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018-2019-65-000
I �/ 1` yet , C . I -Lo 6113-- 261c/ - (,5--_ t1Old �"�r^w� -a L✓ ..,,.ten R c�` s-c c�,(o FIELD INSPECTION & SERVICE REPORT • INS_ • LA ION _ AUTHORIZED SERVICE PROVIDER so ' ,1 o ,_7 ,_ ,.(_. ..),i41 44 11 as 'cr4 installation Address: ... 5-4; Name:_ 'pi ie3 7(": ccfrrp5o 0 Owner Name: 0224 ,a6 "X4nee., Street: .fail Address: /(, 7.5- 7/-✓ Mail Address: LaXe_�ne .5.,0,04g./.5.0-) Ciry Warnirtfitit ate !p/. Zip City O5cec7 t!C State 40(, Zip 5 ;e120 Phone Fax Phone(7/5)-14-T?GP Fax ' e-mail e-mail AcE-Sa&F am6, /'/Iee.•Aei IN STALLATION INFORMATION Model No. Blower Brand and Serial No. Date of Installation Date of last pump-out 6.o/7ieco6x-s Size 0,75-rR3-r 0/07 , 9/ '/,2- EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS- 1 OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) © / Visual Alarm Operating _ V Audio Alarm Operating (if present) Blower(s): Air Inlet Filter Clean / Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment Unit(s): / . Lnusual Odor r144 System Vent d Pumpout Required: Primary Settling Zone a v✓ Aerobic Treatment Zone EFFLUENT: LIMIT RESULT Estimated Daily Flow - L vvh I pH (Standard Units) 6-9 S.U. Color Clear y QS Temperature ! Dissolved Oxygen (effluent) 2 mg/L ,. Odor Slightly vv‘.014 Musty odor 044/0 e / q(�. e� . -440"i6- (not septic �� OWNER SIGNATURE NICIAN S G SERVICE DATE G� AAAM6VI FIELD INSPECTION & SERVICE REPORT INSTALLATION, AUTHORIZED SERVICE PROVIDER i to Installation Address: Z �r - Name rymt3 7� 0 5o r> Owner Name: Street: Mail Address: / 7ff ✓ -. Mail Addl_e%�� Cit g1�/yf cafe W� Zip city SGed(Ct State L�)/. Zip 5Y4?0 Phone Fax Phone(?/S�a419-77Gr Fax e-mail e-mail cC li� �, e INSTALLATION INFORMATION Model No. Blower Brand and Serial No. Date of Installation Date of last pump-out Size D.75 FRS =7' Z) EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS- OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) Visual Alarm-Operating Audio Alarm Operating (if resent Blower(s): i Air Inlet Filter Clean Blower Hood Vents Clear ac., hl�� Excessive Noise Excessive Vibration Treatment Unit (s): Unusual Odor System Vent Pum out Required: Primary Settling Zone _ :aerobic Treatment Zone EFFLUENT: LIMIT RESULT Estimated Daily Flow H (Standard Units) 6-9 S.U. Color Clear Temperature Dissolved Oxygen effluent 2 m /L Odor Slightly ) Musty odor not se tic) OWNER SIGNATURE TEC NICIAN SI URE SERVICE DATE 2d ~ ~ ~1 ~1 ` > > N O \ a ~ tb { ~ m ~ ~ ~ C ~ @ 3 Ll ~ v ~ 01 ~ _ ~ N No - o o n ~ c ° c c ~ 3 > o ~ ,,^ z D m cz~" D '^ ~ c ~" ~' ~'- W ~ ~ f~"'i CD _ '-%• m N ~ ~ A c c 3 3 ~ N ~ N m 3 0 ;t1 CP c m m N ~IrN ~'N N ~.~. D No N N~ o v a 0 0 0 N ?. 7 (~ fl. V ~ ~ O. ~ ~ N p O ~ X• ~ o N o Q~ o ~ m ~ _ ~ c w n z m m~~° ~rnoA ° -O ~ CD N O. (Jl ~ ~ N ~Do-o --Irn~ "' N N ~• 3 0 C .O ~' w CJl A fD << V W O ~~ (D COfD < d fD ~ - ~ N fD A O ~ ~ . O. N 7 N N -i (D ~o >>fN~~ N N ~ F ? O 67 O O ~ S -~ C 7 Q ° ~. O N O. fl - (D O. O N O ~ ~ fq 7 N 3 ~ ~ O fD EA O ~ O ~ o N 0 i 3 v n C ~ O ~ ~ 3 ' ~I ~ p A tD 'C ~ ~ d ~ A '° 3 c '` 3 =r x~ ° ~ ° m ° 00 N _ '~ ~ v co - O. ~ o ; o ~ o N 3 N '. ~ O f /1 m i o ~ ~ a o a n ' r N N m !. N N W ' I O o rn ' n r y ° ' ~ V J ~ ,, i ~ , "', 6 .. D Ii °.: O O O , ~ '~ ~ ~ N m ~ ~ O O ~ ', ~ fD N ~ '.~ ffl 01 '8 ~ ', = N GI y j ',. 3 m _ a I ', T .'. ~ 'I m ~ ~ D o ° 'I c ~ ~ '' ~~ a n N A O O N 3 ~ o N y ~ --~ y N c ,p Z m ~ J ~ M ~ ? Z O (D ~ N O _ Z N W ~ m f0 ~ a z 3 A ~ °o " ~ ~ 3 '~ ~ I ~C' < N Z i ~ ~ ii A A G T c a d ~~ a~ ~. m .c ~! '~ O m O '~ ~ h t,. R o- z A N ti N O O ~. b 6p A ~ ti a a +. WisconsirR~epanment of Commerce PRIVATE SEWAGE SYSTEM Safety and Piuilding Civision r , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 'ermit Holder's Name: City Village X Township Rollin Hills of Hammond LLC Hammond, Town of ;ST BM Elev: Insp. BM Elev: BM Description: Sao . c~S 6 - E GST TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic / y 2 S~ Dosing /I ~,__ ~U / ~~ Aeratio [ ~ [ Holding A _ ~ 2(~ TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD (IV Septic ~ / /~ / / , C ~ Dosing ~ / ~ 03 ~ 7S ~ e tin 5 i I.al• l .3L ~ (c ~ 7 ~ Q " Holding PUMP/SIPHON INFORMATIONC~ti21.1~~1 ~'~d1N~'~-t b~` Manufacturer /{ _~ Demand ~ ~ e J GPM Model Number ~ ~ ~~~ TDH Lifl r' Fricti~~ ~ ~ System He~ Ft TDFj, C ' ~ f T b ~ 7 ,J Forcemain Leng th ~ Dia. ' ~ Dist. to Well / 7 ~0 3 l~'3 S(lll ARSORPTI(~N SYSTEM ELEVATION DATA County: St. CrOIX Sanitary Permit No: ~~~~ ~ State Plan ID No: Parcel Tax No' ~ ~ L 07-(p Tern ~~ Section/Town/Range/Map N 29.29.17. STATION BS S~ 5 HI X06, ~5 FS ELEV. /ao. vS Benchmark 5 ~ ~ iay, ~ 5 /~ I dos Alt. BM ~,c~~! • 5~ 7, s Bldg. Sewer ~ G. ~ n ~ S• e~~ St/ t Inlet~U o ~ / ~ - / 9 ~OJ `7' ' St/ t O tlet 7. 3 ~ 5, i3 Dtlnlet ~. ~ aS` ~3 •3g Dt Bottom yz6a ~s.y .~~ a.S s Header/Man. . q ~~~ • 6 Dist. Pipe ~~ 9 ~d~ • 6S Bot. System $. S ~~ • a5 Final Grade 3.q , bs ~oz St Cover Yl~ G~ - ~ 7 ~~ z ~b ~ ~ ,5 ~ 57. b3 Tt~ I~ ~ - QS ~3.3~' BED;TRENCH Width ~ Length i No. Of Trenc v PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~d ~z 0 Q `~ `" ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L CHING Manufacturer: ~ CHA R INFORMATION Type~fnSystem: / ~ ~`,,,~ (O ~ dad ~ A (~ /U N Model Number: " / ~'c-rnl/l'2G( 7~7 u ifIICTRiRIITI(1N CYCTFM I..JGSir"' ~wLt. L6.h (.,5 G.aJ~ ~./it.(1 nl. JJ. R tf': w.~Q_ Header/Manif9ld i~ Length~_ Dia ~~ ~ Distribution ~(o i / Pipe(s) Length 58•' ~ Dia /' ~ Spacing~_ x Hole Size ~~ ~ ~ x Hole Spacing ~ ~ Vet Air I ke ~ °C Coll f'_f1VFR „ o.e«...e e.,~re.,,~ n.,i., ,,,. Mn~~nrl nr ~t.C;rarla Svctems Crnly Depth Over ~ Bed/Trench Center Depth Over • Bed/Trench Edges \ xx Depth of Topsoil xx Seeded/Sodded - xx Mulched No Y ~I /` ~ ' ~ • No Yes .~ , es t COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: [ /~_/QLD~[~lnspection #2: ~ / ~ / " ' Location: 1636 75th Avenue H mmond, WI 5 15 NE 1/4 Sw 1/4 29 T29N R17W) Rolling Hills Farm Lot 65 ICI Parcel No: 29.29.17. Pf 1.) Alt BM Description = ~Q ~~G QtJ ~ ~Ol~~ sl ~ J S~I,¢-~-~ ~j~ ~ DT ~~'`""_`-"~~w C~" 2.) Bldg sewer length = ~ GS -amount of cover = ' ,~ .i ~a~ t°~ ~ ZZ • ~'Z 83 .'~ 3 b /1~o6d~ col ~~`~-- Plan revision Required? Yes o ~ I' ~J (0 ~ ~ Use other side for additional information. I Date Ins rs Signa re Cert. No. SBD-6710 (R.3/97) s • Gl"3tTIrIlBrCB.Wl.gov Safety and 13uiidings ~rvision ,~ CC~ 2Ul `N. Vvashingto Ave.~~~-1~ fit/ Y ^ s W ~ ^ 1 tVIadlSOti, . I S' 7 /__ ' Degsartrrrent tit Gomtrrert;e unitary Permit A~plicati n In accardancc ~ i:h s. C'ontm~ 83.2I(2), 1~"rs. Aden. Code, submitisurn of dtii form t the a v ~~~~~~ urnt :< rectwre i pr,or to obtaining a sanitary perrrn. Note. ,4pt~lication turn+- fu, stale-owne• r . ~ suhtn,tted to the Liepaitn;ent u; Commerce. Peisorm: intbrnta:iun you provid ~ be used fn!' seco Ta+•y x. +rNos_^ in~~ curda_ice with the Frivacy L,aw, s. t SAS{ 1 itt~5tats. ____ ~__ _ _ !. ;application in!'ormation -Please Print All Information Property QYwter's Natne _- ----- ---- ~ -~ --__._ __T. i Properi} Owner's'±C7aiiing Address +;;~, State --- - _ Lip Code ~~ T Phone Number 11. 't'ype of Building (check alt that apply)- ~ Lot ~ t ~,I o~~2 Fanuiy Dwelling- Numheroi'Bedrextms ~ __ _ bk ~ p.~. 