HomeMy WebLinkAbout008-937-04-5308-SAN-2024-102 _- Department of Safety c°°°�' �
Sawyer
� � &Professional Services, Z
. s - Sanitary Permit Number(to be filled in by Co
�,r, �. �_ , Industry Services Division
..�R,� ... . \1� C I � �� 1 �
Sanitary Permit Application State Transaction Number �
In accordance with SPS 38321(2),Wis.Adm.Code,submission of this form to the appropriate govemmental unit �T�52400846-C �
is required prior to obtaining a sanitary permit.No[e:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing addi.,.,,
thc Department of Safery and Professional Services.Personal information you provide may be used for secondary �
purposes in accordance with the Privacy LaH�,s. I 5 04(I)(m),Stau. OI'Hays Rd.
L Application Information—Please Print All Information
Property ONroer's Na�ne ����} (i�C\i� Parcel#
Cathy Borgschatz �� -}Y �,p� 008937045308
I-
Property O��mer's Mailing Address Prope�Loca[ion
981 170th St. P"'� 3
Govt.Lot
City,State Zip Code Phone Number
Hammond WI 54015 �-�� Section 4
II. pe of Buiiding(check all that appty) Lot# T 37 N R 9 E or W
1 or Z Family Dwelling—Number ofBedrooms 3 � Subdivision Name
Block 1�
❑Public/Commercial—Describe Use
"" O City of _
❑Sta[e Owned—Describe Use CSM Number ❑V ge of _
3��q .�$'j$6 own of �gewater —
0
III.Type of WTS Permit:(Check either"New"or"ReplacemenY'and other applicable on line A. Check one box on line B.Complete line C i
a licab .
A New S stem
y ❑ Replacement System ❑ Other Modification to Existing System(explain) ❑ Addiuonal Pretreatment Unit(explain)
B' ❑ Holding Tank ❑ In-Ground ❑At-Grade ound ❑ Individual Site Design yp ( p
❑ Other T e ex lain)
(conventional)
C. ❑ Renewal Before � Revision ❑ Change of Plumber ist Previous Permit Number and Da[e Issued
❑ Transfer to New Owner
Expiration �
IV.Dispersal/Treatment Area and Tank Information:
Design Flow(gpd) Design Soil Application Rate(gpds� Dispersal Area Required(st) Dispersal Area Proposed(s� System Elevation
450 1.0 450 450 99.0
Capacity in Total #of Manufacturer
::
Tank Information Gallons Gallons Units � � �? y :
�
New Tanks Existing Tanks � o a� a Y � `� `�
a CJ v� H v� w C7 a.
Septic or Holding Tank 100� 1600 1 WieSel }{
Dosing Chamber 600
V.Responsibility Statement-I,the undersigned,assume responsibili for installatlon of the POWTS showv on the attached plans.
Plumber's Name(Print) Plumber's Signature MP/MP Number Business Phone Number
Rick Brown 23��5� 419-0739
Plumber's Address(Street,Ciq,State,Zip
Cade)
PO Box 637 Spooner WI 54801
VL Coun /Department Use Ooly
�A� ❑Disapproved Permit Fee Date lssu Issuing Agent Signature _
❑Owner Given Reason for Denial a r�y� 5�`'���I ���'�'��'�`-�'E-1�7'�"� `�"'�
Conditions of Approval/Reasons for Disapproval �'—"1�r—��-.,
r�
� ■ . ."� l � L,ti' ' i�,� t '�'
a � �11 � �.l��`.__..S!.._� `��.... ._ ... . �� r"���J��:.2'i/15�,�
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Attach to complete plans for the system and submit to the County only on paper not lesa than 8 1/2 x 11 inches in aize � � �-
St3ll-6398(K.03/22) NO REFtJNDB AFTER
IS�UE OF PERMIT
�l 3 i.��'S
\�.�',\It 1�11/1T
Wisconsin Department of Safety and Professional Scrvices �;/ �i Phonc:608-266-2112
r
DivisionoflndashyServices c�� �; Web:hup:�-u��v.�a^.��c��
4822 Madison Yards Way ;� ���� -• ��� Email:d, v.�i�+_uconsin����
PO Box 7302
Madison,w1 s37o� 11', ' : Tony Evers,Governor
�J�k�\S�—,\t��e-°�� Dan Hereth,Secretary
May 2,2024
CUST ID NO.:231251 Identification Numbers
RICK BROWN Plan Review No.: PWTS-052400846-C
PO BOX 637 Application No.: DIS-042417955
SPOONER,WI 54801 Site ID No.:SIT-129737
Please refer to all identificarion numbers in each
conespondence with the Department.
