HomeMy WebLinkAbout010-841-19-2306-SAN-2023-229 �•' ' Industry Services Division Counry �
4822 Madison Yards Way �,/�L✓�E f`�" �
,', ,�_ - Madison,WI 53705 Sanitary Permit Number(to be filled in by Cc
� �= P.O. Box 7302
, Madison,WI 5302 �Jr S � �% � � �
— W
Sanitary Permit Application stateTransactionNumber �
In accordance with SPS 38321(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit �- t�
is required prior to obtaining a sanitary permit.Note:Application forms for state-0wned POWTS aze submitted to Project Address(if different than mailing addre �
the Departrnent of Safety and Professional Services.Personal information you provide may be used for secondary � Zt_
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. �i n 1/� / I ���
I.Application Information-Please Print All Information 1�r� /\/
Property Owner's Name Parcel#
��l �rlo L � ���� �2��� c� 1o�3 '-� ! ! `l, 3� �
Property Owners Mailing Address Property Location
J�� ��/`� � J�� ��' �� Govt.Lot
Ciry,State Zip Code Phone Number � /
Sr �O✓� S J►' `O C�3 ( � �` �� �/,, \�W '/<, Section�
II.Type of Building(c eck all t6at apply) � Lot# � � T � N R E or W
[�tor 2 Family Dwelling-Number ofBedrooms Subdivision Name
Block#
❑Public/Commercial-Describe Use ��
❑Ciry of
❑State Owned-Describe Use CSM Number ❑Village of
3'$ g`� �-$�`� f�'o�,or � A Ywh�-h
IIL Type of POWTS Permit:(Check either"New"or"Repiacement"and other applicable on line A. Check one box on line B.Complete line C if
a licable.
`� �New System ❑ Replacement System ❑Other Modification to Existing System(explain) ❑Additional Pretreatment Unit(explain)
B' ❑ Holding Tank �fn-Ground ❑ At-Grade ❑ Mound ❑ Individual Site Design �Other Type(explain)
(conventional) ��/�.��}-
C• ❑ Renewal Before ❑ Revision ❑ Change of Plumber List Previous Permit Number and DaYe Issued
❑"1'ransfer to New Owner
Expiration
IV.Dispersal/Treatment Area and Tank Information:
Design Flow(gpd) Uesign Soil A plication Rate(gpd/s� Dispersal Area Required(st) Dispersal Area Proposed(stl System Elevation
� � b.� � v �,�1. 4 �
Capacity in Total #of Manufacturer �
Tank Information Gallons Gallons U�its � � o � �
�O U
New Tanks Existin�Tanks ` o � � Y ,a m �
n. U �n � v� c:. C7 C-
Septic or Holding Tank O /J .Q � � 1 � r ���
v
Dosing Chamber
V.Responsibility Statement- I,the undersigned,assume r onsi 'lit r' tallaHon of the POV4'TS shown on the attached plans.
Plumber's Name(Print) Plumbers Si ature MP/MPRS Number Business Phone Number
Dan Burch 253808 715.416.1642
Plumber s Address(Street,City,State,Zip Code) N5921 ounry Hwy K Spooner WI 54801
VL C un /Department Use Only
�A ov ❑Disapproved Permit Fee Date Issued Issuing Agent Signature
❑(hvner Given Reason for Denial $ l.�� L� ��(� �� ����'`��1 '" _"`"�
Condition's of Approval/Reasons for Disapproval D � y � �
� � � oZ 3
`--` `' 13 2023
�G I ���� �� :��� _...�_.�. ���
� � ,��
:.�� � � �� � _
GST �3 — ( S 1 ��"y �' �4N1NG A�NO T �
Attach to complete plans for the system and submit to the County only on paper not less than 8 t/2 x 11 inches in size
NQ F3i FUND�S A'FTER 4�i�`��1
SBD-6398(R.02/22) ISSLIE QF f��it1ltl�
eoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN
Reside��tia'Apoiication
INDEX AND TITLE PAGE
wner Info
Project Name: Saito Geomat
Owner's Name: Matz Satio Living trust
Owner's Address: 8327 Kingbury Blvd St Louis MO 63105
roperty Info
Property Address: Birken Trail
Legal Description: SW NW S 19 T 41 N R 8 W
Township Hayward County: Sawyer
Subdivision Name:
Lot Number: 40 Block Number: CSM#: CSM
Parcel I.D.Number: tax ID 11904
Plan Trensaction No:
ndex Pages
Page 1 Index and title Page 9 Filter specifications
Page 2 Data entry Soil test
Page 3 GeoMat dist.cell drawings 8 calculations
Page 4 Lateral and cell cross section
Page 5 Management 8 contingency _ _
Page 6 Maintenance&specifications
Page 7 Distribution media — --
Page 8 Plot plan
Dan Burch License Number: 253808
Date: 09/13/ Phone Number: 715.416.1642
Signature:
Designer Stam . State of Wisconsin Approval Stamp:
Designed Pursuant to the
GeoMat In Ground Component Manual Ver.June 26,2018 Version
Page 1 of 10
In Ground and Dosing Distribution Component Design
Gesign 1Plr�rksli�et
Site Information _ . _
R Residential or Commercial Design N ISD Required?
