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018-2019-79-000 (11)
Wisconsm Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)imf] permit Holdeia Name City Village Township Rollinq Hills Farm Residential Property TOWN OF HAMMOND TANK INFORMATION TYPE MANUFACTURER CAPACITY Sept c Dosing Aeratlgp., 1 Hoij TANK SEJBACK INFORMATION W,es. BMW®®= PI IMPlSIPHON IMCnPNIATIn NI Manufacturer Demand GPM Model Number ,;l TDH Lif[ Faction o Syste Head / TDH t 3Z _ Z.o Forcemam Length J M Dist to Well 2 SOIL ABSORPTION SYSTEM BEDITRENCN Width J 'Lengthl DIMENSIONS t/O p SETBACK SYSTEM TO INFORMATION_ 3G DISTRIBUTION ELEVATION DATA STATION BS HI FS ELEV Benchmark • O a 5. /071.5Z Alt BM Bldg Sewer Sr" Inlet w db /0�938 St/Ht Outlet DI Inlet / DI: Bottom 113Z •7 IDlos (Z/ Header/Man Dist Pipe 3.elo 0 1073, 3 oYz. be Bot System Finradepsr- CGV.rt•"L( �jQ� �Z� COVRr 1 St Cover sV ` , � ITT• /fJ y•oy o 1.s y 81 I070.?3 CHAMBER UNIT HeaderrMamfild 1 ( tj Length�.� Dial IZ Distribution t -_ Length 94.or Dia I �Z' Spacng �-- x Hole Sae 1 �.�•7W I SI/ x Hole Spacing 3.O f Vent to Av Intake �— OVIL COVER x Prrtecure Svcfomc rinly r 7 Depth Over Depth Over xx Depth of xx Seeded r Sodded xx fei.lc^ed Bed/Trench Center Bed/Trench Edges Topsoil Yes No yes f Na r- u Nn Jude (;ode discrep es persons present, etc) Inspection #1 tow I g W � Ada n n D � r oca[ion: No Address Available 1 ) Alt BM Description =In-ta ce �}� 3• p ^a 1���� 2) Bldg sewer length = /V/A ^ O - amount of cover = /J//'T I ,yf G� �J�C f LO Plan revision Regwredv _Yes No /O/J3 Us 2- Data rs � Snsepct�s. 5igna re. -}- (I� /[ _t1-�ert No r a 1 - 2 X 5 Safety and Buildings Division St. Croix �= P: 2021 201 W. Washington Ave, P.O. Box 7162 Madison, WI 53707-7162 Sanitary Permit Number (to be sued in by Cut -- AUG 16 - d f OU t Cam 1 o en t Application State Ttansa;hon Number In accordance with SPS 383 21(2), Ws Adm Code, submission df this form to t e p a ental upit 082101888-C Project Address (ifdiffererm than mailing address) is required prior to obtaining a sanitary permit Note Application forms for state-owned )1 TS are submmed io the Department of Safety and Professional Servies Personal information you proNide may be used for secondary purposes in accordance with the Privacy Law, s 15 "I m), Slats 2- I. Application Information - Please Print All Information Property Ohvner's Name Parcel 4 fyme Properties We,2 018-2019-79-000 Property Onvacr's Mailing Address mt,� ^�^ ' u\ Property Location 3435 Labore Rd. Ste 150 Govt. Lot NE iA SW 'A, Section 29 City, State Zip Code Phone Number Vadnais Heights, Mn. 55110 29 17 (Circle T N, R EX II. Type of Building (check all that apply) Lot # Subdivision Name A' 1 or2 Family Dwelling -Number of Bedrooms 33- 3S Rolling Hills Farm Block# ❑ PubadCommernal -Describe Use ❑ City of ❑ State Owned - Describe Use Village of CSM Number y❑, 'IJ Town of Hammond Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) `t ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑Permit Renewal El Permit Revision ❑ Change of Plumber ❑ Pcrtnrt Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner it W. T of POWTS System/Component/Device: (Check all that apply) f ❑ Non -it ctnrid In-Gri and ❑ Pressurized In -Ground ❑ At -Grade VPFMound 124 in of suitabl—es-o-ill ❑ Mound <24 in of suitable soil ❑ Holding Tank ❑ Other Dispersal Component plain) _ _ _ ❑ Pr reatment Dree (explain) HOOt6 ATU'S to be a ded V. DispersitYrreirmi Area Information• 1 0 Design Flow (gpd) Design Sod Application gpds Dispersal Area Required (sf) Dispersal A Proposed (St) Sys te Elevation 1200 I .1 1200 1200 0(1 1072.50/1071.73 VI. Tank Info Capacity in Total 4 oD Menu timer Gallons Gallons Umts 2 Sim tex filters m , U .. _ o New Tanks Exrsoog Tanks E o a U rn v in .. u C Septic or Holding Tank Dosing Cliabe 1250 ix VII. Responsibility Statement- 1, the undersigned, assum ponsibi 'ty for insta tion of the Poi shown on the attached plans. Plumber's Name (Print) PI tgnature MP/MPRS Number Bminess Phone Number Keith Knudtson 3 651-470-1737 Plumber's Address (Street, City, State, Zip Code) 927 150th St. Roberts,Wi. 54023 VIII. Court /De artmcnt Use Ontv Approved ❑ D a p Permit Pee �( lssuin Agent`ignatur $ /at%�Jl�ss[ue ❑ (honer Given R. r Denial <-j 2Q 21 IX. Conditions pprov URweens-fog N@wppre al SYSTEM OWN . Septic tank. effluent filter and � pL Y]A.i �B"�j 33- 35-. E4"C_� t Div dispersal cell must t serviced /maintained l Curti Sr/ _�I ,I 1' caper management plan provided by plumber, iETll - frtti � ppIL�� All tin(+. D 1 . setback requirements most be maintained W • • W a5 fa II able CDderOffRls9 p09'S1Wele lam for We s4m and Ito the h n not ley than Il inM i i 77f"" �� `f� Cs yam,` I � il 4 Page 9 g� Sanitary Site Plan 19 For:R. H.F. Residential Property Owners Ass. LLC Rolling Hills Farm Outlot 2 �31 NEI/4-SWI/4 ° b .o Sec. 29 T29N-RI7W z1.7e1: P o e v Town of Hammond - St. Croix County OBM LOT 21,ro1 w.ri. �4c. • WEL �1 59 y AL HM3 op of Wooded BobHob LOT 21.750. FrLOT ry T -Some 60 @ ¢i Top of Wooden Hub Si 21,70 So. Fr. iv ASSUMED ELEV. - I072.52' 9 00 30 G& Pt# 4068 Elev. 1072.52 JL° 1071.50' #1 2R b 10% 42.71 Acres ._, 7 LOT 2 *,• 62 Open Field Site 6% Q •60 21,782E ❑ B#1 LEI Septic Easement #10 8 67.30, sn'r411, .rygeaar 31.03, Proposed Two 6' x 100• Mound Dispersal Cells w/ the Upslope Cell located along the 1071.50' 8#3 10 7% contour w/a S.E. of 1072.50'. The Down slope cell will be located along the 1070.73' contour w/o S.E. of 1071.73' 'Proposed Duplex 2' Sch. 40 PVC F.M.'s A"r' Proposed Wieser Concrete 5 WE uplexP Pumps an Tank 1 w/Duplex Pumps and Simtech •13$ STF-100 Filters Typical for lots 33-35 will be Four Bedroom Homes w/4" Sch. 40 PVC Bldg. Sewer Pipe. A Hool H-6W Bio/Septic Tank connected to the dose by 4" Sch. 40 PVC or 4" Astm D-3034 PVC conveyance pipe. Clea outs could he optional. LOT 36 LOT 37 s 21,7W SO. FT. 21,781 50. Fr. L.B.O.