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES:OS/02/2026 _-_--_______. ____.___.__ _--__-
�o,wnan,�y
APPROVED
MUNICIPALITY: =�oNa�
TOWN OF EDGEWATER
FS
SAWYF,R COUNTY
;
i�l�.d���� i
i
SITE: '
BORGSCHATZ ' h"�
OL'HAYS RD. � __ �
BIRCHWOOD,WI 54817
FOR:
Design Wastewater Flow Value:450 Mound Component Manual-Version 2.1 (May 2022-2027)
Bedrooms: 3
Limiting Factor(s): 12" Below Grade
Maintenance Required: Effluent Filter
SITE REQUIREMENTS
• A full size copy of the approved plans,specifications,and this letter shall be on-site during construction and open to inspection
by authorized representatives of the Deparhnent,which may include local inspectors. A Department electronic stamp and
signature shall be on the plans which are used at the job site for construction.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This system is to be constructed and located in accordance with the approved plans,and the"Mound Component Manual for
POWTS(Version 2.1),(May 2022-2027)".
• The pressure network is to be constructed in accordance with publications"Pressure Distribution Component Manual for
POWTS(Version 2.1);(May 2022-2027)"and/or the sizing methods of publication"SSWMP Publication 9.6 Design of
Pressure Distribution Networks for ST-SAS(Ol/81)".
OWNER RESPONSIBILITIES
• The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use
and maintenance of the system. Owners sha11 receive a copy of the appropriate operation and maintenance manual and/or
owner's manual for the POWTS described in this approval and Wis.Admin.Code§SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property
owner must follow the contingency plan as described in the approved plans.
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin
Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with
the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),
Wisconsin Statutes,is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,stats.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval,the Division of Industry Services reserves the right to require changes or additions,should conditions arise
making them necessary for code compliance. As per state stats 101.12(2),nothing in this review shall relieve the designer of the
responsibility far designing a safe building,structure,or component. The Division does not take responsibility for the design or
construction of the reviewed items.
Inquiries concerning tbis correspondence may be made to me at the contact information listed below,or at the address on this
letterhead.
Sincerely, Fee Required:$250.00
Fee Received:$250.00
�/��tl/it.r�flr.r �.ra�r.i Balance Due: $0.00 ,
Matthew Janzen Refund Ex ected: $0.00
Division of Industry Services
Phone: 715.340.0407
Email:matthew.janzen@wisconsin.gov
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX ANO TITLE PAGE
Project Name: Borgscha�
Owner's Name: Cashy Bargschatr
%J7��l�,�'^
Owner's Address: 981 170th St.
Hammond WI 54015
Legal Description: Gov lot 3 Sec 04 Tovm 37 Range 09W
Township: Edgewater
Counry: Sawyer
Subdivision Name:
Lot Number: 3 Bbck Number:
Parcel I.D.Number 8937045308
Plan Transaction No.:
Page 1 Index and title
Page 2 Data enUy
Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System mainlenance specifiptions
Page 6 Management and conGngency plan
Page 7 Pump curve and specificaGons
Page 8 Site Plan
Designer: Rick Brown License Number: 231251
Date: 04/15/24 Phone Number: 419-0739
Signature:��`�
Designed Purauanl to ihe `
Mound Component Manual fa POWTS Version J..� �w�.-y 7pl?-,7'7/ „and both
SSWMP Publication 9.6 Design of Precsure Distribution Networks for Sf SAS(01/81)and
Pressure Distribution Componenl Manuel Ver.2.( /�...,,,��D j1-1�)
