HomeMy WebLinkAbout25-46SRRequest for Sanitary inspection
(Fax this form to Zoning Dept when you want an inspection — 3734114)
E rjn Z: 1 Time Change Discrepancy Other
From Zoning apt j
phone Number
7/S 7yr 2 72 2
Plumber: CA/,� eS CL F<y ai5 pau niumtter
i � 1
Home Owner.
Sanitary....
Psrrrat #:
Plumber's Choice pt No in cftan durins►�1R times
h1:30 am -2:30 pm Wed. Wen)
i %tale.
,5 a 9:3o am -1230 pat Tues- (Josh)
9 30 am —12:30 pm Thurs. (Josh).
Plumber' Choice ��Pt Immediate Phone Number eo Zor,Ing
:
Tinms:^ta fa�' Dept can call you back if needed
,,20o �°� J,�� 71272 036e
L --
Township: -
S
dtddress # .3O? g 1 tcf 7A -CC tAt4v L -
Road Name:
or
Direc£ons
Teo Site:
i Comments:
-J4'(
fteminatar. You must confirm any ct;anga(s) that have been made pdor;o
ar
fhis insneetion wilt not be scIwic4A and s memo will be sent voiding the iospecua'. Thank You!
= ,PIunlbWmust trer#Y any change($) day fax ar rta ins___ _ "'dH be �she[a a �*
\�2
�1 � ! d;^ � � , 'ze:fi
_70n;r DM Wpkal :iwneAec`or 1 m .
Private Onsite Wastewater Treatment
$ps Systems ( POWTS),Inspection Report
et (Attach to Permit)
Industry Services Division
Ge
Pw BRADLEY SIKORSKI
Pe 55600 RED OAK DR
SOLON SPRINGS W1 54873
Tank Information
TYPE
I MANUFACTURER
CAPACITY
I Pro?. Line
Well
Building
Air Intake
I Road
Setic
e5P�
0(S
7
0
N/A
Dosing
N/A
Aeration
N/A
Holdin
• Pump! Siphon Information
Pump Manufacturer ump Model Demand
Filter Manufacturer Filter Model GPM
TDH Lift Friction Loss Head Total
Forcemain Length Dia Dist To Well
Dispersal Cell Information
DIMENSIONS
Width2 Leng
# of Cells
SETBACK FROM
Prop ne BUiIdd
WeJIa
0
Type of Cell Manufacturer:
Model Number.
Pretreatment Unit
Manufacturer:
Model Number.
Li City [J Village
BM Description:
`Taj di 6,loctf
of:
County
Sanitary ermlt No:
State Plan Transaction ID#:
Parcel Tax No:
35/6
stribution
Dia I Length yZ Dia
3o11 Cover
Depth Over
Elevation Data
STATION BS HI
FS ELEV
Benchmark 0v77
lain
Bldg. Sewer
6Z
Tank Inlet
Tank Outlet
Dose Tank Inlet
Dose Tank Bottom
Inst Contour
Header/ Manifold
Distribution Pipe
Infiltrative Surface 7 7
3 c
Final Grade -
f 72 7
X Pressure Systems Only
X Hole Size I X Hole
❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
9//�f,uu4re4d i//
!an revision required? 11 Yeed No ry a' -2}
;e other side for additional information.
Date POWTS Inspector's Signature
❑ Yes ❑ No
❑ Yes ❑ No
/'/237/3
License Number
3RMA71n rR Mlb11
Property Owner
Information
BAYFIELD COUNTY PLANNING & ZONING DEPARTMENT
Telephone: (715) 373-6138
Fax: (715) 373-0114
e-mail: zoning(aibavfieldcountv.wi.gov
Web Site: www.bayfieldcountv.wi.aov/147
BRADLEY SIKORSKI
55600 RED OAK DR
SOLON SPRINGS WI 54873
Bayfield County Courthouse
Post Office Box 58
117 East Fifth Street
Washburn, WI 54891
As you know J (/ ri-C 2!4t 6 V1l was contracted by you to install a private
onsite wastewater treatment system on your property described as:
Notes:
Abandonment of Old System to meet all applicable code requirements:
Tank was pumped by:
C. Tank was crushed / removed and pipes disconnected by:
on
at AM/PM
On D - at 2 (AM a above -mentioned plumber contacted our office to
conduct a pre -cover inspection as required under DSPS 383. One of the following applies:
System was inspected and appears to meet all applicable code requirements.
