�s anr±SSWMP PuG!;catron 9 6 tOtiB��l dnd�cxa�o�staie�a!es oc'eain�na Eo system,r.a+nY?nancc 2nC r�2mte:,ar:ce
repnrt�rY�
5eFtK and pvmp:snk aaanConmem,shaP t�e:n aunrclance wRf SPS 383.33 VYis.Aqm Guee when Ihe tanhs are ne:cngei
i+sed as�OWT S carr�Danen:5
Sept�ar ovmp:ank man.o1e r�sen_a:.t6ss rrsers a�d rnuerS shuuiC be msnr�eG tor walrr Ig?�tness anc soun�nr.es. k:.cess oflen�rga
:Esed f�r sw.v�s n�d asxssr+,ers:sha�l pe eeafee wat+rtgM upon tne�rt+p�:�nn oi serv�ce Ar�Y openrcx)deemeC Ursourtd,4efect+va.o�
sicWea ta tanurs+,tuat Ge rao�actd C-rtposed atce5s uperrn�s grea[er ih�n&-��ches:n 6iameter skati De sewretl W an aRective lock�ng
d�+�!to prevent ac.."vJentai o*unavthartrntl eMry mte a tank o�compprwnt.
S�p2ic 7anlc
The SepfiC tanY sh���e maer,tair�+c.`fiy a^+nhrv,a��a;certif�ro semoe septic tarks unde�s 287 48 Siats Trte cn�t6nts af t�¢5�8pt�.:
�am sY.alt be�sposetl of m acccrdar.�x v�n�h VR��3'vYes Atlm('..ode ThQ Oper2i�PQ OC7fdlit0�Of:tt�SCCUC:Bflk 8�OtA�fitt¢�Sheti!b¢
asserseG a�least oncn every J years by mspect�o-
Thr,nvUe;fi:ter shap�dcaroW as rtecessary to er.sure D���W��at:cr. Tbe filier carttdge sRouW nrn 7e:emoved urKss prorsrons
nre matle to:eizm sotids+n 2t,e iank!hM may sio�gn cR tt,e f�!er vfiery�emoveG from rts ertc�su+e H the!dtci s eqwppnd vnth an a!artn.ine
r:ner ahBtl be xmte0 A:he atgm�s actswat8tl cO��l�n�o�+s!y IntEMt�:t2ltt���IBf 01�rtilg(nA4 If1tlK.�10 31H�C 1tOW5 O!8iy�rr+Pe+iasnq con6nuaus
BaaRi�
'ihe septk ianlc shafi have�ls ConleAiS rMna✓Cd vthen IhE vOlunw OF SiuOgc 2�id SCt�m in Ine taNt BxCeeCa t(1 t�I�Gur�vuiWnf of�tee
t8�1: I�tt�C Wnttlnts ot tt+r.t��k are nul+emoved a!Ihe imle of�tnerinia!aSSBssn'�en`.mainle*urr'�oNBO�ne!ShaN 8dv�se the om:er aS In
when 1ne ne�R 5a+vicB�s to ba perterme:f to ma�niam 4ess than marrmum srum anC sWdge ar.cumusanar.rn�l�e tank
i ne acWf.r,�c+i Crotog�ca'or chem:r��artddives te ennance�Uc tar.R pe!tfor.rance s genera�y nqt reavr.etl Hcwevar.d hurn produ;tx
aro used tMey sha�tx acP�oyed fo�sep[�c!ank use Ey the W�crnnsin peRart:nent of Commerce
Pumo Tartk
"ha dnsing•F�mpi tank sriail be u�pectea al kaAt nnce every:S vearE Nt sw�tcAes atam,s ar0 eiimps sti�l�be:ente�±o ve:ity prc+aer
� OQC•BUOn It en eHhiBnt litte+u an5laifeC wehin 4he tank Ft shalt be msr.ecaeb anet senrnrd as racessari it the tP'CA^�a+r,has e weep hole,d