=1057.50 tit°2T�� w��41 LOT 38 •781 SO. FT. _ .=1057.50 10°2—�—gM ELEV. 4'2`�'E 228.0 1071.71 OLFFLOT 2 -1079.20' 4' Cwrvey,rw, Pipe r OT'r w 2 0. Fr. N 4'Bldg. Serer �_ 4'Conv,yence 600 DWF Akry� pipe _1085.00' r1# 73s OT -600 is Tani : � WELL 21.781 SO. FT. / DEDICATED TO THE PUBLIC 7 4' Convoy,,,, 4' Bldg. Sews Pipe ----1 ,—1093.00, 1# 731 . WEL�ax'�g� N LOT 32 21.781 SO. FT. , �,tra"'^rEtr y j� oFr I/ r t,\ $ FEss DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay httpJ/dsps.YA.gov/programs/iindmtry-serwces www wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary August 11, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-08-11 Plan Review: PWTS-082101888-C KEITH E STONER 23220 Woodcreek Rd Siren WI 54872 SITE: Rolling Hills Farms Lots 33-35 Shared Sanitary 735 163rd St. Hammond Township Town of HAMMOND St. Croix County Total Amount: $325.00 FOR: Descriodon: 1900 GPD GPD Maintenance Required Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE 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: • It is recommended to fence off dispersal area prior and during conshruction to avoid distu rhance, compaction and use of the site. • 1Nith new construction, it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left -over construction products shall not be discharged into the drains discharging to the private onsite Wastewater treatment system (POwTS). Taste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. if the site is too wet to prepare, do not proceed until it dries. • It is recommended to cut as short as possible and remove ground cover prior to tilling the ground surface for the dispersal area. • Electrical connections shall comply with SPS 316.300 and NEC 300 • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewers beyond 30 feet per SPS 382.30 (11xc) • Well shall be located 50 feet from drainfield and 25 feet from treatment or pump tanks. • Verify property line location. • The homeowner must maintain a Servicing Contract with a POWTS Maintainer for the life of the private onsite wastewater treatment system using pretreatment technology. • The inspection, maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection, maintenance, and servicing. • The system was designed to meet the influent quality discharged into a POWTS dispersal component consisting in part of in situ soil to be equal to or less than all of the following: 1. A monthly average of 30 mg/L BOD5. 2. A monthly average of 30 mg/L TSS. 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 POWTS. Sincerely, �itavea �%a�.iren Travis Wagner POWTS Wastewater Specialist, Division of Industry Services (608)598-071S travis wagnerpwi.gov Index and Title Sheet Project Name. Rolling I lilts I arm Shared San itan System fix Lots 33-35 s{�Coonji Propen) Oyuter: Rol line I tills Dann Residential Propcm O sne"Ar rRConditionally VED Address: CO of I %me Properties DEPT. OF SAFETY AND PROFESSIONAL 3435 I abore Rd. STF.150 SERVICES Vadnais Heights MN 55110 DIVISION OF INDUSTRY SERVICES Legal Description: Part of the NL '6 of the SW'i< Section 29129N-R17W To%%nship: Hammond Countv: St. Cron Subdivision Namc. Rolling Hills Fann Outlot 2 Comp. (('Parcel ID: 018-2019-79-00(I CON1LNiS Page: I Plan Narrative Pace- 2 Plot Plan Lot,: 6EElC SFIQA,}QF5N(;r.35 Page: 3 Mound Plan Vice and Cross Sections a +b (t pslope , Doyyn slope Cells) Page: a Lateral La}out (Ivpical) Page: 5 Dose Chamber Cross -Section Page: 6 Pump Curve Page: 7 A, B Duplev Pump Panel Specilicannns Page 8 1loot S\ stems H-600A I ant. Specs and Hoot Service and Inspection Form Pace: 9 Management and Contingency Plan Attachments: Soil and Site (:valuation Relx is. Soil Verification Boring,. Sample ATL Sen icing .Agreement and Hoot System, I LC Product Approval \%ith maintenance requirements. Mound Component Manual Used = Version 2.0 SBD-10691-P (N'.01,01 R. 10'12) Pressure Distribution Component 'Manual Version -'.0 SBD-10706-P (N (11 /01 R. 10112) Designer Keith F. Signature: � n��ui•J` License;; Designer 157-007 6-25-2021 Phone a (715) 653-2324 Pagc 1 of 9 Plan 'Narrative the billowing shared sanitan system desig discussion foc cs on the proposed 12 Bedroom' 1800 gallon per Jay sanitar) system to sernc .ots ,I lh �f the Rolling Hills Farm Subdivision. 'I his plan complies with the St. Croix County L nd Use and Development Ordinances. A "Conservation Development". Rolling Hills Farm is designed for 77 lots scniced by "_ dispersal components located on common ground. Appropriate casements and maintenance language Here 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 he located within Sanitary Easement Area 10 and the tested areas for lot 61 within the common area known as Outlot 2. A four bedroom maximum design tlow has been established for each lot. the count will require a sanitary permit for each lot prior to construction fix ,citing the septic !treatment components vcrif'ying 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 fixated north of Lot 15's north lot line. that will altematel) distribute the highly treated effluent to a common mound dispersal sy stem consisting of two 6.0 ft. x 100 ft. mound dispersal cells. 'the soil tests completed by David Steel are provided. I he BNI for the soil test for Lot 61 equals 100.00' or—1072.00' using NAVD 88 Datum. A suneyor 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 I -posts marking the lot corners had been disturbed as it has been I: years since the original soil tests had been completed. c use e wooden hub set on the northeast corner of Septic Easement K 10 with an elevation of �1072.