HomeMy WebLinkAbout024-741-30-5238-SAN-2024-011 �„'�< ,'.; Industry Sen�ices Di�ision County �
��� _ 4822 Madison Yards Way S8W)/2f �
� , �� = Madison,WI 5370� Sanitary Permit Number(to be hlled in bti C
= P.O.Box 7302
— Madison.WI 53707 l,p s ( 1 �� .�
r�
�
Sa�l*a� Peri.nit A„pllCa+lOn State Transactio�Numbcr Q
l l.J L
_�
In accordance with SPS 38321(2),Wis.Adm.Code,submission of this form ro 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 address)
the Department oFSafety and Prolessional Services.Personal inti�rmation you provide may be used fo��«o�d�� 10349N Sandy Beach Rd. Hayward, WI
purposes in accordance with the Privacy La�v,s. 1�.04(1)(m),Stats.
I.Application Information—Please Print All Information
Propert�O��ner�s Name Parcel#
Karen Wick 024741305238
Property O��'ner's Mailine Address Proper[�'Location
8920 Itasca Trail N. f`�fi 2
c�vc.Loc
City,State Zip Code Phone Number
Stillwater, MN 55082 952-935-9100 - "�- � ,�Q: Se�t+on 30
11.Type of Building(check all that apply) I.ot# T 41 N R �� E or`W
� I or2l�amil}�D�celling—Numberoff3edrooms 5 7
Subdivision Name
f3lock#
❑Public/Commercial—Describe Use
�City of
❑State Owned—Describe Use CSM Number �Village oY
36/250 #8464 �To"n°f' Round Lake
I11."Cype of PO��'TS Permit:(Check either"�ew"or"Replacement"and other applicable on line A. Check one box on line B.Complete line C if
a licable.)
`�� New S stem Re lacement S stem Other Moditication to Existin S�stem ex lain Additional Pretreatment Unit(cx lain)
�✓ Y � P Y � €-Y ( P ) ❑ P
B' �Holding Tank �In-Ground �At-Grade �Mound �Individual Site Design Other Type(ex��lain)
(conventional)
C• ❑Renewal Before �Revision �Change of Plumber �I'ransfer to Ne�v O�vner List Previous Permit Number and Date Issued
Expiration 20-291 (Expired before install)
IV.Dispersal/Treatment Area and Tank Information: �1 O�.O
Design Flo�v(gpd) Desien Soil Application Rate(gpd/st) Dispersal Arca Required(st) Dispersal Area Proposed(st) System Elevation
750 0.7 1071 1200 94.5 �
Capacity in Total #of Manufacturer
y
Tank Information Gallons Gallons Units � � o ,'n, �
'Vcw Tank� F.�isting Tanks � � " a� � � �
0
c, U rn r v: ._ :7 —
Septic or Holding Tank 1530 1530 1 Infiltrato� �
�o���,�Ct,a�„b« 1060 1060 1 Infiltrator � Q � ✓
�'.Responsibility Statement- 1,the undersigned,assume responsibility for installHtion of the PO��'TS shoNn on the attached plans.
Plumber�s Name(Print) Plumber�s Signature � � MP/MPRS Number Business Phone Number
Jason Kuettel f'��`�� 675751 715-798-3355
.,;�.���.;,;,
Plumber's Address(Street,City,State,Zip Code) �'
PO Box 66 Cable, WI 54821
V1. oun y/Department Use Only
�Approve ❑Disappro��ed Pz���Fee Date Issued Issuine Agent Signaturc
�k/ $ �7�.�° \�7 L�'2� �✓1 Gc-fii,t���vcv.c'
�O�tincr Given Reason for Denial
Conditi � r a �n�fo Disapproval �r � k� L,,{� �„
'�� � � Kg �t�c N �R�� • D � �� �'`"�—��^'�''�
�� � '�
r i�i li�� Li 4J:r�i 1 5_�% �`�._._...__._.�, ���,/
` � �� JAN 2 6 2024 -
���ic# � �1 I �S
C, �1 ��- �3-1 � SAW�E� ��:.�:���
���
ZONING�DAAINiSTRATION
Attach ro wmplete plans for the system and submit to the County only on paper not less than 8 I/2 x l I inches in size
ss�-639s�x.o2iza> NO REFUNDS AFTER
ISSUE OF PERMIT
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet
Component Manual Design References:
i✓-t;,i....nD Sc-� A�,;�nu.� r=��— P�W'rJ V�S';�_ Z. 1 ��-.�r7cz -z��
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
Karen Wick-5 Bedroom septic
Owner Name(s): Karen Wick Phone: 9sZ_ I'3s -53ao
Owner Address: $920 Itasca Trail N. Stillwater, MN Z�P: 55082
ProjectAddress: /�3�19� s'AN�Y �c�e�- 2� y�Y,�,y��, �,�,�
Govt.Lot: 2 1/4 of_ �1/4,Section 30 ,T 41 N-R�� E❑or W ✓❑
Township: Round Lake County: Sawyer
Project ParcellD#: 024-741-30-5238
Designer Information
Designer Name: �ason Kuettel Phone: �15 _798 _3355
Designer Address: PO Box 66 Cable,WI Zip; 54847
E-mail: �ason@andryras.com
License Number: 675751
Remarks:
-f� „_`—
_ `�;i
,, ,,_-_,
Signature: = ���"����"'
, �� � Date: I. 2 a zrT�l
Onginal signature required on each submitted copy.
ow✓Ecrs� Le a :
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. pr�.l : Oz�{ —�41-30— SZ3S
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� WH�.T�AT(� �M 1060 rviyP 'r'9N��
IN-GROUND DOSED-GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with EZ1203HP Bundles
3-ft Trench (down-sizing credit)
-��' ��
� min.1Y
ce°�e�'a I �HP;�,� TYPICAL TRENCH
cove.
