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HomeMy WebLinkAbout040-1016-10-000 o O m o d ro CD ro ti st c c� 3 M O N y 0 O W N A A A '1 �• OD O (D 3 O N O N n 9 Z Q` A (D Oo C O tD W = (n N c0 CIl p N 00 O Via (� G• W N N U 3..: =. 0 0 00 (bD z o w w ° CL N O O O CL w f N N 3 N !el E v - 0 0 0 m N CD D m m o g go a - .d. .. N O 3 °' rn o. CD o Z z Q Z m Z o „�, D N v (n !III "WA s CD O "06 N N ro n� � c c Im -i N 'p Z (9 `p Z O CL G7 Cn N A W ro m w a z o � z W (D A n O D G N N O T N O C CD Z a N O O C N fl W ro cn o v O O CL 7 cn O ro n N 7 � N ti N O n O 0 (4 ✓C �o C Q � o C) COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 p 715 - 962 -3121 800 - 962 - 5227 p „f. c ST, CROIX ZONING REPORT NO.' 29745/01 PAGE ST. CROIX COUNTY REPORT DATES 9!25/92 COURTwJSE DATE RECEIVED! 9/23/92 HUDSON, WI 54016 ATTNS THOMAS C. NELSON jq OWNER! Ruby Carter Z0 LOCATIONS 503 Bauer Rd., Hudson COLLECTOR! M. Jenkins DATE COLLECTED! 9 -22 -92 TIME COLLECTED! 3200pm SOURCE OF SAMPLES Kitchen faucet DATE ANALYZED29 -23 -92 TIME ANALYZED22204pm } COLIFORMS 0 /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE -N! 11 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria /100 ml Nitrate - Nitrogen, mg /L t / CO f. r 2�wcout, LAB TECHNICIANS Pam Gane Fib, cu WI Approved Lab No. 19 1 � G Means "LESS THAN" Detectable Level Approved by! C P 4 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street 42'�I'f2-- Hudson, WI 54016 f Telephone - (715)386 -4680 The St. Croix County Zoning Office offers the service of septic o' . and water inspections to Lending Institutions, Realty Firms, and private individuals. �1 �y Completion of this form ,j a essential ag that tag property can h U located Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as ` soon as possible after fee and form are received.. WATER TESTING--------------------- - - - - -- -FEE: $ 35.0 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) 'I �\ SEPTIC SYSTEM INSPECTION---------- - - - - -- -FEE: $25.00 ey (Determines if system is properly functioning at time of inspection) PROPERTY OWNER'S NAME: _� tl By 0-n— £' o �2 ti � � �c.e ud5 PROP. ADDRESS: .3 _ C ITY � Jv 0 S 2 Legal Description 1/4 of the 1/4 of Section, I t Town of Lot Number Subdivision: y N FIRE NUMBER D 070 ' /Q/ ���` (Q6 �( \ j _ LOCK DQ7 NUMBER \` Color of house x/ Realty sign by house ? �✓o If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, \ WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. � Testing of residential water requires a sample that is fresh. If 1 ttik the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. �\ WINTER .TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. � r Firm or individual requesting services: :�'F Telephone Number �6 �0 7° —�! REPORT TO BE SE T TO: CLOSING DATE • .�.� -- signature /- - _ r-s c- a� -,-✓° ST I CO A PLANNING &. ZZONING ` SEPTIC INSPECTION/ WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $200.00 XCounty water Testing Fee $50.00 )(Water (Nitrate & Bacteria) $ 34.00 ❑ Nitrate & Bacteria retest $15.00 Code A dministra 0 Water (Lead concentration)$ 25.45 386_4 d o 715- 680 4 q- Total Fees: $ Information Land ii, Planning 'k Owner: ( Lkg Requested by: 5A,4A&e_ 715-386-4674 Address: 503 64UC Address: Real Prop 5"LIC lla 715-3 1 ' 677 Telephon (±S I 4 0 3% - Gip;fo Telephone #: Re cling i5.386-4675 Property address (Fire # & Street): 3 mu&c_ Location:'56 1 /4, S txrl /4, Sec. -61, T zg N, R 19 W, Town of gc Y Computer #: 0 -j!!lb -_10 - © ®o Parcel #: o 4. 2g . 19 Coo F TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: 16% 6*.) th-e Is the dwelling currently occupied? N: es ❑ No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s): Have an of the following been observed? ❑ Yes an Slow drainage from house. ❑ Yes )r,)No Sewage back-up into dwelling. � ❑ Yes %No Sewage discharge to ground surface or road ditch. ❑ Yes ?ZNo Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE �, DATE: ST CROIX COUNTY GOVERNMENT CENTER 110 1 CAc?m1cHA_ HuDsoN, W1 54016 71 x386,4686 FAx RZOCO.SAINT-CROIX. MUS WLNYW CO SAINT-CR01X WLUS Commercial Testing Laboratory, Inc. a &® 514 Main Street P.O. Box 526 Colfax, Wisconsin 54730 WWW.CTLCOLFAX.COM Phone: 715 - 962 -3121 Phone: 800 - 962 -5227 Fax: 715 -962 -4030 ANALYTICAL REPORT St. Croix Zoning Office RECEIVED eport Number: 06028019 Page: 1 St. Croix County Gov. Center ample Number: 06 -C9648 1101 Carmichael Rd. O C� 2 9 2006 eport Date: 10/23/06 Hudson WI 54016 ate Received: 10/19/06 ST. CROIX COUNTY I Owner. Ruby Carter Address: 503 Bauer Road Hudson WI 54016 Collector: KG Date Sampled: 10/17/06 Time Sampled: 11:00 Sample Source: Kitchen Tap Date Analyzed: 10/19/06 Time Analyzed: 8 :30 Coliform- Colilert: Absent /100ml Interpretation: Bacteriologically SAFE p g y E Nitrate -N: 9.0 ppm Above 10 ppm Nitrate -N exceeds the recommended Public Drinking Water Standard. Lab Technician: Pam Bane WI Approved Lab No. 19 < Means "LESS THAN" Detectable Level Approved by: �� UMAX UUUNff A FAX DATE: 3 --)C? -, 0 '7 Code Administratz TO: 715- 386 -4680 FAX NUMBER: Land Information 1 04 Planning FROM- 715-38646, FAX NUMBER Real l' erty 7 -4677 PHONE NUMBER: — 11(� - ( ('0S0 R cling 3 - 386 -4675 Number of pages including cover sheet: ilk ws x0j Ulu la rt V eF r~:. -� -- S T Z� AA lk PLANNING & ZONING r G �+ SEPTIC INSPECTION/ WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $200.00 )<County Water Testing Fee $50.00 'Water (Nitrate & Bacteria) $ 36°683` ,60 ❑ Nitrate & Bacteria retest $15.00 Code Adminisrrau ❑ Water (Lead concentration) $ 25.45 715 - 386 -4680 f Total Fees: $ Land Information & ' Planning Owner: Lg_h� C'-� -- 7 4quested by: 715 - 386 -4674 Address: �� „�r� ,e�� Address: Real Propel* d / 715-3% a Telephone #: ( 3 , � elephone #: ( ) - R,,4 lnw 7 5 386 -4675 Property address (Fire # & Street): J'D Location: Sc /4, S 0, � 1 /4, Sec. , T Z9 N, R 11 W, Town of "I'tdy Computer #: p<fo_ olio - )o - 800 Parcel #: 04 2g 19 6oF TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: - �° Is the dwelling currently occupied? >KZ Yes ❑ No If vacant, date last occupied: Age of septic system; Septic tank last pumped by: Date: Previous Owner's Name(s): Q Have any of the following been observed? []Yes ❑ N�6_ Slow drainage from house. f ❑ Yes R Sewage back -up into dwelling. ❑ Yes 7No Sewage discharge to ground surface or road ditch. ❑ Yes Ztents ouI odors. Other relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: DATE: ST. CRO /X COUNTY GOVERNMENT CENTER 1 101 CARM/CHAEL ROAD, HUDSON W1 54016 715 - 386 - 4686 FAX PZ9C0.SAINT- CR01X.WI.US WWW.00.SAINT- CR01X.W1.US Commercial Testing Laboratory, Inc. 514 Main Street P.O. Box 526 Colfax, Wisconsin 54730 WWW.CTLCOLFAX.COM Phone: 715 - 962 -3121 Phone: 800 - 962 -5227 Fax: 7 - - RECEIVED APR 1 0 2006 ANALYTICAL REPORT ST. CROIX COUNTY St. Croix Zoning Office Report Number: 06007612 Page: 1 St. Croix County Gov. Center Sample Number: 06 -C2227 1101 Carmichael Rd. Report Date: 4/ 6/06 Hudson WI 54016 Date Received: 4/ 5/06 Owner: Ruby Carter Address: 503 Bauer Rd Hudson WI 54016 Collector: KG Date Sampled: 4/ 3/06 Time Sampled: 13:00 Sample Source: Kitchen Tap Date Analyzed: 4/ 5/06 Time Analyzed: 9:10 Coliform- Colilert: Absent /100ml Interpretation: Bacteriologically SAFE Lab Technician: Pam Gane WI Approved Lab