�'_as our be for the sanitary systems construction. perimeter of the cases mcntt I as staked with shots taken on the existing easement iron9wo soil serifiwation pits were dug to verify the soil conditions and tied into the benchmark along with contours within the system area. I e4 / // 'O'er fh Page . _ 9 h� Sanitary Site Plan C19 For: R.H.F. Residential Property Owners Ass. LLC Rolling Hills Farm Outlot 2 (C31 NE114-SWI/4 1 e X ro Sec. 29 T29N-Rl7W z, 7e, p° I Town o Hammond - St Croix County BM LOT a,� } . WEL 59 yrY Iz A BM op of Wooded Rub LOT 21,783 SO Fr LOT 60 67 r _m -�_ e 11 Topof Warden Hub 21.783 SO Fr ^r W ASSUMPD FLEV. - 1472.52' 0 � 170,G& f ptq .t(168 Elev. 1072.52 107150, / #1 2 10% 42.71 Acres —1 7 LOT Rr .a. 62 2 Open Field Site 6°r. zR?�, -50 Qb 21 782 0 Bit L-61 Sepbc Easernerrt #10 ` er. 37.E Proposed Two 6' a located fMound Dispersal Cells w/ the Upslope Cell located along the 1071.50' 803 1C 7 % contour w/a S.E. of 1072.57 The Down slope \ cell will be located along the 1070.73' contour \\\\ wia S.E. of 1071.73' .072 50'J _ OLI LOT 2 73.34' \ d3 Duplex 2" ❑ Al1�,716.W _1079.20' posed ,i2' Sy Sch. 40 PVC F.M's �.3q t. Proposed Wieser Concrete 4'Ca oyam, S WI Duplex - Tank pig Pumps u w/Duplex Pumpsps an and Simtech STF-100 Filters _ 1 1t:, Typical for lots 33-35 will be Four Bedroom „^�, • OT 7i Homes w,J" Sch JO PVC Bldg, Sewer Pipe 2 . Fr. $r. A Hoot H-600 Bio/Septic Tank ='' 4' &dg SaUBI 4• (,p,ygygKg connected to the dose by 4" Sch. 40 PVC � ro' Ph - or 4" Asun D-3034 PVC con,eyance pipe. 600 DNF ��'-1085,00, Clean -outs would be ophoual LOT 37 �j, LOT T FWELL5 � OT Tank 21,7e2 SO FFT 21.751 SO FT ,} 21,7e1 SO Fr. / L.B.O.=1057.50 g 600 /� ra FNe 733 1' 4 comeyenoe 4 Bldg sewer pipe DEDICATED TO . -1083 sea LOT 38 THE PUBLIC soo Took let so Fr. LOT 33 • 163RD''STREET '-1057.50 FNq 731 FT 3y vE20. y0�2425•E 22t3.M ELEV. IC43 • xgE 1071.71 LOT 32 221.781 SO. FT. \ E 6� Page 3a of 9 N Cross Section of a Mound System Using Two Cells for the Absorption Area I 110 A B —3D4--� 0 B A E B HOO It I F 9 Cl4' 1 G D I2" (R q ) nupervl Ccll Arcs Tote) (t,QQ Igpd dl Lnear Loadlnu Rate Note: C dimension = cell separation. I Shading Key ® Topsoil Cap ® Subsoil Cap ASTM C33 Sand ® Tilled Layer ® Aggregate L K 1 14El L II ' J W i lR'I B.] Area A, ailahk (it)Ir I(I BOtn Pipe Pla ent Mound Cross Section View for the Upslope Cell Aggregate Dispersal Area Finished Grade � e 7 % Site Slope Detail of Typical Dispersal Cell A o Note: Prepare Mound Site per Component Manual Constuction Procedures. / (ft) Contour Elevation / ®p = System Elev. Geotestile Fabric Cover a" ohaenanon Pipe N M Acrprooi cap and anchored F securett eta/R" re4od of altenime method 6" slots T 1 Cross Section of a Mound System Using Two Cells for the Absorption Area 1110 observation -13-_0 n Q Q H A 6 F. r )- ]7L), g IOU It. < v� C 4' G U 1 2" I2OO , It ,q I I otdl ti),tnn D"Per.di,\red 6,O) I wd In ' mcur I nadme Rare Note: C dimension - cell separation. 1 772.2 (It ) Lateral I n\ ert I Page 3boft) K Hg12 K 9.00'' I.1 I R.00'' N' 3,.71 It iRa,dl \rea \t dddhIc j p.00' I It) I l i it( lb, Pipe PI.teemenr Mound Cross Section View for the Down Slope Cell Aggregate Dispersal Area Finished Grade IO73b0' k1 E I070.73 (ft) Contour r:1e\ation System Ele\ Shading Key ® Topsoil Cap ® SUbSoll Cap AS I N1 C3 3 Sand ® IilledLayer ® Aggregate Dkrwr,al l01, �- 9 Detail of rr-w - _��WIYYlilll� �: • iI i-•___•_•--1 �I it —i�.� a A —�- Note: Prepare Mound Site per Component Manual ConStLICtion Procedures. Page a of9 Lateral Layout Typical of Both Cells emu\ End Connection Lateral Layout Diagra -� S Lateral, and I mu Main 0 PAt sch Lin jPr sl's i ahlc 194 )p-j \ I urn- p hamI +al+e or dean ��. uut PI c Laterals centered over the ARB dimension Number of Laterals '- Orfice Diameter in, Lateral Diameter 1' in. Orifice Spacing (X) fi. IateralIength1P1 99.00 It Orifices per Lateral Lateral Spacing t5> 3.00 1�, Orifice Densil) W/ onfice I ateral Flom Rate i 18.36 cpm Manifold ! ength ft Cell Flow Rate 3f�'- epm Manifold Diameter n i SN.Irn FFInv+ Rate ?>.la epm Total Dynamic Ilead It. Lateral Turn -up Detail Finished Grade Threaded Cleanout Plug or Ball 6" to 8" diameter La\vw Sprinkler Boy Vahe 000000 Long Sweep 90 or Iwo 45' Bends Same O O O Diameter as Lateral O O O ODOOOO O O O O O O Distribution Lateral Note � Lateral ends at last orifice where variable length to cleanout begins. I �615/3'_" 3.00 3a 8.82 3.00' Lp13.59-DN I 13._3 Page > of 9 Duplex Pump DoseTank Component Cross Section Approved Manhole C'o\crN \Pith Warning labels and I ocking Device 4" Min. Above Final Grade either Proof Junction Box Electric per NEC 300 K SPS 4" Sch.10 Vent 316.012 W'AC or = to 1 2" Above Final Grade rl Disconnect \ote: SJf Rhombus type I22Duplex (Demand Dose) t op of inlet - 106N.40 (Set b\ Installer) Simtech S"I F 1001 ilter -J Note: Pump switch and alarm to be A u ired to separate circuits. t3 N LPI'>0-MR Gallon C Tank Mfr. Wiesen Concrete - C D Vertical Difference Herhseen Pump Off and Distribution Pipe Minimum Required Supply Pressure ......... ..................... _ 32' 1" 1 of Force Main \ 2.94 friction Factor 'IOOF f. _. Note: Ma\imum dose per Preswre Loss Through F iller ................... cell 180 uallons. IDtal D\narnic I lead .. ............. Min. dose per cell - 91.IIN gals. Alternate Outlet Location NV Appro\ed 4" Sleeve I orce Main Diam. cep Hole or Anti Siphon Deice Duplex Force Mains Pump Off Ele\. I W.40' Duplex Pumps Dose lank Flex. 1064.90' 7.6ft, 6.83 Down Slope cell 41 4,s; -'(1' .30 13 59' 13.23' Number of Doses ...