SOILCOVER CROSS SECTION VIEW
,z• � (No Scale)
min.tranch : OBSERVATION PIPE DETAIL
depm L '�, (No scak)
(�YPical) T — — .'. . S`rew-TyPeor
SlipCaPQoose� FinislreCGrade
//p� (mulched 8 seede0)
`,.•
System Elevation= �''•5 R Y �� ' a•0 avc P�� ,'�� . TOUsoa co,rer
' ToP of P��la tertninate (min.1 foot)
�ryP��y�� Provideminimum3ft atora0ovelnisneGgratle
separation between trenches.
(4)1/4'-1/$'%6'Sbts
�96 apan
1,'..'
TYPICAL TRENCH (Show location of inlet/outlet pipe connection on plan view.) Anchoong Oevice i�r�n�eo�
PLAN VIEW Su��
(No Scale) 4n � O�servalion piDe s�all ba instatleG
atjunWon Cetween hvo units. �Q ft
Perforated Lateral Observation Rpe
�tYPical) (ry��0 (Hpica�)
r — — — — — — — — — — — — — — ��— — —— — — — — — — —— — — — — — — —
� °__"_ '__°__' I A- 3.0 ft �
_-___ _= ___ =_=___'
_______= D
� - - - - - - - - - - - - -- - �f- - - - - - - - - - - - - - - - - - - - J cryP��o G�
g = ao ft I m
ctyw�n w
INSTALL PER TRENCH: E21203H Bundle �
(typical) �
$ 10-ft bundles @ 50 ft EISA/unit=400 g= (mfd by Infiltrator Systems, Inc.) �
Install pursuant to manufacturefs instn�ctlons.
+ � 5-ft bundles @ 25 ft EISA/unit= � ft'
= Proposed EISA per trench= 400 ft' Required Infiltration Area= 1071 ft� Distribution Method:
x 3 trenches = Proposed Total EISA= �200 ft� branched manifold �
RESET
�,--
�
INFILTRATOR IM 1530
tan ks
Features & Benefits
The Infiltrator IM-1530 is a lightweight strong and • Strong injection molded
durable septic tank. This watertight tank design is polypropylene construction
offered with Infiltrator's line of custom-fit risers " a • Lightweight plastic construction
and heavy-duty lids. (nfiltrator injection '� ' , :.� and inboard lifting lugs allow for
molded tanks provide a revolutionary �: '1'°� easy delivery and handling
improvement in plastic septic vR • Integral heavy-duty green lids that
tank design, offering long-term .�,,,, ���: ' interconnect with TWTM risers and
exceptional strength and �' ,x pipe riser solutions
watertightness. � ; , . `��`� �` y m r
- � , • Structurally reinforced access
� " ports eliminate distortion during
.
��� : j �. '" installation and pump-outs
�-.,.���-�,`� � � • Reinforced structural ribbing
, and fiberglass bulkheads offer
� ��`` � additional strength
,
�
� • Can be installed with 6" to 48"
� � � x
of cover
b ,,,, _ � * , f s / • Can be pumped dry during
� w.�._. �
pump-outs
• Sultable for use as a septic tank,
- pump tank, or rainwater
(non-potable) tank
Inlet Side • No special water filling
Infiltrator � requirements are necessary
TANK CUTAWAY � Riser • The tank may be backfilled with
System � suitable native soil. See installation
� - instructions for guidance.
-�
,�. -
Partition �, ,�.. _' " �`�
baffle wall`, t *_ ��' . • .
�
� �� � ' r � � � � �� '� , " HEAVY DUTY LID
� ` � y CUTAWAY
� Reinforced
��� •_ � E , ti
y � . �
' '� .,�;,,� 24" structural
, , � :� access port
/ ' � �
"'4'1+ � .;... �
_ �,.,� ,,
� ' ���` � Structural
�� °� '�
� � -`��' bulkheads
� � � �, ;
' ` �� �� � � � � � � � MID-SEAM CUTAWAY
� i ; �� ���- .�
Reinforced water tight mid-seam
` , � •` � � gasketed connection
., ,
,,
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;��� x -
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,`� � ; �
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a .,, ,
� Protecting the Environment with lnnovative Wastewater Treatment Solutions � N F I LT R ATO R�
water technologies
IM-1530 General Specifications
and Illustrations
--IIFfING lUG(IYP.) R�SER CONNECTION(7YP.)
The IM-1530 is an injection molded two piece mid- ��FT�N�ST�,P R�P.,
seam plastic tank. The IM-1530 injection molded i
7 T*f 1 r �r�'�f isrr. r�'T i`t �t', i- � i* r ir,�i: 'T - __
plastic design allows for a mid-seam joint that has �, l� �i�'I.�' �f1 I � r II�JI �rT ��° f '���'
precise dimensions for accepting an engineered �,,?�_ : �� � !j� I ��t-�S f"��; �� � '� i�: ;�' ;;�, �
/.__._.\, ./--� , 1 ��''
EPDM gasket. Infiltrator's gasket design utilizes � �� '; � •4 , � �y � � � �,�
� ' ,�
technology from the water industry to deliver ' ; ����, �'. =� �' r f' ��i'l o �-''' • � EXTEROR
s �� e � � x,! WIOTtI
proven means of maintaining a watertight seal, '�T;�,��� � ;,�`_,�� . � _ _��/:%- .,�
7i.' '� �� 1� � rt t � � � �
The two-piece design is permanently fastened �� � (,��f��� � �'( � � � � � �I � �E O I��,� � ���'
��'tr_.'�2� �L._� 't�. ��..-.,t�}�Y��•F�i_..L�x.u.�+, t,�r'� �
using a series of non-corrosive plastic alignment - "� � �
dowels and locking seam clips. The IM-1530 is _ „5.8�.,46o�ExTER�oR�EN�TH _�
assembled and sold through a network of certified
Infiltrator distributors.
