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Home My WebLink About024-741-33-4416-SAN-2024-079 � � -:��.�""'=�� Industry Services Division County -�'� _ ' 4822 Madison Yards Way �j¢w y g/' � ; � S : Madison,Vl'I 53705 Sanitary Pcrmit Numbcr(to be ftlled in by Co.; ` P= P.O.Box 7162 �';r,,.''v=� Madison,�'�I 53707-7162 �5 I �]� �y' � .��-- � Sanitary Permit Application S2ateTrnnsactioni�uinber o In accordance«ith SPS 38321(2),�Vis_Adm Code,submission ofthis form to the appropriate goveiamental unit � is requircd Qrior to obtaining a sanitary permit Note:Application forms for state-owned POWTS are submitted to Project Address(if difTerent lh:u�m�iling addre: � the Dcpartmcnt of Safctp and Prc�fessional Sen�iccs.Peryonal information you providc may be used for second:uy purposes in accordance with thc Priv:icy Law,s.15.04(1)(m),Stats. L Application[nformation-Plcase Print All lnformation __ //066 ld GJ'y//�uY Propem�O��ne-'s Ne�ne Pareel�# Je�a/ G�1a 6�'/ y/ yy/6 Property Owne-'s:�iailing Address Propert_y Loca[ion 4S go a e•v 1 o�p R Govi_Lot Cin,State `Lip Code Phcne\umber / ,` � 3 S/' ��t/T /V� D�� Z-�'%a, .st� '<, Sec[ion� IJ.Type of I3irilding(check all ttiat apply) Lut;= T / N R__7 G u � �I or2 Family llweflin�-NumberofBedrooms / _ _ � Subdivisioni3amc Block�' ❑I'ubliclConmiercial-Describe Use_ �--' ❑Ciry of ____ ❑State O�oned-Describe Use_ CSht Numbcr �illage of_ �roRn or ,Qou�d Gakc � 3�/,?��l- 'a876� III.Tppe of POWTS Pe�mit:(Check either"New"or.`'Replacemeut"and other applicable on lipe A_ Check one bot on[fne I3_Cnmplete linc C if a Iicahlc.) A. �-7" �i ie��Sy:teti: �'�/pteplacesnent 3ystem �Other�4odification w E?:istino Sy�stem(explain) Addirional Prctrcatment tinit{exptain} i L^J ` �' ❑Hol�in�'I'anR ��In-Ground �t-Grade �VSound Individual Site Desism Other TyPe(cr�lainl (convcndonal) C• ❑Rcne�i�ai Qefnrc �Revision ❑Change of Plumbcr I�rausfer to New Owncr LiSt Prcvious Pcmtit Number and Datc Issued ( Expir�tinn ��'—1� O tt �� _� _ , .. . .; _ ._. _.. , IV.Dispersalrt'rcatmeni A[ea and Tank Infoemadon:; :- -' �:' - Design Flo:v(�d1 � Decign Soil APplication Ftatc(�ci�'sfl Dispersal Area Re.�uired(s� Dispeisal rlrea Proposed(s� Sv,tem El��ation � � bb � . �dd0 �400 9/p� Capacity in j Totai � �af Manufactucer � j , 7'�n};(�{��;�i� � Gallons _� Gailons � L'niL� � � � �o 'v � � J � i i�c��T:uil:s Existing Tan(:.e i � �a^- u � � + ? `! � �/ • � ^ ^il c% r :n :c. U _cpti�or Holdin,7�an1: )[�U 1 ��v / /`Q� �� I q i! Dosing Cl�ambc: � �� i V.Responsibilih�Statement-I,the undersigned,assume responsibility for inst•i1laGon of thc:°POWTS sho�vn on the attached plans.� Plumber�s\ame fP:int) � Plumber's Signahire A�t �SPIZS Number I3usines;Plione A'umber /.��PUGQ v,'��e,�d4 �v y4�- 7�s=9 3-.7�38' Phimb�r's Add�c„t;Strcci.Cin•.Stacc,Zip Codcl �y� ,v sr w % �,Ye( d, w� 5y�3 VI.Coun •rDepartment Usc Only �;\�r�d� 3 ❑Di,:,,;proved `�t Fcc Date Issued Issuing Agent Signatnrc _ � ' C'O«•ncr Given Etc:ison for Dcnial �DO� ��I I� I:�-� � ��"�'"""�- Conditions of.ApprovaVReasons forDisapproval D � �� ''! � �� 1.��_� _ _,, .. � � ��GI �� . � _ ,;� I�3�� APR 19 2024 �..�--__._.. _ G � � �r �L-(�,' (I l�l,� � SAWYFR i3OUNTY ZONff�1G ADMlNISTRATlUN Attach to complete ptans tor the systrn�and snbmit to the C:ounty onty on paper not I�ss thaa 8 t2 z 11 iocha in size P10 RCFUND6 A�TER SBD-b39S(R.03;��} 4�C�E OF PERi1A1T N �� s �ART /,F Department of Safety and Professional Services . �l��---_..,C�. ,� Division of Industry Services f.,, ;, � Plumbing Produd Review ri�` D S , ��=.��1. 4822 Madison Yards Way '� P J' P.O. Box 7162 ?'1);� S :;'1 Madison,Wisconsin 53707-7162 \JA�. `---� Phone 608-266-2112 ��F�s�\-c��!