300.00 Estimated Wastewater Ftow (gpd)
1.50 Peaking Factor (e.g. 1 .5 = 150%)
450.00 Design Flow (gpd)
0.00 Site Slope (%)
98.00 Prop. System Elevation (ft)
66.00 Depth to Limiting Factor (in)
1.00 In-situ Soil Application Rate (gpd/ftz)
101.00 Lowest Original Grade Ele. In System Area (ft)
101.00 Highest Original Grade Ele. In System Area (ft)
95.50 Limiting Factor Elevation (ft)
1 .50 Depth Below Grade
Distribution Cell Information
3.25 Cell Width (ft) 1 Number of Cells
2.00 Dispersal Cell Design Loading Rate (gpd/ftz)
2 Influent Wastewater Quality (1 or 2)
Distribution Information
E Center or End Manifold, Dist. Box or Drop Box
� Number of Laterals System dosed N
0.00 Lateral Spacing (ft)
System not dosed
Manufacturer Information
Treatment Tank Information Effiuent Filter Information
1000.00 Septic Tank Capacity (gal) Polylok Inc./Zabel Filter Manufacturer
Wieser Concrete Products, Inc. Manufacturer 3014-525-1/16-10,000 GPD Filter Model Number
Project: Saito Geomat Page 2 of 10
In Ground Plan View
:1 �- <�;�•IlIl �����i�1I�i
� o a;0000000000000�000�00�0000000�0�o 0 0 0 0 0 0 0 0 0 0 o a o 0 o a�o 0 o a.''
o�oa o0000 0 0 0 0 0 0 0�,o�o�o0000 0 0�0 0 0�0 0�0 0 0�0 0�0�0�000�0�'�0�0�0�oo�o :
��°�°�o�o�o�o�����o o���o�o�o�o�o o�o�o� ��M� o 0 0�0���0�0��o o :�
a o o a o�a o 0 0 0 0�0 0�0�0�0���0�0�0� �o a o�a�,;�o 0 0�0�0 .
alculat�ons
I ft A 3.25 ft Basal Area Required 450 ft`
K 1 ft B 86 ft Basal Area Pro osed 451.5 ft2
S O.00ft L 88ft
W 525ft
Basal Area Calculation GeoMat Dis ersal Cell Basal Area Calculation
GPD Loadin Rate GPD Loadin Rate
450 1 gallsq tuday 450 2.00 gal/sq tuday
Total 450 ftz Total 225 ftz
Proposed 279.5 ft2
Number of Cells 1 GeoMat Width 3.25 ft
Cell Length ft Lineal Feet of GeoMat Required 69.2
Min.Cell Len th 69.2 ft Lineal Feet of GeoMat Proposed 86
Cell Spacing 0.00 ft NOTE.Min S dimension=1'
S stem Elevation 98 ft
Limitin Factor 95.5 ft
Se aration 2.5 ft 2hfin
Directions
Play with cell length to get desired cell spacing.length and width Remember system SHOULD be longer than it is
wide. It must also Satisfy basal loading rate and GeoMat cell loading rate.
Project: Saito Geomat Page 3 of 10
End Connection Lateral Layout Diagram
s�,
Hole spacing is every 12" , 1/2" hole at 4 & 8 O'clock, starting 4 O'clock 6"from end and
8 O'clock Holes at 12"from end.
Lateral Spacing 0.00 ft Pipe Diameter 4.00 in
stri ution eIl ross ection
101 ft � F;!+lehrA rnAc •Y'� V'�2'Y W V'
I , � - ' � � � . ,' 12"`48' BaMfill `.v` jJOQi1�EYt�
1 .
t.5 ft — S+md CaKs ieeommaoded , . , '
� . ' � .
. : � �
4 in —► pipeDil. . � �„+� ' F�hcie
. . .� v�a �: , �
Top of geomat to be at 1. • .-~ „� GFA MAT
or below original grade � ^ � � 2�p�.M 33 �a� I � I , I � i � 1 �
I I I . I � ���
- _ � _ � :� �. _.
_ - - �NATIVE�SOI�L: �
It = = � _ � � � �� _. � � � �F�cmr
66�y
bservation Pipes
���
101 f Fm""°da"°°
a•wen:.
12" Min.
48" Max.
moa
Tuilct Flan c . Rcbar
ansY.
�n� � mmu.
ae�a.ur �,'=.f. m°'s°' - �.�
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98f � � � � � � � � � � � � � � � � � „ � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
Project: Saito Geomat Page 4 of 10
Notes/Maintenance ReQuirements
MANAGEMENTPLAN
This private onsite wastewater(POWTS)has been designed,and is to be installed and maintained in accordance with SPS 383,Wis.Admin.
Code,the in-Ground Soil Absorption Component Manual for Private Onsite WastewaterTreatment Systems Version 2.0 SPS-10705-P
(N.01/01). GeoMat in ground Component manual Version 1.
1.This POWTS has been designed to accommodate a maximum daily flow of 45�ons of wastewater per day. The quality of
influent discharge into the POWTS treatment or dispersai component shali be equal to or less than all of the following.
A monthly average of 30 mg/L fats,oil and grease
A monthly average of 220 mg/L BODS
A monthly average of 150 mg/L TSS
Wastewater shall not discharge to the POVJTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement
standards and preventative action limits specified in ch.NR 740Tables 1&2 at a point of standards application,except as provided in DSPS
383.03(4),WisAdmin.Code.
2.The owner of this POWTS is responsible for system operetion and maintenance.
3.Defects or malfunctions identified during maintenance described above shall be repaired in conformance with SPS383 Wis.Admin.Code,
and the pertaining county Private Sewage Systems Ordinance. The user's manual,provitled to the owner of the POWTS includes the names
and telephone numbers of the properly licensed individuals to contact for such repairs.
5.No product for chemical or physical restoretion or chemical or physical procedures for POWTS may be used unless approved by the Dept.
of Commerce in accordance with SPS.384,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 6e installed where possible 1 to be installed in ST,and or 1 in pump tank in
order to insure particle size less than or equal to 1/8". Filters should be deaned once in spring,and once in tall.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 piumber,or county shali 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,eledrical 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 probiem occurs.
The homeowner is responsible for formulating a water conservation plan that will ensure the system is rarely overloaded. LE.spread laundry
out over time,not 6 loads fn 2 hours,while everybody showers,and uses the toilet,ETC.
CONTINGENCY PLAN FOR COMPONENT FAILURE
A.Septic Tank.Any shuctural failure resWting 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 replacing fautty seals with approved materials to make joints water
tight.
B.Outlet Filter.The outlet flter shall be replaced or repaired when it is either no longer capable of preventing the discharge of particles larger
ihan 7/8 inch or when it has become permanently degraded by clogging so as to interfere with the design flow out of the septic tank.
Q Dosing chamber and pump.The dosing chamber shall be replaced if any structural failure is found Leaks in joints between manhole risers
or covers shall be repaired by replacing faulty seals with approved materials to makejoints 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.PaRial clogging of fhe distribution network may result in unduly long dosing cycles.The ends of the
distribution laterals may be exposed and the threaded end caps removed.The piping can be disconnected on the outlet end of the pump.
The distribution piping may then be back flushed to cleanse any accumulated mader from the piping.It is recommended that the dosing
chamber then be pumpetl by a licensed plumber.
E.Soil Absorption CetL The discharge of sewage or wastewater to the ground suAace is strictly prohibited due to the human health hazartl
created by the efflcenL All failures created by surface discharge shall immedlately be reported to the appropriate county.The pump shall then
be immedialely disconnected to prevent further discharge to the ground surtace via the soil absorption cell.The existing septic tank and
dosing chamber shall be used as a temporary holding tank until the necessary repairs to the soil absorytion celt 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 permit is obtained from the county.
Project: Saito Geomat Page 5 of 10
In Ground System Maintenance and Operation Specifications
Service Provider's Name Dan Burch Phone 715.416.1642
POWTS Regulator's 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
EstimatedFlow-Average 300 gpd MaximumBODS 30 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 30 mg/L
Soil Absorption Component Size 279.5 ftz Maximum FOG 10 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform 10E4 cfu/100 mL
Service FrequencV
Septic and Pump Tank Ins ed and/or service once eve 3 ears
Effluent Filter Inspect and clean as necessa at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test periodicall
Pressure System Laterals should be flushed and pressure tesfed eve 3 ears
In Ground Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Materials SWndards
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.March 20,2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the GeoMat In Ground Component
Manual Ver. March 20, 2017. Media is covered with an approved geote�Rile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 384,Wis.Adm. Code.
4. Scarifcation 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-S"Diameter Finished Threaded Cleanout
Lawn Sprinkler Grade \ Plug or Ball Valve
Box �
�
Lateral Ends at Last Orifice W here
Long Sweep 90 or Two
��45 Degree Bends Same
Diameter as Lateral
� ►F �
DistributionLateral LateralCleanout
98 Feet
Project: Saito Geomat Page 6 of 10
GeoMat Distribution Cell Media Layout
3.25 Cell Width (ft) 2.63 Sidewall to Lateral (ft)
Distribution Cell Cross-section Arrangements
_ _ _ �,J
omponen egen _ _ _ . _ . _
O Distribution Pipe
GeoMat is covered with approved geotextile fabric as per the their product approval.
Distribution Cell Plan View Layout - Typical
325 Cell Width -A(ft) 86.00 Cell Length - B (ft)
End Connection Lateral Layout Diagram
� � .� �. �� �� � .�� .� .� ..�� �� �. � .��:
P � �a e _
F';niche.rl f:r-�rir '�V� ` `� Y � W V�
. �, . .:-..•..'��.: �:..: ': . _-. '.�� '. :':-. - . Y�; Qli�1�OG
.. � . ... , ,' • �- '� ' - `..gaCk{II�,�.��'_ �E�L.CYt�
� �,`. � �. 12"-48"V,
S�d Co�ac�eoocommded '
{ . � : ' . �•
��'` � _A ,( r�u �•_ , : �' FlnfiItra�v!
�. _ _ r GFA MAT
� � � � � � � 2'ASTM33�� IiI , I � I � I �
� — � J — = J � = = = = = = — — _ infil�ve Ssutsce
_ _ _ _ _ _NA'T[VE.SOIL= = = � � �
� � � � � � � � � � � � '� �RFactor
See details on page 4 for number, size, and spacing of laterals.
Project: Saito Geomat Page 7 of 10
WLP1000—MR
TANK SPECIFICATiONS � o
o �
s'-a" � �
DIMENSIONS: � o
WALL: 2 1/2" a a
4" CAST-A-SEAL 4" CAST-A-SEAL BOTTOM: 3"
COVER: 5" w
MANHOLE: 24" I.D. PRECAST CONCRETE RISER a
��'�- - � HEIGHT: 53 1/4" �
�' � �.
��' \ ��� LENGTH: 8'-8" >
ii� ��� WIDTH: 7'-2" �
����_ ti� �� BE�OW INLET: 42"
r � `� �-('�e� ��'-``� � LIQUID LEVEL: 36" �
N � i WEIGHT: 6,790 LBS. � a o E
� 1 ( II U o
\ �
� � . _�� �� �� � INLET AND OUTLET: � 3 0 0
��� ` ii� 4" CAST-A-SEA� BOOT OR EWAL GASKET � m o a
�� FILTER OR ii �
`�� BAFFLE ii� INLET AND OUTLET BAFFLE AND FILTER: a � � w
��;� ,;��' WISCONSIN, SEE DETAIL #10 � o o �
� -_____-� (OTHER STATES SEE CHART) `� o
LIQUID CAPACITY: 27.83 GAl/IN ~ �
W �
TOP VIEW �
HOLDING TANK: � � �
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: t,085 GALLONS 0 � �
(�j o I
LOADING DESIGN: 8'-0" UNSATURATEO SOIL a �
� N
o TANK CAN BE USED AS: � �I�
�� SEPTIC / HOLDING / PUMP OR SIPHON W 3 a
¢� COVER: MIX DESIGN #8 (NO FIBER) `� � �
� _ � TANK: MIX DESIGN �10 (STRUCTURAL FIBER) �� �
CUSTOMIZED TANKS: � �
--- ---- � FOR CUSTOM TANKS CONTACT WIESER CONCRETE
INLET - OUTLET
i
� � U I� � � � �U Q
� N d_ I c0 d I rn � �
d' � � i ''� i �� "� � ZQ
i
2�, � o
�--- --------�-G '� =-� p �
REVIEWED BY a �
;,� PUMP PAD REVIEW DATE � W
N
DRAWINGS SUBMITTED
SIDE VIEW FOR APPROVAL
APPROVED BY: SHEET N0.
APPROVAL DATE: �I /
OF
PRODUCTS NEEDED BY: / �
• TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
CHECK 60X AS APPLICABLE. CHECK BOX AS APPLICABLE.
� SOIL EVALUATION s`a�e:�'�=30� �SYSTEM PAGE 2 OF
SITE MAP ° _ so as so PLOT PLANf`
PROJECT NAME: �5, oesicN F�ow�. 7 SJ cPo
�� i'f' ��T Attach tlesign flow calculations for commercial plans.
�� �
PROJEC7 ADDRESS � �Q�G.✓ S n✓4��- Pipe Matenal/ASTM Standard(Tables 384.303 8 384.30-5)
- � N 5a��tary�we� s�� y� P✓C:,
BM Symbd:�} @M Elevation: �J/,� FT Face Main� /
BMDescrlplion'. �u�� �•( ��'i)✓1,�! /V�"-✓l�<
� ma����e�onnq- IMPORTANT:
siope Grad�ent(/) .,�-- y�eu symeoi(ifappi�cabie): � drawme a�ar�+ Show ground elevation contours at suitable intervals.
or resiea aea: o�me evP�oc�ue r�.
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� '"`'``�;, PRIVATE ONSITE WASTE TREATMENT County
���� SYSTEMS
�
� o�$p , , ( POWTS) Sa.Wyer
,- � s _
.,,L� `,-� ,--�
INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division
(ATTACH TO PERMIT)
GENERAL INFORMATION �-3 --a-.Zq
Personal infonnation you provide may bc used for secondary purposes[Privacy Law,s. 15.04(f 1(in)]
Permit Holder's Name: ❑City ❑ Village [�Town of: State Plan Transaction ID#:
Y`lA�- J4`i'�V �c✓�.y �MS� �'"�°'?"^'� �--
Insp BM Elev: BM Description: Parcel Tax No:
�p�:a� 1va:1. ,.. ��..�le.. w.���- D l d-�d'( ! 'I�-- � 30�
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic w��� o�o Benchmark �op,o �
Dosing
Aeration Bldg. Sewer 4�
Holding St/Ht Inlet a,� �
TANK SETBACK INFORMATION St I Ht Outlet �,g '
TANK TO P/L WELL BLDG vENrTo ROAD Dt Inlet
AIR INTAKE
Septic ��; �./ � � ��` ,f.�a NA Dt Bottom
Dosing NA Installation oA �
Contour � Y
Aeration NA Header/Man.
Holding Dist. Pipe ��,Y �
PUMP 1 SIPHON INFORMATION Infiltrative �
Surface �7$ �
Manufacturer Demand Final Grade
Model Number GPM C33 �9 a'
TDH Lift Friction Loss Sys Head TDH Ft
Forcemain L Gia Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS �N , S� L g #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav � Conv ❑ Aggregate ����q�
INFORMATION P/L Bldg Well Waters � IGP ❑ Chamber Model Number:
❑ AG ❑ EZFIow
CELL TO k� �� N N ❑ Mound D� Other
- ------- - -- - - -- ----- -___- -- -- -- - --__---- ---__.
DISTRIBUTION SYSTEM x Pressure Systems Only
-- - --- — --- ---
Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes
Length Dia Length Dia Spac �' Spacing ❑Yes ❑ No
- -- - - - ___ --- --- — -_ ___�
SOIL COVER
__- -- - -- -- _ _
Depth Over Depth Over Depth of Seeded/Sodded Mulched
Cell Center �ell Edges � Topsoit � ❑Yes ❑ No � ❑Yes ❑ IV�
COMMENTS: (Include code discrepancies, persons present,etc.)
���1� l2 IS��3
Plan revision required?❑Yes❑ No �3 I`� �aY I `yh- (iV,���i i� — � �� ��lo �
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Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
ADDITIONAL C�MMENTS ANO SKETCH
SANITAflY PERMIT NIJMBER: 2 3'_�'!z_L
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