l
Versan 7.0(R.11/12) Page 1 of 8
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
I
(R or C) r Residential or Commercial Design Nae: sand r�i(o�nkuiacans assume a
300.00 Estimated Wastewater Flow(gpd) TeDle 38344-3 ineitu wil treatmant for
1.50 Peaking Factor(e.g. 1.5= 150%) �����^^or<_��ncnes.
450.00 Design Flow(gpd)
1.00 Site Slope(°�)
97.00 Contour Line Elevation(ft)
12.00 Depth to Limiting Factor(in)
0.60 In-situ Soil Application Rate(gpd/(t�)
Distribution Cell In(o�mation
60.00 Dispersal Ceil Length Along Contour(ft) = 7.50 Cell Width(ft)
1.00 Dispersal Cell Design Loading Rate(gpd/ft�)
1 Influent Wastewater Quality(1 or 2) Are the laterals the highest int
in the distribution �
Pressure Disribution Informatfon network? Enter Y or N
(C or Ej e Center or End Manifold
3.75 Lateral Spacing (ft) If N above,enter the elevation ft
2 Number of Laterals of the highest point.
0.�86 OrificeDiameter(in)
2.75 Estimated Orifice Spacing(ft)= 7023 ft/orifice
2.00 Forcemain Diameter(in)
150.00 Forcemain Length(ft) Does the forcemain drein back? OY
B0.00 Pump Tank Elevation(ft) Enter Y or N
3.25 System Head (ft)x 1.3 24.4� Forcemain Dreinback(gal)
18.67 Verticai Lift(ft) 53.76 Sx Void Volume(gal)
2.70 Friction Loss(ft) 78.23 Minimum Dose Volume(gal)
0.00 In-line Filter Loss(ft) 28.84 System Demand(gpm)
24.62 Total Dynamic Head(ft)
Lateral Diameter Selection Manifold Diameter SelectWn
in. dia. o tions choice in.dia. o tions choice
0.75 1.25 x
1.00 1.50 x x
125 2.00
1.50 : x 3.00
2.00 x
3.00 x
Gallonsllnch Calculator(optional)
TreaUnent Tank Information Total Tank Capacity(gal)
�00.00 Se tic 7ank Capacity(gal) Total Working Liquid Depth(in)
Wie r Manufadurer gallin (enter result in cell 649)
Dose Tank Informadon Effluent Ffker Infortnation
�600.00 Dose Tank Capacity(gal) Pol lock Filter Manufacturer
11.82 Dose Tank Volume(gaUin) P1-525 Filter Model Number
�Weiser _ _�Manufacturer
Proiect: Borgscha� Page 2 of 8
Mound Plan and Cross Section Views
, —t
— J
. _�rj__�08 ObservalionPipe .�� _1
T_-'_"_T . . . .' T
K . � a: :: A
W � � : —�
B
'{.��}:�:...............:.:.............:.:....:�:�:�:�i>:�:�:�:-.�.�.�.�:�.`.�.'.�.�.'.':�:�.': I
'.�.{3F.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.�.�.'.�.�.�.�.�.�.�.�.�.�.�
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
� �
L
Mound Component Dimensions
A 7.50 ft E 24.90 in H 1.00 R K 11.49 ft
B 60.00 ft F 9.50 in i 10.41 ft L 82.98 ft
0 24.00 in G 0.50 ft J 9.59 ft W 27.50 ft
450.00 (ft�) Dispersal Cell Area 1074.74 (ft)Basal Area Available
7.50 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 100.79 (ft) �
';;,�;:; �I H
,
I F /"Dispersal Cell' 99.50 (ft)Lateral
99.00 (ft)—i — Invert
Dispersal Cell ! �3 : ; p � �
Elevation
�( �V� y°��
r!. /1C1���I`C���:4q5`4S� .
/lll!lJJI> 11 ���C 1 �
l//////l// ll � � � . '
••""`"' "�'�?>�'� 97.00 (ft)Contour Elevation
1.0 %Site Sbpe
t Geotextile Fabric Cover
Shading Key $ I Diapersal Cell See laterel details on
Q 0 Topsoil Cap � a 1.5 ft ..:r-(:::. . . . . . . . . . . . Page 4 tor number,size,
02 Subsoil Cap w a ��,t'.`�;;;;`;;;;;:tit�;::,';�:; � and spadng ot laterals.
� ASTM C33 Sand 9 � � F Laterels are equally
0 ft Typiwl Latenl spaced from ihe
0 Tilled Laye� c� �} dislribulion cell's
Q � Aggregat@ + �7 � cen�eNine in the
�—�A�—� distribution cell(Ax6).
Project: Borgscha� Page 3 of 8
End Connection Lateral Layout Diagram
xe� sce�te� over • s •�Turn-�D�Mb�IIwN�wol��nwtplup
_ p �
AIIIate�NsreideMical �EX—�I NdesQlMAon�he0ottomo(�MlaHrd
�W+MY sD�c W S
Face m�in connettbn Wa taa a noss to ma�WolO x aM odnt.
leRdds Rlacemdn Sch 40 PVC per SPS TeMe 384.30-6
Number of Laterals 2 Orfice Diameter 0.188 in
Lateral Diameter 1.50 in Orifice Spacing(X) 2.79 ft
Lateral Length(P) 58.59 ft Orifices per Lateral 22
Lateral Spacing(S) 3.75 ft Orifice Density 10.23 ftz/orifice
Lateral Flow Rate 14.42 gpm Manifold Length 3.75 ft
System Flow Rate 28.84 gpm Manifold Diameter 1.50 in
Total Dynamic Head 24.62 ft Forcemain Velocity 2.94 tUsec
Dose Tank Information �aq�ing wver with waming
label and lodcing Oevice and
� sealedwalertigM
EleUrical as per NEC 300 and � �
SPS 316.300 WAC �4 in.min.