No. 19 ( Means "LESS THAN" Detectable Level Approved by: I � Com Lkorator ° U Test-In U 514 Main Street P.O. Box 526 Colfax, Wisconsin 54730 � ---_---_'-_-.. Pho 715-962 Ph _ -_ '-----. APR 10 2006 � � ANALYTICAL REPORT ST. CROIX COUNTY St. Croix Zoning Office Report Number: 06007513 Page: 1 St. Croix County Gov. Center Report Date: 4/ 5/06 1101 Carmichael Rd. Date Received: 4/ 4/06 Hudson WI 54016 Sample Date Number Sample ID Test Results Method LOD/LOQ Analyzed � _________ --------------- ------------------------- ----------- _________ --------- -------- 06-D333 Ruby Carter Nitrate-Nitrogen, mg/L 8.8 353.2 0.1/0.3 4/ 5/06 � Hudson,WI � Kitchen Tap 4/ 3/06 � � � � � � � � � � � � � � � � Maximum contaminant level (MCL) in drinking water systems: � Nitrate 10 mg/L WI DNR Laboratory Certification Number: 617013980 Approved by: +� � \x �} ST. CROIX COUNTY r `� f�l ►� of WISCONSIN ZONING DEPARTMENT N t N N M ■ Mr�r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carniichael Road +\� , Hudson, WI 54016 -7710 ,• - °"'�` ` Phone: (715) 386 -4680 Fax (715) 386 -4686 SEPTIC INSPECTION/ WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $200.00 X County Water Testing Fee $50.00 X Water (Nitrate & Bacteria) $ 30.00 ❑ Nitrate & Bacteria retest $15.00 X Water (Lead concentration) $ 25.45 Total Fees: $105.45 Owner: Ruby E. Carter Requested by: Address: 503 Bauer Road Address: s--- -- Hudson, WI 54016 — Telephone #: (715) 386 -6070 Telephone #: ( ) Property address (Fire # & Street): 503 Bauer Road, Hudson, Wi 54016 Locpion: SE 1 /, SW' /, Sec.4, T 28N, R 19W, Town of Troy Computer #: 040 - 1016 -10 -000 Parcel #: 4.28.19.60F TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: \ CtAD Is the dwelling currently occupied? &! No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Narr3(s): Have any of the following been observed? Yes No Slow drainage from house. Yes No Sewage back -up into dwelling. Yes No Sewage discharge to ground surface or road ditch. Yes No Foul odors. Other comments relative to system operation: 1 certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: DATE: / /4"M n a \�_.!Jc== OWNER'S DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION TN TO BE COMPLETED BY INSPECTION AGENT System design &/ or permit on file? Yes No Soil.series per SCS Soil survey: Sheet #: Type of soil absorption system: Below ground At- ground Mound Approx. size ' X Gravity Dose Pressurized Ft. 2 Bed Trench Dry well Holding tank Outfall pipe Other Unknown OBSERVED DEFICIENCIES Septic tank Setbacks: House Well Prop. Line Other Dose tank Setbacks: House Well Prop. Line Other Locking cover Warning label Pump/ Floats Elec. Wiring Alarm Soil Absorption System Setbacks: House Well Prop. Line _ Other Ponding: Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION TN Inspector Title COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 — 800 - 962 -5227 FAX - 715- 962 -4030 WEB SITE: www.cticolfax.com ANALYTICAL RFPORT St. Croix Zoning Office Report Number: 04028085 Page: 1 St. Croix County Gov. Center Sample Number: 04 —C9241 1101 Carmichael Rd. Report Date: 10/26/04 Hudson WI 5401E Date Received: 10/19/04 RECEIVED OCT 2 8 2004 Owner: Ruby Bauer ST. CROIXCOUNTY Address: 503 Bauer Rd ZONING OFFICE Hudson WI 5401.6 Collector: Kevin Grabau Date Sampled: 10/18/04 Time Sampled: 10:50 Sample Source: kitchen tap Date Analyzed: 10/19/04 Time Analyzed: 11:20 Coliform— Colilert: Absent /100ml Interpretation: Bacteriologically SAFF Nitrate —N: 9.1 ppm Above 10 ppm Nitrate —N exceeds the recommended Public Drinking Water Standard. Lead: 2 ug /! Above 15 gag /l exceeds the Maximum Contaminant Level (MCI) in drinking water systems. Lab Technician: Pam Gane WI Approved I._ah No. 19 I C Means "LESS THAN" Detectable Level Approved by: R� i Mail sample immediately._. old samples cannot be tested! Collection Date and Time MUST be filled in. i WATER TESTING FORM FOR PRIVATE WATER SYSTEMS Collection Date MM -DD- i � � � Tn7e : �am Co ected By License # Qf pump installer or Owner's Nam lam' ❑ pal yN C�1Q II - 64L.( well driller) g ugv Owner lephone Nup� er ^ O lWf's Street Address � �* b 3 — k_U&f4_ Well Address (Street Or Legal Description) State, Zip Code Name .5 Mail V Se copy of results to DNR? Results Address 0- �T I � es No To: t p 1 CAQ ' VIA-64 LL Datefrime Analyzed St, ate Zi Cod �y, J :: � fl APPro)dmate Well Construction Date WI Unique Well #. ' Laboratory Use Only Sampling Information (if known) Membrane Filter Test Reason for Test: MFCC /100 ML = Annual Test ❑ Previous Unsafe ❑ New Well ❑Pump work MPN Test (Ten Tube) Presumptive 24 hours ❑ Taste or Odor ❑ Real Estate --- — _ Presumptive p hours 13 Other Reasons: Sample Location: Coliform Group Confirmed ❑ Bathroom tap ❑ Pressure Tank Tap. olile Kitchen tap ❑ Milkhouse Other Absent 11 Present ❑ Does the well serve the public? Y ❑ No Laboratory Results DAr JCe Bacteriological Interpretation Public #: i ❑ SAFE (Coliform Absent) ❑ UNSAFE (Coliform Present) Well Constructi ❑ Invalid - Please submit another sample. on Information ❑ Drilled ❑ Driven Point Nitrate: mg /L as N ❑ Jetted ❑ Dug ❑ Other. Please indicate tests desired. Remarks: Coliform Bacteria $15.00 fv. at V , / Nitrate- Nitrogen $15.00 Iron $11.90 P� Hardness $13.10 PH $4.75 Fax Number: Fax Charge $3.25 I Total Amount Due 1 Lab Name Lab Cart. # 19 Date/Time Received Commercial Testing.Lab, Inc. Check# 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 Date eporte Lab Sample # (800) 962 -5227 t' Prices expire 12131104, caU for current prices. . I i County of St Croix Finance Department Check No. Vendor No. Vendor: Commercial Testing Lab 514 Main Street PO Box 526 Colfax, WI 54730 Check Date Approved: n File Date: 3 Total Check Amount: $52.85 Invoice No. Inv. Date Inv. Amount Description Acct. Number Amount 11/24/03 52.85 Certified Water Testing 0045 -2950 52.85 I Total Check $52.85 DATE �� -2 _V -03 RECEIPT 34990 IJNW IVED FROM ! mo w "� �'� N • Ad dress ICE DOLLARS $ IMENT CENTER FOR SU Wig' IU, fi,�r,� load a _ s 38646ss ACCOUNT HOW PAID BEGINNING CASH BALANCE AMpUNT I CHECK pater BALANCE MONEY isary. DUE ORDER g 03001 REDIFORM SI"7N.CL ❑ Water (VOC's) $299:00 .Septic $42"o A Water (Nitrate & Bacteria) 2$' $_S&.W ❑ Nitrate & Bacteria retest x �p KWater (Lead concentration); 4- $_2+ Tc5 ns -PLIC — scc Ccoaq FL ore - e Owner: RT g Requested by: ku by c4LALI .e. Address: -lo-4 ,2d. Address: _ A/4d w r -5-00/ Telephone M /� ) �6 - 6d 7 a Telephone #: Id \ Property address (Fire # & Street): -5a 3 t�a.cc��- ,( Location: ' / <, '/4, Sec. , T N, R W, Town of L Computer #: Parcel #: 4 L Realty Firm: Lock Box Combo. Closing Date: 0 d TO BE COMPLETED BY PROPERTY OWNER - PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: 54 3 -T a -u-G P 4 - - L, Is the dwelling currently occupied? AYes []No If vacant, date last occupied: Age of septic system: 1 S - �, Septic tank last pumped by: ,V a t-i-s - s e P 7'1,- Date: o Previous Owner's Name(s): U Have_ any of the following been observed? ❑ Yes "o Slow drainage from house. a' 0 Yes R No Sewage back -up into dwelling. ❑ Yes UIN Sewage discharge to ground surface or road ditch. [I Yes XO Foul odors. y Other comments relative to system operation: t U 1 certify that the above information is complete and true to the best of my V knowledge. 4 OWNER'S SIGNATURE: DATE: PLEASE SEE REVERSE SIDE ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT -- -- ST. CROIX COUNTY GOVERNMENT CENTER s — N� ■.' 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 December 9, 2003 Ms. Ruby Carter 503 Bauer Road Hudson, WI 54016 Dear Ruby: Enclosed is a copy of your water test results. All tests appear to be in within the guidelines. If you have any questions, please feel free to give us a call. Sincerely, Kevin Grabau KG /jn Encl. 2 COM RECEIVED MERCIAL TESTING LABORATORY, INC. DEC p 5 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 ST. CROIX C q 715- 962 -3121 — 800 - 962 -5227 ZONING FAX - 715- 962 -4030 WEB SITE: www.cticolfax.com ANALYTICAL REPORT St. Croix Zoning Office Report Number: 03034139 Page: 1 St. Croix County Gov. Center Report Date: 12/ 3/03 1101 Carmichael Rd. Date Received: 12� 2/03 Hudson WI 54016 Sample Date Number Sample ID Test Results Method LOD /LOG Analyzed - - - - -- --------- - - - - -- ------------------- - - - - -- ----- - - - - -- --- - - - - -- --- - - - - -- -- - - - - -- 03 —D1394 Ruby Carter Lead, ug /L ( 1 200.9 1/3 12/ 2/03 Hudson, WI Kitchen Tap 12/ 1/03 Maximum contaminant level (MCL) in drinking water systems: Lead 15 ug /L WI DNR Laboratory Certification Number: 617013980 < Means "LESS THAN" Detectable Level Approved by: 1� COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 5 RECEIVE 715- 962 -3121 — 800 - 962 -962 -5227 L 7 k6j FAX - 715 - 962 -4030 WEB SITE: www.cticolfax.com DEC 0 8 2003 ANAlf TIq JLC#R QRNTY ZONING OFFICE Kevin Grabau Report Number: 03034266 Page: 1 St. Croix Zoning Office Sample Number: 03— C11149 St. Croix County Gov. Center Report Date: 12/ 4/03 1101 Carmichael Rd. Date Received: iR/ 3/03 Hudson WI 54016 I I � Owner: Ruby Carter Address: 503 Bauer Rd Hudson WI 54015 Collector: Kevin Grabau Date Sampled: 12/ 1/03 Time Sampled: 11:50 Sample Source: kitchen tap Date Analyzed: 12/ 3103 Time Analyzed: 13:15 Coliform— Colilert: Absent /100ml Interpretation: Bacteriologically SAFE i Nitrate —N: 9.5 ppm Above 10 ppm Nitrate —N exceeds the recommended Public Drinking Water Standard. Lab Technician: Pam Gane WI Approved Lab No. 19 h < Means "LESS THAN" Detectable Level Approved by:�+�' ST. CROIX COUNTY WISCONSIN ZONING OFFICE ;• ! u t R uli n g ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road �� •' Hudson, WI 54016 -7710 - - -� _ (715) 386 -4680 Fax (715) 386 -4686 INSPECTION/ WATER TEST REQUEST FORM d SEPTIC INSPE 3 -a z 3 U b` Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. /1 Please make arrangements with this office to insure that entry can be gained. �❑ Water (VOC's) $200.00 ❑ Septic $125.00 ater (Nitrate & Bacteria) 55.00 ❑ Nitrate & Bacteria retest $15.00 Water (Lead concentration $ 21.00 L� /-l6 Owner: T ca b • c a e T Requested by: Address: SL'3 h �u es -' Addreq�• SEC ED M r- zhu °aan Y r ro4»�'1' 'aorwuon. 040-1016--10 r•[7 {J4 7 217 2 IMPOR•rA1f1' go aura yy ptll only on malt not b� n lull (Wr °nt� ,3 15 . ()00A - f _ ZO � X COUNTY / 571 x,84/ 5. RUBY E CE 0 - 28N - 19W AR.T> i of SI~C 4 T2 �� 5 1 / 4 GOR , TH PT 5E 5 W C TO poB� 'TH W 54U ON Wj �4c) W 391 30 1.173 FT, E 33 FT HOCCN WI4 527 FT , E 382 e7 FT, g Date: N 175 F'T ' T E 38 � T TO PO8 5 12 DEG E uWNER Ivuot & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: Is the dwelling currently occupied? Yes ❑No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: A e 4?°� -°'' `� Date: z- Previous Owner's Name(s):-- _ Have any of the following been observed? ❑ Yes 04o Slow drainage from house. ❑ Yes Ao Sewage back -up into dwelling. ❑ Yes Ao Sewage discharge to ground surface or road ditch. _ ❑ Yes ❑-No Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: DATE: ` PLEASE SEE REVERSE SIDE I C OWNER'S DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION , u T N i2 t U'�'`J TO BE COMPLETED BY INSPECTION AGENT System design &/ or permit on file? ieYes U No Soil series per SCS Soil survey: sheet #: Type of soil absorption system: VBelow grade ❑ At -grade ❑ Mound Approx. size ` X ❑ Gravity ❑ Dose ❑ Pressurized F0 ❑ Bed ❑ Trench ❑ Dry well ❑ Holding tank ❑ Outfall pipe ❑ Other ❑ Unknown OBSERVED DEFICIENCIES Septic tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other Dose tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other ❑ Locking cover ❑ Warning label ❑ Pump/ Floats ❑ Elec. Wiring ❑ Alarm Soil Absorption System Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other ❑ Ponding: ❑ Discharge: General comments INSPECTORS SKETCH OF SYSTEM LOCATION TN I Inspector Title COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 - 800- 962 -5227 FAX - 715 - 962 -4030 WEB SITE: www.cticolfax.com ANALYTICAL REPORT Jim Thompson Report Number: 02031128 Paget 1 St. Croix Zoning Office Sample Number: 02- CIOSII St. Croix County Gov. Center Report Date: 11/25/02 1101 Carmichael Rd. Date Received: 11/20/02 Hudson WI 54016 RECEIVED NOV 2 7 2002 Owner: Ruby E. Carter Address: 503 Hauer Rd ST. CROIXCOUNTY Hudson WI 54016 ZONING OFFICE Collector: Kevin Grabau Date Sampled: 11/18/02 Time Sampled: 10:25 Sample Source: kitchen tap .Date Analyzed: 11/20/02 Time Analyzed: 8 :30 Coliform- Colilert: Absent /100m1 Interpretationt Bacteriologically SAFE Nitrate-Ni 9.5 ppm Above 10 ppm Nitrate -N exceeds the recommended Public Drinking Water Standard. Lead: < 1 ug /L Above 15 ug /L exceeds the Maximum Contaminant Level (MCL) in drinking water systems. Lab Technician: Pam Gane WI Approved Lab No. 19 < Means "LESS THAN" Detectable Level Approved byt'q J ° ST. CROIX COUNTY 36 ' WISCONSIN ZONING OFFICE �, A M A N b A M • -- ryr�i ST CROIX COUNTY GOVE 1101 Carmic 's�,. • - ' , Hudson, WI �6-7710� f j - � - � 1 6 - �� '• (715) 386 -4680 (715 1I �� a SEPTIC INSPECTION/ WATER TEST REQUEST FORM ,-�, i c ox Please specify desired test(s) & remit appropriate fee with application. O� water T lines are often turned off during winter months, making access to the home ocesswGov Please make arrangements with this office to insure that entry can be gained,:;' ❑ Water (VOC's) $200.00 ❑ Septic $125 ❑ Water (Nitrate & Bacteria) $ 55.00 Nitrate & Bacteria retest Q� Water (Lead concentration) _ $ 2 "0� ----- ��� Owner: ktcbY C (2a X I b,�: Sf-- cp,e�� s! �� Address: __So 3 ZEa-[1 Rj- Address: Rad s o A) w/ S V a /'. Telephone #: ( 7 /.S) 3,f 6 " � 0 ,7d Telephone #: ( Property address (Fire # & Street): - 34 -cee- Q ocatiorr Sec. T N, R W, Town of Computer #: Parcel #: Realty Firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER M *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM N k Water sample tap location: S °.3 Ba' �'� d H Is the dwelling currently occupied? Yes ❑No q-, 4 If vacant, date last occupied: V Age of septic system: �o 1 Septic tank last pumped by: a ,e x` - ° h' Date: -�- a° ° l� 3 Previous Owner's Name(s): I Have any of the following been observed? vi `4 � El Yes B No Slow drainage from house. y ❑ Yes [2-No Sewage back -up into dwelling. t ' M ❑ Yes [TNo Sewage discharge to ground surface or road ditch. U ❑ Yes "o Foul odors. It e, 3 Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: Cam%' DATE: PLEASE SEE REVERSE SIDE OWNER'S DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION S C2o) tt.sT2 /�► N T � n r .