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HomeMy WebLinkAbout024-741-18-5307-SAN-2023-308 "'�;. Industry Services Di��ision County � 1 � 4822 Madison Yards w'a} SBWyef � - ��� Madison,WI �370� Sanitary Permit Number(to be filled in by�- = P.O. Box 7302 Madison.W I 53707 ��r �`�� '�,�j State Transaction Number I Sanitary Permit Application _ � In accordance with SPS 38321(Z),Wis.Adm Code,submission of this form to the appropriate governmental 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 ad the Department of S�fety and Professional Services Personal inti�rmation�ou pro�ide ma} be used for secondan '� �OO7N RObl11 L11. Ha�/WaCC�, W� purposcs in accordance with the Privacv Law,s. 15 04(I)(m)_Stats- L Application Information-Please Print All Information Property O�<ner�s Name Parcel# Elizabeth Moore 024741185307 Property Owner's Mailing Address Properh Location 2153 Oakgrove Ct. �o�� �ot City,State Zip Code Phone Number Hudson, WI 54016 612-249-7755 '%> ''�, Se�t;°� '$ IL Type of Building(check all that apply) Lot# T 41 N R �� F,or p Subdivision Name �Ior2l�amilyD�celling-N�unberofBedrooms 5 2p�3 Block# ❑Public/Commercial-Describe Use �City of �State Owned-Describe Use CSM Number Village of CSM 9/286 #1986 ❑✓ T°"n�+� Round �ake III.Type of PO«'TS Permit (Check either"\e��"or"ReplacemenP'and other applicable on line A. Check one box on line B.Complete line C if a licable.) `�� �Ne�v S}�stem �Replacement System �Other Moditication ro F.xisting System(explain) �Additional Pretreatment Unit(explain) B' �Holding Tank �In-Ground �1t-Grade �Mound ❑Individual Site Desien �Other Type(c>plain) (conventional) I Type C• Rene�cal Betore �Revision �Change of Plumber �Transfer to Ne�v O��ner List Previous Permit Number and Date Issued Expiration NA u�+� � 1�'.Dispersal/Treatment Area and Tank Information: Desien Flow(epd) Desien Soil Application Rate(gpd/st) Dispersal Area Required(st) Dispersal Area Proposed(st) System Elevation 750 0.7 1072 1092 95.5� Capacity in Total #of Manufacturer :l Tank Information Gallons Gallons Units � v v '� � ?�ew Tnnkc F�isting Tanks '�° � � � � � � � 'L` U rn v, v: ... J � sePnc o�Hoid�„�Tank 1585 1585 1 Wieser ✓ Dosing Chamber g50 950 1 Wieser � � � � V.Responsibility Statement- f,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signatur . MP/MPRS Number Business Phone Number Jason Kuettel � ��� 675751 715-798-3355 Plumbcr's Address(Street,City,State,Zip Code) PO Box 66 Cable, WI 54821 VL C unh•/Department Use Onl}• (�A�p� o ❑ Disappro��ed Permit Fee Date Issucd Issuins A_ent Sisnaturc $ �) � �/�� ❑Owner Given Reason for Denial �`�"'� � ' � ;�E � "�� �(��a'�^""I��Z�{'�'�- Conditions of Approval/Reasons for Disapproval D � �1� �1 =-' —'�� ' � � � '1 I 1 1�.e 2 3 ____ �'``J =-_-- 1 �� � � � �r'� �i� yl � l ° -' ����W ;� I �___.��_ trC�V � 5 ZO2 �►� �_..�...��...�_.._.�_,._ 3 C5� 23 - �z � �� . 3 ,� , ���,ti,, ----___ ��:.x:. � ._ . , , _... Attach ro complete plans for the system and submit to[he County onl}'on paper not less than S I2 s 11 inches in size t�'S�, =; t�0 n::FJiV}���,�'T�� ss�-639g�R.ozi22� IS�U�0►F�£F�RJ}!