- J.40 Per Da\ Gal. Per Da;of Doses 166.55(ial. (Duplex Volume of Backtlo\\..................... .............. ..... .......................... _ _ 7.50 (jai. PumpNAlternatinc Total Dose Volume.................................................................... 174.0>Gal. bemeen cells ) Pump Iink Capacith 1233.16 Gallons Dimension, Inches Gallons Pump Tank Volune 34.81 Gal Melt A 30.5o 661.39 Pura Mfr. Goulds B ' 69.G_' P -- (' 174.05 Pump Model F.Pit> D 10 318.10 Minimum Discharge Rate = 36.72 GPM per pump AlarmMli. S..1F.Rhombus Iotal- 36.00 1253.16 Alarm Model lank Alert 1 — - lied Tank per SPS. 383.4i(i) Anchor Tank as necessan to negate buo\ant forces per SPS 383.43(8)(g). Note: Tank to ha\ e hro outlets Note: Do"n slope Cell force main - 14 ft. longer. Upslope cell will receive 2.28 gals. more per dose. Nastewater METERS, FEET 10 9 30 8 25 QG W 7 _U 6 20 Q 2 Y 5 O 75 J Q 4 r O ~ 3 10 2 5 1 0 0 0 9 10 20 4 Page 6 of 9 —►��-- 5 GPM L_ 25 FT 5 30 40 50 GPM 6 8 10 CAPACITY Order Number I HP I Vohs Amps Minimum Circuh &esker Phase Float Switch Style Cerd L.engtb Discharge Contlection Minimum level Minimum Ofl 4ve7 Minimum gash Diameter, Maximum Sdids Size Shipping Weight Ibs.kg HEP0411 4 5 12 20 Sl 'tManual Swath ManualNo 0/9.1 P�9gy/ Wide -Angle back 1 �, 12 EP0411F Plug' No Switch 20' Manual Manual 2 0 i 9,1 EP041>AC Piy gyback W.de-Angle to 1%" 1 ` Manuel Manudi 6 Mai ival Manual 15, A 21 / 9 5 20. 9 1 iNo 20 / 0 1 P0412 kEo P041 _F 230 6 10 Plug/ Switch 10' Mu No S. tm 20 E1F i EP0511 AC 5 115 — 13 20 Plug/ '�O=ch P'J9y0ack/ 1Nde-Angle 20 20 f Manual Manual 22110 �12b 23 / 104 FP0512F 230 65 10 Plug/ No Swrtd� 20' 1 _ Manual Manual 22, 10 Single phase, duplex albrnating pump control with override. Page 7a i b of 9 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 aftemating action equalizes pump wear. In addition to the alternating pump control, this system provides override control should either pump fad. If an alarm condition occurs, an alarm switch activates the audiolvisual alarm system. Common applications include pump chambers, sump pump basins, irrigation systems and lift stabons. 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 NEMA 4X (ultraviolet stabilized thermoplastic with removable mounting feet for outdoor or indoor use). Note: Options selected may increase enclosure size and change component layout. 2. Magnadc Motor Contactors control pumps by switching electrical lines. 3. HOA Switches for manual pump control (mounted on circuit board). 4. Control Circuit Board provides pump Control and allemation. 5. Green pump Run Indicator Lights (mounted on circuit board). 6. Circuit Breakers (optional) provide pump disconnect and branch circuit protection. T. 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 ►AC "E 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 warming of alarm Condition (83 to 85 decibel rating). Note: NEMA 1 style utilizes an internally mounted buzzer in lieu of horn. 13. Exterior Alarm Tesf/NormagSllence Switch allows hom and light to be tested and horn to be silenced in an alarm Condition. Alarm automatically resets once alarm condition is cleared. 14. Norm Silence Relay (mounted on circuit board). NOTE: other options available. / Entire control system (panel and switches) is UL Listed to meet and/or exceed industry safety standards / Dual safety certification for the United States and Canada / Standard package includes three 29 SJE SignalMaster' control es / Complete with step-by-step installation instructions / Five-year limited warranty Model Shown 1221W114X$A C©W LVE SE- J pus. PO Box 1708, Detroit Lakes, MN 56502 1.888-DIAL-SJE • 1-218-847-1317 1-218-847A817 Fax 122 C MODEL122 ALARM PAC 0 =selectopr no alarm package TT 1 = alarm package (includes test/normal/silence switch, fuse, red light, & hom) ENCLOSURE RATING m ®I = Indoor, NEMA i (metal) W = Weatherproof, NEMA 4X (engineered tftermoplastic) EgSTARTING DEVICE I 1 = magnetic motor contactor 120I208/240V 9 = magnet 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 51 0 = no plump disconnect 4 = circuit breaker 120V (select STARTING DEVICE option 9 above) 1202M40V (select STARTING DEVICE option 1 above) FLOAT SWITCH APPLICATION H or L = pump down or pump up (select 17 option) X = no floats OPTIONS Land bofw ENCLOSURE UPSIZE - If you selected one or more of the * options, or two ** options, a one -tine enclosure upsae fee would apply. CODE DEaCROMON 6A Q to Red Deacon only I no audio oDDE oescantoN (must sekd V tor alamh package) ** 10K An i-corberwUon healer Q 1C Flom aMy / no visual 11C NEMA 1 alarm panel (must seled 17'lor BWM package) 11D NEMA4Xalemparel Q ** 3A Alarm flashy * 140 Main disconnect (rotary style, mounted through door, non-Nseoi * 38 Manual alarm reset (must select Orcuif brasker) *4A Redundant of *ED G-20 FLA (bfal of both pumps) (select Option 4D if floats mdWed) *M 20-W FLA (total of both pumps) Q 4B Red redundant of indicator 8 alarm 16A 10' cord in Neu of 20' (per foot (must sailed Option 4A also) 168 15' cad in lieu of 20' (per Ibei) Q 4D Redundant off Boat 16C 30' cord in Neu of 26 (per float) (Must select 4A option) (select 17 option) 16D 40' cord in lieu of 20' (per float) Q * 5A Thermal amlotdMeat sensor auto reset 17A SJE SignallAaster- I pipe clamp 0 (per foe) (for pumps wAhermal switch bads) 178 SJE SignaMastef- / enemely weighted 0 (per Aoet) # 5E Seal failure circuit 8 and Indicator (2 wire) 17C Sensor Float / iMemmally weighted A (per Bost) BA Auxisary alarm contact, form C 17D Senses Foar / externally weighted A (per Aoa) (included as standard) 17E Senses Fbar ON / pipe damp A (per float) Q * aA Elapsed tale meter 17F Sensor Float° Rani / externally ~led A (per floe!) * 8C Evert (cycle) canter 17J Sensor Float- / pipe clamp A. (per Aoat) * 9_A Pump overload 196 Lead lag selector switch sp" amperage after number 9 followed by btter'A'... 