❑ System was inspected and appears to meet all applicable code requirements; however, a plan revision
is necessary because the installation was substantially different than the original approval.
System could not be inspected because plumber covered prior to scheduled time of inspection.
❑ System could not be inspected because plumber was not ready at scheduled time of inspection.
County was unable to return to complete inspection.
System could not be inspected because plumber was not ready at scheduled time of inspection.
A re -inspection and $50 fee are required.
System could not be inspected because County could not respond to plumber's time constraints.
Comments:
W (ormslsanilarypropertyawner-input
April 2019
r. OQ�7�[/
Department of Safety
County Bayfield
& Professional Services,
Sanitary Permit Number (to be filled in by co ,
Industry Services Division
S /ipu�l�
anitary Permit Application
State Transaction Number
In accordance with SPS 383 21121. Wis Mn,. Code, submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note. Application forms for state wvricd POWTS are submitted to
Project Address (ifdilTerent than mailing address)
the Department of SafcN and Professional Services. Personal mformatmn you provide may he used for secondary
purposes in aecrydancc.ad, the Privacy Law. s 1 s a( sift . Scat.
2309 Birch Tree Trl
I. Application Information -Please Print All Information
Properq Owner's Name
Parcel # M)f 3S/
Bradley Sikorski
o - -0 - 30w53.2aaifo -�"oe4,�45'�4-0t3-
Property Owner's Mailing Address
Propene Location
55600 Red Oak Drive
Govt Lot
City, State Zip Code
Phone Number -
Solon Springs, WI 54873
715-969-4276
-:. Section _08_
1 45 N R 09 [ 4W)
If. Type of Building (check all that apply)" j; p rc7
Lot #
01 or 2 Fanflvy Dwell,,,_— NumbcrnfRedwwns 3
28
Subdivision Name
Commanche Add to Potawatomi
Block#
❑ PublicjCommercral—Describe Use
Ocity of
O State Owned — Descnhc Use
—
0 Village of
('SM Numhr:
a Town of Banes
ail. Tyke of POWTS Permit: (Check either "Ness" or "Replacement" and other applicahle on line A. Check one box on line B. Complete line ('ii
a Ucable.
'A
NcwSystcm-
lJ r
System ❑ Oilier Modification to Gxisting System (explain)
❑ Additional Pnvreaunent Unit (explain I
a
O Holding Tank
,❑,/Replacement
Ly In -Ground O At -Grade I❑ Mound
❑ Individual Site Desl n
F
❑ Other Type (explain l
(convenunnal)
C.
O Renewal Before
g' Revision O Change of Plumberlast
F O Transfer to New Owner
Previous Permit Number and aie Issued
Expiration
1
I
$- y6 S ('79.2.5
IN'.
Dis rsal/ t'eatment Area and Tank Information:
Design Flow icpol
f Design Soil Application italdFpdsll
Dispersal Area Required (s0
Dispersal Area Proposed (st) I System GIeeanon
450
0.7
642.9
646.6 93.5
Capacity in
Total # of j Manufacturer
l
Tank Information
Gallons
Gallons Units I C
o'P,
g
New Tank: Erithng lanky
i
n u" $ n
septic nr Hniding Tart 1000 I
1000 1 Wieser
:. jRnponsibllily Statement- 1, the undersigned, assume responsibi lty for imWUalion o(ihe POWTS shown on the attached plans. -
Plumber'sNarneWrintl 'musher's Sign Lure UiMPRS uiu,be,
F Btuiness Phone Nunit'cr
C9
Plumber'sAddress (Street, Ott. Sra
•
nt Use Onl'. - .
Penal I'cc
Approved ❑ Disappr wt d
Dnie tssu[ll
rig ell or,lllic
O Owner / : -cn Reason or Deninl -?5�
to
Conditions of Approval/Reasons for Disapproval
SeQ_ a ��d C "Ci PUG 1 g 1625
w,i+ngDept
4}aytir;u',CO
mrtile nano carom o.act wnh only on paPn not Ina than a tea x it inchn in tire
SBD-6399 (R. 032?)
