HomeMy WebLinkAbout040-1209-50-000 (2)STATEMENT
Bird Plumbing, Inc.
Shaun Bird
MPRS#226900 CSTM4226900 DNR#7640
1432 120th Street o New Richmond, WI 54017
Phone 716-246.4516 a Fax 715-246-8906
_ sbird@frrontlernet.net
20-- 2-1-2.::_3
Deposit required on all Jobs. Full payment due upon completion.
FINANCE CHARGES OF 1-1/2% per month (which Is 18% per year) are applied to amounts 15 days past due.
Liens filed on all balances 45 days past due,
Price does not include charges for bedrock, ground water or acts of God.
Owner responsible for locating all underground lines and electrical hookups to house.
Not responsible for damage to utilities,
Owner responsible for cleaning effluent filter once a year.
1 year warranty on all parts and material (labor not Included).
Not responsible for ground settling, freeze ups, or backups caused by filter.
Warranty void If water condltloner discharge la disposed of in systorn.
Septic System and Well Inspection Report
Bird Plumbing Inc
1432 120th St.
New Richmond Wi 54017
715-246-4516
sbird@frontiernet.net
I Shaun Bird, certify that on 2/21 /23 1
XXX Inspected the Septic System (POWTS)
XXX
Inspected the Well
XXX
Obtained a drinking water sample
Property Owner/Buyer
Ben Solberg
As a result of my inspecton, I certify that:
Site Address
242 Glen Circle River Falls Wi
XXX
In my opinion, the septic system was, on the date of my inspection, in working order and in
compliance with the standards set forth by the Department of Safety and Proffesional Services.
Any exceptions or needed repairs will be listed below.
Date of last pumping 6/21/2021 System appears to be sized for 3_ Bedrooms
XXX
In my opinion, the well at the date of my inspection, is in good condition and complies with all WDNR
standards. Water sample sent to Quality Water Testing Lab Somerset Wisconsin.
See attached Property Transfer Wells form. Any exceptions or needed repairs will be listed below.
In my opinion, the septic system or the well is not working or not in compliance with the
Departmet of Safety and Public Services or WDNR. See attached Property Transfer Wells
Inspection form.
The septic tank was inspected via the inspection pipe at the end of the tank due to the fact that the ground
was frozen above the septic tank manhole cover.
18" of snow at time of inspection.
Septic System maintance information: Pump tank every 3
For further information, contact your local zoning office.
Disclosure: This test is not a guarantee of future perfo
different owners. This is not a warranty of this system
cerfication. Past problems with this system,( if any) n
Shaun Bird MPRS/CSTM #226900 DNR# 76401
and clean effluent filter if installed once a year.
but a proffesional opinion. Usage can change from
laim all liabilty for any loss caused by reliance on this
ig.e discloylhe seller.
Date__ 2/21/23___
State of Wisconsin Property Transfer Well and Pressure System Inspection
Department of Natural Resources Form 3300-221 (R 08/21)
dnr.wisconsin.gov
Notice: Pursuant to ch. 280, Wis. Stats., and ch. NR 812, Wis. Adm. Code, this form shall be used to document any well and pressure system
inspection conducted as part of a property transfer. Inspections are voluntary, and well owners are not required to bring systems into compliance as a
result of the inspection. Inspectors must provide the completed form to the requester of the inspection. Do not send forms to DNR.
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Inspection Requested By
Telephone Number
v'
Mailing Address City
State ZIP Code
Well Owner's Name
Telephone Number
Mailing Address
City
7 El���:&M
State
ZIP Code
Property Location
'Fire Number Street or Road 0 City 0::�:p
County
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Section Township Range E 0 of
(DID, ex. 44.444)e (DD, ex.-89.999) WUWN
N W 0
1 ❑ Unused Well
13. ❑ Nonpressure Conduit
2, ❑ Stovepipe or Thin -Walled Well Casing
14. ❑ Hand Pump
3. ❑ Dug Well
15. ❑ Offset Pump or Piping Height Above Basement Floor
4 ❑ Buried Suction Line
16. ❑ Yard Hydrant
5 ❑ Alcove (Subsurface Pumproom) or Pit
17, ❑ Materials for Pump and Supply Piping
6 ❑ Non -Walkout Basement or Below -Grade Crawl Space Well
18. ❑ Flowing Well Installation
7 ❑ Poor Well Casing Pipe Condition
19. ❑ Check Valve Location
8. ❑ Contamination Source less than minimum separation distance
20. ❑ Well Cap or Seal
from well:
21. ❑ Casing Height
9, ❑ Well in Floodway or Flood Fringe
22. ❑ Electrical Wires at Wellhead Not Enclosed in Conduit
10. ❑ Well at Risk from Localized Flooding
23. ❑ Sample Faucet is Missing or Noncomplying
11 ❑ Cross -Connection
24. ❑ Casing less than 6" in diameter for a well terminating in
limestone, dolomite, shale, quartz or granite
12 ❑ Driven Point Well < 25 well casing pipe or installed after
1-31-1991 with no well construction report
25. ❑ Extreme Health/Safety Hazard
Comments _
❑ Evidence of Some Corrosion on Well Casing Pipe
❑ Pre-1979 Two -Wire Submersible Pump
❑ Inaccessible or Difficult Location for Future Well Work
❑ Pre-1991 Driven Point Pipe Depth < 25 feet
❑ Inaccessible or Difficult Location for Future Pump Work
❑ Well Construction Report Not on File or Unlocatable
❑ Unable to confirm whether well terminates in limestone,
Well Located in Special Well Casing Depth Area
dolomite, shale, quartz or granite
Non -Vermin -Proof Well Cap or Well Seal
❑ Other:
;Compliance Determination
Based on my personal inspection of the real property, the well and pressure system: (check one)
Complies with NR 812, Wis. Adm. Code
0 Does not Comply with NR 812, Wis. Adm. Code
0 Complies with NR 812, Wis. Adm. Code, except that a more comprehensive search or additional research is needed to
evaluate potential violations that may exist but are not fully identifiable as part of the basic visual inspection, such as:
❑ an unused well
❑ other:
This form lists the visible conditions of the well and pressure system on the property at the time of inspection and does not imply or
give any guarantee. Some features such as well cap, casing height or nonpressure conduit may comply for purposes of this inspection,
but may require an upgrade the next time work is done on the well or pressure system.
❑ foodway/floodplain ❑ contamination source
Pri ed Name of LicenM Water Well Driller or Pump Installer Individual License # Telephone Number
Si ure of Licensed Water Well Driller or Pump Installer Date
E F