19F Fourth float to separate alarm function from log Example: 912A = 12 amp pump. 19T TOA (TeaUOR/Aubmaac) w8tlmes and pump run lights # 0-25 FLA though door mounted * 2530 FLA Q 19U HOA (HandlOWAutomaac) switches and pump tin lights 10E Lockable Nmch - NEMA 4X through door mounted 10E Lockable latch - NEMA 1 Q 19X Door mounted pump run indicator * 10F Lightning arrestor (sakuX pump curxnt breaksr) • Medmanicalty-actvated A ktemuy-activated Nadditlonal features are required, call the factoryfora quote on an Engineered Custom con Vol panel. MODEL 1221 W 9 0 T Alarm Package Enclosure Retlrtg StartMg Device Pump Full Load Amps Ramp Disconnect Float Swi Application Options: Auxiliary alarm contact, form C. Elapsed tkne meter, event (cycle) counter, 6A 8AC 17A 0% 4. 0 A H• •T www.hootsysfems.com 106" 31}" 74}" 4" CAS 11 IHI II 4" CAS -,fir a n � 1 •II IIII POLYLOK 12" ACCESS LID (TYP) _ 1 41" 40" i £Z SET RISER (TYP) I ALT O n h 'ANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS UOD UPD GRAVITYCCHARGE SYSTEM H-600 A TANK SPECIFICATIONS DIMENSIONS: WALL- 3" BOTTOM: 3" COVER: 4" MANHOLE: 12" h 24" I.D. PLASTIC RISER HEIGHT: 70" O.D. LENGTH 106" O.D. WIDTH: 74 1/2" O.D. BELOW INLET: 57" O.D. LIQUID LEVEL 51" WEIGHT: 11.135 LBS. INLET AND OUTLET: 4" CAST -A -SEAL (CAS) BOOT OR EQUAL COVER: MIX DESIGN /8 (NO FIBER) TANK: MIX DESIGN 09 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE DRAWINGS SUBMIT FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCES NEEDED BY: Hoot Service and Inspection Form This besting 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................................... Ci 0 Aeration Plumbing ................. C] J J Air Filter ................................. Effluent Pump (if applicable)....... U G Chlorinator ............................. G D L OK System Light .................... 0 L� Alarm..................................... C] C C D-Box ....................... [] C 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 Signature of Inspector: Required Results Test Method 0 C C Installer 11 or WW Lic # Private Onsite Wastewater Treatment Svstem Mound Management Plan Pursuant to SPS 183.54 Wis. Adm. Code each Private Onsite Wastcµater Treatment S%'stem ( VOW-1 S) Shall Include information and procedures for maintaining the system NN ithin the parameters of SPS 383 and 384, and the conditions of appro\'al by the department. agent, or goy etnntental unit. I he apprm ed plans and permits for the system mll he filed \sith the county toning or health department. 1 his management plan complies kith SPS 383.54, R'is .Adm. Code, the Mound Component Manual tiff Prig ate Onsite \\ aster%ater l reatment Systems (Version 2.0) SBD-10691-P (N.01/01 ) R. 10,12 and the Pressure Distribution Component Manual (Version 2.0) S13D-10706-1) IN 01-01) R. 1011 ^1 Table 1: System Design Specifications Sanitary Permit Numher Number of Bedrooms -- - l j Design Floe (GPD) -- ,1800 Soil Absorption Component Size (sq. ft.) : 1200 (Pretreated Effluent) frash lank Capacity Gal_ - -' 400 gat - Pump - Chamber Ca acm Gal. 1'S(�allons - --------- F��w'astertater Pretreated Domestic Pre -Treatment unit installed per structure HOC)T SYS'I EMS H-600 A Table ?: Soil Absorption Component - Limits of Reliable Operation 11 Septic Tank Component Soil Absorption Component 1 Design Flog -Peak (GPD) 600per structure 1800 Max. Intlucnt Particle size NA 51 /8 Inch -~ Maximum BOD S (mg l) NA ----- � 30 mg/1 - �Maximum TSS (mg/1) NA-- -- — ! < 30mg/ I - Maximum POG NA NA J Table 3: Maintenance Schedule Se tic Tank - IIns_pect and/or sett ice once every 3 years Dose Tank In- line Filter I Should inspect once a year and clean eN en 3 N ears Pump Chamber Inspect once eccn 3 years Soil Absorption Component Hush laterals eNren 18 months. - HOOT SN'STEMS 11-600 A i Sen ice e\ cry 6 months for first '_ years. Then annually - thereafter per maintenance a r icnt. See attached. Pazte9of9a.h-c Septic, l ank The septic tank shall be maintained by an individual certified to scnice septic tanks under sec. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance w ith NR 113. �k is. Adm. Code (Sen icing Septic or I Iolding'fanks, Pumping Chambers, Grease Interceptor. Seepage Beds. Seepage Pits, Seepage I renches, Privies, or Portable Restrooms). I he operating condition of the septic tank and outlet filter shall be assessed at least once ever 3 }ears b} inspection. The outlet filter shall be cleaned as necessan to ensure proper operation. fhe filter cartridge should not be removed unless pro% isions are made to retain solids in the tank that may slough of 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 continuoush. Intermittent filter alarms ma} indicate Surge flows or an impending continuous alarm. The septic tank shall have its Contents renewed %% ien the volume of scum and sludge in the tank exceeds Ira the liquid volume of the tank. If the contents of the tank are not renew ed at the time of an assessment. maintenance personnel shall ach ise the owner of vv hen the next sery ice needs to be perfomled to maintain less Ilia" maximum scum and sludge accumulation in the lank. Pump Chambcr I he pump chamber also requires monitoring once cv en 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 map 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 he used to dose the component «ith onh the proper amount of influent. 