Disconnect �_
�
Tank component is properly vente0 ��� <— Nttemale outlet
loration
Forcemain Oiameter
Weiser Manufacturer � 2 in.
Ca aci 600.00 Gallons
Volume 11.82 gaUnch A
WeeO hole or anti-
Dimension Inches Gallons B sipnon aevice
A 32.14 379.93
B 2.00 23.64 � P'� ump off ekvatwn(R)
C 6.62 76.23 � 80.83
D 10.00 118.20 p
Totai 50.76 600.00
D� ose lank ebvation(n)
3"Bedding un er tank. 80.00
Alarm Manuafacturer SJE Note. Switches
Alarm Model Number HW 101 containing mercury
may not be used in
Pump Manufadurer Goulds this system.
Pump Model Number PE51
Pump Must Deliver 28.84 gpm at 24.62 R TDH
Project: Bo�9schatz Page 4 of 8
Mound Svstem Maintenance and Oaeration Saecifications
Service Provider's Name Rick Brown Phone 419-0739
POWTS Regulator's Name er Coun Zonin Phone 634-8288
Svstem Flow and Load Parameteia
Design Flow-Peak 450 gpd Maximum InFluent Particle Size 1/8 in
Estlmated Fbw-Average 300 gpd Maximum BODS 220 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L
Soil Absorptan Component Size 450 ft Maximum FOG 30 mg/L
Type of Wastewater pomestic Maximum Fecal Coliform >10E4 cfW100 mL
Service Freauencv
Septic and Pump Tank Ins t and/or service once eve 3 ears
Effiuent Filter Should ins ct and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alartn Should test month
Pressure System laterals should be flushed and ressure tested eve 1.5 ears
Mound Inspect for ondin and seepa e once eve 3 ears
Other '
Miscellaneoua Construction and Materials Standards
1. Observation pipes are sloKed and materials conform to Table SPS 384.30-7, have a watertight cap,
and are secured in as shown in the mound wmponent manual.
2. Dispersal celi aggregate wnforms to SPS 384.30 (6)(i), Wis.Adm. Code.
3. All gravity and pressure piping ma[erials conform to the requirements in SPS 38b, Wis.Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound sWcture and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn-up DeWil
Finished ...... ..............
Grade ��
6-8" Diameter Lawn � . ��.�' Threaded Cleanout
Sprinkler Valve Box Plug or Ball VaNe
DisVibution
� Long Slueep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Borgscha� Page 5 of 8
r'r'.iicoOF6
Mound Management Plan
IMPORTANT:
,-=^�+Ter ot Mis mound system shall be responsible for fts perpeWal operation and main�enance pursuant to
requirements of SPS 382-384.Wisc.Admin. Code. Pursuant to SPS 383.52 f21.Wisc.Admin.Code, this system shail t�
considered a human health hazard if rrot maintained in accordance with this apprwed managemerrt plan. Furthermore,
all ins�ection and maintenance activities shall be peAortned by a regislered POYVfS MainWiner in accordance with SPS
383.52(3).Wlsc.AOmin. Code
Maximum Discersal Area Ooeratina Llmlts:
Oesign Flow= 450 g�� BODs 5 220 mgL''; TSS 5150 mgL"'; FOG 5 30 mgL^
Insoection Checklist INSPECT EVERY 3 YEARS
o IYPe O(USC
_ age of system
o nuisance fadors(i.e. odors, user complaints, etc.)
�� .���anical malfunction(i.e., pwnps,valves, switches,floats,efc.)
o material fatigue(i.e.,leaks, breaks, corrosion, etc.)
o solids vdume in anaerobic treatrnent tank(s)and any dislribution appurtenance(s)(i.e.,distnbution/drop boxe�;
o neglect or improper use(i.e.,exceedirg design capacities,prohiDited activities, etc.)
o extent ot pondi�g in distribution cell prior to dosing
o dosing ivegularities(i.e., pump recyGing,float switch settings,etc.) I
o electrical canponents(i_e.,wiring,connections,switches,wnlrols,fimers, alartns, etc.) �,
o disUibution lateral or lateral onfice plugging (meawre lateral distal pressure-compare to design spec�cation) �
o surface discharge of effluent or sewage back-up into slructure served �
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Seotic and dose tanklsl shall be pumped by a certfied septage servicing operator licensed unAer s. 267.48 Wis.