TOP YIEW
Must be backfilled and installed in accordance
with I�fltrator Water Technologies, Infiltrator o�nETTEE ,
IM-Series Septic Tank General Installation `ryP' \
Instructions and for shallow round water � '; ' �' +
conditlons reference the Iniiltrator IM-Series l���'��' ( �����' �I����l �
; j I��� �� j � ��l � u '� i �.�,
Tank Buoyancy Control Guidance. ,,.,s�ri.-�l'�� l�_,�J��„�• n,3�,
[iw.� r � i.�r-inri�nau� ex7eR�oa
Y I�i(',I{T
Please visit www.infiltratorwater.com/images/ S�^^AOL�' j '� � � �` ����1���
pdflManualsGuides/TANKOi.pdf for the latest `TM��' � �C �� f��_� _ ix(( ! �
LIFTINGSfRAP `�,,,��� �,���d �I�, ���-(� !
intormation. cTMP,
� END VIEW
Working Capacity 1537 gal(5818 L)
Total Capacity 1787 gal(6765�) 024A�BtOjACCESSPORT
04(102� � WITH LOCKING LID(3)
AlrspaCe 16.9% Pvc oanes /
`INLET TEE ( 10.1�257J FREEBOARD 94[102�
Length 176"(4460 mm) T , / PVC ORA85
1 _ /,_ � OUTLETTEE
Wldth 62"(1567 mm) �"r�� �-� 1 +e.sxrua sanc� ��� i
_—_- . . �? �...— —1 ._ , WIthI '
1(I - i � �
Len th-to-Width Ratio 2.8 t0 1 r �"� : ; co�E ���7�5�WALL
9 a, � aa,o �_ 4 n+icKr�ss
h.�� I Ff_R j (1.11BJ � € _-F
Helght 55"(1384 mm) `"OfiF ���UID - - 2I51J X 2(51)
DEPTH j � F18ERGLASS
� . SUPPORT(4)
Liquid Level 44"(1118 mm) i 1 I ( _ `TMP'
_u.k: . :-L ...._r-._-1... .. . �. . �.�
Invert Drop 3"(76 mm)
Fiberglass Supports 4 SIDE VIEIN
Compartments t or 2
Maximum Burial Depth 48"(1219 mm) �� CONTINUOUS
TANK TOP HALF --�- �-�
I �t4 ELASTOMERIC
Minimum Burial Depth 6"(152 mm) I � 4 GASKET
Maximum Pipe Diameter 4°(100 mm) TANK � ��� �1ni�_
INTERIOR �-��-�� , �j�1��I .� SEAM CUP
Weight 501 Ibs(228 kg) �� ��� ���-_;�
��I._,, �_
AIIGNMENT � "�
, , OOWEL I - TANK BOTTOM HALF
, � 4 Buslness Park Road �i
X f� P.O.Box 768
Old Saybrook,CT 06475
sso�s�,-;000.F.,x aso-a��-�oo, MID-HEIGHT SEAM SECTION
I N F I LT R A T O R� '1-90p-2y1-4436
�vater technologies www.inrftratorwater.com
U.S.Patents:4,759,661;5,017,04t;5,156,488;5,336,017;5,401,116;5,401,459;5,511,903;5,716,183;5,586,778;S,B39,94a Canadlan Patents:1,329,959;2,WA,564 Other patants pending.Inflftretor,
Equalizer,4uick4,and SideWinder are repistered trademaAcs of InfdVatw Water Technobgies.InfilUator is a registered trademark in France.Infittrata Water Technologias is a registered Vademark in Mexlco
Contour,MicroLeaching.PoryTuff,ChambeiSpacer.MuWPort,Pos{lock,OulckCut,OulckPlay,Snaplock and Stralghtlocic are trademarks of In0ltrator Weter Technobgles.
PolyLok is a tredema.k of PoryLok,Inc.TUF-TITE is a registered trademark of TUP-TITE,INC.U0.ra-Rib Is a hedemerlc of IPEX Inc.
�2074 Infiftrata Wate!7echnologies,LLC.Ali nghts resarved.Pnnted in U_S.A.
IM21 1116
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�
� I N FI LTRATO R " IM- 1 O�O
� �:��t}L ; � � �.. .
• Strong injection molded polypropylene
" construction
a�,+� .,
� • Lightweight plastic construction and
"� ,� inboard lifting lugs allow for easy
� j delivery and handling
:� ,, '"
� • Integral heavy-duty green lids that
� � x '�` interconnect with TWT""risers and pipe
, �, � ��, �� � ; riser solutions
�' -�r,.r • Structurally reinforced access ports
, ,� ��,���' . �, ' eliminate distortion during instailation
and pump-outs
' � � • Reinforced structurai ribbing and
f� �"
��� � �"� fiberglass bulkheads offer additionai
'� • strength
t.
