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042-1018-50-000
Wiscbnsi'DepaltmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 514867 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Cum ton, Jon & Suzanne Hanson I Warren, Town of 042- 1018 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / C>� 6M 1 (-5 — 1 07.29.18.108b TANK INFORMATION % ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic Z Benchmark —7 /61. 16t�. Alt BM _,• / /oI' Aeration Bldg. Sewer Holding St/Ht Inlet S• 94•S TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7AbI -:r I ` Q 7 `� / Dt Bottom (G / \ Dosing 411 Header /Man. 9 ,23 qZ , y7 Aeration Dist. Pipe 9•23 9Z. x,17 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Slot 47 L - CA. Manufacturer Demand St Cover ` GPM : � �-c�. .�s�. / • �� ' Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1� SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: l INFORMATION Type Of System: CHAMBER OR t i UNIT Model Number: DISTR SYSTEM k oCAn, Header /Manifold Distribution x Hole Si x Hole acing Vent to Air tak Pipe(s) Length �' Dia %.,.. Dia Dia Spacin Z SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over i Depth Over xx Depth of xx Seeded Sodded xx Mulched Bed/Trench Center Bed/Trench Edges \ Topsoil i Y • s � Yes E] No '%&=e- 0 No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1021 93rd Streele✓t Rqberts, WI 54023 (SE 1/4 SW 1/4 7 T29N R1 8W) metes & bounds Lot (� Parcel N 07.29.18.108b / 1.) Alt BM Description = � ` ` Z. �•S{b �� "� �, � 2.) Bldg sewer length - amount of cover = � � Qcs4-- 7 i/ Plan revision Required? 0 Yes JeNo 1 Use other side for additional information. cl SBD -6710 (8.3/97) Date Insep is Si ature Cert. No. 23 04/22/08 TUB 09:30 FAX 715 386 4686 @001 Safety andB�uildinpDivision County W. Wasbirtgtoa Ave., Box 7162 ft Madison, WI 53 62 Ummay Permit Number (to be filled in by Co.) Sanitary Permit Application Slue Irmasarbon Number aor Tn admmoe With s. Comm. &321(2). Wis. Adm. Coda, submiss" offt form to the W ,4 unit is mgaimd prior to obtaining a sambuy permit. Nots: Appbaboe forms for atpsowned are Project Address different then mn7iasaddress) aot submitted to the Department of Commerce. Paal idbnnation you provide PAVOM in accordance With dw poyacy Law s. 15.0/ 1 ra L App#Wlon Is6amatfas — Please Print Alf Intarssa Property Owset's Name jj��( �4" Paled d Property Owner's Mailing Address y /L? ( NTY s_ GUM LAt C' state Zip C yV, Y, swi" 7 ade Ode ow O Tgp_N; RE W r' II. y pe of Bunn" (eimeck all drat apply) L4t / 2Famity Dwelling— Numperof Bedrooms �� O( * Block � S� 0 Public/CoaxtrorcuF�/III � "(Agj /`-L 2f/Yl 0 City of 0 state owned — Describe use a CSM Number 0 Vibr of own of G� /Q / / eta✓ 111. Type Ferait: (Check only one box on fine A. Complete line 8 Wapplic ) A. New System R*ao.M System 0 TranemmM Wveg Tank Only ❑ Other Modification a Existing System (04"in) S. 0 Permit Renewal 0 Permit Rtwi . 0 Change M' Plumber Permit Transfer to New List Previous Permit Number and Daee b" Before Expiration Owner '� r vU IV. of POWTS uk Cheek ap that appW / PcessuriadIwQowd 0PressmeedMmGround Mowwl >2 in nisei esoi� 1d 24jjm.ofsamt�lc oil Cl Holding Taak 0 06w Dispersal component (expiate) / `' V. DistlersalkIrreatnewt Area Isfsawadon: C a ✓a. cxg!E�z Lt Des (gpd) I Den" Soil Application Rata(gpdst) Dispersal A Ra9� (d) i Area Proposed (� X J 5 � i' VL Took info Capacity in Toed t of snufaclurer Gallons Cations Units E N"Tanka e� "NSTaaka 2 Q y ,e V V1 ,q V. V 0. OwisSChonbw V11. S4sfratteat L the andersi Ark ass me ky for insWadoa of the POWTS shows on the attaebed Plumber's Name (Print) O"ber's MP/MPRS Number litair mess Phoeme Number - 71 , Plunder's Address (Street. City, State. ZIP I le VI# esa /De partelliat Use Approved 0 Disapproved Perrait Fee 0U Date [ssu S ❑ OmMmer liven Rrason for Denial � (/ Ix. Appn wa R s br Disrppreval s ` S TE 1 Septic tank, effluent filter and maintained dispersal cell m as e l _ 11 cethank nts must be maintained as per applicable cod6lbddln8*west�Jw '*'re°md�ewdw ' "Nr«r�a+ m..sen :u;.rwl.,tar