sncultl Ge�OSetl�f R:5 tuncti0na�durng p�:mD apC�tron.and�t nM d Shou1C ue t:s^arse�
�•"•No one shouid evar enter a septtc er doee tnnk s/nce dangwous gsses mey be present tha!couM c.ause deatli."^
M�nu d and Preg�[e Dist,rit�rtion 4�vstmn
�YD ffB25 G bhfti�5 S�OUiCI Nf±pSBI�}Nij O+1(Atl t110Uft� P'rxntingx rnay bc rnade arn�.�nn:tw mour,y's per,me:e�.a�tl tt±e mound shal!ba�
:c;u9ed and muk.h�1 as necessary tc prer�z:eroslon ana tC piDvidC zOt1'fc RiofeC:nn`tpm f�GSi prz:.et2t�� 7raffic tuti+2�:�an/or
:e��e:.eTN9 rtlaifttl-�an:,Ci o�the mDur`.3'3 ttOi lEfJ?11'.RM:�fC qtlf.fi 501�Cn'np3C11pt1 Rt�](h�f,AP'3Ptal.V;1 011hp,nflhal:`J@ 5��.�W�t�'�11�G
.'�.,::-h 3nd->new cwrDac6n�,�n ehe vnn!e�vnM promoie hesl aert8tralKM Ca!d+.eaFhar m�:attatro�s;Qr�cber-Fgyn�ary��itbt¢Ihat the
i.,.i•;;f t�e!Mavdy mu�cRed as prnter.hon ham frPaz�nq
^�nr'.u�nt 4vairty mto tho m�wrtd system may not exceed 22G m9�1 BODS.�5�mg:i?S:.a.�s?0�'grL F'O(;to�stonc 12nx etRuent or 3G
mqlL BOD,.3Q rm1 T55.:D mg!L FOCi a�d 1?'c�u.`37J m�hyr hegny IfeeteG etfluCnt lnl5�an.liow may nat tYce>d m.aximum dasqn t�cv.
spec�i�ed�n the oermd io�inre i�s�al�ation
',��.c pressure d�stnbutw�aystem�s prow0ed wi�h��:usmng,x+nt at t�e ernf of etx:.��atrra; �nd::�5 re,:o�imentled tqnt eath Satera!be
n,�sl�ty.!al accumulsted sos�s st least once every 3 years `Nhen a pressure?esi!S peclGrTi'!M1 d shL+uW OC cotnparetl�o Er.r.�nR;p!Iest v;nen .
rxn cystem was�nsta�cetl tn determme N or�fw[±cWgping has cccurred and�i an��ce tican�ng is rt�uve0.o marr.ta+�i eQual AxtnLu,ior wamn
thc C�sDPrazl:r_�t
Qbge±vatron p�ut9•.vHhin;he d+S^rCroal CC;I SheU De C=M.CkC6(O�C(:luCni DOfdliRg- PCv�dir7g�2�>tt�SR811 bC Rp8{tCtl to:t.G Owr`2r.�r'.0 dry
yv�is above a mches censroerea as en�rtraerndirtg tiydrau!u taA'.t�6 dBQUtl17e4 3QGAfOn21,RSO�E ftCQUC�1 If7U11tOfiTig
Continaencv Plan
t(1he seG1K i0nk Or e�y of ds components becorne tleleet�ve ihe�8nk or cdnprnent sl�at���epa�rEO or rCplMti4 tc kM�the s�ter^in
Fxo{�e�u0e;atng��Aion
I!the dQsma tank.pumo.p�mp ca:frois a18rt71 oi cE�etCtl srt�p7g be^.Art74s dEfQtWC t}Y f1C`¢rt�vn camDOnei�f;4;Sh�ii bP�mmP11�eIE1y
r9p�lrM or:g�`-aG!C�i11 a COfllponE��t of the 58me or 9qu91 pe�Ormartc2.