• Can be installed with 6"to 48"
of cover
The Infiltrator IM-1060 is a lightweight strong and durable septic iank. • Can be pumped dry during
This watertight tank design is offered with Infiltrator's line of custom-fit pump-outs
risers and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank, pump
revolutionary improvement in plastic septic tank design, offering long-term tank,or rainwater{non-potable)tank
exceptional strength and watertightness. • No special water filling requirements
Inlet Side are necessary
• The tank may b�backfilled with suftable
TANK CUTAWAY Infiftrator native soil.See installation lnstructions
S s em r for guidance.
Y
.�-.pp�� '
.:'-.
��� �.t�:�
- _ ,,
�: ��" � ,
����
Partition � ��`'� ,��,
baffle wall� � r ` �, .
.� , ti, ��;� `
�'� � '; HEAVY DUTY LID
� �: , ;=<. '� CUTAWAY
r''� j�V � Reinforced
� � � 24" structural
-a,tl;�;�`i ,� ' .��� ,�
�,�P� � � �°" �� �� ' access port
�
,,. ; �� �: ��
x, ; � � � � F��
� �� �� �� �, �,�` � `�, Structural
�: �,, � y. bulkheads
r
MID-SEAM CUTAWAY
� Reinforced water tight mid-seam
`'�s,. gasketed connection
,>.
� � �
rf t
� Protecting the Environment with Innovative Wastewater Treatment Solutions � N F� LT R ATO RA
water technologies
IM-1060 Generai Specifications and Illustrations
` imcnu�� i:roieu�G moKeor'vcarow
The IM-1060 is an inJection molded two piece mid-seam � —
plastic tank.The IM-1060 injection molded plastic design � �`I I I F� I i ! i
allows for a mid-seam joint that has precise dimensions n � '� I, � ! _
—� .. a
for accepting an engineered EPDM gasket.Infiltrator's t� �t- QG\'�. ' �o �
gasket design utilizes technology from the water industry `�— . ° -��r � =o-� J ,B,
10 deliver proven means of maintainmg a watertight seal. ` ' " 15°01
0
The two-piece design is permanently fastened using a �\- � i� �°TM
series of non-corrosive plastic alignment dowels and C' I �
locking seam clips.The IM-1060 is assembled and sold
through a network of certified Intiltrator distributors.
�� il�Alli3b1EN1EP10RlENGiH _
Must be backfilled and installed in accordance wfth TOP YIEW
Infiltrator Water Technologies,Infiltrator IM-Series Septic Wr�
Tank General Installation Instructions and for shailow II _ �
ground water conditions reference the Inffitrator IM-
Series Tank Buoyancy Control Guidance.
c
Please visit www.infiltratorwater.com�mages/pdf/ I I ��a9,
ManualsGuides/TANKOi.pdf for the latest information. I `E`�ro"
SF�MC�W���
fnvK�L�
1�1
LIRINGSTR�P
Working Capacity 1094 gal(4141 L) 1Y°""`�
Total Capacity 1287 gal(4872 L) END VIEW
Airspaoe 16.5%
LeflJth 12T(3226�I1m) m��mzi- m:aiaiol�ccEssovtHirmswrtHwcriHcuos�i
wcoxees 0n�o�i rvcon
�✓�h 62.2"(1580mri1) �"�TTEE ..�ozi:ea�vneeeo�no �esamnhe
Length-to-Width Ratio 2.3 to 1 _l �es.
•IpSVMF (wR(1
Height 54.7"(1389 mm) in 3O
C0� V61 vEA
Uquid Level 44"(1118 mm) , �L_
Inveli Dro fBfN"�`"�s.—�I �i;n'u°o _ wova s
P 3"(76 mm) surroxr i oevrH �nvxeu
�*mrc�u wim eu«[
Fiberglass Supports 2 I w,uw�rne I
_ 1_ I ' MEQUflED /
Compartments 1 or2 �'"'�'�'^�"`-L-��` �-�;✓
Maximum 8urial Depth 48"(1219 mm) SIDE VIEW
Mlnimum Burlal Depth 6"(152 mm)
Maximum Pipe Diameter 6"(152 mm) TANKTOP— CONTINUOUS
Wei9ht 3201bs(145 kg) HALF GASKET
TANK
INTERIOR � ——SEAM CLIP
ALIGNMENT I
� DOWEI _
—TANKBOTfOM
/ 6 eusinea.a Park Road HALF
� P.o.Box�89
Ob SeYbrook�CT OBA]5
I N F I LT R AT O R° esa-s„-,�o.F�.a�o.s�,-,�o, MID-HEIGHT SEAM SECTION
i�eoo•sz�-uaa
�v��ar,achi,oioqies M'�'��fihretwsweteceom
U.S.GatenLq:4,159,fi61;5,011,0a1;5,i5fi,488;5,336,017;S,a01,116;5,�01 p59;5,511.903;5,]16,169;5.588,]]e;5,839,840 Canedlan Palents�.1,329,959;2,OOa,564 qner paten6 pendiry.Infihator,Equairzer
OuickC,ene$IOeWeWer ere repisteretl 4atlemarks ol Infillretor Water TeeMqbgles,yifipatw ie a registereE Irtden�erk in Grance.InLlbgtor Water TecMologies Is a registeretl tratlemsrk in Mmico.