5 ~ ~i ___ /~~ f ~(~ ! ~ Pubfirli'orr,mercial Desi'ri'ueUse!14_J~~._..~'~G.~.~._. ~. ~~~ ^ StLYC Olulled - JCSi+I tK` tJSC Ili. Ty1Te of Pert:tit: (Check only one box on lute A. Contplete line B if applicable) --~--- A. ~ kg,New System ~ U Replacement SystPn•+ ^ TteatmentiHotding rank Replacement Only ~ 13. I ~~ Peralit Renews! ^ Permii Revision ~ ^ Change of Plumber fIf LJ Pennn Transfer to hew ~ i3c fore Expiration ; i Uwner - _ _ ___ 1\'. Type of PUVi'TS SpstemlComponent/)Jevice• Check alt than a 1 ') __,_____ ~~___-___.___~1? r~,-~__---- try Permit Number {tu he tilted in by Cu.) '~_~ j_Z_5_(o _ _ Transaction 1Vun,ber ~"et„~~ __/3579y7 __ ~~ddress (iPdiffee'ent tltanmai;irg address) 'IDl i -CIS Propetty 1.ceation V } govt. Lot (~Z (~~ ~ / ~_ '/.. ~ ~ ~, Section ~- E ~Sircle ortey~ T ~ _ N; 2 i' E otQ3/ -_ _ _-~ Subdivision Name i ^ Village of T__--_-- _ ~To'xn U! _~~~~~ 1Jf~tr ~~ - ^ Other 11crd;ticaticn to Existing Sys~t~i `plain) i ~ ermit Number and Date Issued ' ~- ~ , 5 ~ a, j ^Nop-Pressurized ln-Ground ^ Pressurized In-Ground ^ alt-Grade Momtd > 24 ut. of:•.uitable soil ^ Mound < <~ in. o.+ soils ' ` ^ I-inldin~,-Dank L-,' Other Dis'per'sal Component {explain) ^ Prct!'ealntent Device ;explain! -tQ_[_?/_-E_a I ~ __----____------~ _R _ __--____ _ ~._ _ - ---- - ------~ ~'. Uis terse!; Treattrtent ~.rea Information: _ _ _____ _ _ _ ____ ~.~ _L_ ,-- __ X -~_ ~.__._._ i I~esiL;n Flow (gpd) ` Uesrgn Soil Applicaiio ate{ pds DispersalArea~. uired~j j Dispers37A~,rea Pro e~/d/(_s~ I System Elevation r-----.~~..~ ~`I. Tank lnt'o I t+c c,r HcIJtaL Tank ~ be __, --ram- -_--- _ _.:... - __T _•___-. Capacity m W { torsi ~ of ~ M~tytfac rer ~ i y~ (~ ; Gallons rllPi~' `' Galio~ts Units ~+~ ~ a ~ ~ ~ 1 ..SS I New Tanks j Fxr~T +atinb Tanks ~ ~ x1ntCL.C_.~ ~J 6 ^~ i' ~ 4c4 ~ ~ ~ g{ ~ I ~t _~~~ !..L~~ I a V r ~ v, .r. C3 ~. ~ Gosi~ nb ci,antber --- . D t'rR"' `~"' ' ~ lI. Res onsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS wn nn the attached plans. __ I i'li~ +ml•,e-'~'emz . ¢'a inr}_. ~~- Panther's Signature --~~~--^-------- -- ~ .~P MPRti; Num'uer i Business Phone Number G ~ ~ . ~L~._lli`~1~. S G~i ~+ lrc.( _, - . ~~ ~. i o~vZ ~ 7 ~~ /.S t3 GP~ %.7/ Plumber's Address (Street, City, State. 7.ip Code} i t ~___ ~. VIII. County/Ae~artment Use_f)nl;~_T__-~- -__---- _- _- ____ _..__-__. _._~_ -i --~~~ I Permit tee ~ Date ! sued Isst,ing A Signature Approved ii ^ is ~j ! wn iven Reeser far eniai ' $ ' "~ ~ ~ ~ ~~Z' ~~b~ i IX. Cancli i~o ol'A rrova!'Reasoos fur Dlsapprovai \ x ~~ ~~~~ I ~Y~f€kl ~~~~: 3) ~J. ~ _ ~ tk~ ~p ~"D Lot ~ ...llll O~ IMD~ `~ 1. Septic tank, effluent fltd' and 5 ~~ dispersal cell must all be services /maintained ~i ~, ~ Z ~ ~ f~ ~~~ q~~„~..4~ i as per management plan provided by plumber. ~oT ~,__ 2~ All setback r~rements must _,p~itr~Laine~i_.. _- ~A o1 ~ c.~~~-2~c ~ ._._..v.-.____~ i ( ~ ~r art~ttee. s~ste~a and submit to ttte County vnly un paper nut less than 8 tr x ! ! inrhu in size SE3U-ti39'3/ (R. O1'U?1 Valid that 01(U9 n ~ ~ .~-~~' G O~ r ~~-- l.t) . L l ~ ~ a ~-'S (p 5, !o to ~ (a7~ 5ef~ ~ ~~~ 3/~1~7 ".°~ b~ ~' l p ',-_ o f ~_ ~ f ~L ~+ v o (S ~ _...~!_ M .--.. ~ f 3 , ~ ~` -~ _ ,~ ~ ~ I "'----- f d ~ ~ a ~ ~ , ~----- -~--" a ...__ f ~ I_ l r _ . , ~~ ~o + I ~~ J ) ~ ; J e ,.,, ~ .T -~ d N N ~ ~ ~ I - ~ f S ^ j 5 ~ ~ a-- ~ ~ ~ ~ ~- ~ ' 3 ~ j ~ ~u# x p ~ ~ s ~~ o ''~ ~ d ~( i .; . ~ i po ~ -~ S 1 --r 0 of i t~ ~I .~ ~^ J ~~ ~ ~, ~ ~ ~ ~ ~ ~.r 0 ~ ~ ~~s~ ~ ~ J', ~ ~° ~~~~ r ~o~ i 0 3 `~' d' ~ ~ J ~ ~ ' ~' -~ / ~a ~ ~ ~ ,3~ o ~/ _ ~ y ~ ~, ~ - ~ d -~ 8 ~ o ~ ~. ~o ~ ~ ~ -_._ s - ~ s ~ o; .~ o $ _-,--_ ; fo ~ ~~ -=F 0 ~.v.' -~ ~ -- ~ ~ a J c./~ ~, ~. 0 ___ . __ __ ~ ~ ~ ~ ~ ~ ~ ,~ fn pl j Qo s a ~- ~ = c~ ~~ ~ s 0 9 77 -.-d d _d . d _ v J •c~ p ~ .-~ ~ t ~ ~' - d ~ ~ e • a d c~S a f ~I f ,V ...~' O n ]:~ ~ ' ~.- ~~ J J a J ~ i 1 s 1 d y ^ U~_J o d" ~~ ~ 0 S S ~ ~ ~'' s i°" s ~ o. ~ ~ o $ o o ~ _ J ~ ~ 6 ~ o i "_ ~ fl ~ ~,~ - ~' °o M ~ f~1 p~ -- _, ;, .. ~ -_. _ v ~ ~o ~, s tya s ~1 ~ _ ~ 3 1 ~ _ __. _a- l s- ____ a ~ ~~ d '' j a .d- - c. ~, ~ I ~ ~'~ c i s ~ ~ _ f d .___ __ ._ _ s - --1 - ~_ > l ____. ... ~, - -- d ~ i '~ --Y ~ ~ o . g ~/ Q . ~ ~ ' ~ "~' . .. ` ~ ~ 9 ~ t. ~ S'.. , __,__. _ ~ _' ~ I" ~ 1- ~ •~ 1 L1 J f J ; N ~~ t_ f~ ~ .~ ~^ ~ ~ Q ~ ~ ~ ~f^ J ~1 i d s s s __ ~~~ ~_ commerce.wi.gov i ^ ~sconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www. co jn m e rce. w i . g ov/s b/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary February 09, 2007 CUST ID No. 222774 HENRY F GROTE CERTIFIED SOIL TESTING E4366353RD AVE MENOMONIE WI 54751 ATTN. POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/09/2009 Identification Numbers., Transaction ID No. 1357947 SITE: Site ID No. 721805 Rolling Hills Farm Please refer to both identification numbers, 160th Street ~ above,,in all correspondence with the a enC . Town of Hammond ' St Croix County NE1/4, SW1/4, S29, T29N, R17W Lot: 65, Subdivision: Rolling Hills Farm FOR: Description: Residential Mound System /New construction /multiple homes -approved for 12 bedrooms total Object Type: POWTS Component Manual Regulated Object ID No.: 1114594 Maintenance required; 2,400 GPD Flow rate; 23 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual- Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.O1/O1), Aerobic pretreatment unit The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the component manuals referenced above. • The 0.75 Biomicrobics pretreatment unit must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • Comm 83.21(2)(c)4. The application for a sanitary permit shall be accompanied with documentation that the master plumber or master plumber-restricted service who is to be responsible for the installation or modification of the POWTS, has completed. approved training on the proposed POWTS technology or method. • Comm 83.21(2)(c)5. Any maintenance requirements that the pretreatment unit requires at an interval of 12 months or less must be recorded with the deed for the pro e~rtv A copy of the document must be presented to the county before the permit can be issued in accordance with the requirements of Sec 145135 and 145 19 Wis. Stats. • 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. P.O.V4-.~:S. Co~zditionalty HENRY F GROTE Page 2 2/9/2007 Approval Conditions Continued: • 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. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Comm 83.22(7) - 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. Note: This approval includes a recorded document that satisfies Comm 83.22(2)(b)5, Wis..Adm. Code.. Owner(s) Responsibilities: • The current owner of the residence and all subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owner(s) shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • 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. • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan. or as required ander s. Comm 83.54(4) shall be considered a human health hazard. 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. • A full evaluation per Comm 83.25(2), Wis. Adm. Code will need to be conducted whenever a new residence is connected to this POWTS. In granting this approval the Division of Safety & Buildings 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 maybe 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, c ~,~ ~ `'~¢2~Z~~~ ~ot-- Gerard MSwim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon -Fri, 7:15 am - 4:00 pm j erry.swim@wisconsin.gov Fee Required $ 275.00 Fee Received $ 275.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. ~_` ,~ _ ~, ~~~ -~ -~ \ ~ ~ ~ 1 ~ ` G ~. ~. ~ ~ ~ ~ .. ~ \ \ ~ W Q ., N -L ~ 1~ r~~~_. s ~„ -- ~ CIO ~~~ \ ~ Z0Z J~ i~ ` tY \ W~ ~/ \ ~ ~, oW< o \ + _ \ ~, ~ O ~ ~ ~ ~ ~ 1 ~ 00 1 \ 1 ' \ \ \ \ ~ ` ~ / \ .: 0 ~ \ if~ 1 I ~ ' ~ \ _~ ~ - ~ ` ~ _ n ~ ^' ~ ~- ~o pp \ \~ N t0 I d \ \ .q \ ~ ~3 t1.0 ~ $ ,- ~ ~ i ~_ \ ~ ~- \ _. 1 ~ .` , x ~ ~ ~ OD l ~_ \ ~ ~ ~~ ~ n ~ ~ ~ _~ .. ~ 1 `O ., b n ~ _ ~ , -~ ` ~O 333 J~~~555 \ \ `44411 \ N ~ ~ atp. '~V31N r, n =M _ i _ ~ ~ I \ / I~ .~ - t 0 02/07/2007 17:22 FAX 715 233 0398 Certified Sail Testing 3 Lag Commerce ~ 003/003 rtb~, 1. LUUI 4,j~rm kulNR KtALIY HUUSUN NU. 9149 N. 3 t ' ~ ~ AFFIDAVIT ' l?ussnant to Wfs. Admfn. Cpde Comm. 83.x2(2}(b}a.b S'rt~YE ©P WISCONSIN ) . )ss co~'N'Z'X OF S~'. CROI~ ) Dave Peters, being duly sworn, states and ceri~"tas as follows: Z. Y1am maasgex of IZoII9zig I3i11s of Tammond, LLC, a Wiscousaa li~xei~ed liability camgaziy az-d am authorized to sigm tJ,,is Aff`rrlavit oal b~alf'vf tie Said comgan~r. 2. Rolling Bills a£~o~ad',, X;TC is i7ie owner a~the following described pxaperty: Plat ofItaIling'la Far~a, recorded iu ~e Office of the Itegfsi~r o~F • needs of St. Crain Catm~ty, VV'%scarlsin, on Febxusay 5, 2007, iu. Volume 11 ofPla#s,page 19, Documamt~Fo~;43$~6. 3. The above properly.cor~tai~ns, ax;slia~, co`ataur,Qz~e or mare private onsite wastewater treatmeot systems (POWYS} xegulated under Wis. Adtriin:. Code G7a. Comm. 83. 4. 1~o11ingHills FatHt Resic~ex-taal Propert~r Owners A,ssaaiattion, Inc., a Wiscazasin non~stock cozPorati.oz~ z~ the Ariwa'Ce Iogal entity that own. the POWYS and is responsible ftu:'tho operation an ' tenance of t11e FrOW`I'$, a6 provided iA the beclaration of the Ro11m,g Hills Farm • 'd' ~ Prop, Ow~ea''s Assocafiion. ., f , ~ ' Y ~}~~~~ ~~ 4Zl[tR+Lt a. STAN 0~"VVLSCONSIN' } COUNTY OF S'z'. CROIIY ; ~ ._ r:,., ~ ' .. - .. . __ - ~ . _ - 1?crsonallg came before me this ~~ay of Februax}-, 2007, ~.e above ~exned l~aw'e Pettr~, •Ca ma lcuo to be the pexsa~a who, ~c~uted;tla~ fQr~~ai~~.in~t~.nt and. ackaawledge t3~e same. Notary PubLia, state: of Wisecros~q ::; L - - ,' - _f?aCmefa-/A:: Vilitiman My commission t ~ r. /_. - _._.' ... r : _ - .- ~: (Vbtc"3t~~~UbIfC ..~ , - <~ : . ~: _ Stag of ll~isconsin This_Iz~srcurne t was drafted bX:. ' ' Y.onn~men, Aida, Cola, Kiag &tStaggba~, ~.A , Ath1. Tirent R: Jobusoix = - -: _~.__ --~ ,,~ t, Gituldview I'xro£esszoaal }3uildiug Sufte 2310 vF00j~SIaYhut~h }S7~econdCStrect ~`~ y '} .G3~447YM, ...1 544~U .~h~~ 41.1~~ lj YrY L:11J•.5~.,}.~.. .. .42,/47/2447 17:21 FAR 715 233 0398 Certified Sail Testin8 i LaR Commerce I~j042/443 rte.. i. ~uvi ~,j~rm tu1Np KE~LfY HUU~UN N0. 9247 P. 2/3 ~ ~~ ~. ,~~ ~.~ ~ ~ ~~ DPcum~tNsstpbe,~, Titleafriacument 87: CRt1I~Y GCt., liY REC$~VE~ F'4~ F~G~3kA 0~/01T12F~2~7 1,~s15~F'?! '~ n~z~~,vx~ ~7t~T # R~C'~EE: 13.00 •. TRANS F'EE: - CaPY FEE: Z. 0® CC FEEa PAGEJ~ ~ '! _: YiccordingArea . - ~lamc and Recum Address _.~..`s ~_-~,r.:e;li_Y'~J:"!_ ..TA]11m2n1~dO LSW ~IPq- - _.-_ - _-_:..1~..._ __ . _ .. _ - '~ .._ • _ :. _:. Atm. great li. Johnson 400 South Second 9tteety Suftc 214 ~adsan, WI54016 ors-ions ao-ooo; o15-ia6s-3Q"ooo ~ OI8-1065-40-050: O 15-106550-075 ra<~ idr.~li~icatian Nombcr (PIIV) Plat of Rollirlg ~il],6 Farm, reavrded ~ ~lae Office o~ the R~gisster of Deeds of St. Croix Cownty, 'Vl~isconsin~, on February 5, 7.OQ7, f~'~'olt~xne 11 ofPIats, page 19, DocuxasatN'Q. 543836, located irl tlxa 1~VV~1{ of tha SW%, tl~e ~~,~ ofthe o~the $WYa, parE of the 5W%4 of the S'VV'i/4 ,and pant of the SF%< of S~V~/. a1], ia, Section 29, aad part of the 1~TE%4 ofNW% of Sectxoia 32, a1I in 'Y'29N, R17W, 'Pawn of.T~ammond, St. Cxaix Cromtq,'U~iscaasin. . - - - - a J,tJPQ-PRA (800)GSS-2021 www.iafopro~'o~s.ebm Rolling Hills Farm Mound Common System Design for Lot 65 (and future lots 66, 67, and 68) Construction Materials and Techniques W llt ]1 1~ All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: v~ ~ Mound, SBD-10691-P (01 /01) ~ Z ~, ~ Pressure Distribution, SBD-10706-P (O1/O1) o _ N QLo~ion: NE '/a, S W 1/0, Sec. 29, T 29 N, R 17 W .-i o;f Town: Hammond County: St. Croix !„~,,, Dat~ January 11, 2007 Owner: Rolling Hills of Hammond, LLC Address: 400 Second St. ~~ 11 ~ ~ ~ ~ ~ ~i~ /~/ ~~~ ~ ~~~ p N S ~ WI 54016 H d : ~ . _. son, u ` ~ ~G P~~ ':'~ Designer: ~ ~N ,. ~: GP 1699 N\~ : _ He y Grote N p '• _ Signature: • ~~~~~5• ~~, ~ ~ License: WI D - 16 -007 ~i~~~, DE;`G~~ Attachments: SBD-10577 -Plan Approval Application SBD-8330 Engineers final grading plan, 1" = 80' Redrawn plot plan, 1" = 60' Page 1: cover 1 a . overview 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management w ~~ ~ gU1LDINDS `"` `~ pFVSAFETY AND IvIS1oN .._-- ONDENGE SEE GORR page 1 of 8 ~- ..: 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 771ots 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 aseptic/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.afnr 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 1 a of 8 Design Criteria & Calculations y * ,~ ~ ~'~' Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL ~~'i Treated Residential Wastewater Contaminant Load: 30 mg/L < BODS Septic tank + "highly-treated" effluent 30 mg/L < TSS Fecal Coliform < 10,000 cfu/100 mL Bedrooms x 100 gal/bedroom/day x 1.5 ~ ~ gallons/day hydraulic load, current 1 Z Bedrooms x 100 gaUbedroom/day x 1.5 ~ ~ ° ~ ,potential future In situ designed loading rate ~ . S ~- gallons/sq. ft. per day Depth to estimated high ground water ~. 2 3 in. Depth to bedrock ~ S-~ in. ~ Cross slope at system ~• ~' % w.ak ~-~-1~~-~~~ Force main length ~~ 8 ft. of 3 in. ~~z-.bt Z~ Z - ~ ~ Manifold/headerlength ~•t' ft. of ~`~z- in.o~~~ Drain-back ~ `g ~ ~ ~ gallons Lateral length ~ @ S c~ •s~ ft. of in. Lateral elevation t ~ ~ ~~ ft. @ bottom of lateral Lateral hole size ~~ `~ in. @ 36 ~ ~ in. ( 3• ~ ft.) Spacing Z ~ holes/lateral ~ ~- ~ holes total Lateral volume ~ ~4- gallons Total lateral discharge rate ~'~ ~ L gallons/minute @ Ste` ~ ft. head Network pressure compensation losses i ~ ~~ ft. Elevation difference ~~~o ft. Friction loss S~ ~ ft. @ Sb gallons/minute Filter head loss ~ ~ s~ ft. Total dynamic head ~ 8 .~ ft. Pump 53 , gpm @ ~ ~' ft. of head Manufacturer ~' °'~~ ~.S 3 $ ~~ Model # ~^''~ ~S ~-1 Dose volume 3 `i"~} . Z- gallons Lift tank W ~ ~•~ ~ 4Z~ ¢Z~ gallons Pump tank filter S ~ ~^~-~~ s-r t= ~ ~ ~ z Septic tank ~'`~ ~ ~~ w Q'~S ~ ~ 4Z~' r3~~~s~~o•n° ~•4-~-~~ gallons, 1 current + 3 potential future Septic tank effluent filter C9 r~.~~ ~T c~gZZ-l4-eta , 1 current+ 3 potential future ATU ~ ~ ~ ~^^ ~ ~ ~~ ~~ ~ s fi~~ ©~~-s~ , 1 current + 3 potential future Measurement pump timer enabled on-off 8 ~ o in. ' Dose pump timer on setting ~` ° min.; field verify dose @ ~°'~• 2--gallons Dose pump timer off setting between doses ~' t•~ min. Height alarm from tank bottom 4- 4 ~ ~ in. Reserve capacity ~ ~ `~~•~ gallons specs.calcs Page Z- of g ., r ~, <, _~;~ `: ° 4' S ~ !, a.. ~.