JO SBD -6398 (R. 01107) Valid thm 01!09 i PLOT PLAN PROJECT Jon Cumoton AI ,HESS 1021 93rd St. Roberts Wi 54023 SE 1/4 SW 1 /4S 7 /T 29 N/R W TOWN Warren COUNTY ST. CROIX t; MPRS Shaun Bird 226900 �4 DATE5 /5/08 BEDROOM <1 CONVENTIONAL )00( IN- GROUND PRFSORE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 261 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 145 # of chambers 7 BENCHMARK V.R Base of Steel Fence Post ASSUME ELEVATION 100' Filter BEST Filter ❑BOREHOLE O WELL *H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 91.5 4.5' below qrade setbacks required by WDNR Alternate Benchmark Base of Fence Post @ 98.0 Scale is F = 40' unless otherwise noted Vent Property Line >6„ Quick4 Standard -W P ro Horse Barn / Leaching Chamber ssessory of Cover with 20.0 ft2 of Area uilding <1 12 5.8ft ^2 /pair of end caps Bedroom, 4' Long ever to have sleep Grade at System Elevation quarters or livable 34' 1 1 -3' X 30' Cell ST —16 * Vent Ad..B �M. 1190' B.M. 720' , 100' 10' 40' 10 250' B -2 B -1 30' 20% Slope 93' B -3 20' Plans Designed Using 90' Conventional Powts Manual Version 2.0 500' Property Line Ec COPY PLOT PLAN PROJECT Jon Cumoton A ESS 1021 93rd St. Roberts Wi 54023 SE 1/4 SW 1 /4S 7 /T 29 N/R _ W TOWN Warren COUNTY ST. CROIX L" MPRS Shaun Bird 226900 -"' DATE5 /5/08 BEDROOM <1 CONVENTIONAL XXX IN- GROUND PRF CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 261 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 145 # of chambers 7 BENCHMARK V.R.P. Base of Steel Fence Post ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL - H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 91.5 4.5' below qrade setbacks required by WDNR Alternate Benchmark Base of Fence Post @ 98.0 Scale is 1" = 40' unless otherwise noted Vent Property Line >6" Quick4 Standard -W P ro Horse Barn/ Leaching Chamber ssessory of Cover with 20.0 ft2 of Area B uilding < 5.8ft ^2 /pair of end caps Bedroom, 12' 4 Long ever to have sleep Grade at System Elevation quarters or livable 34' 1 -3' X 30' Cell 30' ST Vent At1 ; M. 100' B.M. 20' >- 100' 10' 40' 10 B -2 B -1 30' 20% Slope 93' B -3 20' Plans Designed Using 90 , Conventional Powts Manual Version 2.0 500' Prop erty Line i Wisconsin Department of Commerce SOIL E U TIO REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. County Attach complete site plan on paper not less than 8 112 x 11 inches in siz . 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. ! �G'l Fin Please print all information. Reviewed by Date i Personal information you provide may be used for econd Ei+�w, Property Own a- �+ Pro jerty Location UU � Lot54� 1/4 A s7 T Al N R/ � E (or Property Owner's Maaii�li Address Lot Block # Subd. Name or CSM# D oZ 7 �Lk ✓� CROIXCOUNT City State Zip Code Fhone by ❑village ^own Nearest Road 49'1�S' e-4-2 k5Yb4 ( /si - 31.3 wa e ,' ?� New Construction Uso!5 esidential / Number of bedrooms Code derived design flow rate /M GPD ❑ Replacement ❑ Public or commercla (Describe: Parent material Flood Plain elevation if applicable CZ / T� C> v ` ft. and ret onvnend !` S /! ,S / 7 ' Ut/� r Ee /Jam' i System Type z System Elevation , S F-11 Boring # Boring �f ® pit Ground surface elev/ - ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 - Eff #2 F-11 Boring # Boring Pit Ground surface elev.f4l ft. Depth to limiting factor / l in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color j Gr. Sz. Sh. •Eff#1 - Eff#2 0- Z / .S / • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715- 246 -4516 1 Property Owner _ Parcel ID # Page of E Boring It ❑ Boring l Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d- d 00V_ 7 , Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil licetion 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 Boring # ❑Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BOD < 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. seo -8330 (RAW) f 1 Project Name Jon Cumpton Soil Test Plot Plan Shaun Bird / 7 Address 1021 93rd St. Roberts Wi 54023 / CSTM #246900 Lot ------ Subdivision -------- Date 5/6/08 SE 1/4 S W 1/4S 7 T N /R W Township Warren [� Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Base of Steel Fence Post System Elevation 91.5' *HRPSame as Benchmark Alternate Benchmark Base of Fence Post c 98.0' Property Line Pro Horse Barn » > ssessory � Scale is 1 = 40 Building <1 unless otherwise B edroom, noted ever to have sleep quarters or livable AtI.B.M. B.M. 6 20' , 100' 10' 40' 10 250' B -2 B -1 30' 20 Slope 93' B -3 20' 90' 500' Property Line I TH 1562 AVE. 214.31 437 354 C. S. M. ' 80 � . Q C [ , e l C. S. M. 7/ 1959 U, D 4 . S. M. CERTIFII WL I DT.� /5 / 1772 C "1 - - v . 2 , PQ. 4 9�Q_ _ 105 C 105E a N LOT � I I Q C m In to LOT I to I ` a q� tC f, T V-cts ' Il � I I 1' _ 43 - 7 138.64 354.0 Tl ���3/ a3( 940. 10 ' 460.8 t- D3 �l1� 53� o rt I l c\ 4.- 111 B CV SE 114 - SW _ 21 ,� �' • �, N 0 2 75.38' 10 8 B 3 ��s (b 217.6 L ()�91D93fI�L� SW - SE 9t c #�" 0_ In f 150 111 A3C OD LOT 5 206.02 938.41' LOT 2 I 142.01' Z _ I I I A Io I c _ Z oo N r _ I co M I to 1 a III D S � /2 LOT I ,S s 1 /a. C-04-� , I SEC. 14 X 1_3' O" +_ r OHD Openin — -— - - - u? a 0? X o > W OD w w m O O -Ci O? 0 > r m O QD O_ n t (b O 0 QO O_ cq 0 - - O O R x A < x O � a N O °? -02 0 O a ? 3 Qi X� 0 C. OX__ ` y (D W� o • r y 7 .� oA Z 7Q m m a m y O m z 1 O' O" i O' O" `\ O a"a U OHO Opening g Q? O 6 K N o m o Q o CD .J m N > O W i e _ 1 0 A > — =Q T o X -- -- — Q — - p X _— m > - -- — - -. Q 7 - O a 0 7 O -. -w -_�,, . -�- Q? �o _ OD o- o o rn m rn m ° O m -�-- .i - OD -- - -- - -� A N aD W m 10 O" X 1 O' O" m II o Q b 0 o a 0 x 5� � ox �► �. N 7 W G O O OR O (D > - x x / ..L. - cry,-' - -- T -- m - Qo cfl ip to L o CD - O � m o o m O O x N [V CD N O Q Z Z Z (V o O O O X �13' ��� O� 2. _ _ - N_ O 7 N_ -- (7) N N Co W O O (O O r a � ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OV;NEMHIP CERTIFICATION FORM Owner/Buyer Mailing Address � a Property Address (Varification required from Planning & Zoning Department for new coastntetiom. City /State Parcel Identification Number '� a� D � LEGAL DESCRIPTION " / `� f �r , T N R1�, Town of �� ✓ /� �' property Location ,Sec. 2--0 A 0 _, Lot # Subdivision _ Volume C , Paged # Certified Survey Map # O / Warranty Deed # `� �� V ,Volume ` Page # _ Spec house yes o Lot lines identifiabl62 no - SYSTEM MAIlN AND OWNER CERTI7CATION maintenance of your septic system could result in its premature farlure to at Yo use and u put into maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed i? P� the system can affect the function of the septic tank as a treatment stage in the waste disposal system - owner maintenance res Pow bilities are specified in $Comm. 8352(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. and by a master plumbea, j T1re property owner agrees to submit to St. Croix County Planning & Zoning Department a certific$lim:f oam. signed by the ourneyman plumber, restricted plumber or a licensed pumper venfym9 that (1) the on -site owner tin condition and/or (2) after inspection and pumping (if necessary), the septic tank is wastewater disposal system is in proper o pera g less than 113 full of sludge. rivate sewage disposal system with the Ilwe, the undersigned have read the above requirements and agree to maintain the p standards set forth, herein, as set by the Department of Commerce and the Department of Natural Rtsoutcea. State of Wisconsin. Cerafication stating drat 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. 1/we certify that all *tatements on this form are true to the best of my /our knowledge. 1/we am/are the Owner( &) of the property d abov by virtue o a warranty deed recorded in Register, of D ds Office i 16 SIGNA OF APP c () DATE dx * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Departmenu. 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. 08105 i Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C _ontin cy Plan Option #1 If system fails, determine cause of failure, use alternate area and install new sy m in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 -246 -4516 St. Croix County Zoning 715- 386 -4680. Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 1439oArE 535 Ea06290 STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED ST. CROIX Co., WI This Deed, made between AIIen L Lucken a sinele uerson. RECEIVED FOR RECORD Grantor, and 07-06 -1999 2:40 PM - Lonathan D. Cum on and Suzanne M. Hanson husband and wife WARRANT Y N DEED EXEMPT N CERT COPY FEE: COPY FEE: TRANSFER FEE: 900.00 Grantee. RECORDING FEE: 10.00 PAGES: i Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St . Croix County, State of Wisconsin (The "Property "): Recording Area Name and s - Edina Realty Title 400 South 2nd Street Suite #115 Hi on, W1 5 4016 842 - 1018 -50 Parcel Identification Number (PIN) This is homestead property. Part of the SE1 /4 of SWl /4 of Section 7, Township 29 North, hangs 18 West-'. Town of Warren. Sr Croix County, Wisconsin described as follows: Cornmenlctng at the South 1/4 corner of Section 7; thence North 02 degrees 19 minutes 10 seconds Hest along the Quarter Sect3.on line 367.21 teem to the po of beginnings thence, N g North B9 degrees 23 minutes OS naconds West, 938.41-100r, � to th'� =line of an existing town road; thence North 02 degrees 59 minuveo 26 seconds East along said centerline 4 feet; thence North 00 degrees 23 minutes 06 9ieconds Easm along said centerline 725.09 teem: thence Northeasterly along said centerline 166.16 feer the arc of a 1197.315 foot radius curve which is concave Southeasterly and whose long chord beat=s North 04 deacees 21 minutes 38 seconds East 166.03 fret; Chance, Sour-I% 89 deareas 23 minutes 05 seconds East, 9AA-10 feet; thence South 01 degrees 19 minutes 10 seconds west 936.56 feet to the point of beginning. St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any Dated this 2 day of June, 1999. * * Allen L. Lucken * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) j ss. authenticated this J day of County ) Personally came before me this -S 0 day * of June, 1999, the above named Allen L. Lucken a sinele person- TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the (If not, person(s) who executed a foregoing instrument and authorized by § 706.06, Wis. Slats.) ack edge the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristin Ogland Hudson, WI 54016 N tary Public, State of Wisconsin (Signatures may be authenticated acknowledged. Both are not My Comm ' ission per anent. (If not, state expiration date: necessary.) 1 i � 1Tt�•.ttii� *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY D STATE BAR OF WISCONSIN FORM No. 2 - 1498 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI 800$552027 , f • z.� 0 7 ? ƒ 0 0 ? \ _ 7 / \ f ° § / [ ® z n < / \ 2 \ ; / E E \ \ ƒ \ \/ E E y x\ \\ k 6 = _ ] ] ° a < o a § E 2 % ' 5 R § § ! } ° . w e } E f E _ E; a �\ ro ; \ c _ CD \ / § t ¢ to c = f 3 @ \ / \ / ® F § -4 k ° ® o c 0 o CO) m■ r 0 &< o J o \' \ ® 3 % % k e . 7 2 . . » } � \ cr \� � � 2 / � o > >0 \ U CD k � \ 3 & CD . , 3 {f � = i z / Q R - $ ] w CL { z ; 0 ¢ . \ 2 / z * 2 < i . a\ =$± ,, aw= afk«a (D 0 — 3a�&» I i % y&\ // _\ ) CD E£ {g0 3 \ #/ f \ § //& / »/) \ { a / OL 2 {G { 0 \ ¥ A \ \ \ ! \ \ \ \ 1 Y r Parcel #: 042 - 1018 -50 -000 04/18/2006 08:10 AM PAGE 1 OF 1 Alt. Parcel #: 07.29.18.108B 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ' 0 - CUMPTON, JONATHAN D JONATHAN D CUMPTON C - HANSON SUZANNE M HANSON SUZANNE M 1021 93RD ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1021 93RD ST SC 2422 ST CROIX CENTRAL SP 1700 WITC , � � j � f N +!v ' b Legal Description: 20.000 Plat: N/A -NOT VAILABLE SEC 7 T29N R18W E SW 20.281 ACRES, Block/Condo Bldg: COM S1/4 COR SEC 7, - A& DEG W 938.41', N 2 DEG E 45.78', N Tract(s): (Sec- Twn -Rng 40 114 160 1/4) 72 EG E 166.03'S 89 DEG E 07- 29N -18W . 10'S 1 G W 936.56' TO POB Parcel History: Date Doc # Vol /Page Type �^ 07/06/1999 606290 1439/535 WD 07/06/1999 606289 1439/531 TI 07/23/1997 833/600 07/23/1997 739/228 - n 23d 2006 SUMMAk Bill M Fair Mar lu Assessed w' G c "-,, D Valuations: �'� ��'- j� �� 'LA -V t C : 2001 Description Class Acres Land m ove Total State Reason RESIDENTIAL G1 20.000 93,500 225,200 318,700 NO 76 Totals for 2006: General Property 20.000 93,500 225,200 318,700 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 93,500 225,200 318,700 Woodland 0.000 0 0 I Lottery Credit Claim Count: 1 Certification Date: Batch M 502 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Char es P p 9 q 9 Total 0.00 0.00 0.00 Parcel #: 042 - 1018 -50 -000 04/20/2006 08:45 AM PAGE 1 OF 1 Alt. Parcel M 07.29.18.1086 042 - TOWN OF WARREN Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - CUMPTON, JONATHAN D JONATHAN D CUMPTON C - HANSON SUZANNE M HANSON SUZANNE M 1021 93RD ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1021 93RD ST p SC 2422 ST CROIX CENTRAL SP 1700 WITC �J' 6V-t__CdAj4 Legal Description: Acres: 20.000 Plat: N/A -NOT AVAILABLE SEC 7 T29N R18W IN SE SW 20.281 ACRES, Block/Condo Bldg: Q_0�M S1/4 COR SEC 7 N 367.21' -POB, N 89 DEG_'J38 -M �G E 45.78', N Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 725.09', N 4 DEG E 166.03'S 89 DEG E 07- 29N -18W 940.10' S 1 DEG W 936.56' TO POB Notes: Parcel History: Date Doc # Vol /Page Type / /1999 6062 Q 1439/535 WD 07/06/ 8 606289 1 39/531 L !f C — TI 077�M97 833/6 07/23/1997 739/228 (�C – more 2006 SUMMARY Bill # : Fair Market Value: Assessed with 0 b Valuations: ,. Last Changed: " 101W12001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 20.000 93,500 225,200 318,700 NO Totals for 2006: General Property 20.000 93,500 225,200 318,700 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 93,500 225,200 318,700 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 502 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 0 Total 0.00 0.00 0.00 ComOr SuQvlEYo I � CERTIFIED SURVEY MAP MAP NO co PART OF THE SE 1/4 SW 1/4, SECTION 7� T 29 N - R 18W TOWN OF WARREN ST.CROIX COUNTY WISCONSIN l6l '710 L-, C. 4-o - —4 �� "I �'� W D REI OWNER: RICHARD C GO I (`fig j ROBERTS, WI. SURVEYOR; M.E. HALVORSEN HUDSON, WI. MARCH 23, 1981 1 a� � w 0 �6 —N 89° 23' 05" W C940' . 10 0 w z cn —0--- x — 3' 452.70 101.37' 19 3.03' Q ►_ _j _ a h w w E- Io ° Ir W 0� CD U' Z pr O N 2 W Lo - 00 0 — Z 10.217 r N ct Q U. D W W o OD o N LOT 2 � m m m (� yJTo •`_ � '�r m 4.03 ACRE U) ,\ fff M ro /� I �� i / GGiI �-C/ ' ► J ' �V/ ✓,�i�J to 0 1 0 m tD 1 a o - 33 N 89 23� 05" W 910 .93' — g (b �A r': m cv 943.93 '5 0 0, /� N 85 66 M ° 40'50" V o W ' 10 fl �� 234.00' I w O 00, K) i 0 �QLQ64 — C I D I �"m G M c\i LOT I 1 u, o o ro 3.165 ACRE 12(D Z Iw U) U) g \� I w 3 604.16' _ 233.59 66 c o ui 1 66 S 89 23'05" E 870.74' ' 1 SE 1/4 SW 1/4 3 .f' N SEC.7 IJ NOTE: LOT I CONTAINS 3.165 ACRES ~ 2.015 ACRES EXCLUDING ESMT. o_ O lil N co SOUTHWEST CORNER -900 0 > SEC. 7 T29N— R 18W so. U ' i� 0 _ SOU TH LINE S_EC_ l o- $_ "T 29N -R 18W —� S 89 ° 31' 20' 6 6.01 ' — LEGEND — `���� 5G 0 �v.- 0 - - - - - - EXISTING 3/4" IRON PIPE Q - -- - -- EXISTING I" ROUND REINF. BAR S74r MAF',!,. w •— — — — — 3/4" X 24" ROUND IRON REINF. BAR X HALV ! W. WEIGHT 1.50 LB. PER LIN. FT. : _ `= 0 200' 400' 600' ' W1:;. r o • SCALE: I "= 200' °s suR IIIIi1N ERCIAL TESTING LABORATORY, INC. ain Street, P.O. Box 526 FColfax, Wisconsin 54730 715- 962 -3121 ` 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.' 21154/01 PAGE 1 ST. MIX COUNTY REPORT DATE' 4/20/92 COURTHOUSE DATE RECEIVED' 4/15/92 HUDSON, WI 54016 ATTN' THOMAS Co NELSON I OWNER' Willard Cochrane LOCATION: Roberts, WI COLLECTOR' M. Jenkins DATE COLLECTED: 4 -13 -92 TIME COLLECTED. 2:00 PiK i i SOMCE OF SAMPLES Kitchen Faucet DATE ANALYZED' 4 -15-92 TIME ANALYZED' 2:00 Pt$ Coliform Bacteria /100 ml *COLIFOR#' 0 /100 ml INTERPRETATION' Bacteriologically SAFE Nitrate- Nitrogen, mg/L *NITRATE -N' 7 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. s , t it LAB TECHNICIAN' Pam Gane 0 f .oF,NDEVENpfa� WI Approved Lab No. 19 A C mans "LESS THAN" Detectable Level, Approved by' ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 ik \ \n, ST. CROIX COUNTY ZONING OFFICE CS St. Croix County Courthouse �p 911 4th Street Hudson, WI 54016 � Telephone - (715)386 -4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion Qf this form I& essential = #hat � progerty can hg 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: $ 35.00 (For nitrates and coliform bacteria) \/ WATER TESTING FEE: $185.00 l� (For VOCIS) SEPTIC SYSTEM INSPECTION ----------------- FEE:. $25.00 ( Determines if system is , properly functioning at ,*time of inspection) II � f( ) �Y PROPERTY OWNER'S NAME : l T T l PROP. ADDRESS: (b.5 a &1 Kee CITY Legal Description 1/4 of the 1/4 of Section , T Z N -R/X— Town of Lot Number ____Subdivision: FIRE ER r / �_ - /D/ Color of house_ tl(.c� Realty sign by house? V If so, list fir �c yu PLEASE INCLUDE, IF T ALL POSSIBLE, A MAP, i.e,COPY OF PLAT HOOK, 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 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. Firm or individual requesting servi_ges: I� ► `A J 1T J 7 j 7 e4-3 4601e. / Telephone Number D REPORT TO BE SENT TO: aS CLOSING DATE: Signature . W WARREN T. 29 N. 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Asa , Z 65 C a i g _ -9914 tl { C oU e/ v E� /F / /au Ec cs Lenert y o� 817 M E.Lro.,e Gr. or f 0� te _ y 4- cS.,.,; 7f, Pechurnar/ ..y M /317 J I� j 3•�y f?- KSha FA %e 5 s ynderson a. - 7�l— /�o • ro Na �ii 0 rc�a rsa. s 5 �7s R. : ' e h Krez3,9e /. r/O y n De/ahae la. ,., b 66.43 • 7!1 1 ''¢G.L s E o/W o /d r> i � � rorrexe � 4 • e/ss , I� can o f r ebad 4 Fo °/ Do rs Q4da/ h 5 • 0. ❑z r vs✓ 1<',e, >�t 994.3 C /ar a v 17orwes 0 h y f'es.Ea>- W / /.a 9I B7 N FQ ns G R 29772 s !9 w /n/ BSc w¢ /cn r6c JC 2327 -Znc. 193.88 De./! C ai f V Glenda e ar/ K irov N /en II� "'�i 9l /ant ° � w- e, ,T Ner- • .Faye/ .� eC H¢7lse? ° c> N 9nn e rcde- ran Jewir o e vales Z��z�w.,� n Den:7rs r, c': Ceo f ore/7/ srn ti F n g Mana9e- Foyer /y Foyeriy i n/elso>7 Bye � ' a /94 Hav: Fai'7l" /�r Tires1 h S ss6� nerd o meal Cn. rs9! 32 5 •) c' •r3 tr // A O 9 o ec. _ �9Be / l oP' Barron p °w /99/ rPoc.E o dryya�,o� /s,z c. SEE PAGE !T cs> Cr�rx Co<.nty, c rD 900 1000 1100 1200 1300 1400 1500 Dependable Hybrids From BE A 4 -H Dependable People Richard H. Kamm 1382 - 100th Avenue TM Roberts, Wisconsin CIBA -GEIGY Call: 749 -3332 Seed Division ' REALTY WORLD® -- Pauley & Johnson, Inc. 1940 South Greeley Street, Suite #102, Stillwater, MN 55082 Telephone: (612) 439 -1797 REALTY WORLD AGN: JO ITN KIMBERLY (612) 653 -1730 W ELCOME TO: .s .` 1021 03RD STF SET 103E;:IBS, WI PRICY TAh15. $4,243.63/91 � ACItI�:S LOT SI %l:�( 1 I T 1OUNl)A 1 ION . 1600 Y x rlr _ FINISHED: 3000 '` "`• BEDROOMS: 5 S + yf; xi B All IS a X ��iR K7W.14/RM� • "tii. i N a • .a , y 4�i+Mb4. WHAT A WONDERFUL OPPORTUNITY! .4M *THIS ROOMY — QUALITY BUILT, WELL— MAINTAINED 4 -5 BEDROOM IIOMIE IS LOCAmm ` 6 MILS WEST OF RCBERTS, WI. PERCIIED A'ItOP A HILL OVERLOOKING 20 ACRES OF WOODS AND PASTURE. *SET UP FOR HC)RSI S', 1ITE PROPERTY HAS A LARGE BARN WITH 5 STALLS, RIDING RING AND 5+ ACPM NDgLY - ''VELD. * THE HOME NEARLY 3000 FINISHED SQUARE FEET. IT INCLUDES TIE FOLIMING AMENITIES: ' * LARGE EAT — IN KITCHEIi PLUS FORMAL DININGIIOOM. * LARGE LOWER LEVEL FAMILY ROOM WITH r 1II FULL ti ALL I'IREPLACI; , WET Br',R. AND ROOM FOR A POOL mAI3LI: PLlu PLENTY OF SPACE ZO RELAX AROUND THE HEART11. * 7II , BEDROOMS ON 3TTII; MAIN JE VEL _ AND TWO BEDROOMS ON LOWER LEVEL. * MASTER SUITE INCLUDES MASTER BAT[1. * OAK TRIM 711ROUCII -0UT. * BEAMED CEI LING . * ANDERST�N WINDOWS. * PATIO DOOI1 S . * BAZH DOWN — PLUS WCE CARPETED LAUNDRY AREA. * ZIIE BARN * FIVE STALLS — ONE WHICH INCLUDES HEATED, i'INSULA'IED. I'HIIERIFIG T �M WITH DIRECT WATER SOURCE. * NEW WELL LAST 'IWO YEARS — SE J S BARN SOLELY. * TACT{ ROOM, AREA MR HORSE UTAILER PARKING, IOA=TG 'SHED. * P1DING ARENA ADJACEINT 'TO BARN. *LAND / GROUNDS . * 5 — 6 ACT S ELECTRIC FENCED (COMPLETED LAST 2 IS) — * 6 — 7 ACRES OF UNFENCED PASTURE * 6 ACRES WOOLS * 15 x 30' CYCLONE FENCED DOG RUN B111INID HOUSE * KID'S PLAY HOUSE * LARGE DEG 0I,1,' 7IIE KITCHEN * NEW TIMBER RETAINING WALL AND LOVELY LANDSCAPING AROUND 'II-iE DECK A,:i:'A * DRIVEWAY RE— SURFACED 1 YEAR AGO. , *CNN -Y A SHORT DRIVE F1:0M TITS TWIN CITIES — AND ONLY 1.0 MILES FROM THE HULSCN BRIDGE. THIS PROPERTY 0 SRS THE PE Cr CJOUNTRY GET- -AWAY