CaMour,MxroLexhlrg,PoyTUH,C�arMaSpecer,MupWort.PosiLock,OukkCuG OukMPby,SnapLp ii aM SlralghM,ock era haCamarks of Inllltratur Watm Tochnobgks
PolyLok Is a trntlemark ot PoyLek,Inc.NF-71TE Is a registazatl hetlemerk ol TUF-TRE,INC.Uttn�iib a a fredemark of IPE%Inc.
O 2016 IMiRreta Waier TecNwbgies,LLC.NI ngMs emervetl.hntetl n U.S.F.
IM021116
� . • �'• • :1�
�E narMEh, Departmen�of Safety and Professional Services
F�' . ��,,, Division of Industry Services
�^` � ���T`, Plumbing Product Review
1=� ` 0
\ 4822 Madison Yards Way
�,r�',.... \SPS `JI P.O. Box7162
b� � � �� Madison,Wisconsin 53707-7162
��`q`� �—�4�� Phone 608-266-2112
..,ppf`i.lUSP�ti,�
R5 � - - Web htto:/idsus.wi.aov
Email dsps@wisconsin.gov
Governor Tony Evers Dawn Crim,Secretary TTY:Contact Through Relay
April 28, 2022
Infiltrator Water Technologies
Government Affairs Departmen[
4 Business Park Road
P.O. Box 768
Old Saybrook CT 06475
Re: Description: Sewage Tanks,Thermoplastic(PE or PP)
Manufacturer: Infiltrator Systems Inc.
Product Name: Two Compartment HoldinR or Septic Tanks:CM-1060, IM-1060 and IM-1530
Riser Svstems: EZ Set and EZ Snap
Model Number(s): Two Compartment HoldinR or Septic Tanks: CM-1060, IM-1060 and IM-1530
Riser Svstems: EZ Set and EZ Snap
eSLA PTO No.: PP-042200016-PTOPHTC
The specifications and/or plans for these thermoplastic sewage tanks and riser systems have been reviewed and de[ermined
to be in compliance with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160,Wisconsin
Statutes.
The department hereby issues an alternate approval to s. SPS 384.25(7) (b)Wis.Adm. Code based on the Wisconsin Statutes
and the Wisconsin Administrative Code. This alternate approval is valid until the end of April 2027.
This approval is contingent upon compliance with the following stipulation(s):
1. These tanks and riser systems shall:
a. conform to s.SPS 384.25(2)(b)Wis.Adm.Code.
b. be labeled as required by s.SPS 38415(11)(c)Wis.Adm.Code.
c. be placed in accordance with s.SPS 383.43(8�(i)Wis.Adm.Code.
d. have an internal partition,securely attached to a structural support column,separating chambers A and B that has a
watertight seal at the joints with the tank top,6ottom and sidewalls.
e. be watertight in accordance with s.SPS 354.25�2)(d)Wis.Adm.Code.
f. be designed to withstand the pressures to which it they are subjected.
g. be fitted with locking manhole mvers in acmrdance with s.SPS 384.25(7)(h)Wis.Adm.Code. The manhole
cover must be secured to the riser using screws which are not standard or Philips head m be considered an
effectivelocking device.
h. bear warning labels,that are visible after installation,that mnform to s.SPS 384.25(S).
i. be anchored in ac�ordance with s.SPS 383.43(8)(g)Wis.Adm.Code when installed in areas subject to saturated soil
mnditions.
j. be vented in accordance with s.SPS 384.25(5)Wis.Adm.Code.
k. be installed by persons holding the proper license or registration in acmrdance with Wis.Stats.§145.
I. be installed,maintained and used in strict acmrdance with the manufacturer's pu6lished instructions,Chapters
381387 Wis.Adm.Code and this product approvai. If there is a conflict between the manufacturer's
instructions and the Wis.Adm.Code or this Plumbing Product Approval,then the Wis.Adm.Code and this
Plumbing Product Approval shall take precedence.
2. DSPS POWTS plan approval shall be obtained from the department's Private Sewage Section,or the appropriate agent
county,for each installation of[hese tanks.
SBD-10564-E(N.10/97) File Ref:20190125.DOC
Infiltrator Systems Inc.
April 28, 2022
Page 2 of 3
eSLA PTO No.: PP-042200016-PTOPHTC
3. A sanitary permit shall be obtained, in accordance with s. SPS 383.21 Wis. Adm. Code, from the county, or other local
authority having jurisdiction, for each proposed installation of these tanks.
No person shall purchase, or install, a private on-site wastewater treatment system unless the owner of the property
on which the private on-site wastewater treatment system is to be installed holds a valid sanitary permit issued under
§ 145.19.
No person shall sell at retail, as defined under § 100.201 (1) (d), a septic tank for installation in this state unless the
purchaser holds a valid sanitary permit issued under § 145.19.
4. Campgrounds shall obtain required permitting from the Wisconsin Department of Health Services under HFS 178
prior to installing or using these tanks.
S. Drain, waste and vent piping used to install these tanks shall conform to s. SPS 384.30 (1), (2) and (3) Wis. Adm. Code.
6. Cleanouts shall be installed in drain piping associated with the installation of these tanks in accordance with s. SPS
382.35 Wis. Adm. Code.
7. Tank contents removed shall be treated as septage and disposed of in accordance with NR 113 Wis. Adm. Code.
8. This approval shall not include consideration of these tanks for any fresh/potable water uses.
9. The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's
stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the
department.