-` ova ., ' ~ l ~ ` t1 ~ a a.o 4~0 o v ~ ..~ a~. / ~,~ \ fin, ~) -r~~..~ ~v.. ,~,~ ~ `~ ~' Z d .,~ ~ ,c ~. 1 Z~~ t.S j h // h~..S~ ~ b s~~+co:1 1~~~ ~ ~~e... x:540_ ,,,-.,M"~1 >3 ,l ~ .. Sq,~~, l 4 ~ r ~ \ ` J ,~,. _ U ~ I ~- -ii. w. a y . ,,~ .~ ~ ~~ :Y ,.. ~. ,, o ~,~~~ 3.3 ;; ~ ,~}~ Ic-2o' -il 1 _~ ~, g' ~- ~~,~ ~~c,"~' 43.9' ~1 tZO~o' -~q,b' 1~q,2r 4 ~ ~ V L t ~ ~ o~ 1 a.,r v r ii o('... ~. ~.1(l~~ `C'(~ b o ~ o ~`.. ~ r • ~~ `b ~ , ``i o +L ; ~ ~ ta. ~\~ ~ ~ a. v ~+1 0... ~, ~ ~ y 1 1~ ~ o ... o....l~{ O F 1~ a c.~ b s~ tt ` `` 1.wiQhot ~~LiA1~ ~, 31. p I~I~ PVL. SC.~ 40 v^a..~1'~ `~ "~' o.a0' wti :v~'o y.....:~ol.Y ~ ~ \ 1 ~ }1 •-b ~ 4 . i ~ ~ s.e, 40 l ..~ S ~'la`~ (~, ~ L Jb.~ ~ . ~ w~,tq 1~ f 1~ ~~ ~ ~ ~ ~ ~ ~ 3.y~ ~ 3,z3' ~? I--- ~ ~ 3,0' l . '~-, a' ~" ~.. - ~ t` I o v , v ` n.,, I _ ,, 1 b, ~ o, ,,,, . ~ 1 ~~ f 1 Z ~ ~- .~ I \ v - ~ `~ ~ O~ ,. ~ L'' i, ~` PUMP CHAMBER CROSS SECTION Min. 2' \`ent Pipc with cap 210' from door, window or fresh sir intake ~~ venL Cap I~ Weather Proof Junctbn box 12' MIN 1 ~l o ~-o t,~. c L~~ Flnp! I p a Elev. ~`~ ~'~~ ~ u I 1 Conduit ~ ~~ ".-~~ ~ I ~ ` ~~ // ~ S i -1 Tug- ~ Inlet ST~=~ `un to Z Page l~ of ~ Approved locking manhole Dover w/ warning label ; TO`.a 2~n~n N a I 14' MIN j 18' MIN -- - ~ Approved J ~ ~ Provide l ~ ~ ~ Joint \\ A Alrtlght Seal I ~ (~ ~ Approved ~~ I ( II Joints // T( I III // i B I ~ I Alarm // \\ t C l a, l w,~ Pump ~ I pn i S S~O ~ ~ \ --~ ELEv, ft ~~ Off ~/ ~~ 0 / ` Concrete•Block ~ S \\ // // E12v. ~ ~-Z liquid level - ~ ~b`~ - S-S"~ o ELEV, ft ~r p ~ ~ `i 5 ~i .. S `~``a~ gallons/in. •~ 3' approved bedding maurial under tank SPECIFICATIONS Note: Pump and alarm are on separate Number of Doses: 21 Per Day circuits as per : ~~s. Adm. Code Gallons Per Day /# of Doses: ~\4,Z Gallons Volume of Backflow: 2~~•z Gallons Tank Manufacturer: `-^~ `~~ Total Dose Volume: 3~g.Z Gallons Tank Size: ~' 4Zoo• Gallons Alarm Manufacturer: ST L ~~ ~~ Model Number: ~ °' ~`"" Pump Manufacturer: ~' ~ w`~i Model Number: ~ `~$~~ `•^'~ ~~ H Minimum Discharge Rate: 4-~,~ GPM Capacities: A ~~b•a inches or ~~~~~`~ Gallons B 2~•~ inches or ~s~~,g~~ Gallons C ~~~~' inches or 4~-0`~ Gallons D q inches orSzg•~s Gallons Total........ = }2- inches or4Z'~'~~z. Gallons Vertical Difference Between Pump Off and Distribution Pipe :............ : ~.nFt. Minimum Required Supply Pressure: s~o .~-\.s' ~-~s ................................................ + _ Ft. ~'~g Ft. of Force Main x o ,~ a Friction Factor/100 Ft .................. + S3 Ft. ~ sb ~~ •~ Total Dynamic Head = 5g_3 Ft. _ N b\ N Internal Pump Tank Dimensions: Length ~ S g width ~ Depth to inlet ~'9 F f ` ' -. • For Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent Systems anywhere effluent or drainage must be disposed of quickly, quietly and efficiently. Heavy-Duty Solids Handling Dependable Capability to 3/0" 'h, 'h H.P. 60 Hz Single Phase 115, 230 Volt. 'h, 3/4, 7, 1'/s H.P. 60 Hz Single Phase 230 Volt. Three Phase 208-230, 460 Volt. 90 80 WE15 ~ 70 w WE10H LL 60 Q = 50 U Q 40 WE05H 2 0 30 WE03M J H 4 20 'WE03L_ t- _~ 1U 0 10 20 30 40 E ~~ ~. ~~ I ~ -- MODEL 3885 RPM 1750/3450 ~n Rn an inn inn r GALLONS PER MINUTE Bulletin CL2.1A July 8, 1983 ~IV~~~J Model 3885 (Supersedes Model 3870) Submersible Effluent Pumps Pump Specifications Solids Handlmy Capability to 'i." Discharge Size 2" NI'T Semi-Open Impeller 3 vane design. Inie~idoil c,i~ shaft Three pn,;s~. units use nuFn:Hur lucki~~ut to pr event UCGiUcnLa back-off. Pump out canes on backside of impau~ for' protacti~rn of mechan!cal Seal Casrng Volute type for nt,~xinu,m ,efficiency Stainless Steal Fasteners Series 300 Sta~nlass weal for corrosion resistance. Mechanical Seal Cerztn~,ir' vs C~;ro:~n nc~,,~~!~c; (aces sl.tinless ~I~~~~ Spnny .,na E„na N ~I~„I~,tners Maximum Temperature 160"F Capable of Funning Dry witnout damage: to components. Motor Specifications Motor Fulty Submerged !n nigh gr<<i;<~ luro~ne o. iOr perrna!;i-rt !ur.r~c,t- lion of n~~6;rin;)>. <tnd n ~~cn;;nical Seal .end efficient neat :;!ss~pat~c~n tvtotor sc~an_~d troop environment uy ruggcc7 cast iron enclosure Bearings Heavy-eery ~,II ban oear~ny constr..,:t!~n Stainless Steel Shaft ;ienus 30U ~Lnnli s SI~i)I for COrrp,~.~n resistance. T nrcaaad snaft Single Phase Units All Sinyli., pli,c„~ „!nt:, i~.f ~. ~• Uuilt-ii~ lni~:~ii.fl overrlc,ad prnt~rct:,!n ~v,tn ,urtomet~c reset Three Phase Unrts OveilG:id pr~:ri.:~t~ ~n ~.,;rtci uni; _bo .3J Or tib~; vOiL~ ~ ~ ~~ -.., i] ~I~~,i~, Oti r1.' Oprr,iL~~ii Power Cord ~ rile! ., i, ,.. - _'.a!~t _ '~„y' Soil Jn a~UI~~ ~,~.. acts ,i, a 5~ ; ,,.;!y :c!~.;,,re oan~~r ,r. oaac ,,, a8!l~a;;~- t~ : ,.__ ,,iCnrLr1~J ~i01'fOjiJfl reSiSt ~~1 yl;i!~~~1 it„t Sinyle Phase Units ri'. ~,,..., . ~ ~ , a with ~, ,~! lr :~ .~Jl l" ..~~n . ~ „.,~ .. i,~~ .y p., ~ n moa~ls ~g 7 r~tn '-~ Os 1~3 S70 power cord SPECIFICATIONS ARE SU6JECT TO CHANGE WITHOUT NOTICE '° ~GOULDS PUMPS, INC. SENECA FAILS NF`"~ v(X7r. Gi:.~ ~~ ~ i ., ~ « `'~ ~ ~ ~ System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet-rock and/or painting,.pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Aerobic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic, treatment or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. The upslope toe of the mound system must be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run-off; final settled slope should be 2-3% over the system or 2-3% diverting surfac@ run-off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank and aerobic treatment tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the septic compartment filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. This system has an aerobic treatment tank which must be inspected every six months according to specifications and contract. 6. The aerobic treatment system has a blower which runs continuously; if blower operation has stopped a licensed plumber should be notified for service as soon as possible. 7. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 8. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 9. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 10. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 11. Surface drainage must be diverted azound the system; avoid landscape changes which might send surface run-off into the system area. 12. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs aze implemented. Additional testing, designing, and/or installation of additional treatment components or repair/replacement of the adsorption system may be necessary. Page 8 of 8 .`i. '~`t6t~ ~ ~ .: , ~~ ~ ~ ~%" ~~ '~• 'fit .,. ~ ~ ,.. ~ ~f~.~,~~ ~ ~~ ~~ •~ i ~`~ ~ / ~ - ~ ~ ~•~ ~Il8f1d 3FLL Ol a31tl'Ji ~ / / / '~~ ~ :. ~ ~~~ ~ ~~~\ ~ ~ ~~~~ Ca p ~ I M \. ~~. ~.~ .` O A 1 J~ `` -„- _ °° 'aim°- ~ ~ ~ M„oL~N ~" a~c Q ~~~ .. L M.~idO.~ON~1 . ~ st ZzL O ~ ~ ~ W J a . I A8.9LL 3.9L~~ ~ ~y ~'~ ;~ ,98•S6L M.~.~o.ooN •. ~ •~~ ~ - ~ ~ ~ ~" . ~ ziztii enazsi.oorr' ' w ~g, i~ ~ J ~ ~ ~ AO'£ft3.lZ~lE.IOS '~' _ ,~, ~ , ,.~, ,J i~~ 89R ~ ! _ .. /i ~ ~ w ~ cod ~ ~ ~ ~ ~ m • ;% ~ ~ •. r /~ ~ (V ...\ a~ ~ti"i I i ~ ~ ~ _ / ~ ~ li ~ !i~~FU"-'---~ ~ ~~ ti NSF • ~ 0 ~ \~ _AV'9ll ~ .~ f - _ ~L1"tiLS3L~,LL.~pN--- -•~ ~ / -ham gg r ~ ~ ~ ~ ~ OF / ~• ~ ~. Y 4 ~ ~~-~ ~ ~ ~ ~ ~ _ ~ ~ ~ $t J ~! ~ ~ ~` --- ~'~~~eo~s- ~~~ ~ ~~, , tit a I~ a -_ SlO1s ~ ~ ~ °~fq ~~ ~ ~ ~ 4r ~~ ~ _ _7~ \ ~ ~ ' - - t/LMS 3Hl d0 ifl 3Hl d0 3NI11SV3 "o ,,~ , ~--- __ -_- t 4 -- --__, ti/LdOZ/Z ~I1d03Nt'i18~M ~~,~• _~. ~;,.. q J N ~. • ~ ~ ,: Qp,,b ~ ~ ~~. ~~ Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code #1896 Page 1 of 3 Steel's Soil Service Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must i l t li it d b t d t i l h i County St. Croix nc no u e, u m e o: vert and or ca zontal reference poi M), direction and percent slope, scale or dimensions, north arrow, and ~ n and istance to nearest road. Parcel I.D. G " end g Please pr ~ bn Review By Date Personal information you provide may a use f "secondary purposes (Priva Law, s. 15.04 (1) (m)). Property Owner 1 ` Property Location Rolling Hills Of Hammond LLC. ~U " Y Govt. Lot na N 1/4, 1/4, S29, T29N, R17W Property Owner's Mailing Address Rp1X Lot # Block # Subd. Name r CSM# S~ C 400 2nd st 65 na Rolling Hills Farm City State ip Phone Number ^ City ^ Village ^ Town Nearest Road Hudson WI 54016 715-386-0230 Hammond 160Th St ^ New Construction Use: ^ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ^ Replacement ^ Public or commercial -Describe: na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 100.88ft b sed on contour line elevation 99.80ft. Minimum of 13 inches and recommendations: of ASTM C33 mound sand. ~~ ~Q~ ~ ~ ~ ~ ~~~ Boring # ^ Boring ^ Pit Ground surface elev. 100.65 ft. Depth to limiting factor 23 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 10-18 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 18-23 10yr5/8 none scl 2msbk mfr gw na .4 .6 4 23-50 10yr5/8 c2d 7.5yr5/6 scl/sl om na na na .0 .0 Boring # ^ Boring ^ pit Ground surface elev. 100.65 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-14 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 14-31 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 31-48 7.5yr4/4 c2d 7.5yr5/6 sl/scl om na na na .0 .0 "` Effluent #1 = BOD _> 30 < 220 ma/Land TSS >30 < 150 ma/L "Effluent #2 = BOD~ < 30 mg/Land TSS < 30 mg/L - - - - ~ - CST Name (Please Prin Signature: ,.-" CST Number David J. Steel ~ 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 6/12/2006 715-760-0347 Sf3ll-FS33U (1(.U7/UU) Property Owner Rolling Hills Of Hammond LLC. Parcel ID # Pending Page 2 of 3 r^3^ Boring # ^ Boring ^ pit Ground surface elev. 98.3 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 13-24 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 24-32 10yr4/4 map 7.5yr5/6 sicl 2msbk mfr cs na .4 .6 4 32-48 7.5yr4/4 c2d 7.5yr5/6 Is osg mvfr na na .7 1.6 Horizion # 3 is wet. ^ Boring # ~ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EN#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce 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) Steels Soil Service r ' ~ - ~ ~ STEEL'S SOIL SERVICE 3 of 3 David J. Steel Rolling Hills Of Hammond LLC 994 200t" St. CST-POWTSM NE1/4,SW1/4,S29,T28N,R17W Baldwin, WI 54002 Lic. #248956 Town of Hammond, St Croix Co. Direct 715-760-0347 Rolling Hills Farm Lot 65 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. ~b ~~ N ,/^' ~--) c~~' ~- ~-~ ~ Legend 1" = 40' • =Benchmark Ele. 100.00 ft p of 3/4" pvc pipe Alt Benchmark Ele. 100.15 ft p of 3/4" pvc pipe Borings Boring Elevations B 1 = 100.65 ft B2 = 100.65 ft B3 = 98.30 ft B4 = 0.00 ft • e OWNER ROLLING HIt160F NAMMOND. LLC ROLLING HILLS FARM ATTN: DAVE PEIERB aoo s. secoND STREET LOCATED IN THE OF NW7/4 OF THE SW1/4, THE NEt/4 OF THE SWt/4, PART OF THE SW1/4 OF nuosoN, vn eaole SW1/4, AND PART OF THE SEt/4 OF THE SWt/4 ALL IN SECTION 29, AND PART OF THE NEY(4 OF THE SURVEYOR NW1/4 OF SECTION 32, ALL IN T29N, RY7W, TOWN OF HAMMOND, ST. CROIX COUNTY, WISCONSIN. Apo EDWIN C. FtANUM w;;{{ NORTHLAND BURVEYIND. INC. :r9~~ eeBAHWY'66'\P.O. BO%14 op~~ LEGEND ST_fJRMWATEIi NWNAPEMFNT FACILITIES MAINTENANCE PLAN AND OWNER RESPONSIBIL111EB: ROBERTB. WI e4D23 r• l; ~ ~: ater mewdemsn„ecnler. ww~ rew+ro ~ e nvnnrnu aM °rendfa nnp,cu n.u .n w.eu e:. er ro~xw, PHONE ]16-]as-t T1S "wA~4 wxnM xoxuRr.xl EOUx° riw r,en.w un, ertu m.+en FAX TIe-T4e-l TtY wia ~ wenwwwe tewu.nv~tp°.vxvmee cu ENGINEER ~y~~ i7 ,.1°, PR.ExuxEM ..xwl no..n wew.erowww•tlw ww. www a,ewn.me°~newnd.w°~nonwaw~we Fe a ~lwu~ lMTT HIES H a k ~° xExs ~ °e~ sescl ~~.ae. wwwe aria w~°.oHwa W x~. e°crvale~e ve. ronw. ~ r AUTN CONSULTNO AND " G Fa s TM~~e9 rMn d °yweC IwtlewP a w ro nvlnwn me nesetee °°nw vw w.xe•ae. ene,Wwe~w veal. nro ~w » I~ve+r.u r~a n ABSOCIATE8 ~ ~ e r, a e. a a.w. w1a uw e°woacw xe.tvatlan ane Nenee,mwa ac°.am d.w 2920 ENLOE 8TREET aTall wa nwn u.e HUD60N. WI etetB ,ix nnE °xu °net„.e .am:.wl,n iuuctlan,+,wtunner nwlmww:c. w•wld no rvnwaue aam wta xw R s O a rse, ene w u ~: LOCATION SKETCH j a wnsoxnxr xN. xooxo .ro„nw.w. m.ned.m.m Hal w.. al:w.,wna •rvrwnnen°w nwe.,..w e:ewnn dwn.w dReu. wn a a°n...nowd tle ,°°enea w.e .a „Iw.xe °e ,.:,,r»n I__ ..._ -. ~ i•o°wox RxE EOUx° wuw.,rvedon vau„at,uw.arwre(roW. adrom, eddeanal woe.. aom°rotlw•, e.owanruL,ro1 ;.... I ... , '~: ~' ) I, eodment In me,arrtw'aw meneeemant Rell tlee aawwd, ror,°-,ex el one uW°neo ra~ ~wWlnel wawa: MC Mtln IG~s Ox eOM II°E fOYN° ~poel„d, arw eueNtep,u°nan,nwll,w rwau a, ,wrmwnar mevaenwn, redline, ~' O N PIxE FOYXD m wNeeW: gi1,wr Mm°ax eraeMp edlNWe. we wx mat' need ro Le nxaMd m amwm,mel~ ow:N ant waancwu ' '~ • v n%O o Ixo a ans ove.xew wM, ae, nm roeW 41rwMe a moa eMWd W R°a1Rd b dr alynal Walen wwatlon. I r w°°eM awnea,IWI M nepan,wR rer rod,ser mantw~a,re ro xw (edlltlu ~ tlr anPexv ~rx .t~ M wa W Wn,M euueMYan . cuY en tnownd a av.Fedee M lerya npdR, ead u,Y woad W elw,w eoo4tl ... . ~........_ III +i 4_ pxOPOSUI nxnEWAY LOCPIIaI RWI w Farm Rxwentld wdpwN OwuRY j ~'. _-_ Ixwlp5Yn4tt IJ,D ORYIN4EMeFMart e. Ja,MeW In,M BW.raYm NMa ,w x. j I ~., _ Th. °x)ccti°ia Wlhia plat wilA mxprttw : cdr ~ ~~: ~ -xww.eeBLxERExr,°w°eawxo 1 ~. 1]G I5.1)6.16.=1628 end 2)G 21(11 end ll), 1 _ ! -- sloE VUto N,o s MdE ataNO afM VM° W'. lwt, ds aa'~~ ~' <. ; JM1 11, the 51nH _ .. l 6 x ....... xo.oW.YxseNT,oRx ae sxdWN) ] I ~ (Sa ixea ~ e a ., I~~ ,- _. xw.L=wax warzn axe PRIMARY BUILDING SETBACK UNES ,~ ~ i N.w L IBee z ; ~n °HneoreM TYPICAL ~ . ~~~ _~ ..._.._-__.. r I _ .. ..a°. .°wea.Rxde°Ewxd i_ _.~ j n,,.~ex,dA ' 15~~m1° nd-Nritial ~ - o '"wEE<a,n„a°x°E.da~ "° r - -, sE.,«.xrex°xNx.w.° j _ _ - I orz . ~ i r 1...,, / i I ' wx NEE in° a, .~ - - _ _ _... ~ ,. !_ Ii -..... i oeti.ti ~ =tt von Ewa ~~ ~ I n.~ _.._ i, ~ i -_-i ._. ~ I t. '': ~f l1c; JSd" '.ul.us,. I _. - _..__. _ -~ E,.. coxxna ~.. _ ... _ _... s,rnonw - - .. xw~n wsd T29N. R17W ._._ .. ~ b N99°47'69"E 2820.29' _ ,]1nl. 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P~~' i wED..n°awxo N,na.,aMxMde - J„ ", ~e ~ ffiZ• Ix zy ~j OUTL~2 ` ~Y~ M T s/ ¢s°,yPp4~ • I "~e,,,"°`cE O,~"s.w " ,."-BTORMWATER ~-~ i at" Y,i MANARFB~M6NT ,~% ~ I & i ~ I ~ ,wavsrea ~ r `~' \ It: LOT 73 iY ,yy ~s° r E°nc,axxa RuR aa, : Ro ~H.W,L. 10362 ! / 119 ~lOu no3T61 ~ L0~~6/~ ~`®~- - - '~ ~N~~ ~~ ,~, i.=a'A°~ ~~8 yt y '., ~. ,,.aE°eeai~xenelouls16iaiux'lorn~lle g,~' g.~ '1 ,G ,y^~ .._ ... ~ E x~'e~ S~' i ~=~ ~I ~. ~~o w~,E.txenxarR~aluu„wa' • r ;~ ~ j ~ ~ '~ LOT3 4 ~? ~~ 9~ LOT 74 ~ c .now exn mentlo aw'.iidO~ ~~ x ~ S ~ :.. ~ LOT 37 + ! ,'r,;<' , I ~+~ ~ ~, ~e'o~ao`oo'/ wy?'~~ ~~ 3 adxanrsn. . - T b -; ~ OT 75 44 ccc~UOU,r~ro wu~re~wlxee essERBtrovea,xE r ~,. - . uE \ i ~ 8 ~ to `z) ~, /+tl~ .o. ~ miwarxaa „~ i '"rwwn E ~ ~~~~~~.'-~ rw ~I~ ~~ ~ ~ vaaixa ,le,se' ~` ~ ~i Qw~ A/ / ai/L0T7 j °C sERUnls we ax ~~ TM LOT 33 ~ et ~ l ~ x semeErerze,. LOT 36 -4 ~ / g o,~ ~ „u Ie <3 / ~ w r >ti~~ j°"'asea <° ;. ~~~7 E' II LOT ~2 \~ ~ >~ \~~~ r'" /LOT 77 ~,., (/ d ay ~ ,~ vl I .~~, 9~ ~I rs~' :«S` i ~ ~ * "°x LOT 3Tt ,i '~ ' ~,.ro~i ~;\ \ / ~ / n" . 7 Jc mn ~-.-- --I`~., J, ~~ %~-0 '5~~ ~~1g9a' ~ .t~'w ~-°art ' e I ~~ T ~;~ '~~ ssAC .:i ~!A .~ ~~pg~l. ~a. LOTs30 ~.~ ~'~, ~.. y IC 1... ~ a~ ~.. >;~a ~- ,e;.l's ~ ~ ~~~„ K~. ~~ \ nn. ~~, is I ' 1~a ~1 n',, ei'~"~ ax' ~ LOT 7~F N LOT 29 ~ Ij \~~~ \ N :, ~ i .fi yrOd, ~1 nt?~+• %::~ ~ \ LOTs EB q ~:ji `- rs rx i- ~ tit 1 ~ ~ S 27 ea rt. ~: i 1a~ ~ are ._ ! _ t xo ~wt),~. ..- ~ _._._._.~ :..~. -..._ % }x~l.~/ - ~I a fietnox,nEew,w - i LOT~i x67 ~ :\ ~` ~~~ L:~--rc-r_t~ -i ~: ~ i ul 0 '. 25 sh ae ~ ~. = I F D _ ~ i aF i .~ ~ CW .. YFi9 ~ -... ^ _~ 1xPnT ~ I y i ~, ¢i. - ~~ ~Q~, ~ _ i 1, j ^tl~ wS \ 207 ~\ y*°I x1 a.naN~„AA~,,,fwJ%°„ l ~ ~` I! LOT ~ LOT j LOT SEE SH 4 / ` `. ~.4~ ~ /~~ 1 YD 9 ~ 8 LOT7 L07 - ~ - ~ ~ ~ ~. ~Fl~ a ~ ~ OUTLOT 1 j 23 \/ ~~ '~ ~\ LOT 1 ~ j ~ LOT 6 ~ J, ~ t. d a?° ~ 13T~ yZT ~1'l ~t ~ jLOTS ~ ~ \ ." ~+ ~~ x J~ \ ~r^a'1~~` ~ .. ~ \ ,LOT` i '~Y~~ p~\~ ~ 14 ~ LOT 4~ ~ ~V s. ~ ~ ` ~~ fl LOT \ J MATCH LINE SEE SHEET 3 MATCH LINE SEE SHEET 4 -^--+~T I ^LOT\Y 5 ~ O ~ SCALE IN FEET 1" = tD0' ~. `T nnsmsTxuRTlrt auxlDr evxewx xEEn ,roossm ~~'.t:' ~; SHEET 2 OP 5 SHEETS teB a 100 200 fA1~ YBSEE SFiEEf3 \\ ____ .~ Title St. Croix County AEROBIC TREATMENT UNIT (ATU) SERV1CiNG AGREEMENT p late Plan Transaction Number - Name - (Owner) Typed or printed/~~G~~~j - ~f~% Being duly sworn, states, under oath, that: 1. He/she is the owner/part owner of the following parcel of Land located in St. Croix County, Wisconsin, recorded in Volume Page Document Number ~dN ko~o St. Croix County Register of Deeds Office: A parcel of land located in the ~ '/4 of the5"~ `/< of Section "Z~t , T ~-9 N - R 1 `7 W, Town of Q,,.,h.,G ~- , St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or d t '1 d 1 1 descri tion)~ O ~~~~~~ KATHLEEN H. IiALSH REGISTER OF DEEDS ST. GROIX CO., MI RECEIVED FOR RECORD 02/21/20tZY7 08:25AN AGREEMENT EXEMPT IR REC FEE • 11. 00 TRANS FEE: COPY FEE: CG FEE: PAGES: 1 S ~~ e a) a ega p ~o ~ ~o s ~ i ~~/t i (,/~~ Parcel Identification Number-(PIN) Agreement Date: Z' /Zf ~~ Raft 1 ,~~ ~'` ~ 1~ \ G.~'v~- As an inducement to the county 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: 1. Owner agrees to conform to all applicable requirements of Comm 83, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onstte Wastewater Treatment System) technology. If the owner fails to have the POWTS and ATU properly serviced in response to orders issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stets., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stets" 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, and 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. 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, Stets. 4. The owner recognizes that the county, Department of Commerce, or POWTS maintainer may make periodic inspections of the components to complete pertgrmance 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 10 business days from the date of inspection, maintenance or servicing. 6. This agreement w(II remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. 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 in a manner that wi!! permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is installed. Owner(s) Name(s) -Please Print Subscribed and sworn to before me on this date: vj9Gl~ ~y ~~ %.~ '[ S February 21 , 2007 re(s) Notari wner"s Signatu~ ~ NotaJry-{Public erg Campbell, Deputy j ~/ F ~L .x.h5[ [I,.+~ Govemmenta/l U~it Offici~Name, Title -Please Print r t d 1 Zo~~ ,tic{ ~2f.~~cJ-~ ~y.a.1 74 //.i~. My Commission Expires J ~~/l J 12/31/2006 Govemm I Unit Officf Sig lure Drafted by: David G. Peters / PerS6~(al inforaf~tion~.pr6vide may be used for secondary purposes [Privacy yaw s. i 5.u4('r )(m)! // "THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE^ This information must be completed by submitter: document tltie. name 8 Tatum address and P(/V (if required). Other information such as the granting clauses, legal description, etc. may be placed on this first page of the document or may be p/aced on additional pages of the document. Note: Use of this cover page adds one page to your document and ,ff2.00 to the recordlno fee. Wlsconsln Statutes, 59.517. OwnerBuyer Mailing Address Property Address City/Slate `. ~~ Zoning Department for Faucet Identification Number ~GG~ /q r~/~ J.',t. _ :' ~. ~~ ~_ LEGAL DESCRIPTION J / Property I..ocation '14 , ~~'.~ ,Sec. ~, T ~N R~_VV, Town of 17a.~ ,,.~~d Subdivision Certified Survey Map #~ Warranty Deed # _ ~ ~ ~ 07th ST. CROIX COUNTY SEPTtC TANK ?vIAINTENANCE AGREEMENT AA"D OWNERSHIP GERTIFICATfON FORM ~--- ~~ J a h n S a ~\ / i~~-~ ~i~~~~ Spec house yes no I.ot # (p s . Volume ~~ _` ____----, Page # ~~'~` Volume _, Page # . Lot lines identifiable yes no SYSTEM MAI~iTENANCE AIr~F~R CERT,~,F~CA~ON Improper use and nmintenance of your septic system could result in its premature failure to handle K antes. Proper tttaintenatu.e consists of pumping ar3t the septic tank every three years or sooner, if needed, by s licensed pumper. What you put into the system cars affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Corztn. 83.52(11 and is Chapter 12 - Si. Croix County Sanitary Ordinance. T'ke property owner agrees to submit to St. Gxoix County Planning & Zcsning Department a certification form, signed by the owner and by a trsaster plumber, jcruraeyuwn pturnber. restricted plumber or s licensed pumper verifying that (I) the ors-site wastewater disposal system is in proper operating condition and,'or (2) a8rr inspection and pumping (if necessary), the septic tank ss less than 1/3 full of sludge. L'we, the undersigned have read the above requiretrtetttis and agree to maintain the private sevwage disposal system with the standards set forth, heroin, as set by the Department of Commerce and the Department of Natural Resources, State of W isconsin. Certification stating that your septic system hasi been maintained must be completed and retttraed to the St. Croix County Planning & Lohtng Department within 30 days of tke three year expiration date. Uwe certify that all statements on this form are true to the best of t»yiour laiowledge, live arn/arre the oamer(s- of -he property described above, by virtue of a warrant•,~ deed recorded in Register of Deeds Ofl3ce. ~/ Number pf be SI OF PLICANT(S) DATE *~'*Any information that ib misrepresented may result in rho sanitar3~ permit being revoked by the Planning ~ 7,oning Depamnert. ~`*"` (0 3 (Verification *equired from include with this application a recorded warranty creed from the Register of Dees Office and a copy of the certified sur~•ey map ii reference is niadc in the warranty deed. ~t