IUR 'THE HORSE LOVER OR GMVING � FAMILY. , � — Each of /ice independently owned and operated REALTY WORLD° tS 111E RESULTS PEOPLE" k ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386 -4680 April 13, 1992 SERCO Laboratories 1931 West County Road C -2 St. Paul, MN 55113 To Whom It May Concern: Would you please Fax the results of Cochrane to us as soon as you have finished the testing? Our Fax No. is (715) 386 -4628. Tha k -you Ma ,--,,7. J nki s Assistant Zoning Administrator cj ST. CROIX COUNTY WISCONSIN F ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 15 (7 ) 386 -4680 Apr. 15, 1992 Matthew Huepfel 1966 James Ave. St. Paul, MN 55105 Dear Mr. Huepfel : An inspection of the septic system on the property of Willard Cochran, located at 1021 - 93rd St., Roberts, WI was conducted on Apr. 13, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them from the laboratory. At the time of 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 may be dependent upon proper maintenance of the system. + ly, enkins Assistant Zoning Administrator c7 04 -27 -1992 13:56 612 636 7178 SERCO LAB P.03 I SERCO Laboratories 101 Wul COUnty Road C2. &, P". Minnmta 68113 Phony t612) 636.7173 FAX (612) 63E.7176 LABORATORY ANALYSIS REPORT N ©s 21135 PAYS 2 04/27/93 SERCO SAMPLE NOm 27952 SAMPLE DESCRIPTION: Cochrane ANALYSISs .. -------------------------------- -- - - -- - -- - - - -- Mathylene chloride, u9 /L <5.0 (Dichloromethane) 191,2,2 Tetrachlorowthane, up /L <0.2 Tetrachloroethene, ug /L <1.5 1,101 Trichloroethane, ug /L <5.0 1 , 1 ,2 - Trichlorowthane, up /L <0.1 Trichlorofluoromethane, ug /L (Freon 11) <0.7 Vinyl chloride, ug /L <1.0 Benzene, ug /L <1.0 Ethylbenzone, ug /L <1.0 Toluene, ug /L <1.0 Trichloroethene, ug /L <0.4 This samples's analytical results PO/91 * the U-8 SDWA Maximum Contaminant level of 1 for thoseorequasted9 EPA's compounds which are also on the SDWA MCL list. I i < means "not detected at this level ". 1 mg 1040 ug. MNMber '04 -27 -1992 13:56 612 636 7178 SERCO LAB P.04 C� 7J SERCO Laboratories 1931 W"I County P-0W C2, k PWt. MinnUM $5113 RMN (012) 9847173 FAX (61 ) e.71" LABORATORY ANALYSIS REPORT NOt 2 11 35 PAGE 3 04/27/92 All analyses were performed using EPA or other accepted methodologies. Samples that may be of an environment4l1 hazardous nature will be returned to you. Other samples will be stored for 30 days from the date of this report, then disposed of by SERCO Laboratories. Please contract me if either arrangements are needed. This report may not be reproduced, except in its entirety, without prior written approval from SERCO Laboratories. Report submitted by, Diane J. Anderson Project Manager � R fi t.. A �\ ✓� < means "not detected at this level ". 1 mg loco ug. M.ma► 04 -27 -1992 13:55 612 636 7178 SERCO LAB P.02 em :O SERCO Laboratories 1931 Wnt County Roth C3. M. ftW, MIMMMM 65113 PON (012) 030.7173 FAX (912) 930.7170 LABORATORY ANALYSIS REPDRT NOa 21135 RAGE 1 04/27/92 St. Croix County Zoning DATE COLLECTED: 04/13/92 911 4th Street DATE RECEIVEW 04/14/92 Hudson, WI 54016 COLLECTED BY i CLIENT DELIVERED BY s CLIENT Attnt Mary J. Jenkins SAMPLE TYPE r DRINKING WATER SERCO SAMPLE N0i 27952 SAMPLE DESCRIPTION: Cochrane ANALYS1Se ----------------------------- ----- - - - - -- -- - - - --- Bromodichlorowthane, ug /L <0.2 Bromoform, ug /L «.5 Bromomethane, ug /L (Methyl bromide) <1.0 Carbon tetrachloride, ug /L <0.2 Chlorobenzene, ug /L <1.0 Chloroethane, ug /L (Ethyl chloride) <0.4 2- Chloroethylvinyl ether, ug/L <0.4 Chloroform, ug /L <0.5 Chloromethone, ug /L (Methyl chloride) <0.6 Dibromochloromethane, ug /L <0.4 (Chlorodibromomethane) 1 ,2 - Dichlorobenzene, ug /L <1.4 (o-Dichlorobenzene) 193- Dichlorobenzene, ug /L <1.0 (m Dichlorobenzene)_. 1 9 4- Dichlorobenzene, ug /L <1.0 (p Dichlorobenzene) Dichlorodiflucromethane, ug /L (Freon 12) <0.5 i,l- Dichloroethane, u /L <0 4 .1 '1 192- Dichioroethane, ug /L <0.2 t ? (Ethylene dichloride) 1 Dichloroethene, ug /L <0.2 trans- 1 9 2- Dichloroethene, ug /L <0.1 1 9 2- Dichloropropane, ug /L <0.1 cis- 1.3- Dichloropropene, ug /L <1.5 trans 193- Dichloropropene, ug /L <0.9 < means "not detected at this level". 