�� Web http://dsps.wi.gov Email dsps@wisconsin.gov Govemor Tony Evers Dan Hereth,Secretary Designee TTY:Contact Through Relay May 31, 2022 Dept. of Safety and Professional Services Bureau of Technical Services Division of Industry Services Brad Johnson - Section Chief 4822 Madison Yards Way Madison WI 53705 Re: Description: POWTS Component Manual Manufacturer: Dept. of Safety and Professional Services Product Name: In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems Version 2.1 (May 2022-2027) Model Number(s): v. 2.1 eSLA PTO No.: PP-051700077-PTOVPCR The specifications and/or plans for this plumbing product have been reviewed and determined to comply with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 2027. This approval is contingent upon compliance with the following stipulation(s): 1. A copy of this approval letter shall be submitted with all plans using the In-Ground Soil Absorption Component Manual for Private Onsite WastewaterTreatment Systems Version 2.1 (May 2022-2027). Plans submitted without a copy of this approval letter may be denied. 2. This approval recognizes that POWTS systems designed, installed and maintained in accordance with this manual will provide treatment and dispersal of domestic wastewater that is acceptable in the context of ch. 383 Wis. Adm. Code. 3. Systems installed in accordance with this POWTS Component Manual shall use leaching chambers that conform to ch. 384 Wis. Adm. Code. 4. Systems installed in accordance with this POWTS Component Manual shall be installed, maintained and used in strict accordance with the manufacturer's published instructions, Chapters 381-386 Wis. Adm. Code and this product approval. 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. 5. Complete operation and maintenance instructions POWTS systems designed in accordance with this manual shall be provided to each system owner and remain onsite. 6. Systems designed in accordance with this manual shall be installed by persons holding the proper license or registration in accordance with Wis. Stats. § 145. 7. Drain, waste and vent piping used to install these systems shall conform to s. SPS 384.30 (1), (2) and (3) Wis. Adm. Code. � � Dept.of Satety and Professional Services May 31,2022 Page 2 of 2 eSLA PTO No.:PP-051700077-PTOVPCR 8. Cleanouts shall be installed in drain piping associated with the installation of these systems in aaordance with s.SPS 38235 Wis.Adm.Code. 9. Commercial food processing,food production,food service,restaurantr,taverns a�d similar establishments which may generate greases,fats,oils or similar substances;shall have state-approved grease interceptors installed upstream of POWTS systems designed in accordance with this manual in accordance with s.SPS 38234 Wis.Adm. Code. 10. DSPS POWTS plan approval shall be obtained from the departmenYs Private Sewage Section,or the appropriate agent county,foc a. each installation of POWTS systems designed in accordance with this manual;and b. high-strength and/or commercial POWTS systems designed in accordance with this manual. 11. 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 systems designed in accordance with this manual. 12. A complete and acceptable soil evaluation report,mnforming to s.SPS 385 40 Wis.Adm.Code,shall be performed for all proposed systems designed in accordance with this manual. Technical notations: a. This approval supersedes the approval issued May 9,2017 under product file no.20170147. The department is in no way endorsing this mmponent manual or any advertising and is not responsible for any situation which may result from its use. Sincerely, Brad Johnson—Section Chief Department of Safety and Professionaf Services Bureau of Technical Servi�es Division of industry Services Phone: 920 492-5605 Email:6radlevJohnson @ W isconsin.Rov Jerald Grint Property Owners Name 11066W County HWY B Property Address 24741334416 Tax Parcei Number Sawyer County SE-SE Legal Description 33 Section 41 N Town 7W Range Page Index 1 Property Information 2 Data Entry 3 Plot Plan 4 Drainfield Cross-Section 5 Tank Information 6 Maintenance Plan 7 Contingency Plan Bruce Vitcenda Plumber's Name Plumber's Signature M.P.220498 Plumber's License Number 715-943-2382 Plumber's Phone Number 4/18/24 Date Pow�s I�v6�ov.v "o .ve.