52- o03?.Z
/v/`-F'•""r Wscansin Department of Safety & Professional Services (OREVISED
Division of Industry Services
EVALUATION REPORT
4°� _ " c • OIL TEST # << In accordance with SPS 385, Wis. Adm. Code County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must Include,
but not limited to vertical and horizontal reference paint (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and.distance to nearest road, 04 -004 -2 -45 -
Please print all Information. I13e4%veI1$M
Page 1 of 3
Property Owner Property Location O . ❑
Bradley Sikorski Gavt. Lot Y S 08 T 45 N R 09 E (or)
Property Owners Mailing Address Site Address or CSM and Lot #:
55600 Red Oak Drive 2309 Birch Tree Td
City, State, Zip Phone Number ❑ City ❑ Village 1O Town - Nearest Road
Solon Springs, WI.54873 _715)969,4276 Barnes 2309 Birch Tree Td
gNewConstrUc00n Use:IResidentiai/Numberofbedrooms 3 Code derived designflowrate 450 GPD
❑Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable N/A fl,
Parent material Outwash sands (Rubicon Series)
: General comments and recommendations:
o Boring# east ❑Boring 99,6
®Pit Ground surface eiev. ft. Depth to limiting factor 10$ In. I. elev.90_6 ft
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
aun srppncanon rate
GPO/Ft'
•Efl#1 -
- •Eff#2
1
0-5
10YR 2/1
—
S
Osg
ml
cs
2vf
0.7
1.6
2
5-B
7.5YR 312
"—
s
Osg
ml
es
if/1vf
0.7
1.6
3.
8-16
7.5YR 3/4
—
s
Osg
ml
gs
1vf
0.7
1.6
4
16-47
7.5YR4/4
s
Osg
ml
cs
1vf
0.7
1.6
5
47-108 .
7.SYR 5/4
—
s
Osg
ml
—
—,.
.,1 G7 ':r `
1.6
Bans
of lamellae in hc
`zon5
I
p�G tom_
2�. Boring #.. west 6 ❑Boring 99.
gpit• Ground surface elev._ft. Depth to limiting factor 84 in. / etev: B$ fl.
,Horizon
Depth
In.
Dominant Color
- Munseli
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary :
`Roots
GPD/Ft?
•8#i
1'Efl#2
1
0.3
10YR 2/1
--
s
Osg
ml
aw
2vf
0.7
1.6
2
3-6
7.5YR 312
—
S
0sg..
ml
cw
2vf
0.7
1.6
3
6-21
7.SYR 3/4
—
s
Osg
ml
gs
+ca'rmnr
0.7
1.6
4
21-38
7.5YR 4/4
—
s
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ml
cs
1Qtvf
0.7
1.6
5
38-84
7.5YR 5/4
—
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16:
CST Name (Please Print)
Signature "�
ST,Number
Keith Wiley
��, 7
654921
Address .
Date EluaUon Conducted
Telephone Number
11623 E Larson IX. Lake Nebagamon; WI64849
5/4/2025, 8/10/2025
.218-451-2611
EBluent #1 = SOD > 30s220 220 mglL and TSS > 30 5150 mg/L • Effluent #2 = BOD, s 30 mg&L and TSS S 30 mg/L
SBD-8330 (R03122)
p Dortrtg : ' :00.
a acting # south . ® Pct. 1
d surface slay:--•
Pepthtohnit1ngfactor 84 in
Page : 2 _. o'. 3-
R.
Horizon
Depth
In.
tom1b�ntCc10r;
Munselt:
l do Description
Qty: A2�:Cont: Cotdi'
Texture
' St owe •
'G z.'S1i.
Consistence
Bts ndsry
Roofs
GPCtiFt?:
ml
aw
:tirf
07
t8:
' ' '
7 BBYR 2 :
0sg.
' ml
≥ w
:
'�: m/2v1
Q7
6
3:.
; gip
: 7 5Y ..:
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'7 55YR4/4 ::.
• • ...::,::
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ps .
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4 J Boiing # Pitng 'Ground surIa tew9 94'7j1 Depth'to r 98 rj:e 8i7
• • i�fu�zort � •
' [#na'ttt'.C�or�:`
•' R � as}x
e�uc pigli
.
Texture
.. _ • • .._
ivcttme '
.::..:: ' .....
Colsfst�9'
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=Boiriji ' ,
. •
' Rcct§
• a�,r: newt r�a�e
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ept.
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:`t3�`ltiel .
REVISED:Sikorski-(3bedroom)
Soil Repot Plot:Pla i'
North. ., ... .:: •. .. :: •- _ ._•..
�� .. r • • r.t. ••••• - . ��..�•. • _ �i..•T•�.r .•• •,. Viri..'• CentedineoieircI Tree.Tri'.
BRADLEY:SIK.ORSKI
L :. 2309 BIRCH' tEE:TRL
�. ti COMMANCHEAJJD TO PO:TAWATOM LOT 28
i �► DESCIN DOC.2024R:- 604823: 23,60:
S08 T N- R09W.