-� a �j S � � t; �e TO BE COMPLETED BY INSPECTION AGENT System design &/ or permit on file? 0 Yes ❑ No Soil series per SCS Soil survey: sheet #: Type of soil absorption system: ❑ Below grade ❑ At -grade ❑ Mound Approx. size ` X ❑ Gravity ❑ Dose ❑ Pressurized Ft. ❑ Bed ❑ Trench ❑ Dry well ❑ Holding tank ❑ Outfall pipe ❑ Other ❑ Unknown OBSERVED DEFICIENCIES Septic tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other Dose tank Setbacks: ❑ House ❑ Well ❑ Prop. Line 0 Other ❑ Locking cover ❑.Warning label ❑ Pump/ Floats ❑ Elec. Wiring 0 Alarm Soil Absorption System Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other P Ponding: 0 Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION TN e Inspector Title I� :: �� fix- ��-- �- - �'C� -�� � ' Q� a-Tv o- �- �J� -�-Z. ST. CROIX COUNTY WISCONSIN ZONING OFFICE ^•.�\ N N N N ■ N ■ Maur ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 June 27, 2001 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results Dear Ms. Bauer: Enclosed are the original water test results from Commercial Testing Labs, Inc which were taken at your property on 06/19/01. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, a Kevin Grabau Zoning Technician Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 — 800 - 962 -5227 FAX - 715- 962 -4030 WEB SITE: www.cticolfax.com Jim Thompson Report Number: 01013961 Page: 1 St. Croix Zoning Office Sample Number: 01 —C3732 St. Croix County Gov. Center Report Date: 6/21/01 1101 Carmichael Rd. Date Received: 6/20/01 Hudson WI 54016 Owner: Ruby Carter Address: 503 Bauer Rd Hudson WI 54016 Collector: Kevin Gurabue E JUN' 2 7 Date Sampled: 6/19/01 ST GROW Gouwry Time Sampled: 11:10 ter, t Sample Source: kitchen tap Date Analyzed: 6/20/01 Time Analyzed: 13:30 Coliform,MFCC: 0 /100m1 Interpretation: Bacteriologically SAFE Nitrate —N: 9.2 ppm Above 10 ppm Nitrate —N exceeds the recommended Public Drinking Water Standard. Lab Technician: Pam Bane WI Approved Lab No. 19 < Means "LESS THAN" Detectable Level Approved by: �� r� ST. CROIX COUNTY f-- �- WISCONSIN s ZONING OFFICE N N W ■ rn�r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 -- (715) 386 -4680 FAX (715) 386 -4686 June 28, 2001 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results (Lead) Dear Ms. Carter: Enclosed are the original water test results from Commercial Testing Labs, Inc which were taken at your property on 06/19/01. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincekely, Kevin Grabau Zoning Technician Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 7 Colfax, Wisconsin 54730 �6,j 715 - 962 -3121 — 800 - 962 -5227 /7 FAX - 715- 962 -4030 WEB SITE: www.cticolfax.com 16io Kevin Grabau Report Number: 01013998 page: 1 St. Croix Zoning Office Report Date: 6/26/01 St. Croix County Gov. Center Date Received: 6/20/01 1101 Carmichael Rd. Hudson WI 54016 Sample Date Number Sample ID Test Results Method LOD /LOG Analyzed --- - - - - -- --------- - - - - -- ------------------- - - - - -- --------------------- --- - - - - -- -- - - - - -- 01 —DE50 Ruby Carter Lead, ug /L ( 1 200.9 1/3 6/22/01 Hudson, WI Kitchen Sink Daycare 6/19/01 i •+ y ; ST CRO Y, COUNTY , Z0NING0F* Maximum contaminant levels (MCL) in drinking water systems: Lead 15 ug /L W1 DNR Laboratory Certification Number: 617013980 ( Means "LESS THAN" Detectable Level Approved by: �� 7 ST CROIX COUNTYzqgU WISCOW61N - ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715 1 7 SEPTIC INSPECTION/ WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. OW �_ teRrCrjV­rj o lines are often turned off during winter months, making access to the homl nelcessary. Please make arrangements with this office to insure that entry can be gain d.i 7 20011 ST CROIX ❑ Water (VOC's) $200.00 ❑ Septic $125COONT ti 0OFFICE , ,,'*W4t9r_(NW6t9 &1380w. a) $ ❑ Nitrate & Bacteria rete concent ra N V . iter (LAW tion) $ 21.00 AV N4 Owner: RUBY CARTER Requested by. Kusy eArt , en 503 BAUER ROAD SM BAUER ROAD I AddressNUDSON, W1 M1&-_J24 Address: VW tl o Telephone #: (/I-< ge Telephone #: Property address (Fire # & Street): i t ' 1("- �ocation: 1 /4, _ 1 /4, Sec. T N, R _ W, Town of Computer #: Parcel #: Realty Firm: Lock Box Combo: Closing Date: q TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: Is the dwelling currently occupied? KYes ❑No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Jv/0/ N k9. Date: R .2- Previous Owner's Name(s): Have any of the following been observed? ❑ Yes 14 Slow drainage from house. ❑ Yes "o Sewage back-up into dwelling. ❑ Yes M� o Sewage discharge to ground surface or road ditch. [I Yes PNo Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: DATE: 1-1- OD PLEASE SEE REVERSE SIDE OWNER'S DRAWING OF HOUSE &SEPTIC SYSTEM L CATION • T y o Ul C /2 P ,..4 W h 0?­ j e- e - 0- R c� 7a TO BE COMPLETED BY INSPECTION AGENT System design W or permit on file? ❑ Yes ❑ No sheet #: Soil series per SCS Soil survey: Type of soil absorption system: ❑ Below grade 0 At -grade ❑ Mound Approx. size ` X ❑ Gravity ❑ Dose ❑ Pressurized Ft. ❑Bed 0 Trench El Dry well ❑ Holding tank ❑ Outfall pipe ❑ Other ❑ Unknown OBSERVED DEFICIENCIES Septic tank Setbacks: ❑ House ❑ Well 0 Prop. Line ❑ Other Dose tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other ❑ Locking cover 0 Warning label ❑ Pump/ Floats ❑ Elec. Wiring 0 Alarm Soil Absorption System Setbacks: ❑ House ❑ Well 0 Prop. Line ❑ Other ❑ Ponding: ❑ Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION T N Inspector Title ST. CROIX COUNTY WISCONSIN ZONING OFFICE r r N r ■ - ..,. ST. CROIX COUNTY GOVERNMENT CENTER -- 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax (715) 386 -4686 January 24, 2001 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results Dear Ms. Carter: Enclosed is the original water test result from Commercial Testing Labs, Inc which was taken on your property on 1/16/01. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, Kevin Grabau Zoning Technician Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 , Colfax, Wisconsin 54730 715 -962 -3121 — 800 - 962 -5227 FAX - 715- 962 -4030 WEB SITE: www.cticolfax.com Jim Thompson Report Number: 01001395 Page: 1 St. Croix Zoning Office Sample Number: 01 —C321 St. Croix County Gov. Center Report Date: 1/22/01 1101 Carmichael Rd. Date Received: 1/17/01 Hudson WI 54016 Owner: Ruby Carter Address: 503 Bauer Rd Hudson WI 5401E Collector: Kevin Grabau Date Sampled: 1/16/01 a qZ � Time Sampled: 11:00 Sample Source: kitchen tap fi X ,; Date Analyzed: 1/17/01 J - Time Analyzed: 14:00;_«.:: Coliform,MFCC: 0 /100m1 Interpretation: Bacteriologically SAFE Lead: 1 ug /L Above 15 ug /L exceeds the Maximum Contaminant Level (MCL) in drinking water systems. Lab Technician: Pam Gane WI Approved Lab No. 19 ( Means "LESS THAN" Detectable Level Approved by: �� ST. CROIX CQUNTY WISCONSIN' ZONING OFFICE N N N ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 -- _ (715) 386 -4680 Fax (715) 386 -4686 SEPTIC INSPECTION/ WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water o lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $200.00 ❑ Septic $125.00 Ql XWater (Nitrate & Bacteria) $ 55.00 ❑ Nitrate & Bacteria retest $15.00 'Water (Lead concentration) $ 21.00)1vo � Owner: RURY Requested by: t 503 BAUER ROAD 509 BAUER RW Address win s4ma mm Address: qo \ ^l Telephone #: .38 6' ° Telephone #: ( 7s ) � y6- t Property address (Fire # & Street): o �ocation: 1 14, ' /4 