'I his rna} include manual operation of the pump controls until such time the pump chamber has reached its nornial 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 risen and covers should he inspected fix water tightness and soundness. Access openings used for sen ice and assessment shall be scaled watertight upon the completion of sen ice. Ana 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 kicking deice to prevent accidental or unauthorised enln to the tank Warning: No one should enter a septic or other treatment or holding tank for am reason w ithout being in full compliance with OSI IA standards for entering a confined space. the atmosphere vv ithin the septic or other treatment or holding tank may contain lethal gases. and rescue of person from the interior of the tank ma} be difficult or impossible. I ank abandonment shall be accordance with SPS 381 33. Nis Adm. Code when the tank is no longer used as a POWTS component. Page 9 of 9 a, b + c Soil Absorption Component I lie soil absorption component sen ing this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shomi in Table 2. I he longed ity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good eater 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 component's operation must be assessed b% inspection at least once esen 3 }cars. lateral turn ups are pro%ided at the ends of the laterals for the purpose of flushing the lines of any solids. Flushing these lines should be done c%cry 18 months. I he inspection shall include recording levels of ponding, it -an%. in the observation pipes, and visual inspection for any evidence ol'surface discharge from the component. On steeply sloping sues areas of erosion should be identified and reported to the owner for repair. 1'he surface discharge of domestic wastewater or sewage from the system is prohihited and considered a human health hazard. Traffic around or o%er the soil absorption component should be avoided particularly during vv inter months. The compaction or removal of snow cover over the component may lead to hvdraulic failure by freezing. Tltis type of failure is usually temporan, but is difficult or impossible to repair until %veather 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 directh over or %%ithin 10 feet of the component should be avoided since root intrusion into the component may obstruct wastewater tlow. Continaencv 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 trait should he addressed to the POIA TS Maintainer. Bi-annual' annual inspections should present am 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 insolve the removal of a hio-mat which would require cleaning or replacement of the distribution nct\vork as %Nell as replacing the aggregate system and clogged portions of the sand till. Component Owners Contact List Keith Knudtson St. Croix Count\ Zonis Wieser Concrete Products Stc Pum er HOOT SYS I EMS LI Page 9of9a,h4 c Plumtns'ATL Maintainer (6511470-1737 (715) 386-4680 I Maiden Rock W1 (8-00) 3 36-3416 Powers Sanitation 11-600 A 15)249-5738 0 878-4668 Z sin SOIL EVALUATION REPORT a1892 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page _ _1_ of 3- . Division of Safety and Buildings Steers Soil Service County Attach but not site Dian on paper not leas than ref x 11 inches in lira. Plan most SL imlz includeperoem but not Writteno to. ventral and horizontal and locce point (BM), direction are Potosi I D. pp -- percent slope, tcale or dimensions, north anow, and location and tlistanrt to neemst road ��O- Please print aff information. � p Personal toanoaon you Mvioe may w used for -WData d _ a ( r Law. s 15 04 (1) (ml) Rev �1 / /.avis._, o1'/o�'�(Q Rolling Hills Of Hammond L Govt- La r1a NE1/4. SW1/4, S29, T2gN, R17W - ..- -" -- ---- - -- - -- -- ---- - - Property 0wnsrs Ms!" Aden! Lot* .. _ _ ti -- ' Sued: Wme or 6iMS — 400 2nd st jUL 61 na Rolling Hills Farm 17n - ------------- ---- Coy X. S ZIP Tooa_OtRImDU iher CM vtlage Town NeareM Road Hudson 5A116 Hammond 180Th St New Construction ,..saalerntiaf I Number of bedrooms - 4 Coda derived design flow rate 600 -_Gl'0 -i Replacement Public or commercial - Describe.na Parent material S1 sediment and underlyringreddish sand loam till Flood plain elevation, a applicable Ge,r,afai comments Mound design, system elevation 101.01R based on contour line elevation 99.608. Minimum of 17 inches and recornrnendatwne. of ASTM C33 mound sand. Boring a Boring 100.25_ - ;�. Pt Ground surface earn. fl Depth to limging factor _ 19In. Soil Application Rare Noraon j Depth Dominant Color Redcx Description ' Texture t Structure 'Comiate Boundaryl Roole -GPDIM _ — -'E1fe2 in. Munsell Oa Sz. Cont Color I Gr. St. Sh I 'Ene1 1_0yr3/1 I none sil 2msbk mfr l CS Svf_ .6 _1 _0-9 ..l _.8_ 2 i 9.19 10yn4/4 l none Sid 2msbk mfr na 1 .6 --T---,. 1..- ._--�.---. _-_f-. _.. L_._----__.4 -_,i__6_.{.--4-. - L..-- 3 19-26 10yr4/4 1 f2d 7.5yr5/6 ' Sid 2msbk na 9w na 1 .4 1 .6 _ 4 26-55 I 5yr4/4 c2d 7.5yr5/6 l sysci Ont na 1 na na I .0 .0 -f--'-'-- ---------- --- -L'--- --" -'t---- - ----'-L-----`-----�---'- --T-- 1 r--------T---'----r-------T ---'---- -----�- --t-...-t--'-- 1 l 1 . 1 I Boring a _ Boring __ ., pry Ground surface elev. 100.25 R. Depth to limrOng factor 55 In. ppacation Rater Soil g Monzon Depth Dominant Color Redox Description Texture I $lnuluro _ Cons'istenoe Boundary Roots __ GPD_1fl' in. Murseu Ou. Sz. Cont. Color Gr Sz.sh 'EOat l 'Fan i _0-9 i 10yr3/1 none sir I 2msbk mfr if �_-6 .8 - ` - _ -- - _---cs -_ -- 2 9.24 I 1Dyrr4/4 none Sits 2msbk mfr if .4 6 gw ' i - .. _ ... �. �. I 3 24-37 ' 7.5yr5/8 none edxd '- �._ 2msbk mfr i -� if - .4 i .6 9W _ -_ 4 37-55 l 7.Syr4/4 none gist j 2msbk I mfr 9w rta .6 i 1.0 4--.._ .r.. _ 5 15-70 ' 10yr6/6 c2d 7.5yr5/6 - Wql orn na na na I .0 .2 I I I , ' Effluent •1 = BCD? 30 < 220 mg/L and TSS >30 < 150 mg1L, ' Effluent a2 = BOOS < 30 mg1L and TSS ! 