Town of Barnes
• a - 04-004-245-09-08-3 00-•15324000
M : 068acre . ' ..
- •; o 7.46• �% . ' .'
971
. • _ . • •., .. .. ash . �;
3 bed abmhous
.eq- 103,'
I :1
rape y torte
Scale 1.30 NOTES
*. ': BendMark Top of'greeh electric
EIi=fooc1
-CST' 1196600-42,' �� Page 3 of ,.
REVISED Sikorski (3 bedroom)
Gravity •In�Ground• Plot Plan
iyoth - 0------- ------ r --=r ltne of B. dt Tree Try
• • lw- w-.. R.......r.r..+-.r.wr..{.rti _.-----CeE ter--•i♦
•' F •...--r.w..rr,-rLru r-F..........►..-..-.r-r�
BRADLEY-SIKQRSKI
2309 BIRCH TREE TRL
'• ~ w COM I i' CIfE•ADD TO RDTAVI/ATOMI 1O1 28
• w
' • s w DESC IN DOC 2024R- • 6048212360
SD$'?45N ROOW
Town of Barnes:
! a 04-004-245-09-08,3 00-153.24000 •
.. N 0.689acres
i M•7.4%
• - ..j: a -. .. _______(UI
.•
In
iIL9T
• ; %free rowso •u !»fEitmtor Quidc4 Plus Standard.eharribers -.1
wu ser precst WI.Pi
• •w/•polylolc
3heccomjuuse
ill
• ell
: '' • Property line
\c •Scala •130
NOtES
Bench Mark = Top of greenelectric box - All vent; observation Sc conveyance pipes
Elau w sopv'
4" ASft l Di785 oY tbdo agolvaldit
:Page 3 of
Sikorski
Property Owners Name
:h Tree Trl
Property Address
)8-3 00-153-24000
Tax Parcel Number
field
County
o Potawatomi Lot 28
Legal Description
8
Section
t5
Town
9
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
Keith
0 2922 PSS
ESKO
µ1NNO901A
Designer's Name
Designer's Signature
Designer's License Number
Designer's Phone Number
Date
Page 1 of 7
\n\ A�� 19 2025
eld Co. Zoning 0eP
g2yf
In -Ground of sorption for POWTSComponent
Version 2.1 (May 2022-2027)
Manual Used
3
Number of Bedrooms
7.4
Percent Slope (%)
96
Depth to Soil Limiting Factor (in.)
0.7
In Situ soil application rate
300
Estimated Wastewater Flow (gpd)
450
Design Wastewater Flow (gpd)
1
Number of System Elevations
93.5
Proposed System Elevation #1
93.5
Proposed System Elevation #2
93.5
Proposed System Elevation #3
99
Original Grade #1
99
Finished Grade #1
99
Original Grade #2
99
Finished Grade #2
99
Original Grade #3
99
Finished Grade #3
Wieser 1000
Septic Tank
�Polylok PL -525
Effluent Filter
Infiltrator Quick4 Plus Standard
Chamber Type
12
Height of Chamber (in.)
20
sq.ft. per chamber(ESIA)
3.3
sq.ft. per end cap (EISA)
4
laying length of chamber(ft.)
1.5
length of endcap(ft.)
34
Chamber width(in.)
3
Rows of Chambers
3
Distance Between Cells (ft.)
11
Number of chambers in first row
11
Number of chambers in second row
11
Number of chambers in third row
33
Proposed Number of Chambers Used
642.9
Minimum Distribution Cell Area Required (sq.ft.)
669.9
Distribution Cell Area Proposed (sq.ft.)
Page 2 of 7
REVISED Sikorski (3 bedroom)
Gravity In -Ground Plot Plan
North
-..