-t' PAGE 1 OF 5 In-Ground Dosed-Gravity Plan Index & Cover Sheet Component Manua/Design References: In-Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027) Pg 1 of 5 Index&Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Cross-Section & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Soil Evaluation Report&Site Map Project Name/Description Elizabeth Moore 5 Bed Replacement Owner Name(s): Elizabeth Moore Phone: 612 249 _7755 Owner Address: 2153 Oakgrove ct. Hudson,WI ZiP: 54016 Project Address: 11007N Robin Ln. Hayward,WI Govt.Lot: 1/4 of _ _ .1/4,Section�$ ,T41 N-R�� E�or W❑✓ Township: Round Lake County: Sawyer Project Parcel ID#: 024741185307 Designer Information Designer Name: �ason Kuettel Phone: �15 _798 _3355 Designer Address: PO Box 66 Cable,WI ZiP: 54821 E-mail: tim@andryras.com License Number: 675751 Remarks: Signature: -��/..��� Date: II � Z� Ori signa�ture required on each submitted copy. E �� be� G . 1-''�or� $c�� Co. � �oc��.t � Lu�LeZ''�� zls3 04.�.�re�e. c-I- . Prn�. � ov-l_-t�l_ fs- �30� �� dso�, � t s4D�c� �o{- L cs�t 4/zgb � r� 8t� s:�2: I ( DD�7 N R-o� �n �h � Ro�n� t.at<� .� , +�e, � � Z(oD `I / S�e l `� -6D L {'1bo tJ ons.�o � 4 FJJ� �FD SCa�C �Y, w,es.0 I V1 � sv< <oo r� o� P� P�r.l �ses/qs� F P / �R) N' °�c'L"-" g P SP �YZ� �'Q� . F'`r� b 1 da�Ic B �. �ib.2. B 2 . QS-S2' ,b � 3 95.1 D 5 �� ,t � �p o ,Z 5�'�5 5f.�5fEwl0l.9z.5 �n i l.� � � � — — ' -IE Ye�U l v-c 5 ��t,l � . � cja� E�f: ST `N BbSS o � « PT BU�-- BZ.`1 I r , } �_ Z•'fcl`. �J F L � e 'Y f, � O c � r� �, ., d #����� � ``�:.,�,�— ' � 6�l �oa �,�p t,'75�5 I 11 II`�l (�''3 2 244r � � n ��O i `e . 3 IN-GROUND DOSED-GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down-sizing credit) � """ 1z� TYPICAL TRENCH SOIL COVER (Nplcap ,�. CROSS SECTION VIEW m;� ,,e�« (No Scale) depfh (ryplcap . . ',n I"'- 34, "� . . �`YPi`a�� Provide minimum 3 ft , . � ' separalion between trenches. System Elevation = 92�5 ft (typical) Quick4 Slandard-W w/End Cap 06serva�lon Pipe (rypicaq (Show location of inlet/outlet pipe connection on plan view.) (rypicap TYPICAL TRENCH Install per manufacWrefs ��s���<�io�s. PLAN VIEW r - - - - - �� - - - - - - - �� - - - - - - - - - — , (NoScale) � ��.. \ TA= 3.0 ft L - - - - - - - - - - - �� - - - - - - - �� - - - - — — — — — � �— avP��ao � � g = 110 ft - � (D (rypicaq Quick4 Standard-W Chamber m INSTALL PER TRENCH: (rypicap W (mfd by InFll�ra�or Sys[ems,Inc.) O Ins�all pursuant�o manufacturefs inshuctions. 2� Quick4 Std-W @ 20 ft` EISNchamber= 540 ft' TI + � Pairs of end caps @ 6 ft'EISA/pair= 6 ft' � = Proposed EISA per trench= 546 ft` Required Infiltration Area = �072 ft� Distribution Method: x � trenches = Proposed Total EISA= 1092 ft� branched manifold � . R�� ET._ PAGE40F4 In-ground Dosed-Gravity Management Plan IMPORTANT: The owner of this in-ground dosed-gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52(2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operatinp Limits: Design Flow = 750 9Pd; BODS <_ 220 mgL"'; TSS <_ 150 mgL''; FOG <_ 30 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution /drop boxesj o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.) o electrical components- if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure—compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filterlsl shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: AIICII'y R8SfT1USS21l 8c SOnS, �IIC phone: �15-798-3355 Local government unit: Sawye� Co. ZOning Phone: 715-634-8288 �oca� 9overnment unit address: 10610 Main St. #49 Hayward, WI Z�P 54843 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1),Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383,Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384,Wisc. Admin. Code. Continqency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. Svstem Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. PAGE50F6 SEPTIC / PUMP TANK SPECIFICATIONS (No Scale) 4"OJ Venl Pipe >10 ft from Building Elec[rical must comply with 12" Min. or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevation Extend manhole nser as necessary. (typical) Weatherproof Approved Junction Box Vent Cap Approved Locking Manhole IMPORTANT: with Waming LabelAttached Anchor tank(s) as necessary � (rypical) �—Conduit pursuant to SPS 383.43(8)(g) a�� Min. or 2.0 ft above Established Fiood Elevation (rypical) �Airtight Seal Finished Grade � Quick Disconnect � 18" Min. CAPACITIES @ 25•� gal/in �% � � . i . .�� � � � ' <<yP���) � a. . . . . � Depth (in) Volume (gal) A 20. 'rJ 512.5 * I � Weep • �Approved Joinls wilh Hole Approved Pipe 3 ft onto B 2.0 50 � �I'I Solid Ground ' (typical) [C] 5.5 137.5 l � ��� ' .1 r ��Alarm � � � 2�J0 B �—On f [c] � PUMP-OFF P"mP ELEVATION = 83•91 ft * Pump Tank Liquid Level = 38 in ; �—Off ' � - I ° INSIDE BOTTOM Force Main Diameter = 2 in Concrete � B�°�k ELEVATION = 82�91 ft . � � �� � � : .. � Force Main Length = 220 ft 3"Approved Bedding Material Benea[h Tank Vertical Head = ��ft Force Main Void Volume = 35.86 gal + Min. Supply Head = �ft [C] Total Dose Volume TDV = 135.86 gal/dose + FM Friction Loss = 4•89 ft (5X total lateral void volume < TDV < 0.2X design flow) � + (force main drainback volume) + Fitting Loss* = 1 .36 ft *(min. supply head x 0.3) � MIN. PUMP DISCHARGE RATE = 4� gpm = TOTAL DYNAMIC HEAD = 2�•20 ft � PUMP TANK: SEPTIC TANK(S): Volume = 950 gal Total Volume = 1585 gal Manufacturer: Wieser Manufacturer(s): Wieser Pump Manufacturer: Champion Install approved effluent filter at the septic tank outlet Pump Model: CPES5 immediatel u stream of the ump tank inlet. (See attached pump curve.) y p p Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Orenco Controls/Alarm Model: HW101 Filter Model: FT0822 Float switches containing mercury are prohibited. r -- . fiam ion i- � � � � 1�3-1/2 HP ���.,.: , �: �-- �- � �r -� EFFLUENT/SUMP F "'' �p Every pump tested in water to ensure pump _ meets pejormonce curve. .�:�,�...^t �� ,� �:,�"'" ' � � '� ,,,t r S , �,; • � � �.:•Z1 �`� fT� �' .• •.� ^t� �� ��''p 'i^�. "� t .V �p�" }. .. �• -�•• • • � �• • • � � � �s•'��n��i � _ i � t�'+!i��t^'w3• :�q¢."�.,i, _.� .� • • I • ,. • . • � � • `•S • • • ;_.� • �. • � , �ti'. • •• .� .� • 11 ":� .w r • '� �' • .�. • • • •�• • • •. �•. � • •.� � • ' • �. �' .. • • �'. •� • �• ' �' •. • ' . . . � .�.:_ .. �. � •• �• ' • • ' '.. . •� " � • • �' •�' '• • --.. . � . � ' �.� � � • •� •• '• • �•• �. . � • •�" . • �. .�. '• � • . � .�' • '� '� . • • � � • • 1 � � � . j . '—. •" . '• -�_' . � ,' • • _'. �r� ..�:' • �. � • - • •' •.��'� ' • • •• �' ' �• • ' . • � .�' . � � � •• � � � �✓, ��:.f � ' _ �- '• • ' • '• • � • - . . . � • • ' • • • ' • • � • � • .�.� � � . � � • � � ���������������������������������������� �������C�CC��CCCC�C��E��C����������C��� ' ■�i�����������������i������������i�������� �����a���������������������������������� ��������������������������■�������������� . . i ������������i�iiiii��i��i����i�������� ���������������������������������������� ���������������������������������������� �������\�������������������������������� ��������������\�� ���������������������� � ����������������\����������������������� ���������������������������������������� ���������������������������������������� ��������������������\������������������� ����������������\����������������������� .���������������-:.��\����������������� � � ��������_---- ��������������������rY� �� �������������� �����������������������\���������������� ������������������������ ���\����������� � ��������������������������►�.��\���������� C�������CC��C��CC����C:�C��C��:��:������� �������������������������������►.������� ���������������������������������G:���� . . �������������������������������������o�� ����������������������������������►�\�A�� �����������������������������������r�m�� �������������������������������`— ��.___r� , ��������■■������������������������������� ���������������������������������� ��� � i���i i � �� ��i�������i=i���i��!���i�=� . . ���������������������������������������� � � •� • • • ' . • •. ' • :• Z � • ��SI • • • : � �� � • . • 11 • • • • L1z F'loore P�kp— � � s���en� 5 6 d. �3,5 �}«.d�r q�,S t�w S�s�- G�• ,�v� x, 1�cw s,-r/r �� ID S`� I,���-t- �s`E' S,T i� gb,�� o r1-S5 6.�(� -3,S e� �l(L �Z q �t` "''£`�;,, PRIVATE ONSITE WASTE TREATMENT cou�ty '�`''�s s ,� SYSTEMS Sawyer P ( POWTS) ry `-P� �' ' �� INSPECTION REPORT Sanitary Permit No: Safety and Bwldings Division (ATTACH TO PERMIT) GENERAL INFORMATION a 3 " 3b� Personal infonnation you provide may be used for secondary purposes[Privacy L.aw,s. I 5.04(l)(m)f Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: ���,��'f�l `"�IOO�R— �^�"\ `-4� �— Insp BM Eiev: BM Description: Parcel Tax No: vo,o' 6 �r � L. ►� o�Y-7� 1� Ig-53n� TANK INFOR ATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic �,,,;e�sZr — 1�,S' Benchmark (pa,o� Dosing — ���.e ��p Aeration Bidg. Sewer ��O Holding St/Ht Inlet g`,'� � TANK SETBACK INFORMATION St I Ht Outlet 6 ,S' ' TANK TO P/L WELL BLDG vENT ro ROAD Dt Inlet AIRINTAKE Septic k� � koi t-� �-�j'� �-�5-� NA Dt Bottom �b Y r Dosing �� �. �� y NA Installation Contour Aeration NA Header/Man. q I•8` Holding Dist.Pipe PUMP 151PHON INFORMATION Infiltrative �, , Surface � $ Manufacturer �s Demand Final Grade Model Number GPM �f�s�, �• 4Y•� � TDH �S Lift Friction Loss Sys Head TDH Ft Forcemain L �� Dia � �� Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W 3` L Dg .�g #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate �� , INFORMATION P�L Bldg Well Waters Q GP �AC Chamber Model Number: c EZFIow CELL TO fis +100 +luo �-(ob � ❑ Mound. ❑ Other — �Y� DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold Distribution Pipe(s) TX Hole Size , X Ho� Observation Pip�s [ength Dia � Length Dia Spac I Spacing ❑ Yes ❑ No� - - -- -- — _ ---- _ _ __� --- — SOIL COVER Depth Over Clepth Over l Depth of Seeded/Sodded Mulched Cell Center �Cell Edges � Topsoil 0 Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��.��tl�( �2(� I�3 Plan revision required?0 Yes❑ No I��D 3 �S—�� �cr� � .. — — f 6��� � ', Use other sitle for additional information Date OWTS Inspector's Signature Certification Number SBD-6710(R.3/01) i � _ : � � r , . : � _ - � �- s ' ;� n � a" � n F -� n o / � � � � ��o" ���, � � � � �'�� 1 �, � z � �� �, 1 =+ D z � � �'� � n o �� � � rn / Z � --1 C/] � 1 `� o ;� / `s' ' � �v.,1��, � � � � , �� I'� f � ( � � , • � �r�' � O ; . . � I � : _ , _ , ;.._ :- ._ c�J p ' ' .� Q r- . . . . , J Z x 1� � � � � - � ar a o � . t- �