HomeMy WebLinkAbout006-440-29-2101-SAN-2023-228 ��=�s\ Department of Safety �°'mty C J `�
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Sanitary Permit Application �'�T"°�"°°"�"` �
!n ecmrdmce with SPS 38321(2),Vl�a.Adm.Code,sabmissian of t6is fmm ro tte appropiste gova�atil�urit `-� �
is mquircd Poor b obtaming a uoitry P��Note:App6celim forms f��teow�d YOW1S an mbmitbd m Pcojdx Addms(if�Rmrnt Om mdmg addi cb
the Deputmmt of Sefety aod Aohatiaod Savices Paamal m6�m�don Yw p�ovide maY be uud fvr acmndery
m nxords�e mW tLe Ri'ircS Ia�v.s 15.04(I �,Stm.
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II.Type of Bd�e�(eYak aR th�sppb) Lot# T � N R E +�
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❑Public/Commeieid-DetcnlxUx
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❑SmteOamed-UexnbeUx -� CSA4N�ber ❑Viilegeof n n''
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III.Type of POWIS P�miC�(Cherk dther"Naw or"Repl�mi"aad otha'�ppHnbb oa 6neA-Cheelc eoe be:oo Dse B.Comple�6ne C
e llabla. - . . . .. . .
�'' �New System �Rqdacemm[Symm ❑0�6er Modifimrion ro ExistinB SYaem(exPkiu) �Addiuoml P�eua�em Unic(exPlain)
B' ❑HddingTmk �m�a ❑w�r� ❑n�m ❑�smn� ❑anary�(.,�i.;o)
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N.Di ceaVhwtu�t Area md Taek 7eiorms8on: Z O w c_[ S
Design Flow(�d) Ddipp Soil ApplicaGao RaM�� ��RWo�(+'� A�����(� SY9�a���
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SepeicorHold'mgTuJc � � s�'44/ ;� �5t
Doaing Ch�nber
V.Rupo�bi6ly$h6e0lOt-I.thO O�dtla�ed,uwme RapOmib�yl0[ImhB+do!of fie�POWIS aho�rG oY We Mnehed pYet - . .
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cundiriona of approv,uReatons for nisepp�mzl _� n 5-��r-� '—'^
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SBD-6398(R.0322) NO RCFUNDS qFTER
ISSrJE CN=pEkflr,yr
PAGE 1 OF 4
in-Ground Gravity Plan
Index & Cover Sheet
Componerrt Manual Design Referencex
Version d.� SBD-10705-P('frk��/do��-a�d%)
Pg 1 of 4 index 8� Cover Sheet
Pg 2 of 4 Plot Plan .
Pg 3 of 4 Dispersal Area Cross-Sedion & Plan �ew
Pg 4 of 4 Management Plan
Attachmerrts: ci s
POWTS A piiqtion for Review
Soil Evaluation Report & Site Ma
Project Name/ Description
���N�18�g�: �C�.4J1 T 1���`�/ ��.+��� i PFIOI�Ie: L`�� ' ��'_' "�i1�1�1
OwnerAddr�s: 1��73 S, Rasernorrt l�n �� C���C�Zip: .���Sy
ProjeaAdar�: Kn��vles 12c�
tiovt. Lot: �I C— 1/4 of�w 1/4, SecUon e��1 ,T�O N-R�E Qor W�
Township: �fc. Per County: S�c�cr�P/'
Project Parcel ID�: f�0� LI LJD ,�� o? �D �
Designer Information
D�igrrer Name_ ��0.� �iJ M— Q� Phone:���- o�Z L
�—
Designer Addr�s: SD - N 71.�ihl)S�n �'�' G��t�i Zip: .S�/8 i�
E-maih _�o ��i ve. �'c�J✓l ri,�:;:�:�._�:_�_�..,,, �:�: ,::�,,,;:;':_...:,:,�:.
License Num��S�L�
Remarks:
� `
Signatune:
� � �� Date: � �C—
o,� - n��� �b�n.d o�.