Sec. T N, R W, Town of \ Computer #: Parcel #: Realty Firm: Lock Box Combo: Closing Date: o V kkj TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location: Is the dwelling currently occupied? KYes ❑No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: J° Date: 8 Previous Owner's Name(s): Have any of the following been observed? ❑ Yes Ao Slow drainage from house. ❑ Yes la'fVo Sewage back -up into dwelling. ❑ Yes :to Sewage discharge to ground surface or road ditch. ❑ Yes Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNER'S SIGNATURE: �° `' ' �° DATE: PLEASE SEE REVERSE SIDE e OWNER'S DRAWING OF HOUSE & SEPTIC SYSTEM L CATION TN Ae � v I L� V) h e- 0- f` TO BE COMPLETED BY INSPECPION AGENT System design &/ or permit on file? ❑ Yes ❑ No Soil series per SCS Soil survey: sheet #: Type of soil absorption system: ❑ Below grade ❑ At -grade ❑ Mound Approx. size ` X El Gravity El Dose El Pressurized Ft. 2 ❑ Bed ❑ Trench ❑ Dry well ❑ Holding tank ❑ Outfall pipe ❑ Other ❑ Unknown OBSERVED DEFICIENCIES Septic tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other Dose tank Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other ❑ Locking cover ❑ Warning label ❑ Pump/ Floats ❑ Elec. Wiring ❑ Alarm Soil Absorption System Setbacks: ❑ House ❑ Well ❑ Prop. Line ❑ Other ❑ Ponding: ❑ Discharge: Ge.neral comments: INSPECTORS SKETCH OF SYSTEM LOCATION TN i Inspector Title ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER nr:r 1101 Carmichael Road �`•' Hudson, WI 54016-7710 (715) 386 -4680 December 22, 1999 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results Dear Ms. Carter: Enclosed are the original water test results from Commercial Testing Laboratory for a lead concentration water sample that was taken at your property on 12/07/99. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, Shawna Moe Secretary Enclosure Mme• ST. CROIX COUNTY ~ WISCONSIN ZONING OFFICE r r r N w N lose ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify desired test(s.) & remit appropriate fee with o application. outside *at r lines are often turned off during winter months, flaking a� s to t he home necessary. Please make ti arrangements wifith this office to insure that entry can be gained. � �, r r•• i��GA Y + ❑Water (VOC's) iJ $ ?0 00 0 Septic $125.00 Water (Nitratd &;B $55 is Water (Lead Conagntration) $21.0 st 0 owner: C�� �' ��1'Requested 1Yy: Ipu,by �c�► -te Addres So 3 _ �.c ,e 2, /? Address: \V �foc s� Cal ZIPS o l b ZIP `o Telephone W: ( ) 3 F-6 - 6 Telephone W: ( ) Property address (Fire W & Street) : Location: 'y., .:, Sec. , T a2f N, R /�, Town of Realty firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* Water sample tap location: Is the dwelling currently occupied? Yes 0 No If vacant, date last occupied: Age of septic system: S �� Septic tank last pumped by: Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y N Slow drainage from house. ❑Y N Sewage Back -up into dwelling. ❑Y N Sewage discharge to ground surface or road ditch. 0Y I N Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. `� y OWNERS SIGNATURE: � DATE: 1/94 '�l /1 -- f OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN'` �Y M _ L� 3 TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? ❑Yes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system ❑Below grd []At-Grd ❑Mound Approx. size 'X ❑Gravity ❑Dose ❑Pressurized Ft. ❑Bed ❑Trench ❑Dry Well Molding Tank ❑Outfall pipe OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank Setbacks: ❑House ❑Well ❑Prop. line ❑Other Dose tank Setbacks: ❑House ❑Well ❑Prop. line ❑Other ❑Locking cover ❑Warning label ❑Pump /Floats ❑Alarm ❑Elec. wiring Soil Absorption System Setbacks: ❑House ❑Well ❑Prop. line ❑Other ❑Ponding: ❑Discharge: General comments INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title i ST. CROIX COUNTY WISCONSIN ZONING OFFICE ■ M r r — also ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify ed to t(sj & remit appropriate fee with application. jt�z;i � *a t r lines are often turned off during winter months, i(nak'ingj.tt4s to the home necessary. Please make arrangements wi,FtYi this office to insure that entry can be gained. f� 009 ,Y CROIX ❑ Water (VOC's)'� �" ,` •• �•� $�20 00 ❑Septic $125.00 \ , AWater (Nitrates &,' Ba�i� is $55 t Water (Lead Con nt�ra. _n,) "'�� $21 .0 0 ' Owner : git-h G , 4 1� -e t Addres So a ;53 1z a 2 /? Address: " so N' w ZIPS a / f. ZIP Telephone W: ( ! ) Telephone If: ( ) Property address (Fire If & Street) : Location: I Sec._, T e2� N, R Town of -7" Realty firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER * PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* Water sample tap location: Is the dwelling currently occupied? Yes ❑ No If vacant, date last occupied: Age of septic system: S �� Septic tank last pumped by: Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y N Slow drainage from house. ❑Y N Sewage Back -up into dwelling. ❑Y N Sewage discharge to ground surface or road ditch. ❑Y I N Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: DATE: 1/94 G U � _y OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION o� I N o) y TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? Oyes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system OBelow grd OAt -Grd OMound Approx. size 'X ❑Gravity ❑Dose OPressurized Ft•Z OBed OTrench ❑Dry Well OHolding Tank 00utfall pipe OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank Setbacks: OHouse ❑Well OProp. line OOther Dose tank Setbacks: OHouse OWell OProp. line ❑Other OLocking cover OWarning label OPump /Floats ❑Alarm OElec. wiring Soil Absorption System Setbacks: OHouse OWell OProp. line 00ther OPonding: ❑Discharge• General comments INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 , Colfax, Wisconsin 54730 715- 962 -3121 800- 962 -5227 FAX - 715- 962 -4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO,1 34127/01 PAGE 1 ST.CROIX CTY GOV.CTR REPORT MATE: 12/10/99 1101 CARMICHAEL ROAD DATE RECEIVED: 12/08/99 HUDSON, WI 0016 ATTN 1 JIMi THOMPSON OWNER: Ruby Carler LOCATION: 503 Bauer Road, Hudson COLLECTOR: Kevin Grabau DATE COLLECTED: 12 -07 -99 TI ME COLLECTED: 10100am SOURCE OF SAMPLE: Kitchen tap DATE ANALYZED112 -08 -99 TIME ANALYZED11100pm COLIFORM 0 /100 m! INTERPRETATION: Bacteriotagically SAFE NITRATE -N: 940 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Colitorm Bacteria /100 ml Nitrate- Nitrogen mg /L LAB TECHNICIAN! Pam Gaspe WI Approved Lab No, 19 Means "LESS THAN" Detectai;te Level APPi °oared Miy %� G� ST. CROIX COUNTY WISCONSIN ZONING OFFICE r s ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 5401 6-7710 (715) 386 -4680 December 13, 1999 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results Dear Ms. Carter: Enclosed are the original nitrate and bacteria water test results from Commercial Testing Laboratory for a water sample that was taken at your property on 12/07/99. The results for the lead concentration sample will be mailed out to you within 2 weeks. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, �`kw -N " w&--, - Shawna Moe Secretary Enclosure I I COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 -3121 800 - 962 -5227 FAX - 715- 962 -4030 3T, CROIX COUNTY ZONING OFFICE. REPORT NO k! 34420% PAGE i ST.CROIX CTY GOV.CTR REPORT DATE: 12/15/49 1141 CARMICHAEL ROAR DATE RECEIVED: 12/08,/99 HUDSON. WI 34016 ATTN: JIM THOMPSON OWNER: Ruby E. Carter LOCATION! 