30 mgrL CST Name (Please Pont) Signature _ CST Number David J. Steel _ �1 248956 Addrps Steers Sot Service - - - Date Evatuaton Conducted Telephone Number 9% 200dh St. Beldwin, W 54002 6/12/2006 715-760-0347 suoa)le(aoraer Propady Owner Rolk�c'r Hills Of Hammond-Li-C. _ parcel ID s PendLn9—_ page 2 of _3 a Boring0 : Boring Pa Ground surface elev _ MA - It, Depth to limiting factor 30 _ in. ISpil Applxaten Rate Horizon Dept Dominant Color Redox Description Texture Structure Comustence� Boundary Roots GPDM in Munsell Du. Sz Coot Color i Gr Sz Sh `EtMEfAY2 - 1 0-10 IO0/1 none I 2msbk- mfr I cs Ivf .6 .8 , 2 10-30 10yr4/4 none sl i 2msbk mfr gw na .4 .6 3 3042 IOyr5/8 rid 7.5yr5J6 t ! sd om na - �gw -- -- na .0 .--.0 ------1-- -- •- --- -----------=---- -- 4 �i, 42-75 10yr6/6 f2d 7.5yr5/6 I5 osg mvfr na na .7 1.6 I i II i 1 Boring 0 --- Bonag - pa Ground surface elev _ - If Depth to limiting factor _ _ in Sod Application Rate Horizon Depth Donanant Color Redox Description Texture SVuclure Consistence Boundary Roots ._ GPDAN m ! Mansell Ou. Sz Cont. Color Gr Sz Sh. _ EIMI T1182 I I ❑ Boring 0-'Bong pit Ground surface elev. — - ItDepth to lundmg tailor in Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPDIR' m Muns ll Qu Sz Cont. Color Gr. Sz Sh f-"'Eep •Etfa2 EffluentOt = BODS> 30 < 220 mg/L and TSS >3C < t 50 mg/L ' Effluent 02 = BODS < 30 rig/L and TSS < 30 mg& The Department of Commerce is an egtud oppoRunit) service proNider and employer If you need assistance to Guess services or need material in an altcntate fnnoat, please contact the department at 608-266-3151 or ITY 608-264-8777 sn1 sew Ia n7r , Sbw, Saw Sec,¢ STEEL'S SOIL SERVICE David J. Steel Rolling Hills Of Hammond LLC 994 200' St. CST-POWTSM NEl/4,SW1/4,S29.T28N,R17W Baldwin, W154002 Lic. #248956 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 N 1" = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 9995 ft Top of 3/4" pvc pipe J0 = Borings Boring Elevations f B1 = 100.25 ft j B2 - 10025 ft B3 = 98.40 ft B4 = 0.00 ft i I i go, 9' 87' ' I � Y c� � 33 b ' a £l_., 1 �� 14.6a 10_1,4� 3of3 .7A:(or��. toy- (01 Wisconsin Department of Safely and Professional Services DNrslmOfmaustyServices SOIL EVALUATION REPORT in accordance with SPS WS, Wis. Adm. Code Page _1 of i Keith Stoner CST Attach complete site plan on paper not less than x inches m Plan must County St. Croix refs include, but not limited to: vertical and horizontal reference poim (BM), n M), direction and ---_ ._ - _ percent slope, scale or dimensions, north anow, and location and distance to nearest road. Parcel I.D. 018-2019-79-000 fofaeaeprint 811Infomfatfon. — - ---- — ---- --- Reviewed By Date Personal informal" You provide MY be used kx ser»ntlary Pui"P s (Privacy Law. s 15.04 (1) (m)) Property Owner Property Location R.H.F. Residential Property Owners Ass. Govt. Lot NE1/4, SW 1/4, S29, T29N, R17W - Property Owners Mailing Address — - _ _ _ Lot # ', Block # Subd. Name or CSM# 3435 Labore Rd, Ste 150 Rolling Hills Farm Outlet 2 _ City State Zip Code Phone Number ❑ City ❑ village ® Town Nearest Road Vadnais Heights MN 55110 Hammond I 75Th Ave Ej New Construction Use: ® Residential I Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public -- - -- - -- -- - or commercial - Describe- Parent material Flood plain elevation, it applicable (t. General comments Verification borings for soil test competed for Lot 61 _- _ that fell within Septic Easement #10. and recommendations: Bering if ❑ Boring I ® N Ground surface eiev. - 1069.0r. ft Depth to limiting factor >42 in. Son Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in Munsell Ou. Sz. Cont. Color Gr. Sz Sh. I •Ea#1 •E##2 1 0-12 10YR2/2 - sit 2msbk mvfr a 'i 3f-m 0.6 0.8 --- 2 12-25 10YR4/3 t - sid — 2msbk mfr gs --'� 2f-m I- 0.4 y 0.6 3 25-34 10YR4/4 sl 2f-msbk mvfr gs if ! 0.6 1.0 4 34-42 10YR4/4 _ is i - Osg mt - - 0.7 1.6--- 1 � i Boring # ❑ Bourg Pit Ground surface elev. _ 1068.91- h- Depth to limiting factor 26 in. Soil Application Rate Horizon Depth li Dominant Color Redox Descnpbon Texture Structure Consistenc9 Boundary Roots '__ GPD_Mr in. Munsell Ou Sz. Cont. Color Gr Sz. Sh. •ER#t •Ee#2 -1- _ 0--9 -- 10YR2/2 ! - sit 2msbk ! mvfr rs 3f-m 0.6 0.8 2 9-16 10YR4/3 - sld 2msbk mfr gs 211 0.4 0.6 3 16-26 --- - 10YR4/4 - sl - ---c2d5YR6/2 2msbk mvfr j s g 1f 0.6 1.0 q 1 26-36 10YR4/4 si - if-msbk mvfr - - 0-4 0.7-- ,•�e„, .., = ow s> ,w < ccu mgiu aria 1 �.> >30 < 150 mglL ' �frluent #2 = BODs < 30 mgrL and TSS -30 rtxyl CST Name (Please Print) Signature: - CST Number Keith _Stoner _ -- .- --- _ -- _ / y _ 224059 Address Kerth Stoner CST 5 Die Evaluation Conducted Telephone Number 23220 Wood Greek Rd Siren, WI54872 5'27/2021 715-566-0900 SRO 33V Ix CrI131 AF,ROBICTREATMENT UNIT (ATI') SERVICING AGREEMENT IhII w1Tcc!11cnl l+made pursuant to S ItS i% 1_1I12 it a I S I N I, \din lace Agreenuom Date Parcel Number I i-iopcm U"nen,I 1 curl Io,p, oftion a Pmp,am ~ L\Iia%h eopt of J. cd II ncce++an I I I't) % I S Pquipmart Description — \Ltrrafa%« ncr .mJ M1L,drl j Sanitary %NasteNater Aerobic Hunt Systems LLC Treatment Unit 1 Huot 11-600 A iIZC,JRIInf \M1d L _ Raemt In St ( rot Count% Communit, Ikvelupmrnt Ihpt \, ,ut Inducement to the (bung of St. Croix to „tic d sanl!an pemtu for it Pr/A I S equmpcd t%ith :m aerohlc treatment unit on the aho%c dc,a shed pmpern. oc aurec it) do the Iill to, tile hhe o%tner agrn•, to conform to all apph%ahle regturemcnto of Ch. tp].3 83, \\ k Will. Code relating to aerobic treatment and the m:nntenance requirements tiff the propo,cd PO 1 S 1 Prit alc I )mite A n,te\\atcr I rcann<nt S.