10. Bedding and backfilling of these tanks shall be in accordance with the manufacturer's published instructions.
(attached)
11. The following are approved for use with these tanks:
a. 4-in. inlet, outlet and vent openings;
b. 4 in. ASTM C923/C923M-20 and ASTM C1644-06(R2017) compliant pipe connectors;
c. watertight electrical openings <_ 2-in. ID in access risers;
d. EZ Snap riser systems (24-in. diameter, 2, 6 and 12-in. heights), or other code compliant riser system;
e. EZ Set riser systems (24 and 36-in. diameters, 6, 12 and 18-in. heights, or other code compliant riser system);
f. Safety Star Systems, or other code complaint safety system;
g. ASTM F477-14 compliant mid-seam elastomeric seals;
h. Approved effluent fiiters installed in outlet tees; and
i. Bottom connection holding tank configuration.
12. Use of the EZ Snap, EZ Set and Safety Star systems shall not be limited to, or required for, use with Infiltrator tanks by this
approval. The EZ Snap, EZ Set and Safety Star systems may be used with any compatible tank in accordance with infiltrator's and
the tank manufacturer's instructions. Any code compliant riser, lid and safety system may be used with these tanks in accordance
with Infiltrator's instructions.
Two Compartment Tank Specifications
Model Liquid Level (in.) Gal./in. Gal./day' ' Max. Depth of Bury (in.)
CM-1060 QQ.Q Ae�er to Table 7 in�he infiltrator IM-and CM-Series Septic Tank General Installation Instructiuns 356 4$
IM-1060 44.� Thefirstrompartmentis'/.ofthetotalvolumeandtheserondmmpartmentisRofthetotal 35� 48
IM-1530 44.0 "o�°'"` a9z 4$
♦=When Useo as a Septi<Tank Based on a 3�yc Serviu•Interval for Fesidential Wastewater
1=at the Plan Reviewer's di5cretion,a(actor of 1.04(i.e.5 4%)may be applied to account for a mulfi-Aedroom resiAential pmperty.
Infiltrator Systems Inc.
April 28,2022
Page 3 of 3
eSLA PTO No.:PP-042200016-PTOPHTC
Technical notations:
a. This approval supersedes the approvals issued on April 11,2022 under eSLA PTO No.PP-042200010-PTOPHTC,October
22,2020 under eSLA P70 No.PP-102000070-PTOPHTC and lune 7,2019 under eSLA PTO No.PP-042000060-PTOPHTC.
b. Manufa[[urer's webtite: https://www.infiltratorwater.mm/products/infiltrator-tanks/cm-series-plastirseptio-tanks-1/
https://www.infiltratorwater.mm/productz/infiltra[or-tanks/im-series-septio-tanks/
c. ASTM C923/C923M-20 and ASTM C1644-06(R2017)s[andards for re5ilient connectors pertain to pipe connections to
reinforced concrete risers and tanks respectively.
The department is in no way endorsing these tanks,riser assemblies or any advertising and is not responsible for any situation
which may result from their use.
Sincerely,
Glen W.S�hluter
Plumbing Product Reviewer
Departmen[of Safety and Professional Services
Division of Industry Services
Bureau of Technical Services
(608)267-1401 Phone
glen.schlueter@wi.gov E-mail
7:45AM-4:30PM CDT M-F Work Hours
Table 2: Nominal Volume Chart
Liquid height a6ove Liquid volume in tank at' � ated height(measured from tank bottom to liquid surface)'
tank bottom'
IM-540 IM-1060 CM-1060 IM•1530
in cm U.S.Gal Liters U.S. a i ers U.S.Gal Liteis U.S.Gal Liters
1 3 3 11 3 11 5 21 17 64
2 5 8 30 73 49 17 64 34 128
3 8 14 53 28 106 31 119 51 192
4 10 21 80 46 174 50 168 68 256
5 13 29 109 65 246 70 263 94 357
6 15 37 141 86 326 91 344 122 463
7 18 46 �73 107 405 113 429 152 573
8 20 55 207 �pg q88 137 517 180 681
9 23 64 243 152 575 160 608 212 802
10 25 74 279 176 666 185 700 245 928
11 28 64 317 200 757 210 795 280 1,061
12 30 94 356 225 852 236 892 312 1,182
13 33 105 396 257 950 262 991 351 1,328
14 36 116 437 p77 �,pqg 288 1,091 387 1,463
15 38 127 480 303 1,147 315 1.192 422 1,597
16 41 138 523 330 1,249 342 1,293 464 1,756
17 43 150 566 357 1,351 369 1,396 500 1,892
18 46 161 611 384 1,454 396 1,499 537 2,034
19 48 173 656 411 1,556 423 1,602 575 2,177
20 51 186 702 43 1,656 451 1,706 614 2,322
21 5? 198 749 465 1,760 478 1,811 652 2,468
22 5E 210 796 49 1,866 506 1,916 690 2,612
23 SE 223 843 521 1,972 534 2.022 729 2,758
24 61 235 891 549 2,078 562 2,129 770 2,914
25 64 248 940 577 2,184 591 2,236 808 3,058
26 66 261 988 605 2,290 619 2,344 847 3,208
27 65 274 1,038 633 2,396 648 2,453 887 3,356
28 71 287 1,088 662 2,50fi 677 2,563 928 3,513
29 74 300 1,137 691 2,616 706 2,671 968 3,665
30 7E� 313 1,185 719 2,722 734 2,778 1,007 3,814
31 75 326 1,233 747 p,gpg 762 2,885 1,048 3,966
32 81 338 1,281 775 2,934 790 2,991 1,087 4,113
33 84 351 1,328 802 3,036 8l8 3,096 1,126 4,262
34 86 363 1,375 830 3,142 846 3,201 1,165 4,410
35 89 375 1,421 857 3,244 873 3,305 1,204 4,557
36 91 387 1,466 884 3,346 901 3,409 1,242 4,701
37 9< 399 1,511 911 3.449 928 3,512 1,280 4,846
38 9i 411 1,555 g38 3,551 955 3,614 1,318 4,986
39 99 422 ��598 965 3,653 982 3,716 1,355 5,131
40 102 433 1,640 gg2 3,755 1,008 3,817 1,393 5,272
41 104 444 1,681 7,018 3,854 1,035 3,917 1,430 5,412
42 107 455 7,722 1,044 3,952 1,061 4,016 1,466 5,550
43 109 465 1,761 1,p69 4,047 1,087 4,113 1,502 5,685
44 112 475 1,799 1,094 4,141 1,111 4,207 1,537 5,817
45 114 485 1,836 �,��g q,p3p 1,136 4,302 1,572 5,950
46 117 494 1,871 1,142 4,323 1,160 4,393 1,604 6,070
47 119 503 1,905 1,165 4,410 1,184 4,481 1,638 6.201
48 122 512 1,938 1,187 4,493 1,206 4,566 t,667 6,310
49 124 520 1,970 1,208 4,573 1,228 4,648 1,697 6,422
50 127 528 7,999 1,228 4,648 1.248 4,724 1,724 6,527
51 130 535 2,027 1,247 4,720 1,267 4,794 1,749 6,621
52 132 542 2,050 1,265 4,789 1,282 4,851 1,766 6,684
53 135 547 2,071 1,278 4.838 1,293 4,896 1,777 6,726
54 137 5512 2,087 1,287 4.872 1.3002 4,922 1,785z 6,758
1.Liquid height measured from lowermost insitle surface at bottom of corrugation in tank to the liquitl surface elevation.
2 The total capacity of ihe IM-5401ank is 552 gallons;the total capacity of the CM-1060 is 1,309,the total capacity of the IM-1530 tank is 1 787 gallons.
3.To determine liquitl volume between liquid heights,subract lhe Table 2 volume intlicated for the upper and lower heigh[s.Example:CM-1060 volume
between 60 In(127 cm)and 40 in(�02 cm)=1,248 gal(4,724 L)-1,008 gal(3,81�L)=240 gal(907 L).
� :��
PAGE 5 OF 6
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4"O Venl Pipe
>1091rom
Building Beclncal musl mmpty vnin
12"Min.or20 ft abova SPS 376 and NEC 300
EstabllshedFloodElevallon Wealherpr�f Exlendmanholenserasnacessary.
«Yp��) J�ncllun Box
AnpfO� qppravatl Locking Manhole
IMPORTANT: Ve"�CdP with Waming label AlWched
Anchor tank(s)as necessary (ryp"a�>
pursuant to SPS 383.43 B —cond���
O(9) 4"Min.or 2.07t above
Eslablished Flood Elevellon
(rypical)
�Ainight Seal
Finishad Grade �
- Ouick Disconnect
CAPACITIES 24.86 +e M�.
@ galfin , , .. ' c�rv��aq
• ` I
Depth(in) Volume (gal) —
A 22.5 559.35 boj *� wee, �qpp�ovedJoinlswilh
Hole Apprwed Pipe 3 fl onlo
B 49.72 � q SofdGrounE
[C] (0 186.45 � I 3 � ��YP����
D 1 298.32 eZ2S' -B�-�— 0 0���'
� ['c� P mp PUMP-OFF
*Pump Tank Liquid Level = 44 i� � b_orr ELEVATION = � 6� ft
° INSIDE BOTTOM
Force Main Diameter = 2 in �ea�ku ELEVATION = 64 ft
Force Main Length = 200 ft 3"Approved 6etlding Malanal Berree�h Tank
Force Main Void Volume = 32.6 9a� Vertical Head = 31.5 ft
+ Min. Supply Head = - ft
[C] Total Dose Volume TDV = 182.6 gal/dose
+ FM Friction Loss = 9•98 ft
(5X total lateral vad volume<_TDV 50.2X design Oow)
+(force main drainback vdume) + Fitting Loss" _ - ft
�`(min.supply head x 0.3)
MIN. PUMP DISCHARGE RATE = 50 gpm = TOTAL DYNAMIC HEAD = 41 .48 ft
PUMP TANK: SEPTIC TnNK(S):
Volume = 1287 gal Total Volume = 1787 ga�
Manufacturer: Infiltrator Manufacturer(s): Infiltrator
Pump Manufacturer: Zoeller
Install approved effluent filter at the septic tank outlet
Pump Model: 165 i immediately upsire�m �f the qump tank inlet
(Seo atlachetl pump curva
Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Orenco
Controls/Alarm Model: HW101
Filter Model: FT0822
Float switches containina mercury are prohibited
�
�
w w PUMP PERFORMANCE CURVE
w
� " M O D E L S 1 61/41 61 - 1 6 3/4 1 6 3 - �5/4 6
so
24 80
1 5/4165
a 70
w 20 163/4163
_
� 60
�
¢
} 16
0 50
J ��
� ���/
� �2
30
8
20
161/4161
4
10
0
10 20 30 40 � 60 70 80 90 100 110
GALLONS `'-=�
LITERS 0 80 160 240 320 400
FLOW PER MINUTE
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, aIl inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Disaersal Area Operatinq Limits:
Design Flow= 750 gpd; BODS <_ 220 mgL''; TSS <_ 150 mgL''; FOG <_30 mgL''
Inspection Checklist INSPECT EVERY 3 YEARS
o type oi 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 boxes)
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 recycling, 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 surtace 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 operetor 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 filter(s1 shall be inspected every 3 years and shali 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: AC1CIf'y RaSfT1USS0C1 & SOfIS Phone: �15-798-3355
�ocal government unit: SaWyer CO. Zonitlg Phone: �15-634-8288
�ocal government unit address: 10610 Mairl St. #49 Haywal'd, 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.
Continuencv 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.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
1126124, 1:07 PM Real Property Lisling Page
R2dl EStat2 Sawyer County Property Listing Property Status: Current
Today's Date: 1/26/2029 Created On: 8/5/2020 1:08:00 AM
�Description Updated: 8/5/2020 '� Ownership Updated: 9/15/2021
TaxID: 43878 � KAREN A WICK STILLWATER MN
PIN: 57-024-2-41-07-30-5 OS-002-000380
Legacy PIN: 024741305238 Billing Address: Mailing Address:
Map ID: KAREN A WICK KAREN A WICK
Municipality: (024)TOWN OF ROUND LAKE 6920 ITASCA TRAIL N 8920 ITASCA TRAIL N
STR: 530 T41N R07W STILLWATER MN 55082 STILLWATER MN 55082
Description: PRT GOVT LOT 2 LOT 7 CSM 36/250
#8464 � Site Address * indicates Private Road
. . _ _ ._.___ . . . _. ... .
Recorded Acres: 5.450 10349N SANDY BEACH RD HAYWARD 54843
Calalated Acres: 0.000
Lottery Claims: 0 L� Pro e
First Dollar: No P KY Assessment Updated:4/5/2021
Waterbody: Round Lake 2023 Assessment Detail
Zoning: (RRl) Residential/Recreational One �ode Acres land Imp.
ESN: 404 G1-RESIDENTIAL 5.450 443,600 0
2-Year Comparison 2022 2023 Change
�� Tax Districts Updated: 8/5/2020 Land: 443,800 443,800 0.0%
1 State of Wisconsin Improved: 0 0 0.0%
57 Sawyer Counry Total: 443,800 443,800 0.0%
024 Town of Round Lake
572478 Hayward Communiry School DistriR
001700 Technical College ��property History
Parent Properties Tax ID
. Recorded Documents Updated: 4/15/2021 57-024-2-41-07-30-5 OS-002-000310 43760
TERMINATION OF DECEDENTSINTEREST
Date Recorded: 3/26/2021 430806
WARRANTY DEED
Date Recorded: 7/6/2020 424837
CERTIFIED SURVEY MAP
Date Recorded: 6/19/2020 424527
EASEMENT
Date Recorded: 6/5/2020 424213
EASEMENT
Date Recorded: 6/1/2020 424099
IUDGMENT
Date Recorded: l/28/2020 422275
QUIT CLAIM DEED
Date Recorded: l2/17/2019 421660
CERTIFIED SURVEY MAP
Date Recorded: 12/13/2019 421609
AMENDEDFINAL]UDGMENT
Date Recorded: 11/21/2019 421244
WARRANTY DEED
Date Recorded: ll/8/2019 421016
CERTIFIED SURVEY MAP
Date Remrded: 10/28/2019 920791
QUIT CLAIM DEED
Date Recorded: SO/19/2018 415001
TRUSTEES DEED
Date Recorded: 10/19/2018 414999
QUIT CLAIM DEED
Date Recorded: 10/17/2018 414927
WARRANTY DEED
Da[e Recorded: l0/11/2004 325714
QUIT CLAIM DEED
Date Recorded: 2/14/2003 306253
https:lltas.sawyercounrygov.orglsystem/frames.asp?uname=Eric+Wellauer 1�2
1/26/24, 1�07 PM Real Property Lis�ing Page
QUIT CLAIM DEED
Date Recorded: 2/8/2001 289077
QUIT CLAIM DEED
Date Recorded: 2/8/2001 289076
DEED IN TRUST
Date Recorded: 2/11/1963 115752
QUIT CLAIM DEED
Date Recorded: l/3/1958 104375
(_.hild Historv�Ld o�mt 7-
HISTORY O Expand All History White=Current Parcels Pink=Retired Parcels
0 Tax ID: 25982 Pin: 57-024-2-41-07-30-5 OS-002-000040 Leg. Pin: 024741305204 Map ID: :2.4
O Tax ID:43703 Pin: 57-024-2-41-07-30-5 OS-002-000250 Leg. Pin: 024741305225
O 7ax ID: 25981 Pin: 57-024-2-41-07-30-5 OS-002-000030 Leg. Pin: 024741305203 Map ID: :23
O Tax ID: 25980 Pin: 57-024-2-41-07-30-5 OS-002-000020 Leg. Pin: 024741305202 Map ID: :2.2
O Tax ID:437ll Pin: 57-024-2-41-07-30-5 OS-002-000260 Leg.Pin: 024741305226
O Tax ID:43720 Pin; 57-024-2-41-07-30-5 OS-002-000290 Leg. Pin: 024791305229
D Tax ID:43760 Pin: 57-024-b41-07-30-5 OS-002-000310 Leg. Pin: 024741305231
43878 This Parcel Parents Children
https:l/tassawyercountygov.org/systemlframes.asp?uname=Eric+Wellauer 2�2