503 Bauer Road, Hudson COLLECTOR! Kevin Grabau DATE COLLECTED: 12- -07 -99 TIME COLLECTED! 10 :00om SOURCE OF SAMPLE! Kitchen Tap LEAD: 1 Pp4 i i Lead, uq//L LAD TECHNICIAN: Fars► Gane WI Approved Lab No. 19 Means ''LESS THAN' Dkecfabte Level Approved by: ST. CROIX COUNTY ItA WISCONSIN r�rrrrrr: ~ ZONING OFFICE ST. CROIX COUNTY C CENTER '•. _ ._ .1101 I '�;:;� Hud 5401&-771 SEPTIC INSPECTION / WATER TEST REQU ST -� il"}i.iNYY Please specify desired test(s) & remit app 'air;@ application. Outside water lines are often t �► off ` 'fig ,J winter months, making access to the home necessar / ake 1� �p arrangements with this office to insure that entry ca gained. 0 Water (VOC's) $185.00 0 Septic $50.00 0 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria t '' ..water ( Lead Concentration) ,A,/ -- 21.00 / retest $15.00 � Owner • r,Gb �-e 7. J C'-+ - Requested by: Address : �.rz_e r .- Address: f _r _ ZIP S ya ZIP Telephone W: t6r—) 2P6-6G Telephone 'W: ( ) d Property address (Fire W & Street) • .�'v Location: ' ' +, '., Sec. T 2t N, R_W, Town of - 1 , )e-0 �( Realty firm: Lock Box Combo: Closing Date: 040 - 101& -/0 - 000 04. ZS. ►9. &0F TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* Water sample tap location: i Is the dwelling currently occupied? Yes 0 No If vacant, date last occupied: Age of septic system: /I- XA� Sept c tank last pumped by: q }� # Date: Previous Owner's Name(s): Have any of the followin g been observed? OY ON Slow drainage from house. OY ON Sewage Back -up into dwelling. OY ON Sewage discharge to ground surface or road ditch. OY ON Foul odors. Other comments relative to system operation: - ��' I certify that the above information is complete and rue to the best of my knowledge. OWNERS SIGNATURE• DATE: 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 1 N TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? OYes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system OBelow grd OAt -Grd OMound Approx. size 'X ❑Gravity ❑Dose OPressurized Ft. OBed OTrench ❑Dry Well Molding Tank OOutfall ripe OBSERVED DEFICIENCIES 00ther OUnknown Septic tank Setbacks: OHouse Owe 11 OProp. line 00ther Dose tank - Setbacks: OHouse owe 1l OProp. line 00ther OLocking cover OWarninglabel OPump /Floats ❑Alarm OElec. wiring Soil Absorption System Setbacks: OHouse OWell OProp. line 00ther OPonding: ODischarge: General comments INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title I ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 September 4, 1997 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results for Ruby Carter, located at 503 Bauer Road, Hudson, Wisconsin, St. Croix County Dear Ms. Carter: Enclosed is the original water test result from Commercial Testing Laboratory for a water inspection that was taken at the above referenced property. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, f, Mar Jenkins Y Assistant Zoning Administrator Enclosure sm 5 t COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 800- 962 -5227 FAX - 715- 962 -4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO. 46544/01 PAGE 1'' ST.CROIX CTY GOV.CTR REPORT DATE* 8/26/97 1101 CARMICHAEL ROAD DATE RECEIVED* 8/21/97 HUDSON, WI 54016 ATTN* THOMAS C. NELSON WI DNR LAB CERTIF."17013980 DW1140 Method . MDULOQ Iate Kitchen 8 -20 Code Analyzed Ruby E. Carter ------------------- ---- -- ' ---- -----_ -- --------- Lead, u9 /L _ 200.9 1/3 8 -21 -97 �_ �Q w 1997 s� caojx o Zorut40 L Z� The The ximum confa mi nani leve (MCL) for lead in drinking systems i s . ma 15 ug7L. _ The makimum contaminant level (MCL) for copper in drinking water systems is 1300 ug /L. < Means "LESS THAN" Detectable level Approved by. p� f PROFESSIONAL LABORATORY SERVICES SINCE 1952 ��.Ba Cif ST. CROIX COUNTY WISCONSIN ZONING OFFIC r r N r r r ...e� ST. CROIX COUNTY GOVE F. 1101 Carmic d ; f � = - Hudson, WI 771 (715) X4680 itcE VE8 SEPTIC INSPECTION / WATER TEST REQUEST F RM 'P 6 1 9 sr CF301)( 98 0 Please specify desired tests) & remit appropriAe' fee lftth F� -�i application. Outside water lines are often turned `q'f, during'° winter months, making ccess to the home necessa Pl�e g Y __. _ � arrangements with this office to insure that entry can be gained. / 4 ❑ Water (VOC's) $185.00 ❑ Septic $50.00? . 0 Water (Nitrate & Bacteria) 45.00 X Nitrate & Bacteria Water (Lead Concentration) ,g- L 21 retest /-- $15.00 W Owner: g?,y y J;, d a,,, r Requested by: Address: —c _,? g aa-) 0?,, Address.- U4 ZIP G ZIP Telephone W: ( .�k - 60 a Telephone W: ( --- -- Property address ( Fire W & Street) : 3 UQ.� -�u1� ILey Location:,',, $0 ;, Sec. , T ,28 N, R W, Town of O \.r Realty firm: Lock Box Combo: Closing Date: o Vo� ioilo - iv - Doc TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* `Y Water sample tap location: I Is the dwelling currently occupied? >C Yes ❑ No If vacant, date last occupied: Age of septic system: O Septic tank last pumpe by: D ate:l/' 9 _ I� Previous Owner's Name(s): Have any o wing following b n observed? ❑Y ❑ dra' g ouse. v ❑Y ON wa e a k -up in dwelling. l� � ❑Y ON dischar to —round surface or road ditch. ❑Y [IN ul odors. r Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE : ,,jg�; /,�.,�_, ATE : / � y 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 1 N TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? OYes ONo Soil series per SCS Soil Survey: sheet # I Type of soil absorption system ❑Below grd OAt -Grd OMound Approx. size 'X ❑Gravity ❑Dose ❑Pressurized Ft. ❑Bed OTrench ❑Dry Well Molding Tank OOutfall pipe OBSERVED DEFICIENCIES OOther ❑Unknown Septic tank Setbacks: OHouse OWell ❑Prop. line OOther Dose tank Setbacks: OHouse OWell ❑Prop. line ❑other ❑Locking cover OWarning label OPump /Floats ❑Alarm ❑Elec. wiring Soil Absorption System Setbacks: OHouse OWell ❑Prop. line ❑Other OPonding: ODischarge: General comments I INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title ST. CROIX COUNTY WISCONSIN ZONING OFFICE ��ar�ara ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 November 10, 1998 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results for Ruby Carter located at 503 Bauer Road Town of Hudson, St. Croix County, Wisconsin Dear Ms. Carter: Enclosed are the original water test results from Commercial Testing Laboratory for a water sample that was taken at the above referenced property. We are still awaiting the results from the water sample that was taken for the lead test. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, Mary J TJln n s Assistant Zoning Administrator Enclosure COMMERCIAL TESTING LABORATORY INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 -962 -3121 800- 962 -5227 FAX - 715- 962 -4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO.'