\,tcm I lechnolog% I he ooner agree, to matntam it contruct %t uh it lircn,ed PON1, TS \luutainer for the file of the ,tstem, the 110PlI S Maintainer "ill perturin periodic tmpectionn and nountemnicc a, required b\ the mmud:xturerund ;he dc•parlmcnt. including, but not limited to: the bloocr. electrical control,. treatment unit operahor, and sluice depth. I here nt,pcctions are to he scheduled c%ert h months for the first too %cars of operation and %carp therealtcr. I he otrncr aerec, to contact the PO\\ IS Plninlamcr Immediwelt upon am no llimcunn of the treatment unit and to maintain the unit so to, It, create a human health h,vard aS deSuribed in s. 254 59. Situ, a 1 ha o"ncr recognves that the .Duna department or PO%N f1 \lamldmer ma\ make periodic Inspeuions of the components t0 complete perlormanec monitoring of the unit. 1 he o%\net or the miner , agent agree, It, report to the dcpartrnent ar de,ienatcd agent ,n the eomnic«on of each tn,pection. n1.111,lenall or ,er\ rcmg et ant In it mantic Specified b\ the deparltnam or destenmted agent wthtn 30 c,dendar da,, from the date of in,pection. muintcnance or per, :cine, I, I Ili, apreenxnl "ill rrnant in effect onh until the cou l\ ill lice responsihfe fur the tcgulattnn I,f pmate onstc %%tole" Ater treatment S\,tent, certifie, that the pnopcn% i, no longer ,er%ed h, the aerobic treatment unit In addition. On, agreement rna% he cancelled M_ c\c\utime and recording „nd certltication "nh reference it, thn agreement in st.,h manner "Oren "ill pernnt the e%ictence of the ccrtllialLon In he ddcrrmined h\ retcren,c to ILc propern v 1 fill agreement +hall he hmdnlg upon the ooner. the hcu, of the m%n.!. and a"Ignec, of the Lionel I'he o"ner ahall submit Thu agreenrcnt to the Register of Deed,. and the agreenlcnt ShaII be recorded h\ the Register of I )acd, n,; a manner. tthlch tt III permit the ev,tencc of the agreement to he detemuncd h.\ rcterrm.c to the propertt. %%here the acrohlc treatment unit I, installed _Lt se RIACKInk On15) _ (hvmrl,l \mncsl sl l l'rnU \•ouvved U% uen,l ;iunawrel s) - - —Fsuht c' bed and s"nm In betixe me ort this dale ' - - _ \oral% I'uhl" (Print[ \loran It,, hhc IS:_nalurel \h commu>,tou e\pme, l trolrrd lit /Crnh 1. Srnudr 2}'_10 11 ,trill ('rc<A Hd Sven If / j!•\": DIVISION OF INDUSTRY SERVICES Plumbing Product Review P.O. Box 7302 Madison, Wisconsin 53701-265e TTY: Contact Through Relay Governor Scott Walker Laura Gutierrez, Secretary 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-500-A (MAX. DWF 600 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 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 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 withstand 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 Now, 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 BOD5 of less than or equal to 30 mg/L. TSS of less than or equal to 30 mg/L TSS and F O.G. of less than 30 mg/L and fecal conform 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. Hoot Systems LLC May 10, 2018 Page 2 of 2 Product File No.: 20180134 Table 1 Maintenance- Insnection- Pumoino Recuirements PRODUCT! Models H-500 600gal/day) Initial/Startup Inspection/ Maintenance 2-yr. service agreement w/manufacturer Ongoing Pumping Cycle And/Or Requirements 2-yr pumping (trash tank only), unless more raslrk&ve try local or state regulation, for aeration chamber, see inspection results Back -Wash Cycle NIA Effluent Performance Levels NSF-40 Class I BOD5 Credit For Downsizing Distribution Area YES Fecal Credit For 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 _< 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, > , glen W. Schlueter ' Plumbing Product Reviewer Department of Safety and Professional Services Division of Industry Services Bureau of Technical Services (608) 267-1401 Phone (608)267-9723 Fax glen.schlueter@wi.gov E-mail LOT I LOT I LOT 56 57 58 / / 1 �40 / b "J -' STORMWATER MANAGEMENT AREA H.W.L. 1055.2 \ ,7 / 01 P / / li � S74y,47,f L At,�\Veb t�- / 1 1 1 I / I I / 1 / I , 1 , 1 / I , 1 1 l ay54 CN90 y M LOT • 4.J21.787! LOT 60 7e1 so. FT,LOTLO 21,78368O. FT. 62T r575°12I'd f �Se! n 71.24' I �I W I� Z3 F wl � \ N80°12'13'ly 1 NO2°5400'E � 65.8T i LOT 361 21,782 SO. FT. I LOT 37 21,781 SO. Fr. _ \ _L.B.0.-1057 � Nry�rOiby.. � / 21,783 SO. , �E9n_ Sn_ I /SO.FM/ OT 34 781 SO. FT. /1 ' DEDICATED TO LOT 38 THE PUBLIC I , 1,761 SO. FT. —� 1.0=1057.60 LOT 33 21,781 SO,, FT. 9q HA•411 eit LOT 32 3\�y �ypp3EgM h (LN80°4026'% 74.18' .y.J J82.917 � S82" 91y11 7 �g/v, 1092.130 \ J?7 �1 F. I p ' " LOT � LOT 63 $ 54 ' / 21,782 SO. FT{ 21,781 I z SO. Ff. z Q e/ ' Aff // / I� ^I SB3.19'11'E� �. \ `6626' 0s i v J�aO� '°eG,\'. 21,781 SO. FT. 9' 113.2 w30°E 188.4J%� 5S OUTLOT 2 4271 ACRES 1,860,359 SO. FT. ' / Q�/ v / �1 I, tiy�:' I W � I •1 401 I O 50, / 11 1 C �\ IIII g'F 1 1� 1 2 1` 2 1 CA \ �,p �IrC4 N88°OT00'E b6 , \ ( *AoR {N �*Ts 33411110.45 ) 5re OTC COUNTY NO. 633892 STATE SANITARY PERMIT z PLUMBERfj TOWN OF SEC- 29 J. AND/OR 04 IRW F*04 RRti ties #%tab ct40n6N N, R LIC.# by$�g3 BLOCK W1 Nti SUBDIVISION NO. (2) W WIX)NSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit (b) I he approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and maybe renewed for a specified period. (d) Changed regulatiinns 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. (0 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. OR[ D ISSUING OFFICER - DATE�`�r S PERMI7EXPMRE UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)