S~. cro~~ CLCCTR~C A Touchstone Energy® Cooperative ~~~"~ ^_ The power of human connections TO: Dave Peters RE: Revised Contract for Services Sanitary Inspections FROM: Mark Pendergast DATE: Apri13, 2007 Dave -per your request the scope of the work to be performed by St. Croix Electric under contract to the Rolling Hills Farm Homeowner's Association has been expanded. The enclosed contract for these services dated March 27, 2007, now includes performing the FAST and septic tank inspections for the private lots. In consideration of the additional work to be performed under this new contact over a five-year period, we have reduced the St. Croix Electric administrative fee on total billings from the pervious 12 percent to 10 percent. It shall be the responsibility of the Homeowner's Association or their representative to contract Jerry Van Someren at our office when construction is completed and a new home becomes occupied for purposes of initiating the FAST and septic tank inspection, and drain field upon the initial commissioning of the drainfield. Jerry can be reached at 796.7000 or jerr v~s(a~scecnet.net. We look forward to assisting the Homeowners Association and residents of Rolling Hills Farm with this important inspection and scheduled maintenance program utilizing the services of our partner EcoCheck, Inc. . For purposes of maintaining a current file on this project I would ask you to forward one copy of the covenants and any related property owner documents regarding the sanitary sys . I'd also like you or another authorized representative of the Homeowner's A oc tion o si n, da d return a co y of this memo for our records. Date: !~- `t~' o ~ S' nature - oiling Hills Farm Homeowner's Assoc /~~y~~ ~• ~~ s Print Name St. Croix Electric Cooperative • 1925 Ridgeway Street • Hammond WI 54015-5039 715-796-7000 • 800-924-3407 • FAX 715-796-7070 • E-malt: stet@scecnet.net • Visit our Web site! www.scecnet.net Wastewater Operations Proposal To St. Croix Electric Coop for Rolling Hill Farms March 27, 2007 ASSUMPTIONS The following assumptions were considered: EcoCheck Assumes the Following: 1. EcoCheck will be granted access to the private lots to check septic tank solids levels, the individual FAST unit and related components. 2. EcoCheck will be granted access to the easements for the pump tanks and drainfields for operation purposes. 3. EcoCheck will provide 24/7 emergency services in the event they are needed. Emergency service calls will be responded to as soon as possible. Most service calls are responded to within a 24-hour timeframe. 4. EcoCheck will bill St. Croix Electric for emergency services that are called for by a homeowner in the easement areas or private property. St. Croix Electric will pass on the bill to the Association, depending upon how St. Croix's contract is set up. 5. The duration of this contract is for 5 years. 6. If permit or regulatory changes occur during the contract period, the terms of the contract will be revised to reflect the increase or decrease in monitoring to maintain compliance with permit requirements. 7. Contract price will increase annually based upon the regional consumer price index starting in 2008. The CPI that will be used is "water and sewerage maintenance" for the Midwest region. 8. Mobilization costs are included in the hourly fee charged for emergency services. 9. EcoCheck may need to partner with one of our industry partners to assist in making mayor repairs. 10. St. Croix Electric will inform EcoCheck when a drainfield initiates operation to schedule for inspection services. 11. St. Croix Electric (or the developer) will notify EcoCheck when a new home becomes occupied after a process is set up between the Developer and St. Croix Electric on how to best communicate this. 12. EcoCheck will notify the Homeowner and Homeowner's Association when septic tanks need to be pumped. St. Croix Electric will receive a courtesy copy. EcoCheck assumes that we will not be scheduling or attending any of the pumping events when they occur. Below are other responsibilities of the Owner: 1. The Owner shall control access by snowmobiles or all terrain vehicles from the wastewater system and other wastewater treatment system components. 2. As-built drawings will be submitted to EcoCheck to assist in operations. 3. A remote telemetry monitoring system or other individual will call out to EcoCheck in the event of an alarm condition. V { ~ 4. The Owner is required to confirm that the individual homeowners pump the septic tanks as directed by EcoCheck. EcoCheck assumes this responsibility will be communicated to the HOA and a process be set up. This Contract Excludes: 1. Septic tank pumping costs are not included in this proposal. II. PROPOSED ECOCHECK SERVICES: Below are the tasks EcoCheck proposes to provide: WASTEWATER OPERATION SERVICES Below is a detailed breakdown of the tasks EcoCheck is proposing to provide for the site visits. General Operations 1. Perform 2 site visits for the first 2 years of operation and thereafter one site visit. This is applicable to the private and commonly owned wastewater system components. 2. Provide e-mail correspondence on items that arise at the wastewater facilities. 3. Note maintenance activities required at the site and maintain a logbook. 4. Complete reporting to St. Croix Electric on site inspection reports. 5. Provide a year end report detailing system performance and summarizing operation and maintenance conducted during the calendar year. She tic Tank and FAST Unit Operations 1. Check septic tank sludge and scum depths. 2. Determine if tanks need to be pumped. 3. Correspond with homeowner and Homeowners Association on the need to pump the tank. 4. Check to see if the baffles are intact and working properly. 5. Make visual inspections of the FAST unit (assuming a viewing manhole is equipped with the unit). 6. Test voltage supplied to the unit and take an amp draw of the blower (if equipped with an accessible control panel without entering home). 7. Determine if the FAST system needs to be pumped. 8. Perform a visual and audible inspection of the airlift, blower and other mechanical components. 9. Check the air filter of the blower. Clean the filter if possible. 10. Take a water sample to test the strength of the wastewater. This will be used to determine if the system is operating properly. Pump Tank and Drainfield Operation 1. Read elapsed time meters and event counters from pumps (if equipped). 2. Observe components in the control panel for proper operation. 3. Coordinate with the analytical lab for analysis of samples. 4. Test pump operation through amp draws and voltage checks. 5. Adjust equipment settings if necessary. 6. Perform a visual observation of the drainfield. 7. Check floats for proper operation. ADDITIONAL TASKS 1. Provide service calls as needed. Service calls are events that fall outside of the "Wastewater Operation Services" tasks and need urgent attention (i.e. alarm light is on, a broken pipe was observed, etc). 