��'7a.✓ �c/ � .N,s .Yo�,� -.Io.Y7 ✓� .i • I Page 1 of 7 n- roun oi sorpt�on - 5- Component Manual Used 'Version 2 � o��- 0�7 4 Number of Bedrooms 3 Percent Slope (%) 130 Depth to Soil Limiting Factor(in.) 0.6 In Situ soil application rate 400 Estimated Wastewater Flow (gpd) 600 Design Wastewater Flow(gpd) 1 Number of System Elevations 91 Proposed System Elevation#1 - Proposed System Elevation #2 - Proposed System Elevation #3 94.3 Original Grade#1 94.8 Finished Grade#1 - Original Grade#2 - Finished Grade#2 - Original Grade#3 - Finished Grade#3 Skaw 1250 Septic Tank �%tc t%me Effluent Fitter BioDiffuser ARC 36 Chamber Type 13 Height of Chamber(in.) 25 sq.ft. per chamber(ESIA) 4.5 sq.ft. per pair of end caps (EISA) 5 laying length of chamber(ft.) 1.17 length of endcap(ft.) 33.75 Chamber width(in.) 3 Rows of Chambers 3 Distance Between Cells (ft.) 13 Number of chambers in first row 13 Number of chambers in second row 14 Number of chambers in third row 40 Proposed Number of Chambers Used 1000.0 Minimum Distribution Cell Area Required (sq.ft.) /ooa.a• Distribution Cell Area Proposed (sq.ft.) Page 2 of 7 O�^'"�t� P/�mb e� Serald Gri✓t �jrucc v:�ee,ud� 4J9oG farje+n O�/Rd- 1y74e/ST y wY 40 Sarn„r�,��.L6B�4 � Cxe/q,vd,wYy'VQ3S 7ir-943•�iJS1 M./.{,{oyf9 � prl,Sf-,�E S.33 T.41ni a.,". �arz•cfM.a8�6y P.rai�vzv�w�34v�c rowN qo�wdc,xe ♦O.+i mo.o�_e.o•,vq��w/R,�er jw/o wcr Qol< !!I 94.7 az g5.s /�3�5�3 sHaw nsn c;Fct�rc6;�+u k�3 cr wiN,a�✓l ecR �°{ �N I I ' Jcalt I''=Yo' I � ' � _��— _ _ � — --� gj. �eJ�S ` .w�ii . .$z �bd� i �„�ayc � 1�sP o '� � —�—_ yy tl, ^ I � � �M I I � 4 rm6c fcsf ico'+- h 3of� GovA�S'NW v� Cross Section of a Thcee Cell Iagwmd Component Using Leaching Chambeia Finished Grade - Original Grade - �y�� TopolChamber #VALUE! / �System Eleaation - Finished Grade 94.8 r Slope 3% f� � � �— ___ Finished Grade� � �3 Feet 94.30 Original Grade `,t'` k� ` �` �� ! � . ,�',�; • 92.08 Top of Chartber • ` —xti-'� � Onginal Grade - „ r .. ':% ....... ....... . , ,yY. �._ � 1 i' . ��^�'� Top of Chamber#VALUEI t y •� Y '. .. . 91.00 System Elevation � �•...�:. , � " ' � System Elevation - Y � ��7`��F�.,R?qd�ae�1741�, r '1-.—•.-' r, -: � • � ' IiiYu�.P�eoi� � . .. 06�svYdVmt pys b 6e me�errd�d e�pped wf6�po�ed mrs�Y tor�p�u�alr ue Dia rams Not To Scale �E 67.34 feet � ;- __ � F�- .-- .. - -- � n(� _ O °� O 1 r. ,. . � �:�,r*� L J � � - - 34 feet 67 � � �� _V � � _ __ = { __ ��; � 3 feet . between ceils � ', _ —__ __- 7�1 � , ', � - - __ _ �� '�� . '� �� . �. ..-�p`wes . ��•,_._ ��--•� ,� ,�:iw�.;�:- < 72.34 feet � bservation/Vent Pipes to be located at the ends of the distribution cells. Page 4 of 7 BAFFLE fi7.00 7L00 '-" 77.00 %,' \`�� WARNING DEATH MAY OCCUR IF TANK IS ENiEREO � Q � WITHOUT PROPER EOUIPMENT 124,50 � I I o � ( I 1 � `\ j 17B.50 � � � I 13.50 TOP VIEW OF MANHOLE COVER FILiER � 12.00 I- 3 00 4.00 T� � 5,00 27.00� 27.00 s.00�24 00— za.00�� TOP VIEW OF TANK (TAPERED) � I—,s,00— ,00� I INL� �2.00 G BKAW'460 � � 8.00 OUT� � � 4 INCH PRESS 3.00 J 18 00 v q INCH �69.50 O I SEALGASKET L SEALS i i INSTALLEO � � WHEN POURED � GASKET i i BAFFLE � � 36.00 FIL7Eft � � I I I I 1 I I 1 1 I I I I I I I 1 I I L_________________________J 3.00� SECTION VIEW OF TANK AND COVER 3 0o OUTLET END VIEW OF TqNK Model Number: 1 L"JO S KAW P RE-CAST Phone: (715) 967-2277 a Approved for. SEPTIC, SIPHON, HOLDWG, OR PUMP CHAMBER -� 26255 105th Street. New Auburn Toll Free: 1-800-924-8625 � W'eight iniet Dim. Gutlet Dim. �p �p Gal. i In. ax. ap. Wisconsln 54757 Fax: (715) 967-2707 84501bs. 42" 40" 36.00" 34.65 �247ga1. WWW.skawprecast.com Jerald Grint 11066W Coun HWY B 2.47E+10 Number of Bedrooms 4 Septic Tank Skaw 1250 Estimated Flow(average)ga��ons/day 400 Effluent Filter i j; D8Si9f1 FIOW(peak), (Estimated x 1.5)gaVday 600 Soil Application Rate al/da /ft2 0.6 I tnfluent/Effluent Quali Monthl Average PRINT PAGE Fats, Oil 8 Grease(FOG) 30 mglL � Biochemical O en Demand (BODs� 220 mg/L otal Suspended Solids (TSS) 150 mg/L !!NOTE!! Servicing frequency of 12 months or less requires the l Management Plan be recorded with the Register of Deeds. J Maintenance Schedule Service Event Service Frequency Inspect condition of tank(s) At least once every 3 Year(s) Pump out contents of tank(s) When combined slud e and scum = 1/3 of tank volume Inspect dispersal cell(s) At least once every 3 Year(s) Clean effluent filter At least once every 3 Year(s) Maintenance Instructions Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:Master Plumber, Master Plumber ResVicted Sewer, POWTS Maintainer, Septage Servicing Operator. Tank inspection must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin AdminisVative Code. A service report shall be provided to the Sawyer County Zoning Dept within 30 days of any service event. Start-Up and Operation For new construction, prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank removed by a licensed Septage Service Operator. System start-up shall not occur when soil conditions are frozen at the infiltrative surtace. Page 6 of 7 Do not drive or park vehicles over qnks and dispersal cells. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the liFe of the POWTS:antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fat,fou�dation drain (sump pump)water, gasoline, grease, oil, painting products, pesticides, sanitary napkins, tampons, and water softener brine. Abandonment When the POWTS fails and/or is permanentty taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance wdh Wisconsin Administrative Code SPS 383.33; -All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. -The contents of all tanks and pits shall be removed and properiy disposed of by a Septage Servicing Operator. -After pumping, all tanks and pits shall be excavated and removed or their covers removed and the voidspace filted with soil, gravel or another inert solid material. Continqencv Plan If the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide a code compliant replacement system: (Check One) OThe site has not been evaluated to identfij a sui[able replacement area. Upon failure of the POWTS a soil and site evaluation shall be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed to replace the failed POWTS. �A suitable replacement area has been evaluated and may be utiiized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should no be infringed upon by required setbacks from existing and proposed structures, lot lines and wells. Failure to protect the replacements area will resutt in the need for a new soil and sde evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. � A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may be installed to replace the failed POWTS. ��WARNING!! Septic, pump and other treatment tanks may contain lethal gasses and/or insu�cient oxygen. Do not enter a septic, pump or other treatment tank under any circumstances. Death may resuR. Rescue of a person from the interior of a tank may be difficult or impossibte. POWTS Installer Septic Pumper Name Bruce Vitcenda Name NoRhwest Sanitary Phone# 715-943-2382 Phone# 715-943-2650 POWTS Maintainer Local Regulatory Authority Name Northwest Sanitary Agency Sawyer County Zoning Phone# 715-943-2650 Phone# 715�34-8288 7of7