CHECK BOX AS APPLICABLE. CMECK 90X AS APPLICABIE.
� SOIL EVALUATION o s��: �ao� � 80 � SYSTEM PAGE 2 OF
SITE MAP PLOT PLAN�j
/� PROJECTNAME: ��, DESIGNROW: <J� cPo
1.0 F) 11 � C(�(y�,� Attach design flow calculations for commercial plans.
{�l-. �_ ��./��1
PROJECT ADDftE55� (�O 4JI eS R-�K Pipe Material/ASTM Standard(Tables 384.30-3 8 364.30-5)
� �'��J�'
/D�o..�O N Sanpery5ewer. � �--t-`—
BM S/mDd: � 8M Elevatlon: FT
Farce Maln: /
BMDescnptlon: �45 i�olt %n �Qoubf� 8" rn:;�1c
i„d��„a,�,�y IMPORTANT:
Slope Graalerrt(%) ---- yy��yympq(�eppp�p�p Q arewrn¢an armx SFww ground etevatlon contours at suihable intervals.
o�iested Arae: p���app��p��g�
Lz1\`7
E
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5a� s�`�
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IN-GROUND GRAVITY DISPERSALAREA s°P"OTeNf�S�"�°��CaSt
S KC�
Uniform Elevation Trenches with EZ1203HP Bundles �,�T�e���6x �
3-ft Trench (down-sizing credit) �
�Be� 8B� 9� 0�
� �—��'� l.'S�5 Merwledurer.
� �� ��'�x
c� � � �? Emuent�ie�awde��:
����� TYPICAL TRENCH
,r •
mm.adw+ , . CROSS SECTION VIEW
�' L "
fiypmq � — . .,.� ,•;•�:' (NO SCAI@� pBgERVATION PIPE DETAIL
:. a�; t' h+new.)
3yetem Elevatlon= l�•� ft •,. y �. �•w�'rywa r�.neaa�.d.
(ryPloal) ' Provlde minlmum 3 ft �OappO°°B� � �� (maewaa...d.a�
separeUonbetweentre�dies. ��wcrp. •. �;°' r�.wc�
TuPofWPeblamiWs �•� . t�� . ._Smin,llpog . .. _....
. Mwabw�Moqedptade fiL �
TYPICAL TRENCH (�10��^�Mlat!autlet ppe cameclbn on plan vlew.) �*"�'�'�
PLAN VIEW �' '•
NoScale 4 � M wv..nre.w�rw �n«�o.w�. w.,�p:' m�
^ OWarvatlon
� � Peiforated Lateral �e°�'�� �ft
(�vP�e►1 (ad� (rip�)
— — -- ----�--------
___:__ __::__: �
: —:: --- -------
_° --- ------- :____._ A= 3.0 ft
--�-------- — fbq�9 I71
� — — —— B_ 6� ft ---I
� �aw�n w
INSTALL PER TRENCH: EZ1203H Bundle �
�tYP��� .P
� 10-ft burldlee�50 fP EISA/uMt=� ft= (mld by IidYtratar 8yetams,Inc.)
Inetdi purauent Eo menulecWrefe p�e6uclbny.
t '— b-ft bUndles�261P EI3A/unft= ft'
=Propoeed EISA pe�trench= � ft° ReqWred trrfiltredan Area a �oCC7 fta DIBVibutio� AAethOd:
x _� trenches = Proposed Total E�3A= �iP �'Sfcti,7 i'��
_ RESET„.,'
PAGE 4 OF 4
In-ground Gravity Management Pian
��n�erarr:
The owner of this in-ground graviry systerti shall be responsible for i�perpetuai operaho�and mai�tenence pu�uarn�
requirements of SPS 362384,Wisc.Admin_Code, pursuant ta SPS 383.52(2),Wwc.Admin,Cpde,ihis system�ai�
6e considered a human heaith hazard'rf not mamtained in accordan�yrith th�g epprov��yeme�t plan.
