HomeMy WebLinkAbout018-2019-80-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) 642279
State Plan ID No.
Personal information you provide may be used for secondary purposes [Privacy Law. s 15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Lots 67, 68 and outlot 3 TOWN OF HAMMOND 018-2019-80-000
CST BM Elev. Insp. BM Elev: SM Description- SectionlTown/Range/Map No
29.29.17.1280
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
AN
Dosing
O
Aeration
Holding
TANK SETBACK INFORMATION I tit, a c
TANK TO
P/L
WELL
BLDG.
\/Ent to Air Into e
ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION r.n..,%I- / . i
Manufacturer
S
Dem d
GPM
Model Number
TDH
Lift
'
Friction Loss
ystem Head
TD Ft
Forcemain Lengtho Dii4
It,
Dist to We, 0k
avlL Hesavi•cr I IUIN srZ5I tM
ELEVATION DATA ') '1'2 II'11 2z
Sl Outlet
•
W-
•
l
MW7�.�0
BEDlTRENCH
DIMENSIONS
Width
Length t
O
No. C c es
I 1
6-4 S
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
JBLDG
IWELL
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer:
Type Qf System:
1
�1 I_
75 Ot
f�/��
Model Number:
I•tn7�C�1=1YLV1Cl�7[.7�a191
Header/Manifold Ni.Distribution
Length Dia
Pil ` t
Length I V Dia
x Hole i e t
�(J
x Hole a ing
Vent to Air Intake
Spacing_
JVIL V V Y Gf\ Y Proe¢ure SvNem¢ rinh• ....A•.. �..d n. A♦ r]....r.. 6.........- n-...
Depth Over/
Bed/Treyefi Center
Depth Over
xx Depth of
xx Seeded/Sodded
xx Mulched
1
Bed/Trench Edges
Topsoil
El Yes 7] No
i
COMMENTS: (Include code discrepencies. persons present, etc.) Inspection #11 Inspection #2:
Location: No Address Availa/ble�/ ' �I yrj I r f��1T f �t'e < t(�;y� ;ny ji l k_
1.) Alt BM Description =V f OWI1/ !will ll�ia/1 �-�IYt•'i-'-.Pi �1 -�(�( ✓S �i /.r'OI�T 5 i�L /��r
2.) Bldg sewer length = �{ �1' `jW,rv' V rr VJ
- amount of cover = Y
Plan revision Required? Yes No
Use other side for additional information /
Date h epctor's Signature Cen. No.
GAT�I,a�l — 03l
Industry Services Division
County
-
4822 Madison Yards Way
St. Croix
qq
Madison, Wl 53705
Sanitary Permit Number(to be filled in by Co.)
_ FEg 2 L
`
P.O. Box 7162
WI 53707 62
2
�V��
- ou
Madison,
V
1p
ermit Applica
State Transaction Number
022200130-C
In accordance 3.21(2), W is. Adm. Code, submission of this form to a approp emmental unit
is required prior to obtaining a sanitary permit Note: Application forms for state-o S are submitted to
Project Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you pro may be used foy
Mound 21
purposes in accordance with the Privacy Law, s. 15.04(lxm), Slats.
1. Application Information - Please Print All Information
Property Owner's Name
Parcel #
Rolling Hills Farm Property Owners Association LLC
018-2019-80-000
Property Owner's Mailing Address
Property Location
3435 Labore Rd. Ste 150
Govt. Lot
'' S"` ''° Section 29
City, State
Zip Code Phone
Number
Vadnais Heights Mn.
55110
T 29 N R 1 7 E or W
H. Type of Building (check all that apply) /
Lot #
V1or2Family Dwelling -N her of Bedrooms ✓
(01- 7L
Subdivision Name
Rolling Hills Farm
4 44rVV „s Fa"-
Block
ablic/Commercial-Desc Use _
�-
E]City of
Elstate Owned - Describe Use
illage of
CSM Number
s
to/ of Hammond
III. Type of POWTS Permit: (Check either "New" or `Replacement" and other applicable on line A. Check one boa on line B. Complete fine C i
applicable.)
A.
,� ew System
I pceplacement System
L
Other Modification to Existing System (explain)
Additional Pretreatment Unit (explain)
B'
1[:]HoidingTank
❑JIn-Ground
at -Grade
✓Mound
tdividual Site Design
Other Type (explain)
(conventional)
C. Renewal Before ❑Revision hange of Plumber �ransfer to New Owner List Previous Permit Number and Date Issued
Expiration f 11
IV. DispersaVYreatment Area and Tank Informatio 4ia PAAA D f = /�jP
Design Flow (gpd) Design Soil Application Rate(gpd/st) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System ElevaC
2400 1.5 1600/4110 1600/4110 1116.0
Tank Information
Capacity in
Gallons
Total
Gallons
# of
Units
1 Manufacturer
Gr / S'k �YZCC" 1 a
w o
v
�'
(
F� 4t�,-�
o
a �
:: 2
w �
New Tanks
Existing Tanks
Septic or Holding Tank
ILI
Dosing Chamber
1250
1250
1
Wieser
F ✓
V. Responsibility Statement- 1, the uadersigned, assume responsibility f 'astallafion of the POWTS shown on the attached plans.
Plumber's Name (Print) Plu be s Signal MP/MPRS Numher Business Phone Number
Keith Knudtson 648443 651-470-1737
Plumber's Address (Street, City, State, Zip Code)
927 150th St. Roberts Wi. 54023
VI. County/Department Use Only
Approved
❑ Di
Permit Fee
Date Iss
Is uin Agent Signature
❑ Owner Given Re or Denial
,1
Conditions o rov e.�.... F.�+ � ' 3) Aft `Ms
S STEM OW
1 Septic tank, effluent filter and Wt -f,�S pa m1+, t
dispersal cell must be serviced / maintained f t
as per management plan provided by plumber. QJ tovrt�
2 All setback requirements must be maintained
as per applicable code/ordinances.
u
Attach to complete plants we me system Ana 9Yomn co me x.onuar om. Y+I w1�� �� -�T�
t-\�-
SBD-6398 (R. 03/21) .
P/L
I111.00' I HAW Ew wm Page 2of9
Septic Easement 021 1116.W ❑ Bft LA9
/�j� / p� OUTLOT 3
V lLEB
18.19 ACRES
� �
'\- Opeu FaOmv Field Sih w�a 705,709 SO. FT.
1. 148.11' 0 so ❑
i
Orb acd. (R.1)
63 Inch d, — a[I R
� Ba3L ❑ ❑
T 68 n Pmpose a 8' z 200' Mound Dispersal Cell Bit L�
w/ the Upslope Cell located along the 1115.W Proposed Duplex 3'
81 SQ. FT commur w/s S.E. of l l 16.W_ Cell will be aoter Rd with Scb. 40 PVC F ws
two fineemains w/ each halfofthe cell with its own manifold.
Ta A B11t =Top of Nail in Wooded Hob CI'P8 5801 � L
Co -Sa.te
AI1fHIV 0, � (too " �f
SSU6D ELEV.= I118A1' SCP4� 1
Walking/Baysie Tra 38.88'
1 .8O
`p Typicd 4' Wr
Maintain well and waterline t OT 69 °� CteertOut Optional as
setbacks per SPS W&43{8)n ?` 21)mSU cr. this is a conveyer ce fire
9 Proposed C Astm-D 3034 rh not a prNate sever main.
PVC Conveyance Pipe Typical AN pIpN shell cxadam M
11 SPS Table 384.303
DWF 600GP yj BPS Table 364.30-5
FN! 75, • WELL �vt P
it
LOT 70 0
C2 Typical 4'saB40 $ m m
Bldg. sews Pipe o N
• //� O W
Cn
OWF f100 ! n ¢ W
P < 6 O
LU
Ddvewa Op n8 00µE'� m a I cc
W
Qe d LOT 71 "B
Tank o
,to SQ Fr d
ELL _ 1 < O
DPW
DWF Proposed Wieser Concrte WLPI2504M Dose Tank D
•Y ,. �G - w/ Duplex Pumps and S 0
.y `\�1Z8 STF-100 F0xn 9
FNt 74 ZaW
M � 01091.0U is
LOT 72 4! 0
DWF two 21.761 SO. Ff. 1090.6V r� o
p L.B.O=1090.00 a m
m
�M745 � 4T4�'L14�
9g • N�
N
U Typical for lots 69-72 will be Four MOM �
m W w°i Hontes w/4" Sch. 40 PVC Bldg. Sews Pipe. 1
py1 ] W �� A Hoot Hfi00A Bin/Septic Tack y
a- O m connected to the dose tank by 4' Sch. 40 ro Y
�* T PVCor 4" Astm D-3034 PVC Caveyance 25, m �;11
0 d pipe. Clea"uts would be optioad. o
O
O dl p ti4'
W LLI
W . �/- sl Fw- Z
Sanitary Site Plan z
i4 "a5 ir o o �'" For: Rolling Hills Farm W
03 0
'M 0 7T Residential Property Owners Ass. Inc.
