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HomeMy WebLinkAbout032-2015-70-000 n ■o:■ 'a n 2 § § K § E $ % ; E 2 2 s _ z o # � n , $ o £ 0 _: 7- i E f f$ � $ g Ln �W ƒ ƒ \� < � R § § / c 4: k k ■ E E E 4 8 • a 0 $ . 2 $ z > % f E a > cn 3 \ §7 \ C @ � /o. z § 2 2 ° E @ § 2 E �_ � z 0 0 0 � - E § @ \ § co cc m CD & J 7 2 � § ; to 2 . — E \ . z a � 2 . \ Em o � ƒ 2f7 ƒCA _ W co w -4 } k = C , U) � k j CL � � R 0 f 2 2 ® CL 2 , § 2 CD / � _> § o m 0 ) 0±& ƒi\ CS CL ( , ƒ � � \ 7 . \ � ; § ® m G i # / \ Nj 2 � t CD \ / _o �m , � Parcel #: 032 - 2015 -70 -000 02/01/2005 08:45 AM PAGE 1 OF 1 Alt. Parcel #: 4.30.19.524D 032 - TOWN OF SOMERSET Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * JELLE, VERNON D & ROBERTA I VERNON D & ROBERTA JELLE 1760 50TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1760 50TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 7.000 Plat: N/A -NOT AVAILABLE SEC 4 T30N RI 9W 7A I NW COM SW COR Block/Condo Bldg: S W NW TH—N-U4.5' TH E 606' TO CEN LNTN RD;'SWCV RD TO PT369rEZTPMB; TA — Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) W TO POB 04- 30N -19W Notes: Parcel History: Date Doc # Vol /Pa Type l 296086 45110 9 LC 2004 SUMMARY Bill #: Fair Market Value: Assessed with 10686 188,700 Valuations: Last Changed: 07/24/2003 Description Class Acres Land mprove Total State Reason RESIDENTIAL G1 7.000 68,000 92,000 160,000 NO Totals for 2004: General Property 7.000 68,000 92,000 160,000 Woodland 0.000 0 0 Totals for 2003: General Property 7.000 68,000 92,000 160,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 304 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Sofety ztnd B gilding Division • INSPECTION REPORT Sanitary Permit No: 488253 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Jelle, Vern I Somerset, Town of 032 - 2015 -70 -000 CST BM Elev: f Insp. BM Elev: BM Des iption: Section/Town /Range /Map No: 04.30.19.524D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. CLv Septic Benchmark yz:7 CUD 6V Dosing n� Alt. )BM se I r �➢ $ T• wKyh c-�A�S Aeration Bldg. Sewer Holding St/Ht inlet / TANK SETBACK INFORMATION St/Ht Outlet r to g i TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic '> y (CD � Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holdin Bot. System `k l PUMP /SIPHON INFORMATION Final Grade 7� 0 J ManulEacturer Demand St Cover GPM S b (� • It Model N ber 3 -ig 9 ? TDH Lift Friction Loss System Head TD Ft I Force ain Length IDist. t SOIL A SORPTION SYSTEM 20 (TRENCH Width Length r No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM ONS ` SETBACK SYSTEM I IBLTDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION T e Of System: CHAMBER OR W h UNIT Model mber' DISTRIBUTION SYSTEM Header /Manifold Dis 'bution x Hole Size x Hole Spacing Vent to Air Intake e I 1 1-ength is 4 L pength Di Spacing /, SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes Q No � Yes Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:A U� • 3 Inspection #2: Location: 1760 50th Street Somerset, WI 54025 (SW 1/4 NVY 1/4 4 T,PON R19 ) o t } .30.19.524D 1.) Alt BM Description = ►Qa.7S'T'� Cam '` S � �, ,d G�-, q �e 2.) Bldg sewer length = th , l - amount of covere,' �• Z - 933'i /n,0z _ `j2'6`�� ow B, / — 32 =93•sa � l 3�' Plan revision Required? E Yes No Use other side for additional information. D Insepctor's Signature Cert. No. 3) V'ftjH � I ;T � - Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ! "�, L > ^c> / ' K Madison, WI 53707 — 7162 Sanitary Visconsin Permi umber (to be filled in by Co.) (608) 266 -3151 Perm, Department of Commerce State Plan I.D. Number Sanitary Permit A In accord with Comm 8311, Wis. Adm. Code, personal information ou rovidc may be used for secondary purposes Priva t m Project Address (ifdifferent than mailing address) 1. Application Information — Please Print All Information KUTIVED Property Owner's Name Parcel # bat Block # elw 0e� /� JUN 2 7 2006 ®lam' 7� .52 D) Property Owner's Mailing Address ST. CROIX COUNTY Property Location L V Section City, State Zip Code Phone Number ircle T N-. R4E . Type of Building (check all that apply) 15*4 £ isien �ktme G&t�FT�xaber or 2 Family Dwelling - Number of Bedrooms n 11 Public/Commercial - Describe Use La ❑ State Owned - Describe Use ❑City ❑Villagexbwnship of Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑New System % Replacement System ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Penn it Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that appl to t — Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ecirculating Sand Fil er ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe El Other (explai 2 '� l V. Dispersal/Treat ent Area Informattotf: ° Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) I Sy te nt — VI. ank Info Capacity in Total Number Manufacturer Prefab Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks tic r Holding Tank n/ oe Aerobic Treatment Unit Dosing Cltamtxr W VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum is Name (Print) Plum Signature MP/MPRS Number Business Phone Number P nber's Address (Street, City, State, Zip C r VIII. County/Department Ilse Onl X Approved ❑ D Sanitary P it Fee ncludes Groundwater Date Issued I suin Agent S' n t re ( o Stamps) Surcharge Fee) ❑ Gi n Reason fo Denial � n 3D ?aG IX. C=onditions Appro al 3 I a � kVAX ) AAA SYSTEM OWNER: � tr c �, D c;eare< a'lr t 1 Septic tank, effluent filter and Z "" -�� - dispersal cell must all be serviced I maintained as per management plan provided by plumber , q .�c� q3s� w��� �3 a m ust be maintained o..�v- �� `-'-max 2. All setback requirements m ) i � n as per applicable code/ordinances. 12 " 56 -Q Gtw-e� i �P_ C.etr2�e� Attach complete plant (to the County only) r the system on paper not less than 81/2 x I l inches in sire / SBD -6398 (R. 01/03) L4 l)e 4 5� d&,,, PLOT PLAN PR6JECT Vern Jelle ADDRESS 1760 50th St. Somerset Wi. 54001 SW 1/4 NW 1/4s 4 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 DATE 6 - 22 - 06 BEDROOM 4 CONVENTIONAL XXX AA rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE $00 X 1000 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE El LOAD RATE •4 ABSORPTION AREA 1500 # of chambers 51 BENCHMARK V.R.P Nail in Spruce ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as BM Vent SYSTEM ELEVATION eq > 12" - - of Bio Diffuser with Cove 31.1 f A2 per 6„ chamber _- - - - - -- - - - -- Long 34" Elevation > 500' to PL 95' SW 15' 40 Insulated s ' ew Pool D st Drat field 60' 25' 100'' �0' 18' 10' 21' caTt°`� st 4 Bed Driveway House g� Well Garage 131 r 75' C PLOT PLAN PRbJECT Vern Jelle ADDRESS 1760 50th St. Somerset Wi. 54001 SW 1/4 NW 1 /4S 4 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX r MPRS Byron Bird Jr. 220527 DATE 6 -22 -06 BEDROOM 4 CONVENTIONAL XXX A CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 8 00 X 1000 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE Cl LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 51 hk BENCHMARK V.R.P. Nail in Spruce ASSUME ELEVATION 100 ❑ BOREHOLE (DWELL *H,R,P, Same as BM Vent SYSTEM ELEVATION >12T, -� C Of Bio Diffuser with Cove 31.1 ft ^2 per chamber _- - 6' 6„ Grade, at Sy Long 34" Elevation . stem > 500' to PL 95' 94' B2 re 15' 40 Insulated 5' Pool Dr ew st Drai field 60 25' 100' j0' 18' 10' 21' st 4 Bed Driveway House W Well Garage 1 75' RECEIVED Wisconsin Department ofCom erce 2 7 2006so1 EVALUATION REP Page of Division of Safety and Buildings ST. &PJ"ro"yA' h Con im 85, Wis. Adm. Code County Attach complete site plan on sin size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. - 7 Please print all information. Re awed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).( Property Owner Property Location Y !`� Govt. Lot j�A 1/4 � 4 S T (� N R 1 E Property Owner's Mailing Address Lot # Block # Subd. Name or CS 0 4 � Qy State Zip Code Phone Number ❑ City ❑ village o Nearest Road r' O�S�(/ ) 3 r'5 g_- 0 �i l ❑ New Construction Use;,3 ! Number of bedrooms Code derived design flow rate 6&v GPD eplacement ❑ Public or com er . I - Describe: __ Zer Parent material 19�0� Gi a. B� �� 5 Flood Plain elevation if applicable /G�7T v ft. General comments and recommendations: 1 y _ f ✓� w 71- - FT Boring # oring _ 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ® Ong # Boring Pit Ground surface elev. ft. Depth to limiting factor lWin. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 � 1 ' Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 < 150 mg/_ ' Effluent #2 = BOD < 30 mgA- and TSS < 30 mgi'L CST Pjpm (Please Print , Signa CST Number Add / Date Evaluation Conducted Telephone Number / �� i If ew- nd!