Furthertnore.all inspection and meintenence acdv�es shall be performed bY a registered POWTS AleiMalnx in
accordance with SPS 3&3.52(3),Wisc.Admin.Coda.
Meximwn D�oersei Ar�Ooeretina Limits:
Design Flow� 3 c� 9Pd> BODS 5 220 mgL-�� TSS S 150 mgL''; FOG 5 90 mgL''
�nsoectioe Cheddist INSPECT EVERY 3 YEARS
o rype of use
o age of system
o nuisence fadors(i.e adors. user complairns, eta)
o mechanical maifuncdon(ia.PumPs.valves,switches,floe�s. efiG)
o ma[erlal latigue(i.e..leaks,breaks,c�orrosion, etG}
o solids vdume in anaerobic treahneM tank(s)arid any cllstri6udon appurtenance(s)(Le.,distr�'bution/drop bwces)
o neglect�improper use(i.e..�cceedirg de�9�caPacitles,Prohibited�ctivitles,etc)
o exteM W pon�8ng in distribution cell prior to dosing
o dosing irregularifies-'rf applicable(i.e.,pump re-cyding,float switch setdr�s, gta)
o elearicai components-ff appiicable(i.e.,wiring.connecUons,switches.�p�trds,pmers,alarms� e�.)
o distribubon lateral or Iateral oriFxe plugging (measure Iateral dsfal pressure—compere to d�gn spedfication)
o �rface discharge oF etfluerrt or sewage badc-up irdo strucWre served
Maintanance Checklist MAINTAIN EVERY 3 YEARS(or when necessaryl
o ^,�Dtic�d dose f�kfsl shaii be pumped by a ceNfied sept�qe servkin9 operator ficensed under s 281.48 Wis.
Stafs.wh�the votume of aopds in the tank(s)�eeeds on�thtrd(1/3)the 1&ryid voiume of the tenk(s)or
as required by local orcflnar�ce. Disposel pf conterrts shsll yg pursuant tp NR 113.Wlsc.Admin.Code.
o Etfluent Ht6er(al�all be inbpected avery 8 yeers and shail be deened when necessary tp remwe arry
accumWated soli��rding to manufacturer's spec'rflcations. A y�enridny peripd y�iil aiways be greater than 12
months.
Syetem malnb�nance rt�w�sh�l be submitted to the praper Wcai gov�nment unft in acc�nce wNh
SPS 3&4,55 Wisc.Admtn.Code. Report any eomponant fdi�ne pr m�fuxtlon to;
Nameofin�vidualarcanpany: ���I�mD�;r� � 5�n5 � /L Pno�e: 7�S-,��� -a8�la
Local gavertenent urtit � ' �w1� � rL� Phone: 7l S-�3 y ` �c7�i
Lw�l gwerrvnerrc uMt addr�s: ID(�/D /�l��n Sz� 5u� y9 I-1����r..��( ziP: SY[�'Ll3
My defecUve part of this system shali be repeired,repl�,or removed pursuar�t to SPS 383.51 (1),Wisc.Admin.
Code.Repair w replacemerrt of fail�or malfunctloning componerris�al�comp�y with SPS 383,Wfsc.Admin.Code.
No product for chemical or physical resroration of the POWTS may be used ur�ess approved by the departrnerrt in
accordance with SPS 384,Wisc.Admin.Code.
Co�innencv Plan
In the eventthad arry fatlad treetrnent componeM of this POWTS cannot ba repaired,it shaii be re�ac�i pursuant to
a plan submitted M the appropriate agency for review and approval. A failed in-grourxi dfspersal component may be
abandoned and replac�d hy a code-c:omplying dfspersal component in a pre-determined area of sultable soils.
Svstem At�ndaxnent
If u8e of thi5 P01NTS is discontinued,tT shail be ebandoned in acmrdence with SPS 389.33,4Visc.Admin.Coda_