Rolling Hills Farm Outlot 3
N 22 Sec. 29 T29N-R17W
�� g1 Town of Hammond -St. Croix CountyCounty
mod' 0,� rn:rue_._. ..--... c . WELL `
LOT 76
21.781 SO. Ff. 15 25'
�j L.B.0=1o90.062e��,L�OT 77
l l _ - s d2"' . w@ULB.o.-1oe0.o
February 3, 2022
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2024-02-03
Plan Review: PWTS-022200130-C
KEITH E STONER
23220 Woodcreek Rd
Siren WI 54872
SITE:
Rolling Hills Farm - Lots 69-72
745 165th Street
Town of Hammond
St. Croix County
P.O. SW, S29, T29N, R17W
Total Amount: $400.00
DIVISION OF INDUSTRY SERVICES
2850 MIDWEST DR STE 104
ONALASKA WI 54650
Contact Through Relay
http:/Idsps.wi.gov/programs/Default aspx
www.wisGonsin.gov
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
Tony Evers - Governor
Dawn Crim - Secretary
FOR:
Description: Commercial -Common Mound System #21 \ Sloping site \ Pretreatment
Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12), 2400 GPD, 24" depth to
limiting factor, Maintenance required, (4) HOOT, Model H-500-A Pretreatment Systems, Effluent
filter, New construction
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
This system is to be constructed and located in accordance with the enclosed approved plans and with
any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin
Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department
per s.145.06, stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with
the requirements of Sec. 145.135 and 145.19, Wis. Stats.
• The application for a sanitary permit shall be accompanied with documentation that indicates the
installer of HOOT systems has completed approved training or that approved training will be provided
by a manufacturers' representative during the installation of the POWTS, (per SPS 383.21(2)(c)4,
Wis. Adm. Code).
The application for sanitary permit shall be accompanied with legal documentation that shows that all
of the components requiring servicing at an interval of 12 months or less have been recorded on the
deed for the property. (Per SPS 383.21(2)(c)5, Wis. Adm. Code).
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8
inches. 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.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be
made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis.
Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the
tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must
be provided per SPS 384 product approval conditions.
• 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.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including
instructions relating to proper use and maintenance of the system. Owners shall receive a copy of
the appropriate operation and maintenance manual and/or owner's manual for the POWTS described
in this approval.
• The owner of the POWTS shall be responsible for ensuring that the operation and maintenance
occurs in accordance with this chapter and the approved management plan under SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a
health hazard, the property owner must follow the contingency plan as described in the approved
plans.
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,
Gerard M Swim
POWTS Plan Reviewer, Division of Industry Services
(608)789-7892 — voice 1(608)785-9330 — fax
erry.swim(a)wi.gov
Index and Title Sheet
Project Name: Rolling Hills Farm Shared Sanitary System for Mound 21 Lots 69-72
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 SW '/4
Section 29T29N-RI 7W
Township: Hammond County: St. Croix
Subdivision Name: Rolling Hills Farm Outlot 3
Comp. #/Parcel ID: 018-2019-80-000
CONTENTS
Page: l Plan Narrative
Page: 2 Plot Plan
Page: 3 Mound Plan View and Cross Section
Page: 4 Lateral Layout (Typical)
Page: 5 Dose Chamber Cross -Section
Page: 6 Pump Curve
Page: 7 A+B Duplex Pump Panel Specifications
Lots: Sanitary System Serving Lots 69-72
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
�
4tsl__Z_,
SEE CORRESPONDENCE
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 and Soil Verification Boring
Sample ATU Servicing Agreement and Hoot Systems LLC Product Approval with maintenance
requirements.
Mound Component Manual Used = Version 2.0 SBD-10691-P (N.01/01R. 10/12)
Pressure Distribution Component Manual Version 2.0 SBD-10706-P (N 01/01R. 10/12)
Designer: Keith E. Stoner.., License #Designer 157-007
Signature: r 'Y`, Bate: 12-27-2021 Phone # (715) 653-2324
IV
Po1
Il l I 110• ' ss"�111 .ar Ewa s=�. Page 2 oj9
Septic Easement #21 11 low D But L-e
/ OUTLOT 3
!!AL68
Open Follow Fidd Site 16.19 ACRES
O1p. 705,109 SC. FT.
148.11' � �
i
Cvsp+e (Ertl
1.7 1 M- a, Ile A
I3r3 L O O
IT 68 h Propose a Wx 200• Mound Mspe sal Cell BY2 LEfi
.�- W/ the Upslope Cell Located along the 1115.W Duplex 3'
r contour w/a S.E. of 1116.00' Cell will be c<eter fed wiM Scb 40 d
81 $Q. FT. Sch. 10 PVC F.M.'s
n two foreenmirts wr each halfof the cell with ib own mmifold.
to #1 • /1 "
ct ABM=T'op of NaB ie Wooded Heb (TPN 30B1 Si
t.
... ca A RP -Same l S - 60 "
ssunEoe4.ev.- tlla.ar sr�r� B/ f
Wdkirg/Bcyclu Traa 38.8&
k• Typical4'
Maintain well am wmedkw 3t' OT 69 Clean-W Optional as
setbacks per SPS 38343t81n 21,780 so. vr. �y this is a conveyance I ne
Pmpwed 4• Astm-D 3034 m� not a piNab sewer main.
PVC Con yarn Pipa Typical'" All pVrg shall cordorm to
1i96� I t SPS Table 364.3D3
DWF 000 Q SPS Table 384.30-5
FNe 751 • WELL d,4 P
IL
LOT 70 0
C2 Typical 4.
4. 8C,. p $
C Bldg. S—Pipe _8
. V L 't lU
I1WF 800 Is ¢ O LL
QP Q
W W
.� Driveway ► 748 p.'.!'3 W :3
012 cc
Z W
cr
QQQ°� A`,E^k �r5r • 2IB, so ,y—P� �1O°LOT 71 Tank5 g
ELL <
p
DWF I -
Proposed Wieser C'oncrte
N'LP1250-MR Dow TanL
rya• .� w/ Duplex Pumps and S ech Q
2� of FNM 7 N.�a.0 21r'� STF-100 Fitters Vr
01091.W F_
LOT 72 41' CC
�z
l7YVF fioo 21F7. 109007 *� o
b L.B.O.7e1 so. .=1090.00
N�•ata(E
a9
Typwd for Ids 69-72 will be Four Bedmom
m W ty ? Homes w/4' Sch. 40 PVC Bldg- Sewer Pipe.
