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Home My WebLink About018-2019-25-000Wisconsin 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)(m)] Permit Holder's Name. City Village Township Rollinq Hills Farm Residential Property TOWN OF HAMMOND CST BM Elev Ilnsp. BM Elev Bi`4 Description TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration lHoildiing 1 TANK SETEIACI JF RMATION V-1 TANK TO PiL WELL BLDG. Vent to Air Intake ROAD Septic Dosing t . \" (�ellxp, I Aeration r Holding PUMP/SIPHON INFORMATION A Manufacturer Demand GPM Model Number TDH L Frio oss Syste Held,/ TD 1 Ft Forcemain Le th 1 Dia. r Dist. to Well OVIL AMOUI I IVN aYA I tM STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer 1-ft Inlet StIHt Outlet Dt Inlet D-1 Dt Bottom Header/Man. Dist. Pipe .Og ID56.� Bot System Finyl Gra e kI, Cover y �' ?•8`f i �oSS of BED!TRENCH DIMENSIONS Width I Len O No, Of Tr es JW14145 PIT DIMENSIONS No. Of Pits Inside Oia, Liquid Depth SETBACK INFORMATION SYSTE TO P!L BLDG WELL LAKESTREAM LEACHING CHAMBER OR UNIT Manufacturer: T Of S s m. y 7 /(,�1 ; 1 %k Madef Number. LJIa 1 rN ou 1 wIY a 10 1 CIVI Header/Manifold 75 Disterisution r t x Hole Size x Hole S acing Vent to Air Intake Length Dia Len 9Dia /� 11 3 I i g(Ih Spacing ,/ JVII_ V V Y CR x Pressure Systems Only xx Mound Or At -Grade Systems Only i Depth 0 Depth Over xx Depth of xx SeedediSaddedi I xx Mulched BediTr ch Ce e BediTrench Edges Topsoil Yes i—] No �_ Yes I_ No COMMENTS: (Include code discrepencies.. persons present, etc.) Inspection #1 b/1o/202.Z_ Inspection #2 50,402 (2 M Location: 163272NDAVE �� y I pL .^000�'''yyy' ��'�-"/1"lgttt�p� �� O/ 1.) Alt BM Description =9rC�i- �� Wit (`5 Q� la J tyl (T ►� 2.) Bldg sewer length = - amount of cover =`V IN Plan revision Required? ❑Yes No 141 ror's signs ure II Use other side for additional information. SBC-6710 (R.311 ate Cart. No. ;:-: n nl n '5AWAda)- —lam Industry Services Division 4822 Madison Yards Way County St. Croix Sanitary PennitNumber (to be filled inbyCo.) Q Madison,W1 53705 P.O. Box 162 Madison, WI 7- t� J ��nm�ni'x p1% panty c e� rmrt Application 032200481-C In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit In Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Mound # 8 purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. I. Application Information - Please Print All Information Property Owner's Name Parcel # Rolling Hills Farm Residental Property Owners Assc. LLC 018-2019-79-000 Property Owner's Mailing Address Property Location 3435 Labore Rd. STE 150 Govt. Lot City, State Zip Code Phone Number Vadnais Heights, Mn. 155110 s ', Section 29 T 29 N R 17 E or W H. Type of Building (check all that apply) / ✓� Lot 5 m tM Subdivision Name F0lor2Family Dwelling - Number o Bµ s 25-28 (�, z J � Block# Rolling Hills Farm ablic/Commercial - Describe Use ❑City of ❑State Owned - Describe Use illage of CSM Number -- ❑Town of Hammond III. Type of POWTS Permit: (Check either "New" or "Replacement' and other applicable on line A. Check one box on line B. Complete tine C i applicable.) A. s/ ew System �-1 I Replacement System ❑Other Modification to Existing System (explain) ❑� Additional Pretreatment Unit (explain) LJ Hoot 600 B' r� Imo`olding Tank In -Ground ❑ LJ"t-Grade Individual Site Design Other Type ( 4lain) ! (conventional)P o C. ❑ Renewal Before Expiration ❑Revision hange of Plumber P/� ❑transfer to New Owner - - Ln/ � <yy�', Q I IF I I W. DispersaUTreatmcnt Area and Tank Information: pp M d = . DD Design Flow (gpd) Design Soil Application Rate(gpolsf) bispersal Area Required (sf) Dis 1 Area Proposed (sf) System Elevation 2400 1.0 .4 ATU 1.5 1600 / 3628 1600 / 3628 1056.00 Capacity in Total # of Manufacturer o Tank Information Gallons Gallons Units a ^ b V ,, New Tanks Existing Tanks 6"� 7 ` p a. U iA a w U R. Septic or Holding Tank Dosing Chamber 1250 1250 1 Wieser �/ I� ❑ V. Responsibility Statement- I, the undersigned, assu a responsi ' for'n Ration of t POWTS shown on the attached plans. Plumber's Name (Print) Sign Number Business Phone Number Keith Knudtson Zuy�s ��MY!IMPRS -48443 651-470-1737 Plumber's Address (Street, City, State, Zip Code) 927 150th St. Roberts W. 54023 VI. County/Department Use Only Approved ❑ Di pro Permitit Fee $ Date Issued Is Is u' Agent Signal ❑ er Given Reason for Denial tV `✓r�l (�n STEM ow A prov 3 yh,t„h �s Septic tank, effluent filter and 25- dispersal cell must be serviced / malntained �L , p' �+ 1� �P P. L✓� by Lf)- 9 6 ` ��" as per management plan provided plumbef. l� l All setback requirements must be maintained ` wi I , as per applicable codetordinances. 1 Q�t4S �l Jr CL -> —�t 2 i.tlt �E- Atta h t complete plans for the system and khbmi[ the Cour aly an r Pot tess a 1/2 a thr1H\ca l m SBD-6398 (& 03/21) Teft4a/ I I C r,Gopy I for Lots 25-28 V - \ 0 ip gz Q Proposed 8'x 201Y Mound Dispersal if me- 'fq .0, located along the 1055.OU contour OUTLOT 2 sq,?� "0 V- 0 1 �31N 4i�s System Elev. of 1056.W x 13W.. ? K -C A 4041 PL 4W 102-54' Elcy 108 35' ip oL mwI 0 Pt. # 4034 Top of Rc PL # 4029 Top Of ROW KS H#I P Elev. 1066.9T Elev. 10745V lz�c 8#2 L25 PI.4 4033 Tap of Reber o PL N 4032 Top ofl2ebmT Ef", = 1064.14! it Flev. = JOK65' O.-tq Q B#21 4 WLP125()-MRDosc'rank 4' nve 0 LOT af WI Simfecb STF-100 Efliumn Fiftm Pt # 4031 Top of Rebu P11 Elm 1056-65, fJ 113#3 L25 I L25 LOT 28 vn --21,781 *3 L24 E = 1057.2r aS. BM0 1 :�7— SQ. FF. B4"Conveyance, Pt 4042 95' LOT 21,781 Pipe Ekv. - 105301, Proposed Two 2" SQ. FT - Sub. 40 PVC FANILS LOT 781. 4" Bldg. S awe DEW St 24 1 is! 25 Hoot H-6W A Hoot 1-14W A m# 0 Bio-SepticTank lo-Septic Tank 1191 L24 21.7 Sq. �11. PL 4030 0 S 4BR 053.37 4% g. 1056.00, SO. FT. 4va Bid Sewer PL 404.1 10.53-00' 4 BR Elev. = 1053.95, 1055.001 O� 4' Bldg - Sewer 4BR All Piping sball conform to SPS Table 394-30-3 FNO 1639 and SPS Table 384-30-5 PL#4039TopoFRtbm 4 BR Elm = 1055.52' FN# 1636 S-Plan Site Ian For: Rolling Hills Farm Residential FN# 1634 Propert Owwrs Association LLC 66- tb Rolling Hills Farm Outlot 2 FN4 1632 JA(T4 Lots 52-54 Part of the SWI14 'I'vo) 7e; Sec. 29 729N-R17W Town of Hammond - St. Croix County �0-1!m fAWLoIIronL&f24 &.oft i. cFw) EtLOT, q�1053.371 b.