%, ------------------------------------------------------- - -- ---------------..._ _.._Centerline-- Birch Tree --
F g
BRADLEY SIKORSKI
E o
2309 BIRCH TREE TRL
U
COMMANCHE ADD TO POTAWATOMI LOT 28
DESC IN DOC 2024R- 6048212360
S0S T4SN R09W
Town of Barnes
o
04-004-2-45-09-08-3 00-153-24000
0.689 acres
a
G
Scale 1:30
7.4°6
y� sand it
i Three rows of 11 infiltrator quick 4 Plus Standard chambers
4.6%
Wieser precast WLP1000
i w/ polylok 525 filter
a i
Q
3 i 3 bed oam house
2D i
o m
a 1
i5''
tl Well
+ Property line
NOTES:
* Bench Mark = Top of green electric box
Elev =100.0'
lJ
95'
97'
fRI
'1U'1
gaytield CO.to'"9
- All vent, observation & conveyance pipes
4" ASTM 01785 or code equivalent
Page 3 of 7
Cross Section of a Three Cell Inground Component
Using Leaching Chambers
6uiuo�'0 4iat}net;
ZOZ
ond Finished Grade 99.00
5 6 Original Grade 99.00
T�t Oew�� Top of Chamber 94.50
_ System Elevation 93.50
Finished d 99 /
Slope 7%
99.00 Original Grade
94.50 Top of Chamber
93.50 System Elevation
Feet
Grade 99.00
%Ck Original Grade 99.00
CXc Top of Chamber 94.50
' System Elevation 93.50
Owzdmfvvmt pipe to be coat4tcmd rmdeepped with approved metrMk the mepsdeeleru ,
47 feet
47 feet
bservation / Vent Pipes to be located at the ends of the distribution cells.
3 feet
between cells
Page 4 of 7
4CAST
WLP1000
TANK SPECIFICATIONS
DIMENSIONS:
WALL. 2 1/2'
CAST -A -SEAL BOTTOM: 3'
COVER: 5"
MANHOLE 24' I.D. PRECAST CONCITE RISER
HEIGHT: 531/4' •_0 r c
LENGTH: B'-8'
WIDTH: 7-2' pT '
BELOW INLET: 42" r U
LIQUID LEVEL: 36"
WEIGHT: BOTTOM 6.79019§?. Q m
COVER 3,195 n
INLET AND OUTLET:
4' CAST -A -SEAL BOOT DUAL GASKET
____
T OUTLET
r1
I h U
1
j•y IM
PUMP PAD
ANKS ARE MANUFACTURED TO MEET OR EXCEED A5TM C-1227 REOUIREMFNTS
INLET AND OUTLET BAFFLE AND FILTER
WISCONSIN SEE DETAIL #10
(OTHER STATES SEE CHART)
'
g
e
W B
LIQUID CAPACITY: 27.83 GALAN
HOLDING TANK:
C
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 1,085 GALLONS
DV.
LOADING DESIGN: 8'-0' UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTIC / HOLDING / PUMP OR SIPHON
/
� x
COVER: MIX DESIGN 0 (NO FIBER)
TANK: MIX DESIGN 9110 (STRUCTURAL FIBER)
a s
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
'C
8z
'C
o
�
F
RENEWED BY
RENEW DATE
a
N
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
r�EET
PRODUCTS NEEDED BY: -
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6 of 7
FILE INFORMATION
Owner Bradley Sikorski
Permit #
DESIGN PARAMETERS
Number of Bedrooms
3
O NA
Number of Public Facility Units
® NA
Estimated (average) flow
300
aUda y
Design (peak) flow - (Estimated x 1.5)
450
allda y
In Situ Soil Application Rate
0.7 allde /i9
Standard Influent/Effluent Quality
Monthly average'
Fats, Oil & Grease (FOG)
≤30 mg/L
Biochemical Oxygen Demand (BOD5)
s220 mg/L
O NA
Total Suspended Solids (TSS)
≤150 mglL
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BOD5)
≤30 mg'L
Total Suspended Solids (TSS)
≤30 mg/L
® NA
Fecal Coliform (geometric mean)
≤10° cfu/l ooml
Maximum Effluent Particle Size
k in dia.
❑ NA
Other:
® NA
'Values typical for domestic wastewater and septic lank effluent.
MAINTENANCE SCHEDULE
Service Event
1
Service Frequency
Inspect condition of tanks)
At least once every:
3 montearlsh(s) (Maximum 3 years) ❑ NA
® )
Pump out contents of tank(s)
la When combined sludge and scum equals one-third ('h) of tank volume
❑ When the high water alarm is activated
❑ NA
Inspect dispersal cell(s)
At least once every:
3 year(s) ❑ month(s) (Maximum 3 years) ❑ NA
®
Clean effluent filter
At least once every:
3 ® ye ($) . ' � t
�{
❑ NA
pump, pump controls & alarm
At least once every:
odtfY\Inspect
❑❑ Yea s)
❑ NA
Flush laterals and pressure test
At least once every.