2. Perform other services as requested by the Owner that are beyond the scope of this contract. III. COSTS OF ECOCHECK SERVICES Wastewater Operation Services will be invoiced in the month the work is performed. Services are split between work conducted on private property, and work conducted on the commonly owned components. Services will be charged on a lump sum basis in accordance with the schedule below: Work Conducted on Private Property Basic Services for Individual Property Inspections (Septic Tank and FAST Units Task Hours Subtotal Individual System Inspections 1 $80.00 Project Administration and Reporting 0.25 $20.00 Misc. Project Expenses (analytical tests and misc 1 $40.00 project expenses) Total Cost per Individual Home Inspection* $140.00 * -For the first 2 years, 2 inspections are required. The total annual cost per homeowner is $280. Work Conducted on Commonly Owned Property Basic Services for Each Individual Drainfield Inspection Task Hours Subtotal Community Drainfield and Pump Tank Inspections 3.0 $240.00 Project Administration 0.5 $40.00 Misc. Project Expenses (test kits, field equipment, 1 $10.00 mileage) Total Cost per Drainfield Inspection $290.00 Schedule of Costs per Drainfield Insnection Number of Inspected Drainfields Cost per Range of Costs per Inspection per Visit Inspection* 1-3 Drainfields Inspected $290.00 $290 - $870 4-6 Drainfields Inspected $210.00 $840 - $1,260 7-13 Drainfields Inspected $185.00 $1,295 - $2,405 14-22 Drainfields Inspected $170.00 $2,380 - $3,740 * - EcoCheck recognizes there will be cost eff ciencies that can be passed along to St. Croix Electric as new drainfields are placed into service. Additional Tasks will be charged as stated below: • Service Calls (Item 1 under Additional Tasks) will be charged at $100 per event, plus time and materials in accordance with the EcoCheck Standard Billing Rates. • Other services (Item 2 under Additional Tasks) will be provided as requested on a time and materials basis in accordance with the EcoCheck Standard Billing Rates. This will include changing out the air filter if it cannot be adequately cleaned or other non- routine maintenance items not included in this scope of work. PROPOSAL ACCEPTANCE - St. Croix Electric Coop for Rolling Hill Farms The Owner accepts this proposal including the attached General Terms and Conditions, and EcoCheck is authorized to proceed with the services described herein. This proposal is valid for 30 days. St. Croix Electric Cooperative EcoCheck, Inc. Name: ~jp~. ~~_~~ Name: Title: PjQf$J~~~~'~Q Title: Date: ®~ JG, ~~ Date: Judv Lissick Sr. Vice President March 27, 2007 i ~ .,. ECOCHECK STANDARD 2007 BILLING RATES for WATER AND WASTEWATER OPERATION SERVICES POSITION Project Principal Senior Water/Wastewater Operator Junior Water/Wastewater Operator Field Services Apprentice Operator (Operator in Training) EXPENSES Mileage Field Supplies and Subconsultants Lodging and Subsistence Expenses OTHER OPERATION SERVICES Confined Space Entry Use of HAZMAT Monitoring Equipment STANDARD BILLING RATE $105.00/hour $80.00/hour $70.00/hour $67.50/hour $65.00/hour EMERGENCY SERVICES/SERVICE CALLS* Service Call Labor associated with repairs or services $0.50/mile (prevailing rate) At Cost plus 10% At Cost $75 per entry permit $40/hour (minimum 1 hour) $100 each response Time and Materials in accordance with standard billing rates x r OWNER HOW NO Hlll6 Of HAMMOND, LLC ROLLING HILLS FARM ATTN: DAVE PETERB LEGEND 400 B. 6ECOND 6TREET LOCATED IN THE OF NWi/4 OF THE SWi/4, THE NE7/4 OF THE 5W1/4, PART OF THE SWi/4 OF THE ' nuosoN, wl 9sota ~ SW7/4, ANO PART OF THE SEi/4 OF THE SWt/4 ALL IN SECTION 29, AND PART OF THE NEi/4 OF THE y cowncw woxxwfx, ,nuxx SURVEYOR NW1 /4 OF SECTION 32, ALl IN T28N, R17W, TOWN OF HAMMOND, ST. 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I. ,: I ~ ~, SCALE IN FEET i" = 100' 100 0 t00 200 SHEEr 1 OF B SHEE71 : vxewx wnco `r~ ~ ~. ,~oe.raa nm ~ " ' ~ f ~"~ I ~~ EcoCheck 7 ~ J D O ~ ~ G Z ~ ~/ / 11347 North Avenue, Suite 4 G, / l~ l~ Chisago City, MN 55013 !~(~ ~e ~`~ /~ ~ e ~ Phone: 651-257-3511 nat V Fax: 651-257-4490 j~n,o~"''J° ~ I ~ ,,~ Wastewater Operation and Maintenance Inspection Summary J a~,~"~ ~S.GGd Rolling Hills Farm 01'x' 20~~+ Residence at 1636 75th Avenue Septic Tank and FAST Unit Operations Frequency Check septic tank sludge and scum depths 1 /year X Completed Not Completed Check baffles to ensure they are properly fastened 1 /year X Completed Not Completed Perform visual observation of the FAST system 1 /year X Completed Not Completed Test voltage to the FAST control panel 1 /year X Completed Not Completed Check FAST system sludge level 1 /year X Completed Not Completed Perform visual inspection of the airlift 1 /year X Completed Not Completed Perform an audible inspection of the airlift 1 /year X Completed Not Completed Check air filter of the blower 1 /year X Completed Not Completed Test strength of wastewater 1 /year X Completed Not Completed Findings of Inspection Do septic tanks need to be pumped? Yes X No Are baffles intact and working properly? X Yes No FAST Unit working properly? X Yes No Any follow-up necessary for St. Croix Electric? Yes X No Any follow-up necessary for JW EcoCheck (service provider)? Yes X No Any follow-up necessary for the homeowner? Yes X No Field Notes: Tbtlk Scum Denth Sludge Denth Septic Tank 0 24 FAST Tank 0 0 Comments Svstem appears to be working well. Effluent quality appears to be good. Blower is operational and controls are working properly. Future Maintenance Needs rouow-u "We're more than just operators...." Providing experienced water and wastewater operations, maintenance, and management services to homeowners associations, local governments, and residential developers. EcoCheck 11347 North Avenue, Suite 4 Chisago City, MN 55013 Phone: 651-257-3511 Fax: 851-257-4490 Wastewater Operation and Maintenance Inspection Summary Rolling Hills Farm ' Drainfield Servicing 1636 75th Avenue Drainfield Operations Frequency Read elapsed time meters and event counters from control panel 1 /year X Completed Not Completed Observe components in panel for proper operation 1 /year X Completed Not Completed Test pump amp draws 1 /year X Completed Not Completed Test voltage supplied to pumps 1 /year X Completed Not Completed Observe settings of the panel I /year X Completed Not Completed Perform a visual observation of the disposal field 1 /year X Completed Not Completed Observe alarm for proper operation 1 !year X Completed Not Completed Findings of Inspection Event counters and elapsed time meters operational? X Yes Panel components working properly? X Yes No Amp draws in line with expectations? X Yes No Supplied voltage within tolerancesT X Yes No Panel settings OK7 X Yes No Disposal field working properly? X Yes No Alarm working properly in test mode? X Yes No Any follow-up required by JW EcoCheck X No Any follow-up required by St. Croix Electric? Yes X No Field Notes: T.;ttt~ Event Counter Ainp Draw Voltaee Timer on Timer off Pump # 1 6zss i z.z zas 3 min 55 min Comments Tank and control panel working properly. No follow up necessary. Future Maintenance Needs Recommend new locks on manhole covers. rouow-u "We're more than just operators...." Providing experienced water and wastewater operations, maintenance, and management services to homeowners associations, local governments, and residential developers.