�( 76! . -a Property Owner I l l ere Parcel ID # Page of oring Boring # Sal Iication mate ❑pit Ground surface elev. � ft Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 /© ii✓ s� 1 r y� F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. • Sal Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 m91L and TSS >30 150 m9A- ' Effluent #2 = BOD < 30 mg1L and TSS < 30 mg1L 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- 2648777. SBD -8330 (8.6/00) Soil Test Plot Plan Project Name Vern Jelle Byron Bird Jr. Address 1760 50th Somerset Wi. 54025 C M #220527 Lot Subdivision Date 6 /21/1906 —Count ST. CROIX SW 1/4 NW 1/4S T 30 N /R 1 9 W Township Somerset Boring Q Well PL Property Line# Alt. BM ,BM or VRP Assume Elevation 100 ft.Nail in Spruce System Ely T -1 =93.6 T -2 =93.5 T -2 =93.4 H.R.P Same as BM SCALE 1" = 40' Unless otherwise Noted > 500' to PL 94' 95' B2 15' 55' Pool D veway Drai field B 25' 100' 24' J 0' w 18' 10' 21' st 4 Bed 55 House 8' Drivewa Well Garage 1 75' 50th St. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the 3" &LLC residence located at: 1 /4, /V Gt 1 1 /a, Section ,Town x N, Range 19 W, Town of ���� , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes Nom_ (if no, skip next line.) Approximate volume or 1 gth of time: gallons minutes Capacity: Construction: Pre Concrete _ Ste 1 Other Manufacturer (if known): Age of Tank (if known): (Licen d Plumber Signature) (Pr ame) o (Title) (License Number) MP /MPRS (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS O� Owner �� r � � G � Septic Tank Capacity al ❑ NA Permit # �ZS� Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ,>�lL ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units A Pump Tank Capacity a l ❑ NA Estimated flow (average) rD al /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) al /day Pump Manufacturer ❑ NA Soil Application Rate al /da /ft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average` Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD :_30 mg /L )p In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once eve earls) ❑ month(s) (Maximum 3 ears) ❑ NA p every: y Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 3 ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ' 7 J21 year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA year(s) Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: ❑ y ear(s) - (s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) •apoO aAlisilslulwpV ulsuooslM '(E) V (Z) '(l)t g•gq Pug (WRIPNINgNZ)ZZ•ES wwoO iaide43 41)M aouelidwoo u! paileip sear iuewnoop si41 eu04d 1 I �' 9 Z au y ✓ aC i c3�!/7 9w8N p r�Q aweN Anuo"15V At1O1VInmu IVOOI (113dWnd) U01Va3d0 SNIO AHBIS 39V1d3S L 14� au04d au ..r t/A.� 9weN 113NM1NIVW S1MOd H3MISN1 S1MOd S W WOO IVNOI11aaV '3181SSOdW1 uo 1111O1d31a 38 AVW )INVl V:10 1:1O1HUN1 3H1 WOHA NOSUM v 30 3n3S311 '11nS3Z1 AVW H1V3a •S3ONV1SWnOu'3 ANV H3aNn )INV1 iN3W1V3Hl. 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City /State Parcel Identification Number j� LEGAL DESCRIPTION Property Location' /4 /a ,Sec., T N RW, Town of Subdirision LoT of= 4eu*z Certified Survey Map # � Q , Volume , Page # Warranty Deed # --2 I L� I Volume 9 , Page # 3S 3 Spec house yes Lot lines identifiable 6110 SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms IGNA OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application 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. (REV. 08/05) 4 d STAIrg W4". WTI sop M� ;*� :rY saT Y `, 3 I4. Cy • t� A - aft f z a 5, An � b V3 prxe ¢ t Qtl a � nE EHRM yA h Croix IPratat3�ta1 Batik f It dtfg 1 E �d"�4t k d 3 w � CauntY. State of Wsscppsint 'ow Riobm d' VisaGikvi 1 i Tax Key # This is homestead property. C oxhg 'at the Southwest corner of the Southwest �7rter o the Northwest Quarter of Section 4, Township feet; . thence fast 6 0 °6 thence North 84,5 ee l � tit h � .x�ge � feet tQ the'certter of a Town Road thence Southwesterly along the Geer of said Town Road to a point which is 269 feet Rest of, the point of beginning; thence West 269 feet to the -14oe of beginning. 'his . de, ie Vr to. a land contract dated April. 28, � �, re ,ded April 29, 1969, in Volume 451, Pa 7 =9 . $0, 8t Croix County. &eg• ster of Deedis, office. Ezc�eptiort tp warranti�,s: Or . E%teeated "at If ni' , And, "W ^. "CQ 18-in thi 3 rd. d of 910NOD A" Si ALED TAT PPSSI�XCR Crp �{�) Walter Trca. r ei�_ � �� _... _. 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