�'�ne mouna.:O1S1Q��kiN fd173�C�CCP.G1 YCFI3SCV/.�21'.'Of I1t9N1�ID C��SChafQQ tYOgSEW8SC1'0 fhC)fOUli(�SU�.]CE.:f M�!Gf fP.RatttlC Ot
r.�Aiaced�r rts'oresent focatinr.�y ir.aeas+ng basa�area�f loe+eakaqe occurs or by ramavmg!�leyecalW;JaggeG aCsorptron arry aispersat
meaia antl retatxd pip�ny.anr repNung said comnonanls aa qoemed�ecesso*y to bnng Me systvm�ntc aro^.¢r cperahno condr,�o�}
Srr Page 6 cit[tns R�an xor tne rame antl tek��roce n;iml��of ynur�oca�pDv{i5 r��iatn�anJ v�.v^ce p:nr�ee:
Pra�ect Wayne and Pauta Auser Par�e i of�0
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�itER5 �, $'� i��
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WAYNE AND PAULA AUSEN
� 1796 235TH AVE.
DEER PARK.WI 54007
N SITE ADpRESS' 2285N Y RD
EXELAND.WI 54835
SCALE IN TESTEDAREA: 1"=40' NE,SE,S1,T37N,R9W
Y RD
SITE CONTAINS 5.3 ACRES.
SITE IS UNDEVELOPED AS OF PROPOSED BULIDING SITE IS APP.240'
11/27/22 gqg� W/O Y RD.
oi
, �,z��
PROPOSEO � \
MOUND � i� ,�
i /
i
B'3 � � i � B-1
❑ � ' �' ❑
i
� i •BM
FORGE MAIN +
/
�+?.3' r 1,600 GAL.
/ � COMB.TANK
�F'' 46.'�
DR.WAY
PROPOSED
HOUSE
�
333'
ELEVATIONS
BM=100.0',NAIL IN 12"DIA.MAPLE TREE
B-1 =96.65'
B-2=93.65'
B-3=93.85'
PRQPOSED HOUSE EL =APPROXIMATELY 99.75'
FORCE MAIN TO DRAIN BACK TO TANK.
INLET=94.45'
OUTLET=94.2'
PUMP EL.=94 45'-3.67'=90.78'
MOUND CONTOUR=96-3'
LATERAL EL.=96.3'+4"(D)+13"(GEOMAT COMPONENT)=97.72'
� ,
SIGNED: �
22428� �
s�n Department d Salely anC Prdessional Services
Divisionoflrbus�ry5ervices SOIL EVALUATION REPORT ��023
Page 1 of
in ettordante wiln SPS 385.Wis.AGm.Code Brawn's Conatrudion
A�IeCh Comple�a si�e pian on peper nol less ihen 8X x 11 inc�es m sae.Plan must Coun�y
intlutle,bul not limitetl ta:verticel entl�onzonial refBRnce point(BM),direciion and _ SaNyer
percent slope.scele or dimensrons,nonh artow,antl lotafion anE tlistante lo nearest roaA. Parcel I.�.
008937014103
Please print ali information. qeviewed ey Date
Personal InloemaM1m you qovqe may pe�setl M secpMary WNo�s(Prrvaq Lax.s.15 00(1)(m)).
Pmperly Ovmer Proparty Lotation
Wayne Ausen GoW.�oi NE1/4.SE7/4,St,T37N,R9W
- _ .._. -. .._..
Proparly Ownar's Meiling AEdrebs LDI M ��Block Y I SubC.Name or CSMtl
1�96 235th Ave. 3 �' NA �CSM 7f306#1485
City Slale Zip Cotle Phone NumDar �Cl�y (�Village�7own Nearest Roatl
�eer Park ��.WI�,54007� 715 3776897 Edgewater Y Rd.
�Naw Construdion ���i�Residentiai I Number o!6earoomn 3 CoEe aemreC tlesign Ilow rxte 450 GPo
L]Replacement ❑ Public or wmmercial-Oescribe:NA
Parent malanal GlaGal Drifl-3456A FboG plein elevation,i(eppliCable . NA R.