1 mg @ 1000 ug. Member 04 -27 -1992 13:54 612 636 7178 SERCO LAB P.01 SERCO Laboratories St. Pain. M,nm$som 1931 West County Road C2 °'.. St, Paul, Minnesota 65113 C Phone: (612) 636.7173 FAX(612)638-7178 DATL�• Ple deliver inim diateIy ZID• Fnw: A 1 PRM: SO= PLO tories Number of Pages (inclu iM cry fit)' ,- >lad. /� If you do rrot receive all of the pages, plww call (612) 636 -7173 as mm as possible. When Ouelity and Service Count FFFFFFFF A X X F A A X X F A A X X F A A XX FFFF A AAA A XX F A A X X F A A X X F A A X X ST. CROIX COUNTY COURTHOUSE 911 Foutth St ee-t Hudaon,Wl 54016 DATE: Z �- 9JP - ?�7, TO: FAX NUMBER: (n / -, - y � C?O/3 NAME: -sj� FROM: FAX NUMBER: (715)386 -4628 NAME: NUMBER OF PAGES INCLUDING COVER SHEET: IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: NAME: Al TELEPHONE NUMBER: So O r� �«f u Q� I a SERCO Laboratories 1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636.7173 FAX (612) 636 -7178 LABORATORY ANALYSIS REPORT NO: 21135 PAGE 1 04/27/92 St. Croix County Zoning DATE COLLECTED: 04/13/92 911 4th Street DATE RECEIVED: 04 /14/92 Hudson, WI 54016 COLLECTED BY : CLIENT DELIVERED BY : CLIENT SAMPLE TYPE DRINKING WATER Attn: Mary J. Jenkins SERCO SAMPLE NO: 27952 SAMPLE DESCRIPTION: Cochrane ANALYSIS: ---------------------------------- - - - - -- -- - - - - -- Dromodichloromethane, ug /L <0.2 Bromoform, ug /L <0.5 Bromomethane, -ug /L (Methyl bromide) <1.0 Carbon tetrachloride, ug /L <0.2 Chlorobenzene, ug /L <1.0 Chloroethane, ug /L (Ethyl chloride) <0.4 2- Chloroethylvinyl ether, ug /L <0.4 Chloroform, ug /L <0.5 Chloromethane, ug /L (Methyl chloride) <0.6 Dibromochloromethane, ug /L <0.4 (Chlorodibromomethane) 1,2- Dichlorobenzene, ug /L <1.0 (o Dichlorobenzene) 1 ,,3 Dichlorobenzene, ug /L <1.0 (m- Dichlorobenzene) 1,4- Dichlorobenzene, ug /L <1.0 (p- Dichlorobenzene) 10 Dichlorodifluoromethane, ug /L (Freon 12) <0.5 1 1- Dichloroethane u /L e , g <0.1 QD ` 1 , 2- Dichloroethane, ug /L <0.2 (Ethylene ene d " r i y ichlo ide) 1 , 1 -Di chl oroethene, ug /L <0.2 r�. S> �� ;•, trans -1 , 2 -Di chl oroethene, ug /L <0. 1 O�� 1 , 2 -Di chl oropropane, ug /L <0.1 `9 cis -1,3- Dichloropropene, ug /L <1.5 S� trans -1,3- Dichloropropene, ug /L <0.9 < means "not detected at this level ". 1 mg = 1004 ug. i Member SERCO Laboratories 1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636.7173 FAX (612) 636 -7178 LABORATORY ANALYSIS REPORT NO: 21135 PAGE 2 04/27/92 SERCO SAMPLE NO: 27952 't DESCRIPTION: Cochrane ANALYSIS: ---------------------------------- - - - - -- -- - - - - -- Methylene chloride, ug /L <5.0 (Dichloromethane) 1,1,2,2- Tetrachloroethane, ug /L <0.2 Tetrachloroethene, ug /L <1.5 1,1,1 - Trichloroethane, ug /L <5.0 1,1,2- Trichloroethane, ug /L <0.1 Trichlorofluoromethane, ug /L (Freon 11) <0.7 Vinyl chloride, urn /L <1.0 Benzene, ug /L <1.0 Ethylbenzene, ug /L <1.0 Toluene, ug /L <1.0 Trichloroethane. ug /L <0.4 This samples's analytical results re � below the U.S. EPA's SDWA Maximum Contaminant level of 1/30/91 for those requested compounds which are also on the SDWA MCL list. i < means "not detected at this level ". 1 mg = 1000 ug. ` Member r i SERCO Laboratories 1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636 -7173 FAX (612) 636 -7178 LABORATORY ANALYSIS REPORT NO: 21135 PAGE 3 04/27/92 All analyses were performed using EPA or other accepted methodologies. Samples that may be of an environmentally hazardous nature will be returned to you. - Other samples will be stored for 30 days from the date of this report, then disposed of by SERCO Laboratories. Please contact me i# other arrangements are needed. This report may not be reproduced, except in its entirety, without prior written approval from SERCO Laboratories. Report submitted by, Diane J. Anderson Project Manager < means "not detected at this level ". 1 mg = 1000 ug. Member From The Desk of MATTHEW HUEPFEL �-f 7/s Le /* ABBOTT NORTHWESTERN PHARMACY 2545 Chicago Ave. South Minneapolis, MN. 55404 (612) 863 -4190