Stals.when the volume of solids in the tank(s)exceeds one-third(7/3)the Iiquid volume of the tank(s)a
as required by local ordinance. Disposal of contents shall be pursuant to NR 113,Wisc.Admin. Code.
o Eifluent fllterlal shall be inspected every 3 years and shall be deaned when necessary to�emwe any
accumulated solids according to manufacturer s specifications. A servidng period wiil always be greater than 12
monihs.
o Ofatribution laterals shall be flushed onoe every 3 years or when necessary.
System maiMenance reports shall be submitted to the proper local govamment unk in accordance with
SPS 383.55 Wisc.Admin.Code. RapoR any component fallure or maHunction to:
Name of individual or company: Ke� WaY Phone: 715-234-7677
��,9�„�,,,�„c,,,,;�: Sawyer County Zoning phone: 715-s�-HZHH
��9w��,+���caaare55: 10610 Main St. Suite 49 Hayward WI ZiP: 54g43
My defective part of this system shall be repaired, replaced,or removed pursuant to SPS 383.51 (1),Wisc.Admin.
Code. ReDair a replacement of failed or malfunctioning components shall comply with SPS 383,Wisc.Admin.Code.
No produd for chemical or physical restoration of the POWTS may be used unless approved by Me department in
accordance with SPS 384,Wisc.Admin.Code.
CoMinaencv Plan
In tlie event that any failed trealment component of thia POWTS cannot be repeired, It shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed mound dispersal component may be
re-consvucted within!he originally approved area after removal o(all failed components.
Svstem Abandonment
If use of ttiis POWTS is discontinued, k shall be abandoned in accordance with SPS 3B3.33,Wisc.Admin.Code.
I T T GOULDS PUMPS
Residential Water Systems
APPUGTIONS MOTOR
SpedaM designed i«me toRowinq uses: eeeeral:
• Mound Systems • Singk phase
• EffluenUDosing Systems • 60 Herh
• Irnw Ressure Pipe Systems • 11 S and 230 volts
• BasemeM Draining • Built-in Nermal oveiload proteAan with automaoic reser.
•Heavy Dury Sumpl • Clau B inwlauon.
Dewaterirg • OiLfilled design.
• High fiength arbon steel sFwtt.
SPE�ICATIONS PE31 Motor:
p��_��. • 33 HP,3000 RPM
• Disdiarge:1'/�'NPT • 115 vol[s
• TemperaNre:104°F(40°Q martimum,mironuous when ' Shaded pole design
iuAy w6merged. PE41 Motor:
• Solids hand6ng:'h'ma�dmum sphere. ' .40 HP 3400 RPM
• Automauc models indude a float switch. • 115 and 230 vohs
• Manual rtadels available. • PSC design
• Pumping ram�e:see periormance chart or curve. pE51 Motor:
PE31 Pump: • .50 HP 3400 RPM
• Ma�omum opadty:53 GPM • 115 and 230 vol[s
• Ma�dmum head:25'TDH • PSC design
PE41 Pump:
• Ma�dmum opatily:61 GPM AGENCY LISTINGS
• Madmum head:29'TDH
PE51 Pump: ��s
• Mazimum apadry:70 GPM
• Ma�dmumhead:3)'TDH c us
Tested ro UL 778 and
CSA 22.2108 Standards
By cana�an shidaras AssodaCon
MEt[u �cr FkxtR3B509
�
vESt rmis:ru�.w�i.ws�
w».�o.m
35
lo �2 GPM Gaddt Pny6 s 1509D01 Wlylmlled
30 �> >R
0
� 25 IE3�
Y
S
10
0
� 15
Q
10
5
� �0 10 30 30 AO 50 60 ]0 [� 80
0 5 10 IS m�iT
ur�cm
cn¢cK xtia�E-
°"E�`°°'"�"'"""�" s�,e: ,•=ao• SYSTEM PAGE20F4
� SOIL EVALUATION o b � B0 pLOT PLAN
SITE MAP 4� �
PROJECT NAME °ES�����
(to 11 oM 10' Atlec�Oe��u��°�'a���dsl plarK.
Borgschatz
OI'Hevs Rtl Pipe Meb�ld 1 ASTM StandaN(Teblea 3b1.303 8 3B�.�) �
w+o�cr�noaess N s�,q.ns„+�, 4 ,
BY S)mOd: Q
BMBevetlorc 100 R foruMdn' 2 � �
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