# 76381/01 PAGE 1 ST.CROIX CTY GOV.CTR REPORT DATE; 11/06/98 1101 CARMICHAEL ROAD DATE RECEIVEW 11/04/98 HUDSON, WI 54016 ATTN'# JIM THOMPSON OWNER'# Ruby Carter LOCATION*# 503 Bauer Rd.t Hudson COLLECTOR'# M. Jenkins DATE COLLECTED: 11 -03-98 TIME COLLECTED'# 1'34pm SOURCE OF SAMPLE'# Kitchen tap DATE ANALYZED111- -04 -98 TIME ANALYZED: 2 100pm COLIFORM,MFCC'# 0 1100 mt, INTERPRETATION'# BacteriologicalLy SAFE NITRATE -N'# 8.4 pAm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria /100 mt Nitrate- Nitrogen, mg /L f LAB TECHNICIANS Pam Gane I WI Approved Lab No. 19 f < Means "LESS THAN" Detectable Level Approved by'# PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY . � WISCONSIN . ZONING OFFICE r r r r r r r r■ ST. CROIX COUNTY GOVERNMENT CENTER moor 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 November 12, 1998 Ruby Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results for Ruby Carter located at 503 Bauer Road, Town of Hudson St. Croix County, Wisconsin Dear Ms. Carter: Enclosed are the original water test results from Commercial Testing Laboratory for a lead water sample that was taken at the above referenced property. If you have any questions regarding this, please call our office at (715) 386 -4680. Sincerely, 7 Mary Jenkins Assistant Zoning Administrator Enclosure j COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 800- 962 -5227 i FAX - 715 -962 -4030 ST. CROIX COLMlTY ZONING OFFICE REPORT NO.** 76560/01 PAGE 1 STCRQIX CTY GOV.CTR REPORT BATE: 11/10/98 1101 CARMICHAEL ROAR DATE RECEIVED: 11/04/98 HUDSON, WI 54016 ATTN2 ,JIM THOWSON I WI DNR LAB CERTI1 DW1594 Method MDL/LOQ Date Ruby Carter Code Analyzed Kitchen faucet 11 -03 Lead. O/L " 1 200.9 1/ 11 -9-98 I I � The maximum contaminant Level (MCL) for Lead in drinking water systems is 15 ug /L. The maximum contaminant Level (MCL) for copper in drinking water systems is 1300 ug /L. { Means "LESS THAN" Detectable Level Approved by: D 'I PROFESSIONAL LABORATORY SERVICES SINCE 1952 i ,1t. , ° ST. CROIX COUNTY WISCONSIN y ZONING OFFICE I�M�NM�IIM _ isun �` d ST. ROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, Wl 54016 -7710 I (715) 386 -4680 1 9 m SEPTIC INSPECTIO TEST REQUEST FORM � Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ' (VOC's) $185.00 C c $50.00 �Water (Nitrat & Bacteria) 45.00 ❑ Nitrate & Bacteria its n Water (Lead Concentration) 21.00 retest $15.00 ) Owner: Ra y C a. r - 6 e- t-- Requested by: Address: � aL u , e) . 1 Address: /-f ".L sa N w ) ZIP S o /-6 ZIP Telephone N°: (L :i ,4 _ 6 G 7 G Telephone N°: ( ) Property address (Fire N &Street) : So3 &jj_L< e. r- R A/C6c=U A -) w i Locatipn: ;, ;, Sec. , T N, R W, Town of ��',� L/ Realty firm: Lock Box Combo: Closing Date: / TO BE COMPLETED BY PROPERTY OWNER U *PROVIDE A SKETCH OF HOUSE & E SEPTIC SYSTEM ON REVERSE OF THIS FORM 1 Water sample tap location: c,cJ i �G 041 Is the dwelling currently occupied? �X ❑ No v If vacant, date last occupied: 0 .M o Age of septic system: l��� o Septic tank last pumped by �^ ---� Date: o / i W Previous owner' Name(s): ° Have any o the following been observed? l ❑Y Slow drainage'from house. ` + ❑Y 21' Sewage Back -up into dwelling. ❑Y EIN Sewage discharge to ground surface or road ditch. F ❑Y @N" Foul odors. � t Other comments relative to system operation: I certify that the above information is complete and true to, the best of m knowledge. e. g OWNERS SIGNATURE: C DATE:' ` /9 1/94 i I OWNERS DRAWING OF HOUSE & SEPTIC S STEM LOCATION �q IN � h �o A Y , �e/ 7 Z p BLS --'� Ste' , Jf TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? ❑Yes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system ❑Below grd ❑At -Grd ❑Mound Approx. size Ix ❑Gravity ❑Dose ❑Pressurized Ft.z ❑Bed ❑Trench ❑Dry Well Molding Tank ❑Outfall pipe OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank Setbacks: ❑House ❑Well ❑Prop. line ❑Other Dose tank Setbacks: ❑House ❑Well ❑Prop. line ❑Other ❑Locking cover ❑Warning label ❑Pump /Floats ❑Alarm ❑Elec. wiring Soil Absorption System Setbacks: ❑House ❑Well ❑Prop. line ❑Other ❑Ponding: ❑Discharge: General comments INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title ST. CROIX COUNTY WISCONSIN 1 ZONING OFFICE " " " " " "" «••.� ST. CROIX COUNTY GOVERNMENT CENTER � 1101 Carmichael Road Hudson, WI 54016 -7710 i (715) 386 -4680 May 14, 1997 Ruby E. Carter 503 Bauer Road Hudson, WI 54016 RE: Water Test Results for Ruby E. Carter located at 503 Bauer Road, Hudson, Wisconsin, St. Croix County Dear Ms. Carter: Enclosed is the original water test result from Commercial Testing Laboratory for a water inspection that was taken at the above referenced property. Also, you should be receiving a reimbursement of $5.00 within the next two weeks as you submitted a check to our office in the amount of $50.00 when actually the water test was only a $45.00 fee. If you have any questions regarding this, please call our office at (715) 386 -4680. in rely, mes K. Thompson Assistant Zoning Administrator Enclosure sm I r COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 -3121 800 -962 -5227 FAX - 715 - 962 - 4030 Dennise St. Croix County Zoning Office Cust.No: 78900 St.Croix Cty Gov.Ctr Report No: 38557 1101 Carmichael Road Date Reported: 515/97 Hudson WI 54016 Date Received: 511197 OWNER: Ruby E. Carter LOCATION: 503 Bauer Rd., Hudson COLLECTOR: Jim Thompson DATE COLLECTED: 4130197 1 TIME COLLECTED: 3:15pm SOURCE OF SAMPLE: Bathroom Tap DATE ANALYZED: 5/1/97 TIME ANALYZED 2:OOpm COLIFORM,MFCC:0 /100ml INTERPRETATION: Bacteriologically Safe i;i!TRATE -N: 1 2 PPm Above 10ppm exceeds the recommended Public DrinkingWater Standard 0) l 1 �` Lab Technician: Pam Gane � �; 1K7 cRolx WI Approved Lab No. 19 col;NTY \w �.. ZONINGOFFIC � < Means "LESS THAN" Detectable Level �� ST. CROIX COUNTY WISCONSIN ZONING OFFICE Ilium ST. CROW COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 May 14, 1997 Ruby E. Carter 503 Bauer Road Hudson, WI 54016 RE: Reimbursement for Water Test Result Fee Dear Ms. Carter: Enclosed you will find a check in the amount of $5.00 for a reimbursement for a water test result fee. The reason you are receiving this is because you submitted a check to our office in the amount of $50.00 for a water test to be done, when actually the water test was only a $45.00 fee. If you have any questions regarding this, please call out office at (715) 386 - 4680. Sincerely, �-/ . Dv-,� David A. Dacquisto Zoning Director Enclosure sm I COU ST. CROIX INVOICE STI67E WMISCONSIN To Ruby E. Carter Address. 503 Bauer Road EIudson State WI 54016 5/14/97 Date 19 ase Quantity Description Unit Cost Unit Reimbursement for water test result fee $5.00 TOTAL $5:00 COMMITTEE APPROVED BY: SIGNATURE: I DATE: i CERTIFICATION - eby certify that this claim for ($ 5.00 ) is true and correct and no portion of the some has been paid. I Zoning Administrator m•) Date 5/14/97 I 3 -88 ST. CROIX COUNTY WISCONSIN ZONING OFFICE 1 M r N N r r r n "i ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 l i (715) 386 -4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 ❑ Septic $50.00 0 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria to Water (Lead Concentration) 21.00 retest $15.00 Owner: Requested by: Address: Address: ZIP ZIP Telephone N°: ( ) Telephone N°: ( ) Property address (Fire W & Street) : Location: ;, ;, Sec. , T N, R W, Town of Realty firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER 7fPROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* I Water sample tap location: Is the dwelling currently occupied? 