0 ear( ) on1 A
IZ NA
Other:
At least once every:
❑ month(s)
fta(d Co- LCf'in9
® NA
Other:
® NA
SYSTEM SPECIFICATIONS
Tank Manufacturer Wieser
❑ NA
la Septic O Dose O Holding
vol. 1000
gal
Tank Manufacturer
® NA
❑ Septic ❑ Dose ❑ Holding
vol.
gal
Effluent Filter Manufacturer
Polylok
O NA
Effluent Filter Model
525
Pump Manufacturer
2 NA
Pump Model
Pretreatment Unit
® NA
❑ Sand/Gravel Filler
O Peat Filter
❑ Mechanical Aeration
❑ Wetland
❑ Disinfection
O Other:
Manufacturer
Dispersal Cell(s)
❑ NA
>a In -Ground (gravity)
O In -Ground (pressurized)
❑ At -Grade
O Mound
❑ Drip -Line
O Other:
Other:
® NA
Other:
® NA
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 Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank
inspections must include a visual inspection of the tank(s) to identity any missing or broken hardware, identify any cracks or leaks.
measure the volume of combined sludge and scum and a check for any back up 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 treatment tank equals one-third ('h) 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 chapter NR 113, Wisconsin
Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of ≤12 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event,
GMW (12/02)
Page 7 of 7 STARTUP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the
contents of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During extended power outages pump tanks may fill above normal hlghwater levels. When power is restored the excess wastewater will
be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels
within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at -grade soil absorption area.
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; foundation drain
(sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS faits and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with chapter Comm 83.33. Wisconsin Administrative Code:
• 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 properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site 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. Barring advances in POWTS technology
a holding tank may be installed as a last resort to replace the failed POWTS.
The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may
be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT., R CUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE it
ADDITIONAL COMMENTS 1111
9
Bay le v _
POWTS INSTALLER
POWTS MAINTAINER
Name fit) ls�__
�(j≤,� �--- --
Name
e Tic
Phone %—fir-5 flrZ7
I t
Phone /7/S
k so
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name ft K Stflri �NameBatylfielcl County Zoning
Phone /5 — 7 309 4 one715-373-6138
This document was drafted by the staffs of the Green Lake, Marquette and W aushara County Zoning and Sanitation agencies In compliance with chapter
Comm 83.22(2)(b)(t)(d)8(I) and 83.54(1), (2) 8 (3), Wisconsin Administrative Code.
P--�YFIELD
Property Owner:
SIKORSKI, BRADLEY
55600 RED OAK DR
SOLON SPRINGS, WI 54873
Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00322
Transaction Number:
SR -00322-349E6
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 4020
Paid by: MICHAEL FOAT, 49755 E SHORE RD, BARNES WI 54873
Payment Type: Check
Transaction Date: 9/10/2025
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
B AYFIELD Bayfield County
Planning & Zoning Department
117 E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
SIKORSKI, BRADLEY
55600 RED OAK DR
SOLON SPRINGS, WI 54873
Description
Sanitary Revisions
Submission Number:
SS -00634
Transaction Number:
SS -00634-3328F
Amount
$25.00
Total: $25.00
Payment Amount: $25.00
Reference: 4017
Paid by: MICHAEL FOAT, 49755 E SHORE RD, BARNES WI 54873
Payment Type; Check
Transaction Date: 9/10/2025
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
BAYFIELD COUNTY
SANITARY PERMIT (#04)-25-46SR
STATE SANITARY PERMIT
OWNER: BRADLEY SIKORSKI
G OV'T LOT: LOT: 28 B LK:
SUBDIVISION: Commanche Add To Potawatomi
1/4 1/4 SEC: 8, T 45 N, R 9 W
TOWNSHIP: Barnes
SOIL TEST: 118-25,46-25
NEW SYSTEM
SYSTEM TYPE: Non -Pressurized In -Ground
PLUMBER: JAMES CLEMENTS
TRACY POOLER DATE: 9/10/2025
Authorized Issuing Officer
CHAPTER 145.135(2) WISCONSIN STATUTES
a. The purpose of the sanitary permit is to allow installation of the
private sewage system described in the permit.
b. The approval of the sanitary permit is based on regulations in force on
the date of approval.
c. The sanitary permit Is valid and may be renewed for specified period.
d. Changed regulations will not Impair the validity of a sanitary permit.
e. Renewal of the sanitary permit will be based on regulations In force at
the time renewal is sought, and that changed regulations may impede
renewal.
f. The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of the
permit, please contact the county authority.
PREVIOUS PERMIT #: 25-46S
LICENSE: # 222924
Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 9/10/2027
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION