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Home My WebLink About018-2019-79-000 (9)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Budding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)(m1l TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO PAL WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TCH Lift FrictionTLoss System Head TOH Ft Forcerl Length a. Dist to Well SOIL ABSORPTION SYSTEM STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer Sl Inlet St Outlet Dt Inlet Dt Bottom Header/Man, Dist Pipe Bot. System Final Grade St Cover BED TRENCH DIMENSIONS Width Length No Of Trenches PIT DIMENSIONS No Of rots Inside Dia Liquid Depth SETBACK INFORMATION SYSTEM TO PAL BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer Type Of System Model Number DISTRIBUTION SYSTEM Header/Manifold JD,strtrubon x Hale Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia _ Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over ax Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bedflrench Edges Topsoil - - Yes ❑ No —] Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Location: No Address Available 1 I Alt BM Description = 2 ) Bldg sewer length = - amount of cover = Plan revision Required? [ I Yes ❑ No Use other side for additional information. Date SBD-6710 (R.3Ig7) Inspection #1: Inspection #2. Insepctors Signature Cart No Svj—a0at —a / l ED IS ��U Safety and Buildings Division County St. Croix 201 W. Waghington Ave., P.O. Box 7162 Sammy Permit Number (to be filled in by Cc) JUL 2 6 2021 Madison, 707-7162 ` -, r trait Apphcati State Transaonon Number ,r ina. In actor is Adm Code, submission of this form to the appropriate gov. unit 07210154 -C is required prior to obtaining a sanitary, permit NoteApplication fortes for state-owned POWTS are submitted to Project Address (if different than marling address) the Department of Safety and Professional Servies Personal information you provide may be used for secondary purposesin accordance with the PnvaLy Law, s 15 I re, guts 1 1 "7 vJ -4 ( G_ 1. A Application Information - Please Print All Information Property Ow 's Name Parcel # Rolling Hills Farm Owners Association Inc. 018-2019-79-000 Property Owner's Marling Address ProLocano p `L9 ) i 12,7c( 3435 Labore Rd. Ste 150 yq, . ' Got Lot NE y, SW y, Section 29 City, State Zip Code Phone Number Vadnais Heights, Mn. 55110 (circle one) T 29 N, R tr E or W 11. Type of Building (check all that apply) Lot a oJ4_10 P9 I or 2 Family Dwelling -N r of Bedrooms 12 1 `{� '- Subdivision Name Block # ( S Pjr �v� Rolling Hills Farm El Public/Commercial - Describe Use _ ❑ City of _ ❑ Stare Owned - Iksinbe Use El Village of CSM Number _ !� w �N 9IK �— Town of _Hammond Ill. Type of Permit: (Check only one boa on line A. Complete line B if applicable) A k) New S stem y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ PermitTransfer to New List Prevtout Pe m l Number and Date Issued Before Expiration (honer � K t (L'1T I Z " to C' <t I i IV. Type of POWTS System/Component/Device: Check all that a 1 ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ffMound > 24 in of suitable sod ❑ Mound 124 in of sortable sod ❑ Holding Tank ❑ Other Dispersal Component ( ui) ❑ Pretreatment Device (explain) hoot 600 for each house V. DisperivaVYineatment Area Information: (J -e Design Flow (gpd) Design Soil plication Rat f) Dispersal Area mred (sf) Dispersal Ar posed (st) System Elevation 1800 1.0 .4 Q. 900 3� 2400 ape o 1064.50 / 1063.50 VI. Tank Info Capacity m Total a of Manufacturer Gallons Gallons Units 2 Simtee filters o New Tanks Existing Tanks Septic m Holding Tank °oi°gChamb` 1250 1250 Wieser X VII. Responsibility Statement- 1, the undersigned, assu responsi ' ity for ins llation of the POWTS shown on the attathrd plan. Plumber's Name (Print) Plum r' ignature MP/MPRS Number Business Phone Number Keith Knudtson 648443 651 470.1737 Plumber's Address (Street, City, State. Zip Code) 927 150th St. Roberts,Wi. 54023 arrment Use Only VIII. Countv/7EE1 Approved Disapproved Perm-7it�FeeDate sued Issuing Agent StOwner " • 0O 8 /3 Z- Given r IX. CWWro UReasome for Disapproval? ep c an. a�iiQentfti+terand J (omxAatt Movv,-5 $ Yt^ r- 5Y&0 ' , dispersal cell ni beservlco_ d/meiMa; M as Per manegenxnt plan provided by plumber, t, All setbeckrpyulrementsmust bemaadeitled a PI Ide s�S � 1 �>�r« P ' iJ P� ak pef bopll€i4il6 wolordi"A rtti .. )Ntvr'WtaTlov. i-o 'C!` OWYvCai f �1 .+,t+ w max' ae pans on, co, systW aria suomrt in sae County only on paper not less than a s 11 indi to size 1^2Jfdp o/r. e0.c 1, '�J\ ,� o a f o { iLtdlv„llti a/ ok,td) 1 h off 4 i �F-639 �R. 1-IS/II) it1U�� Q )� �) �-lt CID dl iJxo+�l� 4-Sar/t �t r"N L l 't �r. 9fc e), e7gec, - L-. , -Act Rolling Hills Farm Residential Property Ij Owners Association INC. Sizing Calculations: Outlot 2 Three Four Bedroom Homes SW1 /4 of Sec 29 T29N-R17W 600 gpd x 3 structures = Township of Hammond - St. Croix County DWF of 1800 gallons. .10• LOT LOT 57 1 58 Proposed Wieser Concrete WLP1250-MR Dose Tank w/ Duplex Pumps and Simtech STF-100 Filters Proposed Duplex 2" Sch. 40 PVC F.M.'s Septic Easement #18 7 o w eo Uer>•� 1 nm - eo rl BM - Top of k6 3/4" Re Rad SW Lot Corner of Lot 59 * ARP -Same / ASSUMED ELEV.- 1061.68' Proposed 4 Bedroom Homes Typical --� FN# f� ' 4" Bldg. Sew Proposed • WELL 600 DWF 4" Conveyance Pipe # 6 Re -Bar 3/4" 21.781 SO. Fr, Pt# 406 Elev = 1061,66' A LOT 2� 59 COPY Page 2 of 9 p LOT 65 �@ o� 21,782 SC. Ff. LOT 66 4@y 3 in 21,781 SQ. Fr, or) R9� `o �8@@ ry c Z FN# 1 �07 ryh Proposed 600 DW • W L co FN# 1637 19 73TH AYES y C31 4' Bldg. Sewer • WELL SO. Fr Locatio of original 8#``� 82� L 59 BM 8#3L-5C'9 I 106�7.3 LOT 60 10% V` 1 3 9 WB#2KS, B#2 L 42.71 Acres 0ys B#1 L-60 1 Open Field Site 600 DWF /- A^ • WELL • W LL ^y 4" Bldg. Sewer Typical for lots 59-61 will be Four Bedroom Homes w/4" Sch. 40 PVC Bldg. Sewer Pipe. A Hoot H-600 Bio/Septic Tank L connected to the dose by 4" Sch. 40 PVC I 21,7e3S0. FT. or 4" Astm D-3034 PVC conveyance pipe. �,p4, 6 Clean -outs would he optional. Proposed Two 6' x 100' Mound Dispersal Cells SQ00, w/ the Upslope Cell located along the 1063.50' contour w/a S.E. of 1064,50'. The Down slope cell will be located along the 1062.50, contour w/a S.E. of 1063.50' LOT 21,782 SO. Fr. 63 5�.30, 03 55.19 N8rIV2 Is � ps July 8, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-07-08 Plan Review: PWTS-072101549-C KEffH E STONER 23220 Woodcreek Rd Siren WI 54872 SITE: Rolling Hills Sanitary Easement 18 Lots 59-61 FN# 1633-1637 75th Ave. St. Croix HAMMOND FOR: Object Type Description: 1800 GPD Maitenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.YA.gov/progranrliridmtry-seNtces wow wisconsin gov Tony Evers - Governor Dawn Crim - secretary cu"a<a..W APPROVED MPT OF SAFETY MD VPOFESSI L SEMKFS pMSpN Of IMW SiMY SFRNCE9 9EE COPPESPoMCEMCE Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12) 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 he 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • This approval is for the shared mound and pump chamber component only. Individual connections made to this system will be evaluated on a case -by -case basis, determined by available capacity. • Off lot components owned by others discharging to this system will require separate plan approval and state sanitary permits. • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.01/01). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NOI/01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81y' A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. 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 for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. the above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the PO WTS. Sincerely, Matthew Allen Janzen Wastewater Specialist, Division of Industry Services (715)340-0407 matthe"- Ianeen awi.aov Index and Title Sheet Project Name: Rolling Hills Farm Shared Sanitary System for Lots 59-61 Property Owner: Rolling Hills Farm Residential Property Owners Association LLC. Address: C/O of Tyme Properties 3435 Labore Rd. STE.150 Vadnais Heights MN 55110 Legal Description: Part of the NE '/. of the SW '/s Section 29T29N-R17W Township: Hammond County: St. Croix Subdivision Name: Rolling Hills Farm Outlot 2 Comp. #/Parcel ID: 018-2019-79-000 CONTENTS Page: 1 Plan Narrative Page: 2 Plot Plan co,�nb,�M APPROVED DEPT OF SAFEtt AND PROFESSNINAL SERVICES DIVISION OF INDOSTRY SERVICES 9H.ti4..0�'Ye. SEE CORRESPONDENCE Lots: Sanitary System Serving Lots 59-61 Page: 3 Mound Plan View and Cross Sections a +b (Upslope + Down slope Cells) Page: 4 Lateral Layout (Typical) Page: 5 Dose Chamber Cross -Section Page: 6 Pump Curve Page: 7 A+B Duplex Pump Panel Specifications Page: 8 Hoot Systems H-600A Tank Specs. and Hoot Service and Inspection Form Page: 9 Management and Contingency Plan Attachments: Soil and Site Evaluation Reports, Soil Verification Borings, Sample ATU Servicing Agreement and Hoot Systems LLC Product Approval with maintenance requirements. Mound Component Manual Used = Version 2.0 SBD-l0691-P (N.01/01R. 10/12) Pressure Distribution Component Manual Version 2.0 SBD-10706-P (N 01/01R. 10/12) Designer: Keith E. Signature: STONER D-1575 `195. ��SifzPd� License # Designer 157-007 6-14-2021 Phone # (715) 653-2324 Page 1 of 9 Plan Narrative The following shared sanitary system design discussion focuses on the proposed 12 Bedroom/ 1800 gallon per day sanitary system to serve Lots 59 thru 61 of the Rolling Hills Farm Subdivision. This plan complies with the St. Croix County Land Use and Development Ordinances. A "Conservation Development", Rolling Hills Farm is designed for 77 lots serviced by 22 dispersal components located on common ground. Appropriate easements and maintenance language were required prior to final approval. The St. Croix County subdivision ordinance requires that each buildable lot has a soil and site evaluation completed. For these 3 lots the mound dispersal area will be located within Sanitary Easement Area 18 and the tested areas for lots 59 and 60 within the common area known as Out lot 2. A four bedroom maximum design flow has been established for each lot. The county will require a sanitary permit for each lot prior to construction for setting the septic/treatment components verifying the design flow for each lot. These lots will required to set an aerobic treatment tank with built in trash capacity that will be connected to a 4" conveyance pipe that will gravity flow to a common duplex dose tank located just southwest of Lot 59's south lot line, that will alternately distribute the highly treated effluent to a common mound dispersal system consisting of two 6.0 ft. x 100 ft. mound dispersal cells. The soil tests completed by David Steel are provided. The BM for the soil test for Lot 59 equals 100.00' or—1061.68 and the BM for Lot 60 equals 100.00' or approximately 1066.00' using NAVD 88 Datum. A surveyor was hired to locate the existing irons and staked the septic easement area as the agricultural fields within the subdivision had continued to be cropped and some of the irons and T-posts marking the lot corners had been disturbed as it has been 15 years since the original soil tests had been completed. We used the 46'/4" Re -bar set on the southwest corner of Lot 59 with an elevation of 1061.68 ft. as our benchmark for the sanitary systems construction. The perimeter of the casement was staked with shots taken on the existing lot irons, Two soil verification pits were dug to verify the soil conditions and tied into the benchmark along with contours within the system area. Page 3a of 9 w Cross Section of a Mound System Using Two Cells for the Absorption Area J i /10 Observation Pipe A B�� O K O O C B 1 A ffill F. 1420"BFC GID (ft >q ) Dispersal Cell Area Total 6.00 (gpd/ft) Linear Loading Rate Note: C dimension = cell separation. b F Shading Key Topsoil Cap Subsoil Cap ASTM C33 Sand L H I lzli' J 5.50' KP15N.51' L W 3000 lk') Basal Area Available (ft) L'I6 B OM Pipe Placement Mound Cross Section View for the Upslope Cell Aggregate Dispersal Area Finished Grade 1066.30' 0 o j _ Dispersal (:zI15 o tP 10 % Site Slope Detail of Typical Dispersal Cell o" D°D°D°D°o°D°D° O°O°O°O°O°O°O° o0q-g000°o°('Qo° Tilled Laver o°o°6006 5 00000 ® Aggregate 000000N000Qo o°o°o°o°o°o°o° 0 0 0 o a A -�- Note: Prepare Mound Site per Component Manual Constuction Procedures. D 9 Q if G 1065.00 (ft) Lateral Invert 106_ .50' (ft) Contour Elevation 1064.50' = System Elev. Deotextile Fabric Cover 4" Observation Pipe NO",aterproof cap and anchored aecureh' w/3/8" re -rod or altemate method 6" slots Rolling Hills Farm Residential Property Owners Association INC. Sizing calculations: Outlot 2 Three Four Bedroom Homes SW1/4ofSec 29T29N-R17W 600gpdx31 structures = �1 10 Township of Hammond - St. Croix County DWF of 1800 gallons. LOT I LOT 57 58 Proposed Wieser Concrete WLPI250-MR Dose Tank w/ Duplex Pumps and Simtech STF-100 Filters Proposed Duplex 2" Sch, 40 PVC F.M.'s Septic Easement #18 7 o w ao i na . eo rl BM -Top of #6 3/4" Re -Red SW Lot Corner of Lot 59 �E FIRP-Same / ASSUMED ELEV.- 1061.68' C. Proposed 4 Bedroom Homes Typical --� FN# ro ' 4' Bldg, Sew h //V 0. 4' Conveyance Pipe # 6 Re -Bar 3/4' 21,781 $o. F Pt# 4062 Elev1061.68" LOT B#11 B#3 V 3 9•% LU B#2KS, B#2 L Proposed • WELL 500 DWF M 42.71 Acres \_ „096' B#1 L-80 1 Open Field Site +� Page 2 of 9 4 LOT 65 `fd' gjb SB, 21,782 SQ. FT. ai' LOT 66 ry �� W rn fn 21,781 SQ. FT,_ CVpop FN# 1 \ Proposed 600 • W L m FN# 1637 19 C31 75TH AVEN — -- (y� 4' Bldg. Sewer • WELL 600 DWF o,^ SO Fr ��' . WELL P' • W LL ^y 4" Bldg. Sewer J 2 � Typical for lots 59-61 will be Four Bedroom Homes w/4" Sch. 40 PVC Bldg. Sewer Pipe. A Hoot H-600 Bio/Septic Tank L connected to the dose by 4" Sch, 40 PVC .SS' 21.783 So Fr or 4" Astm D-3034 PVC conveyance pipe. , Sag a/22, 04, 6 Clem -gouts would be optional- J Proposed Two 6' x 100' Mound Dispersal Cells SO.00, w/ the Upslope Cell located along the 1063.50' contour w/o S.E. of 1064.50'. The Down slope cell will be located along the 1062.50' contour w/a S.E, of 1063.50' LOT 21,782 SO Fr. 63 e7,3p, S77°7g46 E� 31.C�T, 85.16 N87.10'3 Page 3b of 9 A Cross Section of a Mound System Using Two Cells for the Absorption Area 1/10 Observation Pipe _B---0" 0 O O F B L A t12 E 19.20" B F 9.5" C G D I200 ift sq )Total S)slem Dispersal Area 6.00 (grid/tt) Linear Loading Rare Note: C dimension = cell separation. Mound Cross Section View for the Down Slope Cell 1064.00 (ft) Lateral Invert IF K Finished Grade ]065.30' 91 1062.50 (ft) Contour Elevation 1063.50' = System Elev. Shading Key ® Topsoil Cap Subsoil Cap .ASTM C33 Sand [ Tilled Layer ® Aggregate H l �" I 14.00' 1 5.50' K 9. L NI-9, W5.50' 3000 (ft'i nasal Area Available 10.00' (n) I/IU 6 Obs. Pipe Placement Aggregate Dispersal Area % Dispersal Celle O O tl . ------------- 10.0 % Site Slope Detail of Typical Dispersal Cell 4—A� Note: Prepare Mound Site per Component Manual Constuction Procedures. -xtile fabric Cover 4" Observation Pipe w/waterproof cap and anchored securely w/3,8" re -rod or alternate method 6" slots Page 4 of 9 Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S ) Lateral Flow Rate Cell Flow Rate System Flow Rate Lateral Layout Typical of Both Cells End Connection Lateral Layout Diagram 2 1.5 99.00' 3.00 18.36 36.72 73.44 Finished Grade 6" to 8" diameter Lawn Sprinkler Box Orfice Diameter in. Orifice Spacing (X) ft. Orifices per Lateral ft. Orifice Density gpm 'Manifold Length gpm Manifold Diameter gpm Total Dynamic Head Lateral Turn -up Detail Distribution Lateral 156/5/3m-" 3.00 34 8.82 3.00' 1.50 Up 14.78 - DN 13.61 Threaded Cleanout Plug or Ball Valve Long Sweep 90 or Two 45" Bends Same Diameter as Lateral in. ft. ft2/ onfice ft. in. ft. Note : Lateral ends at last orifice where variable length to cleanout begins. KES Sanitary Easement 18 Lots 59-01 Revised 6-25-21 Duplex Pump DoseTank Component Cross Section Approved Manhole Covers With Warning Labels and Locking Device / 4" Min. Above Final Grade Page 5 of 9 Weather Proof Junction Box Electric per NEC 300 & SPS 4" Sch. 40 Vent 316.012 WAC > or = to 12" Above Final Grade n Note: SJE Rhombus Type 122Dupiex (Demand Dose) Top of inlet = — 1059,10 ( Set by Installer) Note: Pump switch and alarm to be A wired to separate circuits. 11. WLP1250-MR Gallon C Tank Mfr. Wiesen Concrete D Alternate Outlet Location W /Approved 4" Sleeve Force Main Diam. = 2 " 'cep Hole or Anti Siphon Device Duplex Force Mains Pump Off Elev. 1056.43' Duplex Pumps Dose Tank Elev. 1055.60' Vertical Difference Between Pump Off and Distribution Pipe = 8.57' 7.57 Down Slope cell Minimum Required Supply Pressure ...................................... = 4.55 4.55 35' FT. of Force Main x 330 Friction Factor/100FT.... = 1.16 .99 Note: Maximum dose per Pressure Loss Through Filter .................... = 50' .50 cell = 180 gallons. Total Dynamic Head .................... = 14.78' 13.61' Min. dose per cell = 91.08 gals. Number of Doses ...= 5.34 Per Day Gal. Per Day/ #of Doses = 168.35Ga1. (Duplex Volume of Backflow.................................................................... = 5.70 Gal. PumpsAltematmg Total Dose Volume..................................................................... = 174.05 Gal. between cells ) Pump Tank Capacity 1253.16 Gallons Dimensions Inches Gallons Pump Tank Volune 34.81 GaUlnch A 19 661.39 Pump Mfr. Goulds Pump Model EP05 Minimum Discharge Rate = B 2 69.62 C 5 174.05 D 10 348.10 36.72 GPM per pump Alarm Mfr. S.J.E. Rhombus Total= 36.00 1253.16 Alarm Model Tank Alert 1 Note: Tank to have two outlets. Note: Upslope Cell force main — 5 ft. longer. Down slope cell will receive .81 gals. more per dose. Bed Tank per SPS. 383.45(5) Anchor Tank as necessary to negate buoyant forces per SPS 383.43(8)(g). Wastewater METERS 10 9 B %i 0 0 2 4 6 s 10 12 DM3/h CAPACITY MODEL INFORMATION Order Number HP TVottaAmps Minimum Circuit Breaker I Phase Float Switch Style Cord Length Discharge Conine Minimum On OLevel Minimum Off Level Minimum Basin Diameter Maximum Solids Size Shipping Weight Ibsi EPC41' ! P`r°r N'c Switch 10' Mrnuai Manual 20/9.1 EF041 IA 12 2C Piggyback r Wide Angle 1U' 12' 6' 2^ /9.L PI°g! No iv. rch '0' Pmanual Manual 20/91 EP0411P 4 i Piggyback / V,;Ede-Angle I 20, 0 1 0' 1 "" 6' ITI 21 / 9 5 °F74114C 1 ,•t .. is" Al." EP0412 230 6 70 Plug! N'Ao tch Manual Manual 20; 7 E00412F Pluq ' No Switch 'rC' Manual Manual 20/91 EPCS1'= -- ,5 115 13 20 Plug; Nc Switch 2C' .manual Manaal 22/1G EPOS 11Ar P.cle bacAngl/ No ISwi*.ch �� 20 12. 6• 23 i 10.4 Er'0512F 230 6 5 1 C Manual Manual 22110 PAGE 3 Page 7 a+b of 9 Single phase, duplex alternating pump control with override. The Model 122 control panel is designed to alternately control two 120, 208, or 240 VAC single phase pumps in water and sewage installations The alternating action equalizes pump wear. In addition to the alternating pump control, this system provides override control should either pump fall If an alarm condition occurs, an alarm switch activates the audio/visual alarm system. Common applications Include pump chambers, sump pump basins, Irrigation systems and lift stations. 1. Enclosure measures 10 X 10 X 6 Inches (25 4 X 25 4 X 15.24 cm) Choice of NEMA 1 (steel for indoor use), or NEMA4X (ultraviolet stabilized thermoplastic with removable mounting feet for outdoor or Indoor use) Note: Options selected may increase enclosure size and change component layout 2. Magnetic Motor Contactors control pumps by switching electrical Imes 3. HOA Switches for manual pump control (mounted on circuit board) 4. Control Circuit Board provides pump control and alternation S. Green pump Run Indicator Lights (mounted on circuit board) 6. Circuit Breakers (optional) provide pump disconnect and branch circuit protection 7. Ground Lugs 8. Float Status Indicator Lights (mounted on circuit board) 9. Control and Alarm Power Indicator Lights (mounted on circuit board) 10. Auxiliary Alarm Contact, form C (mounted on circuit board). NOTE: Schematic is located inside the panel on enclosure cover STANDARD ALARM PACKAGE 11. Red Alarm Beacon provides 360' visual check of alarm condition, Note: NEMA 1 style utilizes a door mounted indicator in lieu of a beacon. 12. Alarm Horn provides audio warning of alarm condition (83 to 85 decibel rating) Note: NEMA 1 style utilizes an Internally mounted buzzer in lieu of horn 13, Exterior Alarm Test/NormallSitence Switch allows horn and light to be tested and horn to be silenced in an alarm condition Alarm automatically resets once alarm condition is cleared. 14. Horn Silence Relay (mounted on circuit board) NOTE: other options available l/ Entire control system (panel and switches) is UL Listed to meet and/or exceed industry safety standards AF Dual safety certification for the United States and Canada l/ Standard package includes three 20' SJE SignalMaster& control switches AF Complete with step-by-step installation instructions Ar Five-year limited warranty SEE BACKSIDE FOR COMPLETE LISTING OF AVAILABLE OPTIONS SEE PRICE BOOK FOR LIST PRICE. Model Shown 1221W114X6A C®us WE Rh usz PO Box 1708, Detroit Lakes, MN 56502 1-888-DIAL-SJE •1-218-847-1317 1-218-847-4617 Fax email. customerservioe@sjerhombus.com www.sierhombus.com 122 ) C MODEL 722 ALARM PACKAGE T T 0 = select options or no alarm package 1 = alarm package (Includes test/normal/silence switch, fuse, red light, & horn) ENCLOSURE RATING = Indoor, NEMA 1 (metal) W = Weatherproof, NEMA 4X (engineered thermoplastic) STARTING DEVICE 1 = magnetic motor contactor 12012081240V 9 = magnetic motor contactor 120V only PUMP FULL LOAD AMPS 0 = 0-7 FLA 1 = 7-15 FLA 2 = 15-20 FLA 3 - 20-30 FLA PUMP DISCONNECTS 0 = no pump disconnect 4 = circuit breaker 120V (select STARTING DEVICE option 9 above) 120/208/240V (select STARTING DEVICE option 1 above) FLOAT SWITCH APPLICATION H or L = pump down or pump up (select 17 option) X = no floats OPTIONS Listed below ENCLOSURE UPSIZE - If you selected one or more of the * options, or two ** options, a one-time enclosure upslze fee would apply 6A CUM De]U(IFTIOR 1A Red beacon only / no audio CODE DESCRIPTION (must select"0"for alaml package) Q**10K Anti-condenston heater Q 1C Horn only / no visual Q 11C NEMA 1 alarm panel (must select "0"foralarm package) Q 110 NEMA 4X alarm panel ** 3A Alarm flasher Q* 14B Main disconnect (rotary style, mounted through door, non -fused) * 36 Manual alarm reset (must select circuit breaker) * 4A Redundant off * Q 0-20 FL4 (total of both pumps) (select Option 4D if floats Included) * Q 20-60 FLA (total of both pumps) 46 Red redundant off indicator & alarm 16A 10' cord in lieu of 20(per float) (must select Option 4A also) Q 16B 15' cord In Ilsu of 20' (per float) 0 4D Redundant off float Q 16C 30' cord in Ile" of 20' (per float) (must select 4A option) (select 17 option) Q 16D 40' cord in lieu of 20' (per float) O * 5A Thermal culout/heat sensor auto reset 17A SJE SignalMasler° I pipe clamp 0 (per float) (for pumps wlthennal switch leads) 0 17B SJE SignalMaster` / externally weighted 0 (per float) * 5E Seal failure circuit & red indicator (2 wue) Q 17C Sensor Float" I Intemally weighted ♦ (per float) 6A Auxiliary alarm contact form C Q 17D Sensor Floatf / externally weighted ♦ (per float) fmcluded as standard) 0 17E Sensor Float" Mini i pipe clamp ♦ (per float) 0 * 8A Elapsed time meter O 17F Sensor Float" Mini / externally weighted ♦ (per float) [] * eC Event (cycle) counter Q 17J Sensor Float` i pipe clamp ♦ (per float) Q * 9_A Pump overload Q 19B Lead lag selector switch specify amperage after number 9 followed by letter "A" Q 19F Fourth Boat to separate alarm function from lag Example- 912A= 12 amp pump O 19T TOA ( teat/OfflAutomatict switches and pump run lights * 0.25 FLA through door mounted * 25-30 FLA 0 19U HOA (Hand/Off/Automatic) switches and pump run lights O 10E Lockable latch - NEMA 4X through door mounted 10E Lockable latch - NEMA 1 Q 19X Door mounted pump run indicator #10F Lightning arrestor (select pump circuit breaker) • Mechanically -activated A Mercury -activated N addAenat feapnVo one reoutaYt# Call the Aletoryfoi a quote on of Engirroaed CustomVdintwparte7. n wuM4 r vwrr a_I— MODEL 122� W 9l T Alarm Package Enclosure Rating Starting Device Pump Full Load Amps Pump Disconnect Float Switch Application Options: Auxiliary alarm contact, form C, Elapsed time meter, event (cycle) counter, SJE Slgnalblaiii I pipe clamp V SJE-Rrorlbus a9114 O, 106" O + 3103 4° b ,r _ `JIFF = l 4" CAS 11 ICI 'D n III—' Ii o r IIII _ rr 41" 40" INLET O n I TOP VIEW SIDE VIEW 4" CAS POLYLOK 12" ACCESS UD (TYP) EZ SET RISER (TYP) OUTLET TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS 600 GPD GRAVITY DISCHARGE SYSTEM H-600 A H-600 A TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" 0 a n COVER: 4" MANHOLE: 12" & 24" I.D. PLASTIC RISER 3 HEIGHT: 70" O.D. $ LENGTH 106" O.D. m oo WIDTH: 74 1/2" O.D. � } BELOW INLET: 57" O.D. aLi LIQUID LEVEL: 51" LLB � WEIGHT: 11,135 LES. W INLET AND OUTLET: d! � 4" CAST -A -SEAL (CAS) BOOT OR EQUAL r„'J C oc COVER: MIX DESIGN #8 (NO FIBER) V TANK: MIX DESIGN #9 (SMALL FIBER) � o 00 CUSTOM12ED TANKS: cV FOR CUSTOM TANKS CONTACT WIESER CONCRETE rl7 WP I = � O W�co �n 3 d J f7 Q O O Z < _U OF- a DRAWINGS SUBMITTED N FOR APPROVAL = APPROVED BY: SHEEI NO, APPROVAL DATE: PRODUCTS NEEDED BY: /OF Hoot Service and Inspection Form This testing and reporting shall be completed, signed and dated after each inspection. One copy shall be retained by the maintenance company. The second copy is sent to the local permitting authority and the third copy is sent to the system owner along with an invoice for services by the maintenance company. 1. Actual Date of Visit: 2. System Inspection of Owner: Address: City, St., Zip: Inspected Items: Operational Inoperative Not Applicable Aerator._ ...................._........ C C C, Aeration Plumbing ................. 7 Air Filter ................................. Effluent Pump (if applicable)....... n C C Chlorinator-... ......................... C 0 0 OK System Light .................... 0 C C Alarm..._.. _... .................... 0 F C D-Box .............................. 0 1 Air Filter must be cleaned each service visit. Operation of effluent disposal system must be made each visit (if pumped). A system with greater than 70% Settleable Solids in the aeration chamber must be pumped to avoid solids leaving the tank for the drainfield. 3. Repairs to system (list all components replaced): 4. Tests Required and Results: Test BOD (Grab) TSS (Grab) Fecal Coliform 5. Required Results Test Method Signature of Inspector: Installer II or WW Lic Private Onsite Wastewater Treatment System Mound Management Plan Pursuant to SPS 383.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) Shall Include information and procedures for maintaining the system within the parameters of SPS 383 and 384. and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for the system will be filed with the county zoning or health department. This management plan complies with SPS 383.54, Wis Adm. Code, the Mound Component Manual for Private Onsite Wastewater Treatment Systems (Version 2.0) SBD-10691-P (N.01/01) R. 10/12 and the Pressure Distribution Component Manual (Version 2.0) SBD-10706-P (N 01-01) R. 10/12 Table 1: System Design Specifications Sanitary Pemiit Number Number of Bedrooms 12 Design Flow (GPD) 1800 Soil Absorption Component Size (sq. ft.) 1500 (Pretreated Effluent) Trash Tank Capacity Gal. 400 gal. Pump Chamber Capacity Gal. 1250 gallons Ty e of Wastewater Pretreated Domestic Pre -Treatment Unit installed per structure HOOT SYSTEMS H-600 A Table 2: Soil Absorption Component — Limits of Reliable Operation Design Flow -Peak (GPD) Max. Influent Particle size Septic Tank Component 600 per structure NA Soil Absorption Component 1800 <_ 1/8 Inch Maximum BOD 5 (mg/1) NA <_ 30 mg/I Maximum'1'SS (mg/1) NA <_ 30m I Maximum FOG NA NA Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Dose Tank In- Line Filter Should inspect once a vear and clean every 3 years Pump Chamber Inspect once every 3 years Soil Absorption Component Flush laterals ewry 18 months. HOOT SYSTEMS H-600 A Service every 6 months for first 2 years. Then annually there after per maintenance agreement. See attached. Page 9of9a,b+c Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under sec. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Pump Chamber The pump chamber also requires monitoring once every three years or the time of problem, complaint or failure. Inspection should include checking the dose rate, volume and frequency. Warning: The dose chamber may fill due to flow continuing during pump malfunction or power outages. One large dose when the power comes on or when the pump is repaired may cause the dispersal system to have problems. In this situation, the pump chamber should be pumped by a licensed pumper before pump cycling begins or other measures shall be used to dose the component with only the proper amount of influent. This may include manual operation of the pump controls until such time the pump chamber has reached its normal level. Note: A Simtech STF-100 effluent filter will be installed in the dose tank for each force main to provide the filtering of the effluent to the dispersal cell. Septic tank and Pump chamber risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry to the tank Warning: No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment or holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be accordance with SPS 383 33. Wis Adm. Code when the tank is no longer used as a POWTS component. Page 9 of 9 a, b + c Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption components operation must be assessed by inspection at least once every 3 years. Lateral turn ups are provided at the ends of the laterals for the purpose of flushing the lines of any solids. Flushing these lines should be done every 18 months. The inspection shall include recording levels of pending, if any, in the observation pipes, and visual inspection for any evidence of surface discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during w inter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. "This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general. soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, clogging of the soil. Planting of deep rooted trees and shrubs directly over or within 10 feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Continaenev Plan In the case of septic or dose tank component damage, measures shall be taken to repair or replace the tanks to there original operating condition. Problems with the pretreatment unit should be addressed to the POWTS Maintainer. Bi-annual/ annual inspections should prevent any complete failure. Should failure of the distribution cell component happen, the system shall be inspected to determine the cause of failure, effluent quality testing and wastewater flows. Steps taken to repair or replace the dispersal cell may involve the removal of a bio-mat which would require cleaning or replacement of the distribution network as well as replacing the aggregate system and clogged portions of the sand fill. Component Owners Contact List Keith Knudtson PlPlumber/ATU Maintainer (651) 470-1737 St. Croix County Zoning 1 (715) 386-4680 Wieser Concrete Products Maiden Rock WI (800) 336-3416 Septic Pumper Powers Sanitation (715) 249-5 338 .I100T SYSTEMS LLC H-600 A (888) 878-4668 Page 9 of 9 a, b + c AEROBIC TREATMENT UNIT (ATU) SERVICING AGREEMENT This agreement is made pursuant to SPS 383 21(2)(c) (5), Wis Adm Code Agreement Date Property Description (Attach copy of deed ifnecessary) Sanitary Wastewater Aerobic Hoot Svstems LLC Treatment Unit Hoot H-W A Recording Area Return To St. Croix County Community Development Dept. As an inducement to the Count- of St. Croix to issue a sanitary permit for a POWTS equipped with an aerobic treatment unit on the above described property. we agree to do the following I The owner agrees to conform to all applicable requirements of Ch. SPS.3 83, Wis. Adm. Code relating to aerobic treatment and the maintenance requirements for the proposed POWTS (Private Ornate Wastewater Treatment System) technology. 2 'the owner agrees to maintain a contract with a licensed POWTS Maintainer for the life of the system The POWTS Maintainer will perform periodic inspections and maintenance as required by the manufacturer and the department, including, but not limited to: the blower, electrical controls, treatment unit operation and sludge depth "These inspections are to be scheduled every b months for the first two years of operation and yearly thereafter 3 The owner agrees to contact the POWTS Maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254,59, Stats, 4 The owner recognizes that the county department or POW"TS Maintainer may make periodic inspections of the components to complete performance monitoring of the unit 5 The owner or the owner agent agrees to report to the department or designated agent at the completion of each inspection, maintenance: or servicing event in a manner specified by the department or designated agent within 30 calendar days from the date of inspection - maintenance or servicing. h This agreement will remain in effect onh until the county office responsible for the regulation of private onsile wastewater treatment systems certifies that the property is no longer semed by the aerobic treatment unit. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 2 "This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded by the Register of Deeds in a manner, which will permit the existence of the agreement to be determined by reference to the property where the aerobic treatment unit is installed Owner(s) Names(s)(Print) i Drulted By Leith E. Stoner 23220 Notarized Owner(s) Signature(s) N'I 54872 Subscribed and sworn to before me on this date. Notary Public (Print) Notary Public (Signature) My commission expires: DIVISION OF INDUSTRY SERVICES Plumbing ProdUt3 Review P.O. Box 7302 Madison, Wisconsin 63701.2658 TTY: Centad Throlgh Relay Governor Scott Walker Laura Gutierrez, Saeretary May 10, 2018 HOOT SYSTEMS, LLC RON SUCHECKI 2885 HWY 14E LAKE CHARLES LA 70607 Re: Description: SEWAGE TREATMENT APPARATUS Manufacturer. HOOT SYSTEMS, LLC Product Name: (trans id 3097849) H-SERIES HOOT Model Number(s): H-600-A (MAX. DWF $00 GPD) Product File No: 20180134 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 180, 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 2023. This approval supersedes the approval issued on March 12, 2013 under product file number 20120398 This approval is contingent upon compliance with the following stipulation(s) • This tank must be designed to vnthstand the pressures to which it will be subjected. • 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. • This product may not receive backwash discharge from a water softener, Water softener backwash discharge must be discharged in another method acceptable to chs. SPS 382 and 383 (formerly Comm 82 and 83), Wis. Admin. Code. • The maximum daily wastewater flow, which may discharge through this product, is 600 gallons per day. • When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum monthly average value for BOOS of less than or equal to 30 mg& TSS of less than or equal to 30 mg/L TSS and F.O.G. of less than 30 mg/L and fecal coliform of less than or equal to 10,000 cfu/100ml. • Plan review for the installation of this product must be obtained from the department in accordance with SPS 382.20 (1) of the Wis. Adm. Code. • This product must have installed a department -approved effluent filter capable of filtering particles of 1/8 Inch in size or larger. SBD-10564E (NAM7) File Ref. 18013403.DOC Hoot Systems LLC May 10, 2018 Page 2 of 2 Product File No.: 20180134 Table 1 Maintenance, Inspection, Pumping Requirements PRODUCT! Models H-500 600 allda _ Initial/Startup Inspection/ Maintenance 2- r. service agreement w/manufacturer Ongoing Pumping Cycle And/Or Requirements 2-yr. pumping (trash tank only), unless mere t0hlctive by local or state regutNtlan; for aeration chamber, see inspecillo resub Hack -Wash Cycle NIA Effluent Performance Levels NSF40 Class I BOD5 Credit For DownsizingDistribution Area YES it Fecal CredFor Reduction Of Vertical Se aration YES Additional Comments none • These tanks shall be fitted with locking manhole covers in accordance 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 to be considered an effective locking device. • These tanks shall bear warning labels, that are visible after installation, that conform to s. SPS 384.25 (8). The tank Is not recommended to be Installed where saturated soil or seasonal high ground water tables are indicated between the bottom of the tank and the ground surface. • BEDDING: 3-inches of compacted bedding shall be provided. The bedding material shall be dry, sandy loam material, or coarser s /, diameter in the largest dimension. • BACKFILLING; must be compacted at s 6-inch intervals. Backfill material shall be free -flowing soil or gravel s 4 inches in diameter in the largest dimension. The department is in no way endorsing this product or any advertising and is not responsible for any situation which may result from its use. /Sincerely, f� / enW.hlueter Plumbing roduct Reviewer Department of Safety and Professional Services Division of industry Services Bureau of Technical Services (608) 267-1401 Phone (608) 267-9723 Fax glen. schlueterewi_gov E-mail YVgVgypM �i e Wir ----- 1641Y" tYEP"i[G"'.I4(W^'•�^..e. �. 1'Yt� WAUWR t LOT LOT f \ o , i Y I/i ew �I V3 to . 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Loge � `'`� e`:� � .:r::L`«.,,, . ; .._......................� «•-•— g �� iL.._ `run._ i� '1 ® :.Y.T.:A _� ',r� \ �• a, LOT LOr / i LOr afg eN q �\ h\/ /iF�� aaCONa Lor oLITLor t t o • a LOT 1 \; i q N'„ to t• , q Lore 'T• Yf tL0 r Yq VNg eY aNe / LOf q \ �� ._.AMN LINe aea eNear . ``\ •±�• #3628 Wisconsin Depatrnent of Safety and Pralessimal Services IAvisan of Industry Services SOIL EVALUATION REPORT in accordance with SPS 385, Wis. Adm. Code Pape 1 of 1__ Keith Stoner CST Attach complete site plan on paper not less than 8Yz x 11 inches in size. Plan must County Croix include, but not limited to: vertical and horizontal reference poem (BM), dlrdirectionSt. -- - — - - -- - Parcel I.D. percentand percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print alllnfonnation. _- - -_ 018-2019-79-000 -- --- Reviewed By Date Personlortn Personal ination you Provide may beused for secondary purposes (PrwaoY law, s. 15.04 (t) (in)),. Property Owner Property Location R.H.F. Residential Property Owners Ass. --- Govt. Lot NE1/4, SW1/4, S29, T29N, R17W Pmperty Owner's MaiBng Address Lot # 8lock # Subd. Name or GSM# -- - 3435 Labore Rd, Ste 150 50,61 Rolling Hills Farm putlot 2 city ❑ Village ® Town Nearest Road City State Zip Code Phone Number Vadnais Heights MN 55110 , Hammond I 75Th Ave ® New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: ---- �_ Parent material _ _ Flood plain elevation, if applicable f . General comments Verification borings for soil test completed for Lot 59 that fell within Septic Easement #18. and recommendations: Boring # ❑ Boring Ground 1060.9 ® Ph surface elev. _ ft. Depth to limiting factor _>42 in. Solt Application Rate Horizon Depth DominantColor Redox Description Texture Structure Cortsiste Boundary Roots GPD/ft' in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Faf#1 •Eff#2-- 1 012 10YR2/2 sit 2msbk mvfr a 3f-m 0.6 0.8 sid mfr gs 2f-m 0.4 0.6 2 12-26 10YR4/3 2msbk 32- 42 10YR4/4 - sl s 2f-msbk Osg mvfr gs M 1f I 0.7 0. 1.0 1.6 - � — - - -- j ----- I 2]Boring # ❑ Boring Ground ® Pit surface elev. 1060.8 _ ft. Depth to limiting factor 24 _in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure IConsisten Boundary Roots GPDRN in- Munsell Qu- C1u. Sz. Cont. Color Gr. Sz. Sh. I •EeIIt •EfM2 1 0-9 10YR2/2 sit 2msbk mvfr Cs 3f-m ! 0.6 0.8 2 3 9-15 10YR4/3 10YR4/4 sid sl 2msbk 2msbk mfr mvfr gs gs 2f-m if 0.4 0.6 , 0.6 1.0 15-24 j 4 . 24 36 10YR4/4- c2d5YR6/2 sl if-msbk mvfr i s> au -S fig' Law 1 a >:su < i tpu mg/L ` Effluent #2 = BODs 00 mg/L and TSS < 30 mg/L CST Name (Please Print) — Signature: 1 �] CST Number Keith Stoner P24�rg Address Keith Stoner CST Date Evaluation Conducted Telephone Number 23220 Wood Creek Rd Siren, W 154872 5/27/2021 715-566-09M Se 30(RAp13) �� D Wisconsin SOIL EVALUATION REPORT #1890 Department of Commerce in accordance with Comm 85, Wis Adm Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan paper not less than 8% x 11 inches in size Plan must County St Croix include, but not limited to vertical rtical and horizontal reference point (BM), direction and - — - percent slope, scale or dimensions, north arrow, and location and distance to nearest road Parcel J.D. L Please print all inTW R iewe B DatePersonal information you provide may he us d far Sy La s 15 04 (1) (m))Property Owner P operty Location Rolling Hills Of Hammond LLC G A Lot na NE1/4, SW1/4, S29, T29N, R17W Property Owners Maling Address Lo # Block # Subd Name or CSM#400 2nd st 9 na Rolling Hills FarmCity State Zip od- City Village Town Nearest Road Hudson WI 54 16 715-386-023Hammond 160Th St New Construction Use Residential / Number of bedrooms _ 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe. na _ Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft General comments Mound design, system elevation 100.30ft based on contour line elevation 99.30ft. Minimum of 12 inches and recommendations of ASTM C33 mound sand Boring # — Boring Ground 100.40 Pit surface elev - ft Depth to limiting factor 36 _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/rP in Munsell Qu Sz. Com Color Gr. Sz Sh •Eff#. •Eff#2 1 0-8 S0yr3/1 none T sit 2msbk mfr cs lvf .6 .8 2 8-24 10yr4/4 none scl 2msbk mfr gw na .4 .6 3 24-36 10yr4/4 none sl 2msbk na gw na 6 1.0 4 36-75 7.5yr4/4 c2d 7.5yr5/6 I Is/scl �m na na na .0 .0 Boring # - Boring Ground 100.40 _ pit surface elev ft Depth to limiting factor 42 in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/N' _ •Eff#1 •Eff#2 in Munsell Qu Sz. Cent Color Gr Sz Sh- 1 0-8 10yr3/1 none sit 2msbk mfr cs if .6 .8 2 8-22 10yr4/4 none Sid 2msbk mfr gw na .4 .6 3 22-42 10yr4/4 q 42-75 10yr6/6 none c2d 7.5yr5/6 sl om Is/sil om na cs na na na na 2 6 0 2 - emuem 41 = ttuu? ao < 22u mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) �_ Signatures CST Number David J Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 SBD-8330 fR 07,W) Property.Owner Rolling Hills Of Hammond LLC. Parcel ID # Pendinc - _ Page _2 of 3 Boring # Boring Pit Ground surface elev. — 97.70 ft Depth to limiting factor 24 in ISoil Application Rate Horizon Depth, Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl' in. Munsell Du Sz. Cent Color Gr Sz Sh. _ 'Emil 'ER#2 1 0-8 2 10yr3/1 none sit 2msbk mfr cs if 6 8 8-241 10yr4/4 none scl 2msbk mfr cs na 4 6 3 24-48 5yr4/4 c2d 7.5yr5/6 scl om na na na 0 .0 I Boring # Boring Pit Ground surface elev N Depth to limiting factor in Sod Application Rate Horizon 1 Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots '_ GPD/ft' in. Munsell Qu. Sz Cent Color Gr Sz Sh 'Eff#1 *Eff#2 - -- - -+-- - - � — - -�-- - III -- ❑ Boring # _ Boring Pit Ground surface elev. _ _ N. Depth to limiting factor in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence' Boundary Roots GPD/ft' in Munsell Qu Sz Cent Color Gr Sz Sh `Eff#1 •Efq#2 -T --J Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <-150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity serN ice provider and employer. If you need assistance to access services or need material in an alternate format. please contact the department at 608-266-3151 or T IN 608-264-8777. SEI -8330!R a7Mi Steel's Soil Semo, STEEL'S SOIL SERVICE 3of3 David J. Steel Rolling Hills Of Hammond LLC 994 200`h St. CST-POWTSM NEIi4,SW1/4,S29,T28N,R17W Baldwin, WI54002 Lic. 4248956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 59 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown. as permanent lot lines were not established at the time the soil test was conducted. M Legend 1"=40' ♦ = Benchmark Ele. 100 00 ft Fop of 3/4" pvc pipe • = Alt Benchmark Ele. 99 75 It Top of 3r4" pvc pipe ❑ = Borings Boring Elevations B l = 100.40 ft B2 = 100.40 ft B3 = 97.70 ft 134 = 0.00 ft I cK `' PA I ll #1891 ''�%y wisconsiA SOIL EVALUATION REPORT Department of Commerce in accordance with Comm 85, Wis. Adm Code P�^e 1 of 3 Division of Safety and Buildings Steel's Sod Service Attach complete site plan on paper not less than 8% x 11 Inches in size Plan must County St. Croix Include, but not limited to vertical and horizontal reference point (BM), direction and - —- - percent slope, scale or dimensions, north arrow, and location and distance to nearest road Parcel I.D. Please print pp�C//CC Rev wed B� Date Personal Information you provide may be us d for sAdY"iEJove8�acy L s 15 04 (1) (m)) Property Owner roperty Location �•W Rolling Hills Of Hammond LLC JUL 19 2006 ovt Lot na NE1/4, SW1/4, S29, T29N, R17W Property Owner's Mailing Address of # Block # Subd. Name or CSM# 400 2nd st ST. CROIX COUNTY_ 60 ne Rolling Hills Farm City State P one Number City Village - Town Nearest Road Hudson WI 54016 715-386-0230 Hammond 160Th St New Construction Use Residential! Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable — _na ft General comments Mound design, system elevation 100 31ft based on contour line elevation 99.40ft. Minimum of 11 inches and recommendations of ASTM C33 mound sand. ❑ Boring # -- Boring 100.20 pit Ground surface elev - it Depth to limiting factor 36 _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont Color Gr. Sz Sh -Eff#1 -Eff#2 1 0-9 10yr3/1 none none none sil sd scl 2msbk 2msbk 2msbk mfr mfr mfr cs cs gw if na na .6 4 .4 .8 6 .6 2 9-16 10yrr4/4 3 16-21 10yr5/8 4 21-36 7.5yr4/4 none sl om na gw na .2 .6 5 36-60 I 5yr4/4 c2d 7.5yr5/6 sli om na na na .0 .0 Boring # _ Boring 100.20 factor 28 Pit Ground surface elev. _ ft Depth to limiting in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu Sz. Cont. Color Gr Sz Sh 'Eff#1 -Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs if .6 .8 2 10-28 10yrr4/4 none Sid 2msbk mfr gw lvf .4 .6 3 28-38 10yr4/4 c2d 7.5yr5/6 scl om na gw na 0 .0 4 38-60 10yr5/8 c2d 7.5yr5/6 Is/sil om na cs na .0 .2 5 60-86 5yr4/4 c2d 7.5yr5/6 scl om na na na 0 .0 ' Effluent #1 = BODS> 30 < 220 nri and TSS >30 < 150 mg/L ' Effluent #2 = BODz < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatu CST Number David J. Steel ` 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 I...11V (K V /IW) Property Owner Rolling Hills Of Hammond LLC. Parcel ID # Pending IP3 1 .-...... « Boring - ---- Page 2 of 3 Pit Ground surface elev - 96.LU _ It uepin to limiting factor 25 in Soil Application Rate Horizon Depth in Dominant Color Redox Description Munsell Qu Sz Cent Color Texlure Structure Gr Sz Sh Consistence Boundary Roots GPD/ft2 'Eff#1 I 'Ei 1 0-7 10yr3/1 none SO 2msbk SICI 2msbk sl om mfr Cs mfr Cs na na if .6 .8 .6 2 7-25 10yr4/4 none 3 25-60 5yr4/4 c2d 7.5yr5/6 na na .4 .2 .6 ❑ Boring # _ Boring _ Pit Ground surface elev It Depth to limiting factor - m Soil Application, R�ale Horizon Depth Dominant Color Redox Description � Texture Structure Consistence Boundary Roots I` _ GPD/ft2 m Munsell Qu Sz Cont Color Gr Sz Sh. 'Eff#i 'Ef2 ❑ Boring # Boring Pit Ground surface elev fi. Depth to limiting factor in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence) Boundary Roots GPD/ft2 In. Munsell QU Sz Cont- Color Gr $2. $h. I 'Eff#1 I 'ER#2 I ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce n an equal opportunih sen ice provider and emplo}er It you need assistance to access sen ices or need material in an alternate format, please contact the department at 608-266-3151 or M' 608-264-8777. SBD-83301ROT0V) Steefs SW Serves STEEL'S SOIL SERVICE 3 of 3 David J. Steel Rolling Hills Of Hammond LLC 994 200`h St. CST-POWTSM NEI/4,SW1/4,S29,T28N,Rl7W Baldwin, WI 54002 Lic. #248956 Town of Hammond, St Croix Co Direct 715-760-0347 Rolling Hills Farm Lot 60 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. emu- Chi Legend I"-40' ♦ — Benchmark Ele. 100.00 It Top of 3/4" pve pipe • - Alt Benchmark Ele. 99.90 It Top of 314" pve pipe ❑ ` Borings Boring Elevations BI— 100.20It B2 — 100.20 It B3 — 98.20 It B4 = 0.00 It S/� v z' N Z/ Wisconsin Department of Commerce Division of Safety and Buildings 1' �a SOIL EVALUATION REPORT #1892 in accordance with Comm 85, Wis Adm Code Paae 1 of 3 Steel's Soil Service Attach complete site plan on paper not less than 81/2 x 11 Inches in size. size. Plan must St. Croix include, but not limited to vertical and horizontal reference point (BM), direction and - percent slope, scale or dimensions, north arrow, and location and distance to nearest road Parcel I D Please print all information. Re vi ed B Date Personal information you provide may be used for secontl es (P ivacy Law, s 15 04 (1) (m)) Property Ownerqi RL Property Location Rolling Hills Of HaGovt. Lot na NE1/4, SW1/4, S29, T29N, R17W Property Owner's MaiL 1 9 2tia6 Lot # Block # Subd Name or CSM# 400 2nd st�V 61 na Rolling Hills Farm -- City Zip Cod Ot�l�N ber City Village Town Nearest Road gg. CeR Hudson54016 7 - 30 Hammond i 160Th St New Construction Use _'Tfesidenhal / Number of bedrooms 4 Code derived design Flow rate _ 600 GPD Replacement Public or commercial -Describe na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft General comments Mound design, system elevation 101 01ft based on contour line elevation 99.60ft Minimum of 17 inches and recommendations: of ASTM C33 mound sand. 111 Boring # Boring Pit Ground surface elev 100.25 ft. Depth to limiting factor 19 in. iSoil Application Rate Horizon Depth In Dominant Color Munsell Redox Description Qu Sz Cont Color Texture Structure Gr $z Sh Consistenc Boundary Roots GPD/ft' _ 'Eif#1 •Eff#2 1 2 3 4 0-9 9-19 19-26 26-55 10yr3/1 10yr4/4 10yr4/4 5yr4/4 none none f2d 7.5yr5/6 c2d 7.5yr5/6 sit sicl Sid sl/scl 2msbk 2msbk 2msbk om mfr mfr na na cs cs gw na 1Vf na na na .6 .8 .4 .6 .4 .6 .0 .0 ❑ Boring # Boring Pit Ground surface elev 100.25 ft Depth to limiting factor 55 in Soil Application Rate Horizon Depth in Dominant Color Munsell Redox Description Du Sz Cont Color Texture Structure Gr Sz Sh Consistence Boundary Roots GPD/ft' •Eff#1 •Eff#2 1 2 3 4 5 0-9 9-24 24-37 37-55 ` 55-70 10yr3/1 10yrr4/4 7.5yr5/8 7.5yr4/4 10yr6/6 none none none none c2d 7.5yr5/6 sit Sid cobscl grsl s/sit 2msbk 2msbk 2msbk 2msbk om mfr cs if if .6 .8 .4 .6 mfr gw mfr gw mfr gw na na if .4 .6 .6 1.0 na na .0 .2 • Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BODs < 30 ni and TSS S.30 mg/L CST Name (Please Print) Signature. - CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St Baldwin, WI 54002 6/12/2006 715-760-0347 SBD-833C (R 07 00) Property Owner Rolling Hills Of Hammond LLC. Parcel ID # Pending_ Page _ 2 of 3 ❑ Boring# — Boring - Pit Ground surface elev. -98.40 ft. Depth to limiting factor 30 in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure (Consistence Boundary Roots I GPD/ft2 •Eff#1 •Eff#2 in Munsell Qu Sz Cent Color Gr Sz Sh 1 0-10 10yr3/1 none I i 2msbk mfr cs lvf .6 8 2 10-30 10yr4/4 none sl msbk mfr gw na .4 30-42�0yr5/8 3 c2d 7.5 r5 6 scl omna w na .0 .0 Y / 9 4 42-75 10yr6/6 f2d 7 5yr5/6 Is osg mvfr a na 7 1.6 ❑ Boring # Boring -- Pit Ground surface elev ft Depth to limiting factor in ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu Sz Cent Color Gr Sz. Sh. •Eff#1 •Eff#2 i ❑ Boring At Boring -- Pit Ground surface elev ft Depth to limiting factor in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence) Boundary Roots GP_D/ft' in Munsell Qu Sz. Cor Color Gr Sz Sh 'Ent •E11#2 • Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg1L • Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg1L The Department of Commerce is an equal opportunity wrvice provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 iR 07,001 stre15 soil Service STEEL'S SOIL SERVICE David J. Steel Rolling Hills Of Hammond LLC 994 200th St. CST-POWTSM NEI/4,SWI/4,S29,T28N,R17W Baldwin, W154002 Lic. #249956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 61 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1" = 40' ♦ = Benchmark Ele. 100 00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 99.95 ft Top of 3/4" pvc pipe r1-n........� 7_so� N 3of3 k co ill r. 4-4,1 12 E_d roo... Cowwe.- INewd. 5�. CrolX coorviv NO. 633870 STATE SANITARY PERMIT OWNER K?ol(l' is PLUMBER TOWN OF %S*c#"o4 iOM 44C. IC.# 60 qLa SEC Zq ,T_7A R 7 E/I& AND/OR LOT Z BLOCK a— PERMIT EXPIRES SUBDIVISION OFFICER — Z-oN E X 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 a 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. (I) 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. DATE RENEWED B O THAT DATE VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)