___-.._.__'._._ ...._._ _.. -.. .._.
Generai wmments Site is suitahle la a rtaurM syslem. �
and recommeritlalbns�
�Boring p �eonng
�Pit GrourW suAace eiev. 96.65 ft. Dep1h ro limiting faCor 25 Soil Appli�at�on Rate�
Honzon', Oept� �'. �ominani Color '�, Retlox Desurylion Tenture��., $lructure ,Consis�encq'Boundary�� Rools GPORI'
' in. �'' Munsell �'�, Qu.Sz ConL Color '� Gr.Sz Sh. � I ' •ER1I1 •EfiC2
1 I 0-8 7.SYR2.5/1 I - sil �. 2fgr � mvfr i cs 3f-c ��, 0.6_ �I 0.8
...2. �� 8-JS ... 7.SYR4/3 '�, - sl ' 2fsbk mvfr !, cs 3f-c ���� 0.6 �' 1.0
. . _ .._. .______ .____ _ '_.._ _- __. �— -�__- ..
3 I� 25-32 7.SYR4/3 �� Ud 7.SYR5/8 5�1 � 2msbk mfr I gs lvf �. 0.6 � 0.8
q 32-55 �� 7.SYR5/3 c2d ZSYR 5/8 , sid -. lmsbk mfr li - lvf ; 0.2 0.3
, I _ ., -__ _.� __._.T-.. ... . i. __.._.
❑Bonn9� L�Boring
�Pit GrourM surtace elev 93.65 h. Depih b lirniting IaUor 20 in Shc Appllcabon Rate
HoriZon� Daplh DomineniCobr ReAo%De8crlpWn �,Texture StNUure .ConaistencqBountlery�i Roote �. GPD/R'
I Muncall .Qu.Sz.Conl Cobr Gr.Sz Sh. ' •EA+n 'EM2
m.
1 ; o- I 7.SYR2.5/1 � .-. ...-i sil -,-.,2f9r �' mvFr � a I 3f-c 0.6 ��I 0.8
_ __.. . ti-. . . . . �
2 5-20 � 7.SVR4/3 � - ' si 2msbk �. mvfr . gs i 3ft . 0.6 i 1.0
3 ��. 20-26� 7.SYR4/3 j c2d 7.5YR5/8 � sil I Imsbk � mfr , gs il lf � 0.4 I 0.6
q 26-33 7.SYR4/4 �I ihl 7.SYR 5/8 ' sl i 2msbk mvFr gs lf � 0.6 I L�
�
5 33-50 7.SYR5/3 i m3d 7.5YR5/8 ; sid �i Imsbk mfr - I - ! 0.2 03
; . �� . ._ .. ... _. .1.. . __.. .__�—_-._.
'E�fiuent#7=BODs>30<�0 mgr�enE TSS>30<150 mglL 'Eflluent 7t2=BODy=30 mglL end TSS<3p mglL
CST Nartre(Pleaae Pnnl) SgnaNre �7 CS7 NumEer
Kurt Bmwn ���4���"Y' "_,ti 224287
AtlOress Brown's Conslrudion Date Evaluation Conducted 7elep�one NumDer
W7048701dMurryRdEzelantl,W154835 11/302022 7159432988
sno-ea3o�a cuv+�
�
�roperty Owner Wayne Ausen __ —_— Parce� ID# 006937014103 _ . Page 2_ ot
__ _ _ - ---
� Boring# n Boring
� p�t Ground surface e�ev. 93.85 R Depth to limit�ng factor 2Q in. Sal Applica8on Rate
korizon ; Depth Dominant Color 'I Redox Description Te�Rure SVucture Consistence; Boundary ; Roots PDHt=
+ �n. I Munsell , pu. Sz Cont. Cobr Gr. Sz Sh. ' � •Erta� •Eftu2
1 : 0-7 , 7.5YR2.5/1 - j sil 2fgr I mvfr es 3f-c j 0.6 0.8
. . _ : _-----�--- � __ ; �_ _ ; .
2 7-20 . 7.5YR4/3 ; - sl � 2msbk mvfr ; cs ' 3f� 0.6 1.0
i
, - — _ ---- -- -- _�-- 1 -- i 9 ', __ —;_ _ � _ _..