Z) fn W A Hoot F14MA Bio/S Vw Taro ,x
0- O m co aed In roe dose took b3. 4- Sch. 40 h y
d1.h w 0. FNt7 PVCor 4- Asam D,3034 PVC cuaveyaace 25,
pipe. CleanKmCs would be optional, a g
7 0
O ♦- 64'
w 0�/ 1 wa U
< W Sanitary Site Plan z g
¢ F"" For: Rollin Hills Farm W W
2 W° g o3 0�
N
D 77 Residential Property Owners Ass. Inc. i
Rolling Hills Farm Outlot 3
Sec. 29 T29N-R17W
Town of Hammond - St. Croix CountyCounty
<Q �i'� rns ,+e-.- --.. •YELL
It
LOT 76,
21,781 SO. FTT ,xaj
.� L.B.o.=IM.D9 ,2e��' �LjOT 77
A 'sue s£ �\ 87.79 dL vLLL.e.o=locoo
Page 1 of 9
Plan Narrative
The following shared sanitary system design discussion focuses on the proposed 16 Bedroom/
2400 gallon per day sanitary system to serve Lots 69 thru 72 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 21 and the tested areas for lots 67 and 68 within the common area known as Out
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 a built in trash capacity that will be connected to a 4" conveyance pipe that will gravity flow
to a common duplex dose tank located at the midway point of Lot 72's east lot line, that will
alternately distribute the highly treated effluent to a common mound dispersal system consisting
of a 8.0 ft. x 200 ft. mound dispersal cell.
The soil tests completed by David Steel are provided. T e BM the soil test for Lot 67 equals
100.00' or —1 1 l8' and the BM for Lot 68 equals 100.00' or approximately 1118.85' 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.
el We used the top of a nail set in a wooden hub at Control PT.#5001 with an elevation of 1118.81
ft. as our benchmark for the sanitary systems construction. The perimeter of the easement was
staked with shots taken on the existing lot irons as documented. A soil verification pit labeled
KS#1 was dug to verify the soil conditions and tied into the benchmark along with contours
within the system area.
Page 3 of 9
Mound Plan View
L
Mound component Dimensions
Ag6o-.
B 0'
D
E 20.64"
F
G 6"
H
I
3
12"
5'
5.5 3'
'
Kg101
L 6'
w8'
1600
(ft. sq ) Dispersal Cell Area
4110.0
(ft °) Basal Area Available
12.00
(gpd/f) Linear Loading Rate
20
(to I/to B Obs. Pipe Placement
Finished Grade 1 1 17.R4'
1116.0 (ft) I F
Dispersal J
Cell
I Elevation
Shading Key
® Topsoil Cap
rINNIM Subsoil Cap
ASTM C33 Sand
Tilled Laver
Aggregate
Mound Cross Section View
Aggregate Dispersal Area
.I.
-\1 1 15.001(ft) Contour Elevation
9 % Site Slope
Observation Pipe to be constructed of 4" diam.
pipe w/ water tight cap, a minimum 6" slot
anchored with 3/8" rebar or a water closet collar.
-xtile Fabric
Cover
Duplex Forcemains to the Center of the
Dispersal Area w/ End Manifolds
Lateral Layout Diagram
4.331
P
Note: F.M. attached to
center of the manifold. S
_ _->
Turn -up w/ball valve or clean
out plug
Number of Laterals
Lateral Diameter
Lateral Length (P)
Lateral Spacing (S)
Lateral Flow Rate
1/2 Cell Flow Rate
System Flow Rate
Total Dynamic Head
X
Duplex Force Main
2 per F.M.
2
98.75
4.00
21.60
43.20
86.40
40.40
Lateral Turn -up Detail
Finished Grade
6" to 8" diameter Lawn Sprinkler Box
.25 ft.
in.
ft.
ft.
;pm
rpm
rpm
R.
P
Laterals and Force Main of PVC Sch. 40
per SPS Table 384.30-5
r
Page 4 of 9
5%
X Holes equally spaced on
bottom of lateral
Note: Forcemains coming into the center of the
dispersal area, 1 st hole approx. 1.25' from the
manifolds with the hole spacing between the
manifolds of-- 2.83ft. North manifold + East F.M.
feeds the north 1/2 of cell and the South manifold +
West F.M. feeds the south 1/2 of cell.
Orfice Diameter
Orifice Spacing (X)
Orifices per Lateral
Orifice Density
Manifold Length
Manifold Diameter
Forcemain Diameter
and Length
5/32 or 0.156
2.50
40
10.00
4.00
2.00
3"/ 536' per F.M.
Threaded Cleanout Plug or Ball
Valve _
in.
ft.
}_/
xifice
0
n.
3.
Note: Lateral ends at last orifice where variable
length to ceanout begins.
Long Sweep 90 or Two 45' Bends Same
Diameter as Lateral
Distribution Lateral
Page 5 of 9
Duplex Pump DoseTank Component Cross Section
Approved Manhole Covers With Warning Labels
and Locking Device / 4" Min. Above Final Grade
\ Weather Proof Junction Box
Electric per NEC 300 &SPS
4" Sch. 40 Vent 316.012 WAC
> or = to 12"
Above Final Grade n
Disco ect
Note: SJE Rhombus Type 122 Duplex Alternate Outlet Location
(Demand Dose) W/Approved 4" Sleeve
Top of inlet = Approx.l 1087.00' 1111 1 1 1 Force Main Diam. = 3" "
Weep Hole or Anti Siphon Device
Note: Pump switch and alarm to be A Duplex Force Mains
wired to separate circuits. 1084.1 T
B Pump Off Elev.
W LP 1250-MR C Duplex Pumps
Tank Mfr. Wiesert Concrete D
Dose Tank Elev. 1083.50'
Vertical Difference Between Pump Off and Distribution Pipe = 32.33' Per .1/2
Minimum Required Supply Pressure ...................................... = 4.55 of cell
53V FT. of Force Main x .57 Friction Factor/IOOFT.... = 3.02' per dose
Note: Maximum dose per Pressure Loss Through Filter .................... _50' F.M. assumed to be
F.M. or 1/2 cell equals 240 gals. Total Dynamic Head .................... = 40.40' near equal in length.
Min. dose per cell = 160.96 gals.
3a Number of Doses ..: 6.37 Per Day Gal. Per Day/ #of Doses = 188.40U. (Duplex
(� Volume of Backflow.................................................................... = 194.51 Gal. ilternztm
Total Dose Volume..................................................................... = 382.91 Gal. between;eei1
a vfiTes )
Pump Tank Capacity 1253.16 Gallons Dimensions Inches Gallons
Pump Tank Volune 34.81 Gal,/Inch A 15 522.15
Goulds B 2 69.62
Pump Mfr. C 11 382.91
Pump Model WEIOH D 8 278.48
Minimum Discharge Rate = 43.20 GPM per pump
Alarm Mfr. S.J.E. Rhombus Total= 36 1253.16
Alarm Model Tank Alert 1
Bed Tank per SPS. 383.45(5)
IIS 1.171N Anchor Tank as necessary to negate buoyant forces per SPS 383A3(8xg).
Wastewater
METER!
40
35
30
1° 25
x
V
Q 20
0
F 15
O
FEET
130 i__ ,SERIES: WE
120 SVSOLIDS
RPM: '
3500 &
110' 1750
bj �--: � �" i SGPM 4 -i
100
5 Fr
90 E _ ,
T .� 1
80
70
60VVE-
50-:-
40 •
L. a.
10 30 1,1-0*447��—
t�- I
s 201
70
IMF
O L O
0 10 20 30 40 50 60 70~ 80 90 100 110 120 130 140 150 160 GPM
I I I 1 I 1 I I I I I I I I I
0 5 10 15 20 25 30 35 m3/hr
CAPACITY
In
COMPONENTS
teem No.
Description
1
Impeller
2
Casing
3
Mechanical Seal
4
Motor Shah
5
Motor
6
Ball Bearings
7
Power Cable
8
Casing O-Ring
5
0
1
6
4
3
PAGE
Wastewater
Page 6 of 9
PERFORMANCE RATINGS (gallons per minute)
Order No.
WE-03L
WE-03M WE-05H
WE-07H
WE-10H
WE-15H
WE05HH i
WE15HH
W620H
HP
%i
/.
1!A
A
1%
2
RPM
1750
1750 3500
3500
3500
3500
3500
3500
3500
5
86
- -
-
-
-
-
-
10
70
63
! 78
9d
-
-
58
95
-
15
52
52
70
90
103
128
53
93
138
20
27
35
60
83
98
123
49
90
136
25
5
15
48
76
94
117
45
87
133
y
30
-
35
67
88
110
40
83
130
35
22
57
82
103
35
80
126
q
40
-
-
-
45
74
95
30
77
121
i
45
35
64
86
25
74
116
=
50
-
-
-
25
53
77
-
70
110
I55
-
-
40
67
-
66
103
60
30
56
-
63
96
65
20
45
-
58
89
70
-
35
-
55
81
75
-
-
-
-
-
25
-
51
74
80
-
-
-
-
-
-
-
47
66
90
-
-
-
-
-
-
-
37
49
100
-
-
28
30
DIMENSIONS
(All dimensions are in, inches. Do not use for construction purposes.)
KICK -BACK
PAGE 5
Single phase, duplex alternating pump control with override.
Page 7 a+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 alternating action equalizes pump wear. In addition to the alternating pump control, this system provides override
control should either pump fail. If an alarm condition occurs, an alarm switch activates the audiovisual 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 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. Magnetic 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 altemation-
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 Hom 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/Normat Silence 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. Horn Silence Relay (mounted on circuit board).
NOTE: other options available.
AF 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
AF Standard package includes three 20' SJE SignalMaster® control
switches
AF Complete with step-by-step installation instructions
AF Five-year limited warranty
SEE BACKSIDE FOR COMPLETE LISTING OF AVAILABLE OPTIONS.
SEE PRICE BOOK FOR LIST PRICE.
Model Shown 1221W114X6A
6OUS
LISM
ReAus.
PO Box 1708, Detroit Lakes. MN 56502
1-888-DIAL-SJE •1-218-847-1317
1-218-847-4617 Fax
email: customer. service@sjerhombus.com
www.sjerhombus.com
122 MODEL 122
� =- C
ALARM PACKAGE
0 = select options or no alarm package
1 = alarm package (includes tesUnormal/silence switch, fuse, red light. & hom)
ENCLOSURE RATING '
®I = Indoor, NEMA 1 (metal)
W = Weatherproof, NEMA4X (engineered thermoplastic)
STARTING DEVICE I
1 = magnetic motor contactor 120/208/240V
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
EQH or L = pump down or pump up (select 17 option)
X = no floats
OPTIONS usmd below
t
�. it ii � t l •J
1Z >-
ENCLOSURE UPSIZE - If you selected one or more of the * options. or two ** options,
a one-time enclosure upsize fee would apply.
CODE DESCRt MN
1A Red beacon only / no audio
(must select "O" for alarm package)
0 1C Horn only / no visual
(must select "0" for alarm package)
0 ** 3A Alarm flasher
[� # 38 Manual alarm reset
(� *4A Redundant off
(select Option 4D if floats included)
Q 4B Red redundant off indicator & alarm
(must select Option 4A also)
(� 4D Redundant off float
(must select 4A option) (select 17 opfior )
* 5A Thermal cutout/heat sensor auto reset
(for pumps wlthermal switch leads)
* SE Seal failure circuit & red indicator (2 wire)
6A Auxiliary alarm contact, form C
(included as standard)
# BA Elapsed time meter
* 8C Event (cycle) counter
* 9_A Pump overload
specify amperage after number 9 followed by letter "A
Example: 912A = 12 amp pump.
* Q 0-25 FLA
n
DESCR1PT10N
Anti -condensation heater
NEMA 1 alarm panel
NEMA 4X alarm panel
Main disconnect (rotary style, mounted through door, non -fused)
(must select circuit breaker)
0-20 FLA (total of both pumps)
20-60 FLA (total of both pumps)
10' cord in Neu of 20' (perfloat)
15' cord in lieu of 20' (per float)
30' cord in lieu of 2O' (per float)
40' cord in lieu of 20' (per goat)
SJE SignalMaslere / pipe clamp fa (per float)
SJE SignalMasterOI externally weighted 40 (per float)
Sensor Rose I internally weighted ♦ (per float)
Sensor Floae l externally weighted ♦ (per float)
Sensor Float° Mini 1 pipe clamp ♦ (perffoat)
Sensor Floats Mini / externally weighted ♦ (per float)
Sensor Floats I pipe clamp ♦ (per float)
Lead lag selector switch
Fourth float to separate alarm function from lag
TOA (Test/Off/Automatic) switches and pump run lights
Through door mounted
*[= 25-3D FLA 0 19U HOA (HandlOHIAutomatic) switches and pump run lights
10E Lockable latch - NEMA 4X through door mounted
10E Lockable latch -NEMA 1 '• 9X Door mounted pump run indicator
* 10F Lightning arrestor (select pump circuit breaker) 0 Mechanically -activated ♦ Mercury -activated
UaddW011a/ 1►eaturss'aro squired, caN ffie t` Wy fora quote on an Efgfiteemd Caatom con&6f panel.
^ A ■A111 r
CODE
10k
11 C
11D
Q# 14B
16A
16B
16C
160
17A
17B
17C
17D
17E
17F
17J
198
19F
19T
VA/IJr LL
MODEL 222 T
T
4 H
Alarm Package LW
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 SignalMasterO / Dice clamp
6A SAC 17A
O SJE-Rhombus 09114
Page 8 of 9
a
r
6,All
600 GAD GRAVITY DISCHARGE SYSTEM
I,M A
H-600 A
TANK SPECIFICATIONS
DIMENSIONS: -
CAS WALL: 3'
BOTTOM: 3'
COVER: 4'
MANHOLE: 12" & 24' I.D. PLASTIC RISER
HEIGHT: 70' O.D.
POLYLOK 12" ACCESS LID (TYP) LENGTH 106* O.D.
WIDTH: 74 1/2' O.D.
BELOW INLET: 5Y O.D.
LIQUID LEVEL, 51"
WEIGHT: 11.135 LBS,
INLET AND OUTLET:
4' CAST -A -SEAL (CAS) BOOT OR EQUAL
TOP VIEW COVER: MIX DESIGN /B (NO FIBER)
TANK: MIX DESIGN /8 (SMALL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
EZ SET RISER ITW)
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
W R
H ,*
W
C Lr)
v
00
�sC4
N
LuxO
�Do
1 OF
Page 8 b of 9
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 ................................... L 0 C
Aeration Plumbing ................. G 0 G
Air Filter ................................. G 0 G
Effluent Pump (if applicable)....... 0 0 0
Chlorinator. ............................ 0 G 0
OK System Light .................... 0 0 0
Alarm ..................................... 0 G 0
D-Box .............................. G' 0 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
Required
BOD (Grab)
0
TSS (Grab)
0
Fecal Coliform
0
5.Comments:
Results Test Method
Signature of Inspector: Installer 11 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 Permit Number
Number of Bedrooms
_
16
Design Flow (GPD)
2400
Soil Absorption Component Size (sq. ft.)
1600 (Pretreated Effluent)
Trash Tank Capacity Gal.
400 gal.
Pump Chamber Capacity Gal.
1250 gallons
Type of Wastewater
I Pretreated Domestic
Pre -Treatment Unit installed per structure
1 HOOT SYSTEMS H-600 A
Table 2: Soil Absorption Component — Limits of Reliable Operation
Septic Tank Component
Soil Absorption Component
Design Flow -Peak (GPD)
600 per structure
1800
Max. Influent Particle size
NA
<-1/8 Inch
Maximum BOD 5 (mg/1)
NA
<_ 30 mg/1
Maximum TSS (mg/l)
NA
<_ 30mg/ l
Maximum FOG
NA
NA
Table 3: Maintenance Schedule
Septic Tank4Filter
Inspect and/or service once eve 3 ears
Dose Tank In- Line
Should ins ect once a year and clean every 3 ears
Pum ChamberIn
et once eve 3 ears
Soil Abso tionCoFlush
laterals ev 18 months.
HOOT SYSTEMS
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 A8, Stars. 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 component's 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 ponding, 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
winter 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.
Contingency 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
Plumber/ATU Maintainer
651 470-1737
St. Croix County Zoning
715) 386-4680
Wieser Concrete Products
Maiden Rock WI
(800) 336-3416
Septic Pumper
Powers Sanitation
(715) 249-5738
HOOT SYSTEMS LLC
11-600 A
888 878-4668
Page 9 of 9 a, b + c
?ice
898
is6onsin JLD #13
SOIL EVALUATION REPORT
Department of Commerce in accordance with Comm 05, Wis. Adm. Code Page 1 of 3
Division of Safety and Buildings Steers Soil 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 referen int (BM), direction and -- — -- _
percent slope, scale or dimensions, north arrow, and Lion nd distance to nearest road. Parcel I.D.ry�`�
Please print all in n. Reviewed By k� L Date
� LL /
Personal rnrornation you provide may be . purpgses ( taw. s 15.04 (1) tmp. i f,&� I
Rolling Hills Of Hammond L �� ovt Lot na NE1/4, SW1/4, S29, T29N, R17W
Property Owner's Mailing Address *G Lot # Block # Subd. Name or CSM#
400 2nd st PO�67 na Rolling Hills Farm
City - ------State Coda Number City Village Town - Nearest Road —
Hudson WI 16 715-386-0230 Hammond 160Th St
�? New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
-_: Replacement Public or commercial - Describe: na _
_ ft.
Parent material Si Flood plain elevation, 4 applicable na
sediment and underlying reddish sandy loam GII -
General comments Mound design, system elevation 100.53ft based on contour line elevation 99.70ft. Minimum of 10 inches
and recommendations: of ASTM C33 mound sand.
Boring #-' Boring —
v.. cad Ground surface elev. 99.50 R.
Depth to limiting (odor
28
x1.
Sal Application Rate
Horizon
Depth
in.
Dominant Color Redox Description
Munsell Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence Boundary
Roar
GPD/ft'
'Eff#1
'Eft#2
1
0-11
10yr3/1 none
sii
2msbk
mff
a
lvf
.6
.8
2
11-23
10yr4/4
none'
Sid
2msbk
mfr
gw
na
.4
.6
3
23-28
-
10yr4/4
--- -t
none
sd
- ---
2msbk
mfr
gw
-
na
.4
.6
4
28-50
10yr5/8
I c2d 7.5yr5/6
I sd
om
na
na
1 na
.0
.0-
❑ Boring # Boring
L P4 Ground surface elev. — 99.50 ft.
Depth to limiting factor
_ 26
in.
ISoil Application Rate
Horizon
Depth
in.
Dominant Color Redox Description
Munsell Qu. Sz. Cont. Color
I Texture
Structure
Gr. Sz. Sh.
Consisten
Boundary
Roots
GPD/fF
'EIM 'Eft#2
1
2
3
0-12 10yr3/1 none sil
12-261 10yr4/4 none Sid
26-50 10yr5/8 I c2d 7.5yr5/6 ! sd/sid
� I
i I
2msbk
2msbk
om
mfr
mfr
I n �
CS
i 1vf
.6
.4
.8
; gw
na
.6
na
I
�- na
.0
.0
t
- Eftluem #1 = 50D5> 30 < 220 mg!L and TSS >30 < 150 mg!L
' Effluent #2 = BOD5 <30 mgrL and TSS <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
6/12QO06 715-76"347
SB"330 (11-07/00)
` Property Owner Rollin Hills Of Hammond LLC. parcel ID # Pending
page 2 of 3
Boring S Boring pit Ground surface elev. _ 98.10 ft. Depth to limiting factor 26 - in. Soil Application Rate
Horizon
Depth Dominant Color
in. Munsell
Redox Description
Ou. Sz. Cont. Color
Texture , Structure
Gr. Sz. Sh.
(Consistence
Boundary Roots
GPD/tt`
'EtTM
'Ef1A2
1
0-9 10yr3/1
nor
sil 2msbk
mfr
cs 1Vf
6
8
2
9-26 10yr4/4
none
sid 2msbk
mfr
gw na
4
6
3
1 26-31 1 7.5yr4/4
none
sd om
mfr
gw
na
.0
.0
4 31-48 7.5yr4/4
c2d 7.5yr5/6
; sd
om
na
na
na
.0
.0
t
❑ Boring # ❑ Boring
7cad Ground surface elev. _ __ __.. ft. Depth to limiting factor in. Soil Application Rate
Horizon
Depth Dominant Color
in. Munsell
Redox Description
Ou. Sz. Cont. Color
1 Texture
' Structure Consistence
( Gr. Sz. Sh.
Boundary Roots
GPD/W
'EfUl
•Ef #2
,
�
I
i
!
i
❑ Bonng # Boring
pit Ground surface elev. ft. Depth to limiting factor in. ISoil Application Rate
Horizon
Depth Dominant Color
in. Munsell
Redox Description Texture
Ou. Sz. Cont. Color
Structure Consistence
Gr. Sz. Sh.
Boundary
Roots GPDflF
•Eth►1 •ERr2
I i
1
I
I
�
I
I
J
,
�
Eft tent #f1 = BOD? 30 -5 220 ng/L and TSS >30 < 150 mg/L ' Effluent #t2 = BODs < 30 mg/L and TSS <30 mall
The Department of Commerce is an equal opportunity service 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.
SRD-8330 (R.o7A0) Steels SO Savio-
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 67 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. 100.10 ft
Top of 3/4"
pvc pipe
❑ = Bonn s
Bonn
Elev
i =
99.5 ft
j B2 =
99. ft
=
to ft
iB3
B4 =
0 ft
P
a
V104- �
99.5-&1:,-
3of3
. Y `
Wis6onsin
Department of Commerce
Division of Safety and Buildings
SOIL EVALUATION REPORT
in accordance with Comm 85, Ws. Adm. Code
#1899
Rege 1 of 3
Steel's Soil 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 locatio distance to nearest road.
Parcel
Pe
Please print all info
Xing ek.�
_ D
Reviewed
Personal irdomration you provide may be used 'poses (Priv Law, s. 15o4 (1) (m)).
'
Property Owner
Property Location
Ljb)
g
Rolling Hills Of HammondAStatee
ovt Lot na NEt/4, SW1/4, S29, T29N, R17W
Property Owner's Mailing Add�ti GO
t # Block Subd. Name or GSM#
400 2nd st O�X
6T, na Rolling Hills Farm
City odes Phon mber
City , Village Town Nearest RoadHudson
16 715-386-0230
Hammond 16oTh St
_ New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
_
_ Replacement _f 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 100.70ft based on contour line elevation 99.7Qft Minimum of 12 inches
and recommendations: of ASTM C33 mound sand.
1
�.�
Boring # -_. Bonng a
Z pit Ground surface elev. 100.30 ft. Depth to limiting factor 24 in. Soil Application Rate
-_...----------
Horizon
Depth
in.
Dominant Color Redox Description Texture ! Structure
Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
I Consisten
i
Boundary
Roots
GPl>/fl'
-ER81
_
•EtW
1 0-9
10yr3/1
none sit 2msbk
mfr cs
1vf
6
8
2 9-24
10yr4/4
none sid 2msbk
c2dc2d 7.5yr5/6 sic[ om
mfrgw
na gw
na
na
4
I 6
3 24-30
10yr4/4
.0
.0
4 3D-60
10yr4/4
c2d 7.5yr5/6 grsd om na na
t
na .0
.0
FBonng
* Boring I )Ground surface elev. 100,30 ft. Depth to limit factor 29 in.
Pit P n9 Soil Application Rate
Horizon Depth
in.
Dominant Color i Redox Description
Munsell i Ou. Sz. Cont. Color
Texture
i
Structure
Gr. Sz. Sh.
Consistence Boundary
Roots
GPDfR'
*Effat
'En*2
1
0-9
10yr3/1 none sil 2msbk mfr cs
10yr4/4 none sci 2msbk mfr gvv
10yr5/8 cld 7.5yr5/6 scl/sl om 1 — na na
i
i
1vf
.6
.8
2
9-29
na
.4
.6
3 `29-50
na
.0
.0
- emuem si = truu5> 30 < 220 mg/L and TSS >30 < 150 /L ' Effluent #2 = BOD5 <_30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature>CST Number
David J. Steel VCED 248956_
Address Steel's Soil Service Date Evaluation Conducted Telephone Number
994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347
SBD4330 (0.07i00)
4
PropdrryOwner Rollin Hills Of Hammond LLC. _ Parcel ID# Pending
Page 2 of 3
Boring # — Boring
;__': Pit Ground surface elev. 97.70 ft. Depth to limiting factor 24 in. Sod Application Rate
Horizon i Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure Consistence
Gr. Sz. Sh.
Boundary !
Roots
GPDfie
Etl#1
EIgt2
1
2
0-12
12-24
10yr3/1
10yr4/4
none sil
none Sid
2msbk
2msbk
mfr
cs
1yf j
.6
.8
Amfr
na
gw
na
na
na
4 I
0
_6_
.0
3
24-50
10yr5/8
f2d 7.5yr5/6
Sd/�
i
-
Boring # _ Boring -- -
BPito Ground surface elev. R. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence
in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh.
Boundary
Roots
GPD/fe
•EMYt -EM
i
i
I
( -
❑ Boring # Boring
_] Pit Ground surfaceetev. _ __—___ fl. Depth to limiting factor in. ISoil AppliZW l Rate
Horizon Depth Dominant Color
in. j Munsell
Redox Description
Qu. Sz. Cont. Color
Texture Structure Consistence
! Gr. Sz. Sh.
Boundary
Roots
I GPDMF _
-ER#1 'Efrri2
I
�
�
i
I
I
I
—
I
i
i
I
' Effluent #1 = BOD? 30 -S 220 mg/L and TSS >30 c 150 mg/L • Effluent #2 = BOD5 < 30 mgiL and TSS -30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-31 Sl or TTY 608-264-8777.
sao.+330(a 07N0) 51MM Sol Servim
,Y • Y
�• t
'4 STEEL'S SOIL SERVICE 3 of 3
David J. Steel Rolling Hills Of Hammond LLC 994 200' St.
CST-POWTSM NEI/4,SWl/4,S29,T28N,R17W Baldwin, W154002
Lic. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347
Rolling Hills Farm Lot 68 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
I,, = 40'
♦ = Benchmark E►e. 100.00 ft
Top of 3/4" pvc pipe
(� �9 • = Alt Benchmark Ele. 100.10 ft
n Top of 3/4" pvc pipe
❑ = Borings
Boring Elevations
B1= 100.30ft
B2 = 100.30 ft
B3 = 97.70 It
B4 — 0.00 ft t
40 S/gyp`
i
/0, 34
Wisconsin Department of Safety and Professional Services
Division of Industry Services SOIL EVALUATION REPORT
in accordance with SPS 385, Wis. Adm. Code
#1375
Page _1 -of . _ 1 _
Keith E Stoner
Attach complete site Ian on paper not less than 8'/2 x 11 inches in size. Plan must
P P P P
County
St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
--
Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
Reviewed By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner
Property Location
Rolling Hills Fame Property Owners Ass.
Govt. Lot SW1/4, U4, S29, T29N, R17W
Property Owner's Mailing Address
Lot # T 0ck # Subd. Name or CSt41#
C/O Tyme Properties 335 Labore Rd. STE. 150
j Rolling Hills Farm Outlot 3
City State Zip Code Phone Number
_
C City village M Town Nearest Road
Vadnais Heights MN 1 55110
Hammond I 165Th Street
® New Construction Use: ® Residential / Number of bedrooms 16 Code derived design flow rate 2400 GPD
—
❑ Replacement ❑ Public or commercial - Describe:
Parent material Silttr sediment over sandy loam till _ Flood plain elevation, if applicable _ Na it.
General comments Proposed a single 8' x 200' mound dispersal area located along the 11 15.00'contour w!a system Elev. of 1116.W.
and recommendations:
❑ Boring
1
Boring #
� Pit Ground surface elev. 1113.9 ft. Depth to limiting factor _ 46 in. Sal Application Rate
Hor¢on
Depth Dominant Color
' Redox Description Texture Structure Constsiterm Boundary
Roots
GPDfi
'E##1 - *eW
in. Munsell
Qu. Sz. Cont. Color - Gr. Sz. Sh.
1
0-7 10YR3/3
I sil 2msbk
mvfr cs
( 3f-co
2
710
10YR4J3
A 2msbk
mvfr I gs
3f-co
0.6 i 0.8'
3
10-24
! 10YR4/4
sid 2msbk
mfi gs
2fto
0.4 I 0.6
4
24-32
i 10YR4/4
c2d SYR5/8
sid� 2msbk
mfi
gs 21'
0.4 0.6
5
32-46
j 10YR4/4
i c2d 5YR5/8
! sl ; m I
Mill
-- ! if
0.0 0.0
1
I
I i
See Sanitary Site Plan for Boring Location
Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L / '�t #2 = BODs <_30 mg& and TSS <30 mg&
CST Name (Please Print) Signature: � / CST Number
Keith E. Stoner. ' 224059
Address Keith E. Stoner Date Evaluation Conducted Telephone Number
23220 Wood Creek rd Siren, WI 54872 11/52021 715-653-2324
Sau.113101R m i ,
DIVISION OF INDUSTRY SERVICES
Plumbing Product Review
P.O. Box 7302
Madison, Wisconsin 53701-2658
TTY: Contact Through Relay
Govemor Scott Walker Laura Gutlerre¢, 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 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 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 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-10564-E (N.10197) File Ref. 16013403.DOC
Hoot Systems LLC
May 10, 2018
Page 2 of 2
Product File No.: 20180134
Tohlc 1 Mmintononro lnrnArtYnn Pumninn RAnuirements
PRODUCT! Models
H-500 600gal/day)
initiaUStartu Inspection/ Maintenance
2-yr. service agreement wimanufacturer
Ongoing Pumping Cycle And/Or Requirements
2-yr. pumping (trash tank only), unless more restrictive
by local or siate regulation; for aeration chamber, see
Inspection results
Back -Wash Cycle
N/A
Effluent Performance Levels
NSF40 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 :5 % 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.
/Sineerely,lueter
duct Reviewer
Department of Safety and Professional Services
Division of Industry Services
Bureau of Technical Services
(608) 267-1401 Phone
(608) 267-9723 Fax
glen.schlueterQwi.gov E-mail
500 GPD GRAVITY DISCHARGE SYSTEM
H-500 A
106"
O
gar cl)
3
69 0"
57A
2.229' Avg. Length
5.600' Avg. Width
4.333' Depth
At
Miler
6s.s Line
Rev. 02 9124102
AEROBIC TREATMENT UNIT (ATU)
SERVICING AGREEMENT
This agreement is made pursuant to SPS 383.21(2)(c) (5), Wis. Adm. Code
018-20194 04M
Property Owner(s) I Legal Description of Property
(Attach copy of deed if necessary)
Description: I Manufacturer
Sanitary Wastewater Aerobic Hoot Systems LLC
Treatment Unit Hoot H-6W A RecordingAtea
Return To St. Croix County Community Development Dept.
As an inducement to the County 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:
t 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 Onsite 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 he scheduled every 6 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 POWTS Maintainer may, make periodic inspections of the components to complete
performance monitoring of the unit.
5. The owner or the owner's 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.
6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment
systems certifies that the property is no longer served 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.
7. 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.
Use BLACK Ink On
Owner(S) Names(s) (Print) Notarized Owners) Signature(s) Subscribed and sworn to before me on this date:
Notary Public (Print)
Notary Public (Signature)
My commission expires:
Drafted By: Keith F- Stoner 23220 Wood Creek Rd. Siren. W1 54872
ST. CRO LINTY SANITARY SYSTEM File#:
OWNERSHIP/ADDRESS FORM officeUse onty
awe zrtort
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email. If you would like to view your issued sanitary permit online, you can
do so by using the Prolerty Files Scanned weblink.
OWNER/BUYER INFORMATION
Owner/Buyer Rolling Hills Farm owners assoc.
Mailing Address 3435 Labore Rd.
City/State/Zip Vadnais Heights Mn. 55110
Phone Number (required) 651-248-1664
Email Address (required) - [6 —
Parcel Identification Number 018-2019- 000
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location SW Yn , NW Ya ,Sec. 29 , T 29 N R 17 W, Town of Hammond
Subdivision Plat: Rolling Hills Farm Lot #�-�Z
Certified Survey Map # Volume Page #
Warranty Deed # 9135-31 (before 2006)Volume Page #
Number of bedrooms 12 Spec house ■ yes O no Lot lines identifiable ■ yes O no
OFFICE USE ONLY
New Property Address
(Veriricati of new address required from Community Development Department for new construction.)
(Staff Initials) (Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified
survey map if reference is made in the warranty deed.
Community Development Department- Land Use Division
715-386-4680 St. Croix County Government Center 715-245-4250 Fax
cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.aov
Visconiin
Department of Commerce
Division of Safety and Buildinqs
SOIL EVALUATION REPORT
in accordance with Comm 85, Wis. Adm Code
#1898
Page 1 of 3
Steel's Soil 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 referen int (BM), direction and
Parcel I.D.
percent slope, scale or dimensions, north arrow, and lion nd distance to nearest road.
Please print all in ` n.
Revievy9d By Date
Personal information you provide may be u Tlda
y p y ry pur ses (Pri oY Law, s. t5.04 (1) (m))._i
Property Owner
Property Location
Rolling Hills Of Hammond L i� t4Govt.
Lot na NE1/4, SW1/4, S29, T29N, R17W
Property Owner's Mailing Address G
Lot #
Block #
Subd. Name or CSM#
400 2nd st �0\*
67
na
Rolling Hills Farm
City State Np Co6a * P Number
_ City []Village _. Town Nearest Road
Hudson WI 16 715-386-0230
Hammond 160Th St
New Construction Use: 71 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement -1 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 100.53ft based o/n contour line elevation 99.70ft. Minimum of 10 cinches
and recommendations: of ASTM C33 mound sand. �-rkm M/lm 0 L /-4 T
/J/ , C/
Pl�Boring # E- Boring
Ph Ground surface elev. 99.50 ft. Depth to limiting factor 28 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'__
•Eff#t •Eff#2
1
0-11
10yr3/1
none
sil 2msbk
mfr
cs
1vf
.6
.8
2
11-23
10yr4/4
none
sid
2msbk
mfr
gw
na
.4
.6
3
23-28
10yr4/4
none
scl
2msbk
mfr
gw
na
.4
.6
4
28-50
10yr5/8
c2d 7.5yr5/6
scl
om
na
na
na
.0
.0
Boring # ❑ Boring
Z Pit Ground surface elev. 99.50 ft. Depth to limiting factor 26 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
-Eff#t
-EB#2
1
0-12
10yr3/1
none
sil
2msbk
mfr
cs
lvf
.6
.8
2
12-26
10yr4/4
none
sic]
2msbk
mfr
gw
na
.4
.6
3
26-50
10yr5/8
c2d 7.5yr5/6
sd/sid
om
na
na
na
.0
.0
' Effluent #1 = BOD -> 30 < 220 mq/L and TSS >30 < 150 mall- ' Effluent #2 = BOD- < 30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature: CST Number
David J. Steel v/ 248956
Address Steel's Soil Service Date Evaluation Conducted Telephone Number
994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347
SBD-8330 (R.07M)
Property Owner Rolling Hills Of Hammond LLC. Parcel ID # Pending Page 2 of 3
FilBoring # C Boring
7 Pit, Ground surface elev. 98.10 ft. Depth to limting factor 26 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft2
'Eff#1
`Eff#2
1
0-9
10yr3/1
none
sil
2msbk
mfr
CS
ivf
.6
.8
2
9-26
10yr4/4
none
Sid
2msbk
mfr
gw
na
.4
.6
3
26-31
7.5yr4/4 none
scl
om
mfr
gw
na
.0
.0
4
31-48
7.5yr4/4
c2d 7.5yr5/6
sd
om
na
na
na
.0
.0
❑ Boring # Boring
] Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure Consistence
Gr. Sz. Sh.
Boundary
Roots
GPDtW
'Eff#1
•Etr#2
❑ Boring # C Boring
Pit Ground surface elev. k Depth to limiting factor in. Soil Application Rate
Horizon
Depth
in.
Dominant Color Redox Description
Munsell Qu. Sz. Cont. Color
Texture Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
`Eff#1
`Etf#2
. Effluent #1 = BOD5> 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 is an equal opportunity service 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 (R.07100) Steel's Shc Service
STEEL'S SOIL SERVICE
3of3
David J. Steel Rolling Hills Of Hammond LLC 994 200t' St
CST-POWTSM NEl/4,SW1/4,S29,T28N,R17W Baldwin, WI 54002
Lic. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347
Rolling Hills Farm Lot 67 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.
Top of 3/4" pvc pipe
• = Alt Benchmark Ele.
Top of 3/4" pvc pipe
❑ = Borines
9b�oFr
100.00 ft
100.10 ft
Boring Elev tons
1 = 99.5 ft
B2 = 99. ft
B3 = 98 Oft
B4 = .00 ft
a�
�j
r�l r
4
Visecmiln
SOIL EVALUATION REPORT #1899
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 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 locati distance to nearest road. Parcel I.D.
Peo4ing
Please print all info Reviewed 1)Date
Personal information you provide may be used urposes (Priva Law, s. 15.04 (1) (m)).
Property Owner LQ� Property Location
Rolling Hills Of Hammond LLC. A,9 ovt. Lot na NE1/4, SW1/4, S29, T29N, R17W
Property
dtO\Owner's Mailing Address GOO t # Block # Subd. Name or CSM#
400 na Rolling Hills Farm
City State Z Cod6 ' Phon mber City Village _-] Town Nearest Road
Hudson WI 154 16 715-386-0230 Hammond 160Th St
'.' New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement J 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 100.70ft based on contour line elevation 99.7_Qft. Minimum of 12 inches
and recommendations: of ASTM C33 mound sand.
�n✓ l37'l dT�S
Fi-IBoring # Boring - 0
[X Pit Ground surface elev. 100.30 ft. Depth to limiting factor 24 in. Soil Application Rate
Horizon
Depth Dominant Color Redox Description
in. Munsell Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
'Eff#1
'Eff#2
1
0-9
10yr3/1
none
sil
2msbk
mfr
cs
lvf
.6
.8
2
9-24
10yr4/4
none
sicl
2msbk
mfr
gw
na
.4
.6
3
24-30
10yr4/4
c2d 7.5yr5/6
sicl
om
na
gw
na
.0
.0
4
30-60
10yr4/4
c2d 7.5yr5/6
grscl
om
na
na
na
.0
.0
Boring # E: Boring
Pit Ground surface elev. 100.30 ft. Depth to limiting factor 29 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu, Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
'Eff#1
T •Eff#2
1
0 9
10yr3/1
none
sit
2msbk
mfr
cs
lvf
.6
.8
2
9 29
10yr4/4
none
scl 2msbk
mfr
gw
na
.4
.6
3 29-50
10yr5/8
cld 7.5yr5/6
scl/sl
om
na
na
na
.0
.0
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 m /L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Sig tureCST 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-9330 (a.07ro )
4 !
Propdrty owner Rolling Hills Of Hammond Ll parcel ID # Pending Page 2 of 3
Boring # _ Boring
Pit Ground surface elev. 97.70 ft. Depth to limiting factor 24 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description Texture
Qu. Sz. Cont. Color j
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
*Eff#t
*Eff#2
1
0-12
10yr3/1
none
Sil
2msbk
mfr
CS
lvf
.6
.8
2
12-24
10yr4/4
none
sicl
2msbk
mfr
gw
na
.4
.6
3
24-50
10yr5/8
f2d 7.5yr5/6
Scl/ssicll
om
na
na
na
.0
.0
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon
Depth Dominant Color Redox Description
in. Munsell Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/W
`Eff#1
*Eff#2
i
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth
in
Dominant Color Redox Description
Munsell Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
*EB#t
I *Eff#2
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 a 150 mg/L * Effluent #2 = BOD5 5 30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an altemate format, please contact the department at 608-260-3151 or TPY 608-264-8777.
SBD-8330 (R07/00) Steers Soil ServkR
' STEEL'S SOIL SERVICE 3 of 3
David J. Steel Rolling Hills Of Hammond LLC 994 200`h 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 68
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. 100.10 ft
Top of 3/4" pvc pipe
❑ = Borings
Boring Elevations
iUAV
B 1 = 100.30 ft
B2 = 100.30 ft
B3 = 97.70 ft
B4 — 0.00 ft
�0 +y
2�
a
S
b
QF
a�
. gz' 3&C`
Wisconsir{7epart;nent of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Piuilding Division
INSPECTION REPORT Sanitary Permit No�`�Q
GENERAL INFORMATION (ATTACH TO PERMIT) W I ( L State Plan ID No: '�-"�
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name. 51
City Village X Township Parcel Tax Nob
1-005-
Rolling Hills of Hammond LLC Hammond, Town of p7-(p TLi;h -4
CST BM Elevv. Insp. BM Elev. BM Description: Section/Town/Range/Map N
,aa ,gas 6 - E csr
29.29.17.
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
_
�.
/y2 S
-sing
Aeratio
1 Gb
Holding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
5 /
/3Z +
/ 5
Dosing
5 /
/ O3
�S '
e tin
r
5
l �Lt
fn,
10
r
Holding
PUMPISIPHON INFORMATION _ Ibr
Manufacturer // /_ Demand '`
GPM
Model Number Z
TDH Lifl4Friction If System He b TDIj u/ 7 Ft
�'jj S 7
Forcemain Length Dia. Dist. to Well ,
7140 3 1T3
SOIL ABSORPTION SYSTEM
STATION
BS
Sr �
HI
lOi..�j
FS
ELEV.
/a0• `S
Benchmark
Alt. BM
war
Bldg. Sewer✓.
(/•
S. 9
SU t Inlet
A�
79
�5• `�
St' O llet
J/1
7. 3
(v5' /3
Dt Inlet
t^' �
. OS
(o3.3g
Dt Bottom
yz6o
/g, y
5 7. a'j
Header/Man.
Dist. Pipe
`I.9
/�/ • 6s
Bot. System
Final Grade
3 •`'t
/aZ • es
St Cover
3,e4m oub
t-ep�
^- It
•a
z�b
b
I! ff
57. 63
TLi
BED!rkENCH
DIMENSIONS
Width J
��
Length i
/Z O
No. Of Trenc
e
PIT DIMENSIONS
No. Of Pits
`-
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
BLDG
WELL
LAKE/STREAM
L CHING
CHA R
N
Manufacturer
Type f n �yslem
�' ^^�
`I3
7/ �
> /ad
. j
/tj
Model Number
LAS I KIt3U I IUN SYS I EM 0P-A , LMt (aS Inds ..A41 1 ..L LJ_ f r%! <L
Header/Manif9ld ry
LengthA� D,a �• s
Distribution �(p i y
Pipe(s)
Length 5$•' Dia /' Spacing
x Hole Size
y ry
/�
x Hole Spacing
v
3
IVet Av e
,pw
C �L • .R.JYi.J•t
JUIL GUVLK x Pressure Svstems Only xx Mnund Or At -Grade Svstems Only
Depth Over /
Bedgrench Center /
Depth Over
Bed/Trench Edges \
xx Depth of
Topsoil
xx SeededrScdded
m Mulched
It
( C
\"Yes No
COMMENTS: (Include code discrepencies, persons present, etc.)
Inspection #1: 1 (� /�
Inspection #2: 7/ / / 67
Location: 1636 75th Avenue H irni 'VI
Lia ll
15,m)15�NE 1,4rS V4 29
T29N R17W) Rolling Hills Farm Lot 65 �I
Parcel No: 29-29.17.
6u
1.) All BM Description =
�XO[�
- h-kl 44k j -�v D-F PLL(vyl
ka-a- I d�
2.) Bldg sewer length = to /
-amount of cover = .�
G S
L0+ �i ZZ.$Z
'r3.-7
'
Plan
' b 115
revision Required? Yes No
1-7
Use other side for additional information.
SBD-6710 (R.3'97)
Date
Ins rs Signa re
Cert. No.
Overview
This system design is intended to be of sufficient size to be capable of handling an increased
wastewater load in the future. This plan complies with the St. Croix County Code of
Ordinances, Land Use and Development, Chapter 12, Sanitary, Enacted July 1, 2005.
Specifically, Section 12.4.A.3.c. (Common Systems, General, Submittal Requirements), requires
state approval from the Wisconsin Department of Commerce for an onsite disposal system.
A Conservation Development, Rolling Hills Farm, is designed for 77 lots serviced by a proposed
22 adsorption/dispersal components located on common ground. Appropriate easements and
maintenance language are required by the ordinance prior to preliminary and final approval. This
design for lot 65 will have common pump tank and dispersal components to service an additional
three lots, lots 66, 67, and 68.
Lot 65 and each future lot are projected to accommodate four bedroom residences. Each
residence will have a combination tank with a septic/trash tank compartment ahead of an aerobic
treatment compartment. Septic/trash compartment outlets will be equipped with filters equipped
with filter alarms to facilitate proper maintenance. Thus, highly treated effluent could potentially
be created in estimated flow of 1600 gallons per day or design flow to 2400 gallons per day. All
this effluent will flow downslope to a dosing/pump tank located just west of lot 65.
This system is designed with surge capacity and timed dosing of the mound component. Surge
capacity is approximately 1983 gallons represented by the pump tank volume between the timer
off liquid level and the alarm float. The surge volume is about 82.6 percent of the design daily
flow assuming potential future loads. Timed dosing is designed to spread the full potential future
design load of 2400 gallons per day over 24 hours in 21 separate dosing events. With drain -back
of 283.2 gallons, a dose of 397.2 gallons translates to an effective dose of 114.0 gallons into the
mound component. At a calculated total dynamic head of 58.3 feet the Goulds 3885-WE15H
pump is estimated to yield 56.74 gallons per minute which indicates a timer on setting of 7.0
minutes or 420 seconds. Since twenty-one doses per day are anticipated at full design load, the
timer off setting should be 61.6 minutes (3696 seconds). Careful measurement of pump tank
liquid level drop is required to field calibrate these estimates and assure a 397.2 gallon timed
dose including drain -back. The liquid level drop should be 6.7 inches per dose prior to drain -
back.
It can be noted that the 114 gallon delivered dose is slightly greater than five times the lateral
volume and will provide 5.26 doses per day for a one residence load at full initial design load.
The common effluent collection line must be constructed with schedule 40 PVC and installed in
accord with Comm 82.30(11)(e). In particular the trench bottom must be over -excavated a
minimum of three inches and the elevation of the pipe established at the pipe invert with at least
three inches of clean sand. Pipe backfill shall be in accord with Comm 82.30(11)(e)2.a for the
initial twelve inches. The collection pipe should be installed at a nominal depth of six feet below
grade to facilitate gravity collection from future residences. The Comm 82.30(11)(e) installation
requirements also apply to the system force main.
Page la of 8
IVlou�tn -f'. Ids G 9 - ?2 5ral /�fCourm NO. 642279
STATE SANITARY PERMIT
PREVIO
tovuu4 14tuS F*Rw►
OWNER%R69y dlugKs /1giK..LLG
PLUMBER C.# 6qSyyq
TOWN OF w�
SEC _9T IN, R
_13-90D
AND/OR LOT ap ItZ BLOCK
LILT #k SUBDIVISION
a
PERMIT EXPIRES
POS
NO.
CHAPTER 145.135 (2)1WISCONSIN 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 maybe renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(c) 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.
ISSUING OFFICER - DATE
UNLESS RENEWED BEFORE
AIN VIEW
�fE
C
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R11/20)