0 Yes 0 No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y ON Slow drainage from house. ❑Y ON Sewage Back -up into dwelling. ❑Y ON Sewage discharge to ground surface or road ditch. ❑Y ON Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: DATE: 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION I N TO BE COMPLETED BY INSPECTION AGENCY System design & /or permit on file? OYes ❑No Soil series per SCS Soil Survey: 1, sheet # Type of soil absorption system ❑Below grd OAt -Grd OMound Approx. size ' X OGravity ODose ❑Pressurized Ft. ❑Bed OTrench ❑Dry Well Molding Tank ❑Outfall pipe OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank Setbacks: ❑House ❑Well OProp. line ❑Other Dose tank Setbacks: OHouse ❑Well ❑Prop. line ❑Other ❑Locking cover OWarning label OPump /Floats OAlarm ❑Elec. wiring Soil Absorption System Setbacks: OHouse OWell ❑Prop. line OOther OPonding: ODischarge: General comments INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title 3 j OMiMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 7T5 - `962.3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.' 09910/01 PAGE 1 ST. CROIX COUNTY REPORT DATES 9/02/91 COURTHOUSE DATE RECEIVED' 9/01/91 HUDSON, WI 54016 ATTNS THOMAS Co NELSON OWNERS S.L. & Ruby Carter LOCATIONS 503 Bauer Rd., Hudson >1 COLLECTORS M. Jenkins SOURCE OF SAMPLES Kitchen faucet COLIFORMS 0 /100 at INTERPRETATION: Bacteriologically SAFE NITRATE-NS 11 Pp0 Above 10 pp0 exceeds the recommended Public Drinking Water Standard. Coliform Bacteria /100 at Nitrate - Nitrogen, mg/L LAB TECHNICIAN' Pas Gane WI Approved Lab No. 19 fit < Means "LESS THAN' Detectable Level Approved byi m PROFESSIONAL LABORATORY SERVICES SINCE 1952 .k 1 ST. CROIX COUNTY ZONING OFFICE 511 4th Street l V Hudson, WI 54016 3 Telephone - (715)386 -4680 The St. Croix Co. Zoning Office offers the service of septic and Lending g water inspection to I Re alty ea t ib Y Firms , and private individuals. COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE ' I � LOCATED. Please provide the following information, enclose appropriate fee made payable to ST. CROIX CO. ZONING, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING-------------------- ---- - - -- --- -FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING -------------------------------- FEE:$175.00 (VOC'S) SEPTIC. SYSTEM INSPECTION----------- --- --- - -FEE: $ 25.00 PROPERTY OWNERS NAME: S • L -4 L C )9-1C'.7'�R. PROPERTY OWNERS ADDRESS: .5 :?,qu.eA CITY. (- Legal Description 174, 1/4, Sec. , T N -R W, Town of :Z::2e\ J , Lot No . , Subdivisions-- - FIRE NO -5 3 LOCK BOX NO. Color of house c H j1'C- Realty sign? My Firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e., COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line i must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill ( cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. J Firm or individual requesting services: _ : j - Telephone No. 1. REPORT TO BE SENT TO: CLOSING DATE: Signature: z _ , 'tVfN .zz. N a ul _ LU CIO N CD _ •o CD w !' v X d ¢ > _ d p Z x 1 w w r ~ t w W � iZ � >•� x Z Z a s am LL) l 1 0 L cn .tv JZ w LC >4 n C F I, F- `n 0 d Z � O> Ly LUU i n Jw Q O o 4 w a v !� f. �Zw2 !- a A C^ ON O r m _ CO oCDO%LICO LAC, 1 N O 1fY a.0 aD Q �. Y W .. • • . • . . . W W X I Q CO M r�• O 1- CA �- r'•- a% w r-- L Q V ILL Sy YI / MLnP 1 �• M M w �,-✓ !- < OD V, wa I N N NI a a LA r z� �u v, ,� -- I •� 0 e„ ? a IL R Go%af- Co cr LL N O CO 3 . � >- 0 i < ' ®+MCQ N N ti F-• r p y w bOM111 W s O . C, z **woo °1 o r ®� ° '.. } W O �tM3 OD i ` � C1+IitWi`-O r w A r C), 111 v CL O x a O W N M N 0 ¢ h•• M DEL Gn ►�.y f~t ` N 3Mr d N U.0 w cu ¢ Cr 2 W h Llr. o v W w 0 i!1 cc V M tit. N z �-+ a c w \0 0 w < w • O+(A 0 W CK0►+t1gr O to c x a Q+� NI-Z_J o ?� O �= U ~ i •- WZ =T o Q w Cn O i-M r N 3 < OZ tfi w . - COZt�Ii W 1-0�� .. r-W0 v ° MCUCD 2 me o cc ° 10 0 ¢ `�' \ cu :I r tJ W2 ?W � W32 w 04MAW �WW ca :1 > ?-0263 N v w¢ t w r G O O M— W 1•- I to J U) U w t F- V W W M CC 0 ccI - OCCK rZz_j t w w w Q \ 019 r Q33Sta ► - - < 0 �JC� Mr — r- ww<Onmwm F-OOUQ 0 < F- w cu -+OU <J 111 --¢Ti> E.. tn cn z vlav)asulzuD J it COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715- 962 -3121 800 - 962 - 5227 ST, CROIX ZONING R EPORT NO.: 36991/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 12/08/89 COURTHOUSE DATE RECEIVED*' 12/06/89 HUDSON, Wi 54016 ATTN; THOMAS C. NELSON OWNER1 Simmie L. Carter, JI LOCATION: 503 Bauer Rd-, Hudson f 2 / v 1 � Z i n COLLECTOR St Croix Lon SOURCE OF SAMPLE; Kitchen faucet COLIFORM: 0 /100 mf !NTERPRETATIONi Bacteriologically SAFE NITRATE —N: 12 ppm Under 10 ppm is safe for human consumption. COLIFORM + NITRATE LAB TECHNICIANS Pam Gane WI Approved Lab No. 19 I I I DECENO �O A V A :Means "LESS THAN" Detectable Level :approved by' �� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 1 lvl PT. CROIX COUNTY ZONING OFFICE N St. Croix County Courthouse �. 911 4th Street Hudson, WI .5401.6 r Telephone - (715)386 -4680 The St. Croix County 4o ling Office-offers.-the service of septic and water inspections tq ending Institutions, Realty Firms, and V private individuals. coaRletion of this fgrm essential that the property can be located Please provide the fgjj 4- Anformat on, enclose appropriate fee made payable to St. Zoning Offce, and mail, aloncf;"with form to the above address. Test ng ill be done as ,/ soon as possible after fee and form are received. WATER TESTING----- - -- - -- FEE: $ 25.00 (For nitrates and colform bacteria) WATER TESTING : $175.00 (For VOC'S) - - M SEPTIC SYSTEM INSPECTION- - - -- -- -_ - - -- EE - -F $25.00 (Determines if system properly functioning at time of inspection) a Property owner's name�� �? e L . Property owner's address S o 3 -•,vet R d_ H V.lSo r� w s �Q Legal Description 1/4 of the 1/4 of Section , T N - Town of TRdy L Number Subdivision Name e FIRE NUl�BSR -s° 3 LOdi BOX NUMBER - Color of house w k) , F' ; Realty sign by house? Alo If so, list firm: PLEASE INCLUDE, IF AT AW POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, A.ND ,6 COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, ma ng access to the home necessary. If this is the case, plse make proper arrangements with this office to ensure time wheTl( entry may be gained. Firm or individuArl que4t'ing services: Telephone Numbbv* 7 1S- 3S- 6 c REPORT TO BE SE TT 1-7 i1- re C rZ i . .» 3 /9L U etZ 2 N v sa�U W s Closing date .. Signature 6 a' �� f At L�L&CIz led w f i v" 1 r� i r ST. CROIX COUNTY ?� WISCONSIN � f ZONING OFFICE {� ST. CROIX COUNTY COURTHOUSE P n - 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386 -4680 December 6, 1989 Audrey Barr 307 2ed St. Hudson, WI 54016 Dear Ms. Barr: An inspection of the septic system of Edward and Michelle Hinchman, 653 Edie Lane, lot 5, Hudson, WI was conducted on December 5, 1989. At the time of the inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of the system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, MZi #.e ki ns, Assistant St. Croix County Zoning Administrator cj ST. CROIX COUNTY WISCONSIN �. ZONING OFFICE ' ST. CROIX COUNTY COURTHOUSE °. 911 FOURTH STREET • HUDSON, WI 54016 wwwwo (715) 386 -4680 December 6, 1989 Simmie L. Carter 503 Bauer Rd. Hudson, WI 54016 Dear Ms. Carter: An inspection of the septic system of Simmie Carter, 503 Bauer Rd. Hudson, WI, was conducted on December 5, 1989. At the time of the inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of the system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Mary J. Jenkins, Assistant St. Croix County Zoning Administrator c' 7