3 20-30 7.5YR4/4 � c2d 7.SYR5/8 sil Imsbk ; mvfr� s 2f 0.4 I 0.6
4 ' 3Q-56 , 7.SYR5J3 _ m3d 7.5YR S/8 I sid � lmsbk : mfr � - i if 0.2 �! 0.3
� _ _ . 1- ._ ;_ �
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, _ __ __ . . _-- - — -_� �_
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--- -- -------- . - - -- , — _ _
� ��� � � �� r i
�
j� 8onng
❑ Boring # � P� Ground surface elev ft. Depth to limding factor in. -
---- Soil Appiication Rate
Horizon , Depth Dominant CoWr Redox Description Texfure Struclure jConsistence Boundary ' Roots ! GPDIft'
I� in. Munsell i Qu. Sz. Cont. Color I Gr. Sz. Sh. ! � �Etrgi �Efiar2
�
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,
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;
❑ Boring
❑ BO��9� ❑ Pit Ground surface elev. k. Depth to iimiting factor i�,
Soil Application Rate
Horizon ', Depth ; Dominant Color Redox Descnption � 7exture , Strudure Consistence Boundary Roots , D
in. � Munseil Qu. Sz. Cont. Cotor Gr. Sz. Sh. ; ' •�� •E�
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' Effluent!�1 = BODg> 30 < 220 mgll and TSS >30 < 150 mg/t. ' EfFluent#2= BODS<30 mg/� and TSS < 30 mg/L
SB0�8330 (R04J15) �ow�'sCmsUu[.Uon
"` ` PRIVATE ONSITE WASTE TREATMENT County
� �_«F,
�; �o�$ � � SYSTEMS
� ps ,� Sawyer
`'`�� `.--,;% ( POWTS)
��k�F ._, .r%,
' �`� INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION 23 ,— l'� �
Personal infonnarion you provide may be used for secondary purposes[Privacy Law,s. 15.04(I)(m)]
Permit Hoider's Name: ❑City ❑ Village Town of: State Plan Transaction ID#:
��.�-Pay�q �.S�e� � �.�,.�d� 73 �o��3 o t�`l�� C
Insp BM Elev: BM Description: Parcel Tax No:
l oo�d' tiq;� ��, �a`' �� l� `�� oog-��-6� � Y�og
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic �W— �oDn Benchmark �Uc�,o'
Dosing -- c,o„p.'� (ov
Aeration Bldg. Sewer —
Holtling St/Ht Inlet q'�(�7S'
TANK SETBACK INFORMATION St/Ht Outlet qY,Y �
TANK TO P/L WELL BLDG vENrTo ROAD Dt Inlet
AIRINTAKE
Septic fi�V N NA DtBottom 9!.0�'
Dosing � •, � � N,q Installation �
Contour `l�.3
Aeration NA Header I Man.
Holding Dist. Pipe ��.oS�
PUMP I 51PHON INFORMATION Infiltrative
,
Surface l�b 3
Manufacturer �� Demand Final Grade
Model Number S',3 GPM C33 �7.63�
TDH � Lift Friction Loss Sys Head TDH Ft
Forcemain L � Dia �" Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS �N L ({S' #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav ° Conv ❑ Aggregate ��y�
INFORMATION P I L Bidg Well Waters � IGP ❑ Chamber Model Number:
❑ AG ❑ EZFIow
CELL TO �}-� N ,V � Mound A� Other
-- _— — ----
- - ---- - --_- - ----—
DISTRIBUTION SYSTEM X Pressure Systems Only
Header/Manifold „ Distribution Pipe(s) , , I X Hole Size� X Hole � `� Observation Pipes j
--
Length 3 26 Dia l•5 Length 'lY•� Dia l•S __ Spac 3.2 S ', p,��$ Spacing � Yes ❑ No _
SOIL COVER
-- -- --
Depth Over „ Depth Over „ I Depth of � Seeded I Sodded Mulched �
Cell Center �� Cell Edges � i Topsoil 6__ T �1Yes ❑ No � �Yes ❑ No
COMMENTS: (Include code discrepancies, persons present,etc.)
� ��(�.� g��-� ��3
Plan revision required?❑Yes ❑ Na �3 13 i�� ' � � !/� -- --- � �R��
. .. I I �
' �-- '
Use other sitle for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
A��ITIONAL COMMENTS AN� SKETCH
SANITAPY PERMIT NUMBER: �3—�� I
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