% - a ft "Copy March 23, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-3-23 Plan Review: PVVTS-032200481-C Keith Stoner 23220 Woodcreek Rd Siren, WI SITE: Rolling Hills Farm Mound #8 72"d ave Town of Hammond St Croix County S Y2 SW Y< S29 T29N R17W FOR: DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843A462 Contact ThroLo Ratay htlp:lldspa.vm.pov/proprsaaWusMy-saMcm www.wbconnn.pov Tony lvwn - Oovornor Dawn Orkin - iaoretwy Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Description: 16 bedroom-2400 GPD — 24" to limiting factor- Effluent Filter - Maintenance required. Hoot Pretreatment SEE CORRESPONDENCE Mound Component Manual — Ver. 2.0, SBD- 10691-P (N.01/01, R 10/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-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 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 • The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • 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. • 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. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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, Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)813-9111 Joshua.rowlev@wisconsin.aov Index and Title Sheet Project Name: Rolling Hills Farm Mound #8 for Lots 25-28 Property Owner: Rolling Hills Farm Residential Property Owners Association LLC. Address: C/O of Tyme Properties Conditionally 3435 Labore Rd. STE.150 APPROVED Vadnais Heights MN 55110 DEPT. OF SAFETY AND PROFESSIONAL SERVICES Legal Description: Part of the S 1/2 of the SW %, DIVISION OF INDUSTRY SERVICES Section 29T29N-R17W Township: Hammond County: St. Croix Subdivision Name: Rolling Ifills Farm Outlot2 Comp. #/Parcel 1D: 018-2019-79-000 CONTENTS Page: 1 Plan Narrative Page: 2 Plot Plan Page: 3 Mound Plan View and Cross Section Page: 4 Lateral Layout Page: 5 Dose Chamber Cross -Section Page: 6 Pump Curve Page: 7 A+B Duplex Pump Panel Specifications Lots: SamEWRReW ervD i b3% 25-28 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 Report, Soil Verification Boring, Sample ATLI Servicing Agreement, Hoot Systems LLC Product Approval with maintenance requirements and Hoot Systems LLC Installer Certification. Mound Component Manual Used = Version 2.0 SBD-10691-P (N.01 /01 R. 10/12) Pressure Distribution Component Manual Version 2.0 SBD-10706-P (N 0 1/0 1 R. 10/12) Designer. Keith Signature: License 4 Designer 157-007 Phone # (715) 653-2324 Page 1 of 9 Plan Narrative The following shared sanitary system design discussion focuses on the propose 16 Bedroom 2400 gallon per day sanitary system to serve Lots 11 tbru 14 of the Rolling Hills arm 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 4 lots the mound dispersal area will be located within the tested areas for Lots 13, 15 and 16 with two verification borings completed. The sanitary system for Lots 25-28 is located within the common area known as Outlot 2. A four bedroom maximum design flow has been established for each lot. The county will require a sanitary permit for each lot prior to construction for setting the septic/treatment components verifying the design flow for each lot. These lots will required to set an aerobic unit and 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 off the northwest comer of Lot 25 in Outlot 2, 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. The BM for the soil test for Lot 24 equals 100.00' or—1053.87' the BM for Lot 25 equals 100.00' or approximately 106030' using NAVD 88 Datum. A surveyor was hired to locate the existing irons and staked the septic easement areas as the agricultural fields within the subdivision had continued to be cropped and some of the irons and T-posts marking the lot comers had been disturbed as it has been 16 years since the original soil tests had been completed. We used Control PT_#4030 the Top of a 46 Re -rod with an elevation of 1053.37 ft. as our benchmark for the sanitary systems construction along with other available control points with known elevations. For this dispersal area site the existing lot irons were verified with elevations as documented_ Soil verification pit labeled KS# I was dug to verify the soil conditions and tied into the benchmark along with contours within the proposed system area. i� Mound 8 for Lota 25.28 �'r�" 1 tr -� Q r Proposed 8' r zoo' Mmtnd Dispersal CeOUTLOT 2 QQ ll 0 �P� 01Of y j O located along the 1055.00' contour wC Q' Q 'lj ,.yam System Elev. of 1056.00 `, Q ��N6 �O for. k* 25-Z$ *ff be ftwll ae- / Pl.4ow"'gPdg 8ewv" —� sty; Q 14,4041 1 Elcv=1058.35' T 1 Llev. = 1052.54' 6 i li 4 * 4* $eJt, 48 iK-, 0 n ,Cv �� a El. # 401 Top of Reba R. # d010 Top ' licba i KS H#I � � _ "'•`� - �> ` Ekv. = 1070.50 Q" H#2 L25 Llev. = I(166.9T Pt. # 4033 Top of Rebnr _ o It # 4032 Tap of Reba Elev = 1064.14' 6% Proposed Wieser Concrete Fler.-1060.65 9A15 13421 4' wIP12%MRDosc lank 4' veyance ">G�1 LOT u= W!Simrech STF-100 i"PN3 r'a, Q Pl. # 4031 cbar Pipe 'j'i Effluenteat Filters P� 28 Ar Elcv. = 1056 65'-65' 9a . �21,781 N Q iH#3L25 'DHN1 LOT SQ. it .4. }rtl3124 95.169 27 E = 1057.21T LOT I 4' Conveyance PC 4042 21,781 Pipe Llev. = 1053 01' 26 SQ. FT. Proposed Two 2" g(q.5T 2 Sch. 40 PVC F.lvl.s LO''" 21,781 d9- rA c S 24 SQ. FT. N 4• Ell 25 y M# Hoot H-600 A w Hoot H-800 A 0 BI0-Sepik: Tank '+ io-Septic Tank 21,781 N PL 4030 SQ. FT. ? $gg N 4 BR 0533T 4% 1056.00 gp 4' Bldg. Z 11 Sews 43 Pt. 4043 1053.00' �N.'{; m 4 BR Elm = 1053 85' \ 1055. W O 4' Bldg. p t All Piping shall conform to SPS Table 38430-3 `�' Sewer m 4 FN9 163811 and SPS Table 384.30-5 PL t 4039 Top of Rebar 4 BR Ela. - 1055.52' 15 FN$ 1636 Sanitary Site Plan T For: Rolling Hills Farm Residential FNb 1634 11 �? Propert Owners Association LLC# 1 �' tl I gB gx N Rolling Hills Farm Outlot 2 - �JfG Lots 52-54 Part ofthe SWI14 50.z 1Q:'�� 3p5.20 Sec. 29 T29N-R17W 5ITa2S Town of Hammond - St. Croix County i fim of NE of Iron Lot 24 CO p s•r. P•+1 LOT EI=1053.37' `"" b0 N. Mound Plan View L Mound component Dimensions A 8.0' E 17. 6" B 00' F D 12" ri 6" PI 6 (n. sq.) Dispersal Cell Arco 12_t10 (gpd/n) Linear Loading Rate Shading Key ® Topsoil Cap ®Subsoil Cap ASTM C33 Sand ® Tilled Layer ® Aggiegate Page 3 of 9 t1 ! 2" KM19. ' 1 L 0' J 6.12' w' 3628. (W)Basal Arco Available 20 (n) tl10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area /' 'gatea Il Contour EIeVBtIOt' 6 % Site Slope � �i 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 .08 fL4 Duplex Forcemains to the Center of the Dispersal Area w/ End Manifolds Lateral Layout Diagram 4.331 P Note: F.M. attached to S center of the manifold. Turn -up wtball Calve 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 21.00 Lateral Turn -up Detail Finished Grade 6" to 8" diameter Lawn Sprinkler Box .25 ft. n. ft. Pm gpm gpm ft. P Laterals and Force Main of PVC I;Lk 40 per SPS Table 384.30-5 Page 4 of 9 r1.08ft. a F 6% X Holes equally spaced on bottom of lateral Note: Forcemains coming into the center of the dispersal area, Ist hole approx. 1.25' from the manifolds with the hole spacing between the manifolds of -- 2.83ft. North manifold + North F.M. feeds the north 112 of cell and the South manifold + South F.M. feeds the south 112 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 2"/ 69 per F.M. Threaded Cleanout Plug or Ball Valve n. ft. 121 xifioe ft. in. ft. Note: Lateral ends at last orifice where variable length to cleanout 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 W AC ' or = to 12" Above Final Grade n Note: S3E Rhombus Type 122 Duplex (Demand Dose) Top of inlet = Approx.1 1 Note. Pump switch and alarm to be I A wired to separate circuits. 1 ri W LP 1250-MR I C Tank Mfr. Wiesert Concrete Alternate Outlet Location W/Approved 4" Sleeve Force Main Diam. = 2" " cep Hole or Anti Siphon Device Duplex Force Mains Pump Off Elev. 1050.17 Duplex Pumps �/-' 1` D r 1 1� Dose Tank Elev. 1049.50' 6.33' Per 1/2 Vertical Difference Between Pump Off Distribution Pipe = rr Y� 6 and Minimum Required Supply Pressure ...................................... — 4.55 of cell �t 60' FT. of Force Main x 4.11 Friction Factor/ 100FT.... = 2.4T 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 .................... = 13.85' near equal in length. Min. dose per cell � 160.% gals. Number of Doses ...= 6.02 Per Day Volume of Backilow ......................... Total Dose Volume ........................... Gal. Per Day/ #of Doses = 199.085al. (Duplex ....................................... = 9.78 Gal. PumpsAltemating ....................................... = 208.86Gal. between cell halves ) Pump Tank Capacity 1253.16 Gallons Dimensions Inches Gallons Pump Tank Volune 34.81 Gal/Inch p 20 696.20 B 2 69.62 Pump Mfr. Goulds C 6 208.96 Pump Model EPOS D 8 278.48 Minimum Discharge Rate = 43.20 GPM per pump Alarm Mfr. S.J.E. Rhombus Alarm Model Tank Alert 1 Total— 36 1253.16 Bed Tank per SPS. 383.45(5) AH@h@f Tafil a§ wm§§Fs 1@ AMI& METERS FEET 10 t 9 30� 8 25 7`. x u 6 20 T -- --- Z 5 .... G i 15j. 4 0 ~ 3 10 i 2 1 0 10 20 30 40 5o GPM 0 2 4 6 8 10 12 ma/h CAPACITY MODEL INFORMATION Order Minimum float COS Discharge Minimum Minimum Minimum Maximum Shipping Ntsmbar HP Vohs Amps Circuit Phase Switch Length Connection On level o1F Level Basin Solids Weight Breaker we Diameter Size Ibs kg EP0411 Plug 1 No Switch 10 Manual Manual 20 i 9 1 EP041 to Piggyback ! 10. 12" 6" 21 / 9.5 .4 115 12 20 Wide -Angle EP0411F Plug / No Switch 20' Manual Manual 20/ 9.7 EP041IAC Piggyback/ 20' 12" 6" 21 /9.5 1 Wide -Angie 1 W 15' 'y. EP0412 10' Manual Manual 2019.1 230 6 1D No Switch EP0412F Plug / No Switch 20' Manual Manual 20/9-1 EP0511F 115 13 20 No Plug i/ 20' Manual Manual 22 '10 EP0511AC piggyback/ 20' 12" G" 23:10.4 .S Wide. -Angle EP0512F 230 6.5 1 D Plug r No Switch 20' Manual Manual 22/10 PAGE 3 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 aftemation 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 (ward). 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 MIARM PACKAGE 11, Red Alarm Beacon provides 360' visual check of alarm condition. Note: NEMA 1 style utilizes a door mounted indicator in lieu of a beacon. 12. Alarm Horn provides audio warning of alarm condition (83 to 85 decibel rating). Note: NEMA 1 style utilizes an internally mounted buzzer in lieu of hom. 13. Exterior Alarm Test/Normal/Silence Switch allows horn and light to be tested and horn to be silenced in an alarm condition. Alarm automatically resets once alarm condition is cleared. 14. Horn Silence Relay (mounted on circuit board). NOTE: other options available. AF 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 1 Standard package includes three 20' SJE SignalMaster19 control switches Ar 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 C @us tt><M J51mb Rhomus, PO Box 1708, Detroit Lakes, MN 56502 1-888-DIAL-SJE • 1-218-847-1317 1-218-847-4617 Fax email: customer.serviced@sierhombus.com www.sjefhombus.com 122 MODEL 122 � ALARM PACKAGE 0 select options or no alarm package T = alarm package (includes test/normal/silence switch, ENCLOSURE RATING r = indoor. NEMA 1 (metal) W = Weatherproof, NEMA 4X (engineered thermoplastic; STARTING DEVICE E& I = magnetic motor contactor 120/2081240V 9 = magnetic motor contactor 120V only PUMP PULL LOAD AMPS ff 0 = 0-7 FLA 1 = 7-15 FLA 2 = 15-20 FLA 3 = 20-30 FLA C fuse, red light, & horn) PUMP DISCONNECTS 0 = no pump disconnect 4 = circuit breaker 120V (select STARTING DEVICE option 9 above) 120/2081240V (select STARTING DEVICE option 1 LOAT SWITCH APPLICATION H or L = pump down or pump up (select 17 option) X = no floats OPTIONS Lrstedbatow CODE DESIMPTION 0 1A 1C 0 #* 3A * 3B 0 * 4A Q 48 0 4D 0 * SA (—I * 5E CO 6A i6A llr aC Q * 9_A 0 `nnF nFSCa TWW Q ** r Q* above) :f,ji,j' C /1fynber- ENCLOSURE UPS IZE - If you selected one or more of the* options, or two** options, a one-time enclosure upsize fee would apply 10K Anti -condensation heater 11C NEMA 1 alarm panel 11D NEMA 4X alarm panel 14B Main disconnect (rotary style, mounted through door, non -fuser!) (must select circuit breaker) 0-20 FLA (total of both pumps) 20-60 FLA (total of both pumps) 16A 10' cord in lieu of 2C (per float) 166 15' cord in lieu of 20' (per float) 16C 30' cord in lieu of 20' (per float) 16D 40'cord in lieu of 20' (per float) 17A SJE SignalMasters I pipe clamp 0 (per float) 17B SJE SignalMaster" i externally weighted 0 (per floet) 17C Sensor Float't intemaily weighted A (per float) 170 Sensor Float° I externally weighted A (per float) 17E Sensor Float® Mini t pipe damp A (per float) 17F Sensor Float"' Mini 1 externally weighted ♦ (per float) 17J Sensor Float® t pipe damp A (per Boat) 196 Lead lag selector switch 19F Fourth float to separate alarm function from lag 19T TOA (Test/Off/Aulomatic) switches and pump run lights through door mounted 19U HOA (HandtOtOAutomatic) switches and pump run tights 10E Lockable latch - NEMA 4X through door rrrounted Q 10E Lockable latch - NEMA 1 r-1 19X Door mounted pump run indicator 0 # 10F Lightning arrestor (select pump circuit breaker) 0Mechanically-activated A Mercury -activated SAMPLE MODEL 122] W 9 0 4 H 6A 8AC 17A Alarm Package Enclosure Rating Starting Device Pump Full Load Amps Pump Disconnect Float SvAtch Application Red beacon only I no audio (must select "0" fur alarm package) Hom only i no visual (must select "0" for alarm package) Alarm flasher Manual alarm reset Redundantoff (select Option 4D if floats included) Red redundant oft indicator & alarm (must select Option 4A also) Redundant off float (must select 4A option) (select 17 option) Thermal cutouth eat sensor auto reset (for pumps wtthermal switch leads) Seal failure circuit & red indicator (2 wire) Auxiliary alarm contact, form C (included as standard) Elapsed time meter Event (cycle) Counter Pump overload specify amperage after number 9 followed by letter "A'. Example 912A = 12 amp pump. 0-25 FLA 25-30 FLA Ilia tip Page 8 of 9 HOOT SYSTEMS, LLC.,'� a 3 d , tos soDGPO GRAVITYCHAPoESYSiEM _ o 31� 74r H-600 A TANK SPECIFICATIONS - 4' CAS al IHI — — II 4" CAS DIMENWALL- 3' �( BOTTOM: 3' I !2q COVER 4" S MANHOLE: 12" h 24" I.D. PLASTIC RISER I HEIGHT: 70' O.D. ) LENGTH 106" O.D. o 0 I lul II POLYLOK 12' ACCESS LID (TYP) �OTIi: 74 7/2' O.D. 'll IHI , BELOW INLET: 5Y O.D. c a W (L r�J - _ _ _ _ J LIQUID LEVEL: 51• o o WEIGHT: 11.135 LBS. W 41" 40" H W INLET AND OUTLET: = 4• CAST -A -SEAL (CAS) BOOT OR EQUALLn C TOP VIEW COVER MIX DESIGN /6 (NO FIBER) f TANK: MIX DESIGN /9 (SMALL FIBER) v o DO CUSTOMIZED TANKS: 3 N FOR CUSTOM TANKS CONTACT WIESER CONCRETE a r EZ SET RISER (TYP) O 00 IMF m n INLET TLET I d J •o LI (. 0 1 Il I 8 F- A. DRAWINGS SUBMITTED i FOR APPROVAL = SIDE VIEW APPROVED BY: SHEET NO. APPROVAL DATE: PRODUCTS NEEDED BY: TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS / 1 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 ................................... I U h Aeration Plumbing ................. ILI 0 � Air Filter ................................. fl 0 Effluent Pump (if applicable)....... Ll Chlorinator ............................. n 0 OK System Light.................... L Ll Alarm..................................... L LI f7 D-Box .............................. C 0 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. n Repairs to system (list all components replaced): Tests Required and Results: Test BOD (Grab) TSS (Grab) Fecal Coliform 5.Comments: Required 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 Privatc 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 l: System Design Specifications Sanitary Permit Number Number of Bedrooms 16 Design Flow (GPD) 2400 Soil Absorption Component Size . f3.) 1600 retreated Effluent) Trash Tank CTacity Gal. 400 gal. Pump Chamber Capacity Gal. 1250 gallons Type of Wastewater I Pretreated Domestic Pre -Treatment Unit installed per structure 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 1900 _ Max. Influent Particle size NA 51/8 Inch Maximum BOD 5 (mg(l) NA 5 30 mg/l _ M Maximum TSS (mg/1) NA 5 30m 1 Maximum FOG NA NA Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Dose Tank In- Line Filter Should inspect once a year and clean every 3 yews Pump Chamber Inspect once every 3 years Soil Absorption Component Flush laterals every 18 months. HOOT SYSTEMS H-600 A Service every 6 months for first 2 years. Then annually there after per maintenance agreement See attached. Page 9 of 9 a, b + c Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under sec. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, W is. 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 113 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 Wareing: 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. Laterdl 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) 3864680 Wieser Concrete Products Maiden Rock WI (800) 336-3416 Septic Pumper Powers Sanitation (715) 249-5738 888 878-4668 HOOT SYSTEMS LLC H-600 A Page 9 of 9 a, b + c -!'�*"W n Department of Commerce Division of SO" and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, wiis. Adm. Code #1913 1 of 3 Steers Soll Service Attach complete site an on nrp Pi paper not less than 8'/. x 11 inches In size, Plan must Coin St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north afrow, and location and distance to nearest road. Parcel I.D. Please pint all Wbrmation. Personal irioanstion you Provide may be used for secondary purposes Law, s. 15.04 (1) (m)). R DJO� Properly Owner Property Location Rolling Hills Of Hammond LLC. ECE1v Govi. Lot na SW1/4, SW1/4, S29, T29N, R17W Proin perty Lot24 ubd.N 400 9 Za�� Bbtk# na HillsrCS Farm City State PhorreCour> S U38Cr02�' j� CRY ;Jl Vi legs f I Town Nearest Road - Hudson7 Wi 01 r-; Hammond 160Th St ® New Construction Use: �A e mbar of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent matdial Silty sediment and underlying reddish sandy loam till Flood plain elevation, If applicable na ft. General comments At Grade or Mound Design. System Elevation for At Grade 100.301t for Mound 100.30R based on contour and recommendations: line elevation 99-80ft. Mknanuum 6 inches ASTM C-33 mound sand. Boring # ❑ Boring Pit Ground surface Blow. 94.90 ft Depth to limiting factor 57 in. Sol Application Rate Horizon Depth in. Daninent Color Munsell Redox Desedplior+ Qu. Sz. ConL Color Texture Structure Gr. Sz. Sh. Consistentaii Boundary Roots GPDAF 'Blot 1E1M2 1 0-12 100/1 none sil 2msbk mfr Cs 1vf ivf .6 .4 .8 .6 2 12-26 1" M/4 none Sd 2msbk n* gw 3 26-57 10yr6/6 crone c2d 7.5yr5/6 I5 cm rrrvrr gw na .7 1.6 4 57.65 100/6 sci om na na na 0 .0 I 80" M ❑ Boring ph Ground surface slow. 99.90 it, Depth to limiting factor 48 in. Sol Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consiwha Boundary Roots GPDffl' *EW1 'EM2 1 0-20 10yr3/1 none sit ; 2msbk mfr ins 1vf .6 .8 2 20-35 10yrr4/4 none sid 2msbk mfr gw 1vf .4 .6 3 35-Q 7.5yr4/4 none 9d 2msbk mfr ins na .4 .6 4 48-75 10yr7/8 c2d 7.5W5/6 sd/ifsi om na na na .0 .0 ' Eflluenl #1 - SODS> 30 < 220 mg& and TSS >30 < 150 mgA- ' Effluent #2 = 13005< 30 mgfL and TSS 1.30 mWL CST Name (Please Print) n:e':: CST Number David J. Steel . 2489M Address Steers Sod Service -- Date Evaluation Conducted Telephone Nuinim 994 200th SL Baldwin, WI 54002 6/1212006 715-760-0347 � Rcwmor Property 0artuer RAIAng HiNs Of Hammond LLC. _ pawl ID et FAWing papa 2 ot_ 3 M Pt Ground surface elsv. 98.800. 4. Depth to WON factor 40 in. Y pia, Rate Florae^ Depth in. Domiard Color Munson Redox Description Qu. Sz. Com. Color Texture Struaue onallej Boundary Gr. Sz. Sh. Root GPnfff `Etfi1 -Ertel 1 0-16 10yr3/1 crone sit 2msbk 2msbk 2msbk om am mfr is mfr gw min gw na CS 1vf lvf .6 4 .8 6 2 j 16-33 10yrr4/4 none rid 3 33-40 10yr4/4 none sI na .6 1.0 4 40-54 7.9 M/4 c2d 7.5yr5/6 SOS na .2 6 5 54-75 10yr5/4 c2d 7.5yr5/6 sct na na na .0 0 &wRlg Pit Ground surface elev. -ft. Depth to Wrnk(rrg factor in. Soo AppOcation Raft Honzon Depth Dominant Color to- murk"" Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh Consistence Boundary Root GPD/n' •Elttt •ERe2 i i BMW# 1-1 Borft pGround surface elev. R. Depth to W&V fa tm in. Horizon Depth M. Dominant Color Munsed Redox Description Qu- Sz. CnM. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Rods GPDW •EffN 'Elsz • Effluent $1 = BOOs> 30 < 220 mg& and TSS >30 < 150 nV& • Effluent e2 - BODS < 30 mg& and TSS <_30 mglL The Departmcnt 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. sanu»o rn a7,00) Sti/c Sol swww STEEL'S SOIL SERVICE David J. Steel Rolling Hills Of Hammond LLC 994 2W 4 St. CST-POWTSM 5wl/4,swu4,S29,T28N,Rl7W Baldwin, Wl 54002 Lic. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 24 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. d Legend I"=40' A = Benchmark Ele. 100.00 ft Top of 314" pvc pipe • = Ah Benchmark Ele. 100.20 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations B I = 99.90 ft B2 = 99.90 ft B3 = 98.80 ft E14 = 0.00 ft 7- 5-6 6 3 of 3 0 W1060own SOIL EVALUATION REPORT DBpartrrlent of Commerce in accordance with Comm 85, Wis. Adm- Code Division of Safety and Buildings Attach complete site plan on paper not less than 8% x 11 inches in sae. Plan must County include, but not limited to: vertical and horizontal reference point (SK, direction and percent slope, scale or dimensions, north arrow. and location and distance to nearest road. Pairce! I.D. P/eaaa print all information. Personal information you pmvde may be used for secondary purposes (Pnvag taw. s. 15.04 (1) (m))- �7 0- if1914 Pm 1 of 3 Steel's Sol Service Rolling Hills Of Hammond LLC. ��VGsr Govt. Lot na NW1/4, SW1/4, S29, T29N, R17W Property Owners Mailing Address Lot* Block • Subd. Name or CSM# 4002nd st 19 204fi 25 r1a Rolling Hills Farm City State Code Plane Number City n Vllloge [ Town Nearest Road Hudson WI 1 .CRtp230 Hammond 160ThSt ® New Construction Use: umber of bedrooms 4 Code derived design flow rate 600 GPO Replacement Public or Commercial - DewAbw na Parent material Sifty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft General comments Mound design, system elevation 100.961t based on contour line elevation 99.80ft. Minimum of 14 inches and moommendetions: of ASTM C33 mound sand. BonrtB R g Ground surface elev. 99.90_ it. Depth to limiting factor 22 in. Sol Application Rats Horizon DapM Dominant Color n. Munsell Redox Description Texture Qu- Sz- Corp_ Color Structure Gr. Sz. Sh. Consistence Boundary Roots GPOW + ' 1 01i 10yr3/1 irons sil 2msbk 2msbk mfr n* I CS if gw na 6 4 8 6 2 11-22 10yr4/4 — row slid 3 22 48 10yr7/8 c2d 7.5yr5/6 9d om na na na 0 0 t El swim Z Borirp a R pl Ground surface elm. 99.90 ft. Depth to limiting factor 50 in. Sol Appfica0on Role Horizon Depth in- Dominant Color Munsel Redox Desciption Qu. Sz Cont. Color Texhae Structure Gr, Sr- Sh. Co Boundary Rods GPD/ft• 'E11ar 'ERi2 1 0-10 10yr3/2 none slr2msbk k mfr cs ivf .6 1.0 2 10-33 10yrr4/4 none Sdk mfr a if .4 .6 3 10yr6/6 none sd min gw na .4 .6 4 50-77 10yr6/6 cid 7.5yr5/6 IsJsd mvrr cs na .0 .0 5 77-96 10yr6/6 none is osg na no na .7 1.6 i i — --------- -- - I ' Effluent #r1 = 8006> 30 < 220 mgA. and TSS >30 -c150 mg,*Effluent a2 = BOD5 <30 mglL ano ) ss <Ju mWL CST Name (Please Print) Sig CST Number David J. Steel 248956 Address Steel's Sol Service Date Evaluation Conducted Tefaphone Numbw W4 200th St. Baldwin, WI 54002 6/12C2.006 715.760-DU7 seo-xrwocerW) pettiparty owrw Rd"- Hills Of Hammond LLC parcel ID # Pending page 2 of 3 Boring 0 Boring OilGround surface elev. 97.10 t Depth to limiting factor 24 in. Sod Application Rate FTI Horizon Depth in. Dominant Color Redox Description Munsell Qu. Sz. Cont. Color Texture Struftre Cf. Sz. Sh . Consists Boundary Roots GPDMI *Effol -E1W 1 0-9 I j 10yr3/2 none so grsd 2msbk 2msbk rnft j mfr CS gw IVIF .6 .8 2 9-24 10yrr4/4 none 1Vf .4 .6 3 24 33 10yr4/4 f2d 7.5yr5ffi grsd orn na M1 OW na JIVIF ro .0 .7 AM 1.6 4 33-50 10vr7/8 c2d 7.5yrSI6 gr1s OS9 T- -1- F-1 Bonn # F] Boring [] Pit Ground surface elev. k Depth to limiting factor in. Soil Application Rat Horizon Depth in. Dominant Color Munsell Redox Description Qu- Sz- Cont. Color Tod= Structure Cortsistance Gr. Sz- Sh. Boundary Roots GPDW Eff#2 Boring Ground surface elev. R. Depth to lim" factor in- Sod Application Rate Hodition Dopth in. Dominant Color Redox Description Munson Qu. Sz- Cont. Color Texture Structure Gr. Sz. Cov"toncel BoundaryRoots I I GPDMV Ff1#2 ' Effluent #1 w SODS > 30 < 220 mg/L and TSS >30 <-1 50 mgA- * Effluent #2 = B005 -S 30 mg1L and TSS -c-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 llbrmsit, please contact the department at 60&266-3151 or TTY 608-264-877T SOD-3330(ROMD) sbL qls Sod Sere" 0 David J. Steel CST-POWTSM Lie. #248956 STEEL'S SOIL SERVICE Rolling Hills Of Harnmo N W l/4,SW 1/4,S29,T28N,R17W Town of Hammond, St Croix Co. Rolling Hills Fawn Lot 25 id LLC 994 200' 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 ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.05 ft Top of 3/4" pvc pipe ❑ = Borings St. Baldwin, WI 54002 Direct 715-760-0347 Fax 715-684-3449 Boring Elevations B 1 = 99.90 ft B2 = 99.90 ft B3 = 97.10 ft B4 = 0.00 ft 3ot3 r, 3ot3 r, Wisconsin Department of Safety and Professional Services Division of Industry Services SOIL EVALUATION REPORT in accordance with SPS 385, Wis. Adm. Code #1379 Page I of 1 Keith E. Stoner Attach complete site Dian on paper not less than 8%: x 11 inches in size. Plan must County St. CtOIX include. but not limited to: vertical and horizontal reference point (BM), direction and - -- — Parcel LID. - 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 Farm Property Owners Ass. Govt. Lot S1/2 1/4, SWIM, S29, T29N, R17W Properly Owner's Mailing Address Lot # Block # ISubd. Name or CSM# Rolling Hills Farm C/O Tyme Properties 335 Labore Rd. STE. 150 Outlot 2 —_1 ❑ City [] Village Z Town Nearest Road - City State Zip Code Phone Number Vadnais Heights MN; 55110 ; Hammond I 72Nd Ave. Z New Construction Use: ® Residential / Number of bedrooms 16 Code derived design flow rate 2400 GPD cem Replaent ElPublic or commercial - Describe: — Parent matimal Silty Sediment over Sandy Loam Till Flood plain elevation, if applicable ne ft. General comments Verification Boring for Mound # 8 for Lots 25-28 and recommendations: ❑ Boling # BoringFq Pi! Ground surface elev. 1053 ft. Depth to limiting factor > 54 in. Satl Application Rate Hottzon Depth Dominant Color Redox Desc iour , Te:Wre Structure Colo Boundary . , Roots in. Murwell Qut Sz, Cont. Cok ( Gr. Sz Sh. "I'EttJlz 1 0-6 10YR2/2 I sil 2msbk mvfr I 2f-msbk mvfr 1 2msbk tI mvfr SO 2mabk mfr Is Osg ml cs 31f-m gs 3f-m gs 2f-m gs 2f-m 2f ' 0.6 0.8 0.6 0.8 0.6 0.8 0.4 0.6 0.7 1.5 2 6-13 10YR3/3 3 13-24 10Y114/3 4 124-34 10YR4/4 I 5 34-54 10YR4/4 T Verification Boring See site plan for location. " Effluent 01 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 Effluent 02 = 8013 < J[r mg/L and 1 as -�:_atj mwy 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 W l 54872 1 M12021 715-653-2324 sec-9330(0.o* 13) AEROBIC TREATMENT UNIT (ATU) SERVICING AGREEMENT This agreement is made pursuant to SPS 383.21(2)(c) (5). Wis. Adnt Code Agreement bate Parcel Number 0t8-2019-79-ON Property Owner(s) legal Description of Property (Attach copy of deed if necessary) POWTS Sanitary Wastewater Aerobic I Hoot Systems LLC Treatment Unit Hoot H-600 A Recording Area Return To St. Croix Ctwnly Community ihvelopment Dept. As an inducement to the County of St. Croix to issue a sanitary permit for a POW I'S equipped with an aerobic treamwnt unit on the above described property, we agree to do the following: The owner agrees to conform to all applicable requirements ofCh. SPS.3 83. Wis. Adm. Code relating to aerobic treatment and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) tmimology. 2. 'Ube owner agrees to maintain a contract with a licensed POWTS Maintainer for the life of the system. The POWTS Maintainer will perform periodic inspections and maintenance as required by the manufacturer and the department, including, but not limited to: the blower, electrical controls, treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. fhe 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 he 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. "Ibis 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. IN r__or arw I -LA §.A Owners) Ntmtes(s3 (Print) Notarized Owner(s) Signature(s) Subscribed and sworn to before me on this date: Notary Public (Print) Notary Pubtic (Signature) My commission expires: Drafted BY. Keith E. honer 2.f720 Wood Creek Md. Siren. tvt .34ni1 DIVISION OF INDUSTRY SERVICES Plumbing Product Review P.O. Box 7302 Madison, Wisconsin 53701-28e8 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 ki 3097849) H-SERIES HOOT Model Number(s): H-600-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), Wm 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 118 inch in size or larger. SOD-10584-E (N.10197) File Ref: 18013403.DDC Hoot Systems LLC May 10, 2018 Page 2 of 2 Product File No.: 20180134 Table 1 Mtaintannn p Insnariinn Pumninn Pn drm�nfc PRODUCT/ (Models)H-500 600gal/day) Initial/Startup Inspectioril Maintenance 2-yr. service agreement w/manufacturer Ongoing Pumping Cycle And/Or Requirements 2-yr. pumping (trash tar* only), urueas more restrictive by local or sti4s regulation, for aeration chamber, see iMSPOCOM resulb Back -Wash Cycle N/A Effluent Performance Levels NSF-40 Class I BOD5 Credit For Downsizing Distribution Area YES Fecal Credit For Reduction Of Vertical Separation 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. Backflll material shall be free -flowing soil or gravel s 4 inches in diameter in the largest dimension. The department is in no way endorsing this product or any advertising and is not responsible for any situation which may result from its use. /S,incmerely,lueduct Reviewer Department of Safety and Professional Services Division of Industry Services Bureau of Technical Services (608) 267-1401 Phone (608) 267-9723 Fax glen.schiueter@wi.gov E-mail 500 GPD GRAVITY DISCHARGE SYSTEM H-500 A 106" 2229' Avg. length 5-600' Avg. WeBh 4.333' Depth 68.5" At Water 65.5" u�re Rev, 02 9124/02 January 1, 2022 RE: Service Provider/Installer Certification Wisconsin Hoot Systems Hoot Systems, LLC (Service Provider/Installer) Keith Knudtson 927 150t" Street Roberts, WI 54023 This letter is to serve as your official certification as a "Hoot Certified Service Provider/Installer" for its Advanced Treatment Units. Keith Knudtson has been listed as an approved service provider/Installer on our listing for the state of Wisconsin. They have successfully completed onsite training on multiple sites and engaged in trouble shooting methods and solutions. Service Technicians have been trained to service and inspect the functionality of our products along with proper installation guidelines. As a "Hoot Service Provider/Installer" we have agreed to continually educate Keith Knudtson on all aspects of our product line. Respectfully Submitted, OA&4H\+jX- Aaron Yonts Regional Manager Hoot Systems, LLC. ST. VNTY SANITARY SYSTEM File Only OWNERSHIP/ADDRESS FORM #: Created Office 12021 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 Property 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) Parcel Identification Number 018-2019-78-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location SW '/a , NW Ya , Sec. T 29 NR17W, Town of Hammond Subdivision Plat: Rolling Hills Farm Certified Survey Map # Warranty Deed # Number of bedrooms New Property Address (Staff Initials) 35 0 Volu Page # 2006)Volume . Page # wwrr OFFICE USE ONLY /`/k- Lot iS � s-?-g Lot lines identifiable ■ yes O no (Verification of new address required from Community Development Department for new construction.) (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.-ov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.aov 2 ) Visemsin SOIL EVALUATION REPORT #1914 Department of Commerce n accordance with Comm 85, Wis. Adm. Code Pane 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. Crobc include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. R awed By Date Personal information you provide may be used for secondary purposes (Priva Law, s. 15.04 (1) (m)). Property Owner CEI� Ep properly Location Rolling Hills Of Hammond LLC. RE Govt. Lot na NW1/4, SW1/4, S29, T29N, R17W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 400 2nd st it 111 9 2�06 25 na Rolling Hills Farm City State ip Code Phone Number F' City Village Town Nearest Road Hudson WI 401®T.CR9%-%V0T2Y30 Hammond 1 160Th St ❑ New Construction Use: R umber of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 100.96ft based on contour line elevation 99.80ft. Minimum of 14 inches and recommendations: of ASTM C33 mound sand. Boring # C Boring Z Pit Ground surface elev. 99.90 ft. Depth to limiting factor 22 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' ETf#t 'Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr CS if .6 .8 2 11-22 10yr4/4 none Sid 2msbk mfr gw na .4 .6 3 22-48 10yr7/8 c2d 7.5yr5/6 scl om na na na .0 .0 Boring # Boring pit Ground surface elev. 99.90 ft. Depth to limiting factor 50 in. Soil Application Rate Horizon Depth in. Dominant Color Redox Description Munsell Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDMe 'Eff#1 'Eff#2 1 0-10 10yr3/2 none sl 2msbk mfr cs 1vf .6 1.0 2 10-33 10yrr4/4 none scl 2msbk mfr cs if .4 .6 3 33- 10yr6/6 none Scl 2msbk mfr gw na .4 .6 4 50-77 10yr6/6 cld 7.5yr5/6 Is/scl om mvfr cs na .0 .0 5 77-96 10yr6/6 none Is osg na na na .7 1.6 ' Effluent #1 = BODs> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and I55 < JU mg/L CST Name (Please Print) Sign e: CST Number David J. Steel 248956 Address Steel's Soil Service Dale Evaluation Conducted Telephone Number 994200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 aau-eneu (n.miuuf Pioperty Owner Rolling Hills Of Hammond LLC. parcel ID # Pending Page 2 of 3 3] Boring # ❑ Boring Pit Ground surface elev. 97.10 ft. Depth to limiting factor 24 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 *Eff#2 1 0-9 10yr3/2 none A 2msbk mfr cs lvf .6 .8 2 9-24 10yrr4/4 none grscl 2msbk mfr gw lvf .4 .6 3 24-33 10yr4/4 f2d 7.5yr5/6 grscl om na gw lvf .0 .0 4 33-50 10yr7/8 c2d 7.5yr5/6 grls osg ml na na .7 1.6 ❑ 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 Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' •Eff#1 'Eff#2 ❑ 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 Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' `Eff#1 'Eff#2 ' Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity 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 M 608-264-8777. SBD-8330 (R07/00) Sheers Sal Service STEEL'S SOIL SERVICE 3of3 David J. Steel CST-POWTSM Lic. #248956 Rolling Hills Of Hammo NW 1/4,SW 1/4,S29,T28N,R17 W Town of Hammond, St Croix Co. Rolling Hills Farm Lot 25 994 200`f' St. Baldwin, WI 54002 Direct 715-760-0347 Fax 715-684-3449 nd LLC 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 Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.05 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations B1 = 99.90 ft B2 = 99.90 ft 133 = 97.10 ft B4 = 0.00 ft r r v e Visconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis, Adm. Code #1915 e-._.Page 1 of 3 Steel's Soil Service Attach complete site Ian on paper not less than 8'%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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. rl Parcel I.D. Qld 1 26 —�v y� ��lJ Please print all f f c ' R sewed Date Personal information you provide may used f r♦� iq� seDs (Privac Law, s. 15.04 (1) (m)). Property Owner Property Location Rolling Hills Of Hammond LLC. 1 9 2p06 Govt. Lot na NW1/4, SW1/4, S29, T29N, R17W Property Owner's Mailing Address Lot # CO Blodc # Subd. Name or CSM# 400 2nd st CROIX 26 na Rolling Hills Farm City State ip Code Ph r City [I Village ❑ Town Nearest Road Hudson WI 16 li 715-386-0230 Hammond 160Th St ® New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 99.55ft based on contour line elevation 100.55ft. Minimum of 12 inches and recommendations: of ASTM C33 mound sand. Boring # ❑ Boring Pit Ground surface elev. 99.65 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth in. Dominant Color Munseli Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' 'Eff#1 •EfW 1 0-10 10yr3/2 none sit 2msbk mfr cs lvf .6 1.0 2 10-21 10yr4/4 none sl 2msbk mfr gw if .6 1.0 3 21-56 10yr7/8 c2d 7.5yr5/6 sl/Is om na cs na .2 .6 4 56-96 10yr6/6 none Is osg ri na na .7 1.6 Boring # C Boring El Pit Ground surface elev. 99.65 ft. Depth to limiting factor 24 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 -EflW 1 0-7 10yr3/1 none sit 2msbk mfr cs 1vf .6 .8 2 7-12 10yrr4/4 none scl 2msbk mfr Cs if .4 .6 3 12-24 10yr5/4 none sl om na cs na .2 .6 4 24-75 10yr7/8 c2d 7.5yr5/6 s I/Is om na na na .2 .6 ` Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) gnature: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 'J bbUbjSu(l Vflw) Property owner Rolling Hills Of Hammond LLC. Parcel ID # Pending Page 2 of 3 Boring # Boring 0 Pit Ground surface elev. 96.95 ft. Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color in. Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Consistence Gr. Sz. Sh. I Boundary Roots GPD/ft' `Eff#1 `Etf#2 1 0-9 10yr3/1 none sit 2msbk mfr CS lvf .6 .8 2 9-20 10yr4/4 none sl 2msbk mfr gw na .6 1.0 3 20-96 7.5yr4/4 none Is osg mvfr na na .7 1.6 Boring Boring # — ft. Depth to limiting factor _ Pit Ground surface elev. 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/R' `Eff#1 I `Eff#2 ❑ Boring # r� Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon i Depth Dominant Color in. Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr- Sz. Sh. Consistence Boundary Roots GPD/ft' `Eff#1 'Efr#2 *Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <_150 mg1L ' Effluent #2 = BOD5 < 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. son-8330 pe.mroo> SbBers Soil Service 3of3 4 STEEL'S SOIL SERVICE David J. Steel Rolling Hills Of Hammond LLC 994 200' St CST-POWTSM NE1/4,SWl/4,S29,T28N,R17W Baldwin, WI 54002 Lic. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 26 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 ,,, _ .O, ichmark Ele. f 3/4" pvc pipe Benchmark Ele. f 3/4" pvc pipe 'ings 100.00 ft Boring Elevations Bl = 99.65 ft B2 = 99.65 ft B3 = 96.95 ft B4 = 0.00 ft 99.95 ft Visconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT P A 1 #1916 in accordance with Comm 85, Wis. Adm. Code Page 1 of 3_ Steel's Soil Service Attach complete site plan on paper not less than 8'/s x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. -t percent slope, scale or dimensions, north arrow, and location and distance to nearest road. f Please print aff information. Revie By Date Personal information you provide may be used for secondary purpos w, s. 15.04 (1) (m)). Property Owner RE roperty Location Rolling Hills Of Hammond LLC. I� ovt. Lot na NE1/4, SW1/4, S29, T29N, R17W Property Owner's Mailing Address 2N 19 6 JUL t # Block # Subd. Name or CSM# v 400 2nd at 27 na Rolling Hills Farm City State Zi CodST CRoOr�ti Y City Village 7 Town Nearest Road Hudson I WI 1 0161 715-386- Hammond 1 160Th St New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement L l Public or commercial - Describe: na Parent material Silty sediment and underlying reddish sandy loam fill Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 100.20ft based on contour line elevation 99.60ft. Minimum of 6 inches of and recommendations: ASTM C33 mound sand. Fi-IBoring # ❑ Boring Pit Ground surface elev. 99.90 ft. Depth to limiting factor 36 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' -Efl#1 -Eff#2 1 0-10 10yr3/1 none sl 2msbk mfr rs if .6 1.0 2 10-19 10yrr4/4 none scl 2msbk mfr gw if .4 .6 3 19-36 10yr7/8 none sl om na gw lvf .2 .6 4 36-50 10yr7/8 f2d 7.5yr5/6 IS/scl om na na na .0 .0 FilBoring # Boring pit Ground surface elev. 99.90 ft. Depth to limiting factor 64 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistences Boundary Roots GPD/ft' -EffM -EfW 1 0-7 10yr3/1 none sit 2msbk mfr cs if .6 1.0 2 7-17 5yr4/4 none scl 2msbk mfr Cs lvf .4 .6 3 17-64 5yr4/6 none sl/Is om na cs na .2 .6 4 64-72 10yr6/6 c2d 7.5yr5/6 Is osg mvfr na na .7 1.6 Effluent #1 = BCD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Signatu CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 20Dth St. Baldwin, WI 54002 6/12/2006 715-760-0347 SBD•8330 (3L07/00) Property Owner Rolling Hills Of Hammond LLC. _ Parcel ID # Pending Page 2 of 3 Boring # ❑ Boring Pit Ground surface elev. 96.50 ft. Depth to limiting factor 30 in. Soil Application Rate Horizon Depth in. I Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' 'Eff#1 'Efl#2 1 0-11 10yr3/2 none I 2msbk mfr cs if .6 1.0 2 11-30 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 30-72 10yr7/8 cld 7.5yr5/6 Is osg mW fs na .7 1.6 4 72-96 10yr7/8 c2d 7.5yr5/6 scl 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 Gr. Sz. Sh. Consistence Boundary Roots GPD/R' 'ER#1 •Eff#2 ❑ 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 Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 •Eff#t 'ER#2 ' Effluent #1 = BOD5> 30 < 220 mg/L and TSS >3D < 150 mg/L ' Effluent #2 = BOD5 < 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 M 608-264-8777. SBD-8330 (R07/00) steers sop service STEEL'S SOIL SERVICE 3of3 David J. Steel CST-POWTSM Lie. #248956 Rolling Hills Of Hammond LLC 994 200m St. NE1/4,SW1/4,S29,T28N,R17W Baldwin, W154002 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 27 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. 99.85 ft Top of 3/4" pvc pipe ❑ = Borings (�; /_2 - �': � Boring Elevations B 1 = 99.90 ft B2 = 99.90 ft B3 = 96.50 ft B4 = 0.00 ft !1> 5 .S'i� Wisconsin SOIL EVALUATION REPORT #1917 Department of Commerce in accordance with Comm 85, Wis. Adm. Code -D9e 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 (BMI, direction and percent slope, scale or dimensions, north arrow, and locati nce to nearest road. Parcel I.D. ( X_wD Please pri ED Revie By Date Personal information you provide may be ed for ary purposes (Privacy w, s. 15.04 (1) (m)). ' Property Owner 1 9 roperty Location Rolling Hills Of Hammond LLC. ,UL ovt. Lot na NE1/4, SW1/4, S29, T29N, R17W Property Owner's Mailing Address C L t # Block # Subd. Name or CSM# 400 2nd st ST CROm 28 1 na Rolling Hills Farm City State 2i one Number ❑ City ❑ Village ^ Town Nearest Road Hudson WI 1 54016 1 715-386-0230 Hammond 160Th St Z New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 100.10ft based on contour line elevation 99.50ft. Minimum of 6 inches of and recommendations: ASTM C33 mound sand. Boring # ❑ Boring ❑ Pit Ground surface elev. 99.80 ft. Depth to limiting factor 70 in. ISoil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Consistence Gr. Sz. Sh. Boundary Roots GPD/ft' •Etf#1 •Eff#2 1 0-9 10yr3/2 none sil 2msbk mfr cs 1f .6 1.0 2 9-18 10yr4/4 none sicl 2msbk mfr gw if .4 .6 3 18-31 10yr4/4 none sl om na Is lvf .2 .6 4 31-70 10yr7/8 none sl/Is om na na na .2 .6 Boring # C Boring ❑ Pit Ground surface elev. 99.80 ft. Depth to limiting factor 96 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/W 1Eff#1 •Eff#2 1 0-9 10yr3/2 none sil 2msbk mfr Cs 1vf .6 .8 2 9-15 10yr4/4 none sicl 2msbk mfr cs 1vf .4 .6 3 15-27 5yr4/4 none sl 2msbk mfr cs 1vf .6 1.0 4 27-96 10yr6/6 none girls osg mvfr na na .7 1.6 • Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD5 130 mg/L and TSS <_30 mg/L CST Name (Please Print) ignatur : CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 snu-aasu rn.wiwt Property Owner Rolling Hills Of Hammond LLC. Parcel ID # Pending page 2 of 3 Boring # Boring Pit Ground surface elev. 97.70 ft. Depth to limiting factor 35 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Texture I Qu. Sz. Cool. Color Structure Gr. Sz. Sh. Consistence Boundary Roots I GPDMV 'Eff#t •EB#2 1 0-8 10yr3/2 none sil 2msbk mfr Cs 1Vf .6 .8 2 8-15 10yrr4/4 none sid 2msbk mfr Cs 1Vf .4 .6 3 15-35 7.5yr4/4 none S1 2msbk mfr gw na .6 1.0 4 35-72 7.5yr4/4 flf 7.5yr5/6 grcos/slom na Cs na .2 .6 5 72-96 10yr6/6 f2d 7.5yr5/6 sl/Is om na na na .2 .6 ❑ Boring # ❑ Boring El 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 Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' 'Eff#1 •Eff#2 ❑ 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 GPD/ft' 'Eff#1 •Eff#2 Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity 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.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Rolling Hills Of Hammond LLC 994 200th St. CST-POWTSM NEl/4,SW1/4,S29,T28N,R17W Baldwin, W154002 Lie. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 28 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. 100.05 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations -� B1= 99.80ft 't B2 = 99.80 ft �J B3 = 97.70 ft `�,.. B4 = 0.00 ft 7 P / 95wCo ^� rn<r` i C C 1/,� T (It* *WA4 0�* km �couNrr NO. 641957 STATE SANITARY PERMIT TJT PREVIO ReLuMA *ILLS F+1tM QIlmliTY � OWNER bwoaft AftQ•104 PLUMBER TOWN OF SEC,T AND/OR LOr N, R &Wj BLOCK #r *Alva SUBDIVISION NO. CHAPTER 145.135 (11 WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c.168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. %1rD ISSUING OFFICER - DATE PERMIT EXPIRES NLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)