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HomeMy WebLinkAbout002-1047-70-000 a o I m o I 3 0 ~°pv > 03 60!> a 0 0 ~ g I ~ I o O N I m I N t ti ~ I = c 0 ~v o m c a~ cYO I ~ E I i~ 0 N E E v ayi ~ I m o I C z -O z '0 C y 3 76 N 7 Fu p = LL c t LL c 'vr •0 3 pc °_t- '6 0 3 y a Q ¢m3 3 co o v 0 I a3i I Z y Z V! w l ~ I E I v ~ c CD cor w a m m` m N H fn a m c t7 0 O z a U) ~ c Z E E -0 I Cl) `r+~J v r _0 01 0 0 Z z O N E z y c 10 c ~N 0 II L R 2 R N 05 M - 0 C }~1 N y y N CL CO ` C fD CD (D v O O G a 4) c N C) a G d .D j cc 0 C~ C> C, f6 N N co d z 3 am Zooo O 0 caCL IL aaa CL to J V CO p O m Dpi W y O O O N co ills N m N m C d N -6 0 d Q Z !n N 'C _d Q Z CA fa N C\l 7 a0 Y y c N O p w Y y y o O y e y o 0= j N v to CD im O N Id y Ovi 'd O a C 4. O O O -ca y € 10 -O N N N M M CD °M° 0 a) ~ c m a m N N E y CO Nr ayi `m E co 0_ _ 0 y o o cli 0 o° N m if o z F- z u o z z to cc IL d L (L m c d m c tt`~1~i a v 'c j c ~1 A ciao 0U))u 0 U)L) ~EPART~NT OF INDUSTRY, L BOR & HUMAN RELATIONS INSPECTION REPORT FOR SAFETY & BUILDING P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 OFFICE OF DIVISION CODES & APPLICATION S E 4 , SW 4 ,Sec . 2 0 , T2 9 - R16 State Plan I.D. Number: ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Baldwin ❑ Holding Tank ❑ In-Ground Pressure Mound _ P IT HOLDER: ADDRESS OF PERMIT HOLDER: v{ r, INSPEC ION DATE: ike Fins terwalder C? li/~w - nos BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: HEF. PT. LE CST PT. EL Name of Plumber: 1610'o' ~~9r MP/MPRSW No.: County: Sanitary Permit Number: Wm. Schumaker 6382 St. Croix 128830 SEPTIC TANK/ y~" r MANUFACTURER: KJ#7 LIQUID CAPACITY: TANK INLET / TANK OUTLE L WARNING LABEL LOCKING COV ago /QrPr~~ 2~ PROVIDED- PROVIDED- BEDDING: VENT IA.: VENT MATL.: HIGH WATER v Y r J YES ❑ NO 11 YES NOS 1 U k NUMBER OF ROAD: PROPERT WELL- I BUILDING: VENT O FRESH ALARM: / AIR INL T: FEET FROM LINE: n ❑ YES NO ❑ YES NO NEAREST ♦ - ad f d t DOSIN CHAMBER: 4-0 P T ti~ CTURER: BEDDING MANUFA : LIQUID CAPA - PUMP MODEL: PUMPf61P4eN MANUFACTURER: WARNING LABEL LOCKING COVER YES NO Q.7 PROVIDED: PROVIDED: G~ ❑ CC// , / c,60!1r- YES ❑ NO YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: (DIFFERENCE BETWEEN tI ^ NUMBER OF PROPERTY WELL:,, BUILDING: VENT TO FRESH FEET FROM LINE: / i~ AIR INLET: PUMP ON AND OFF 7( . YES ❑ NO NEAREST >a~ S ~a C SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAqL AND MARyyING: _ or excavation. (If soil can be rolled into a wire, construction shall cease until / GrCS(rnL Sr,K , the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID DIMENSIONS MATERIAL: PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF LL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV., END: PIPES: LINE:. AIA INLET: FEET FROM NEAREST MOUND SYSTEM: ' 00 Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; I/bl'~ G /-i, S'. / M YES ❑ NO YES ❑ NO DEPTH OV63AENCH/BED DEPTH OVER TffMH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: CENTER: EDGES: MULCHED: /Z! /Z ❑ YES NO YES ❑ NO ES ❑ NO PRESSURIZED DISTRIBUTION SYSTE . 3 BED/TRENCH WIDTH: LENGTH: / 0.0 LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: DIMENSIONS J 7 BENCHES: /1 62 10 IF MANIFOLD PUMP o MANI OLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV,: DIA.: ELEV.: PIPES: DIA.: u HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: INFORMATION COVER MATERIAL: VERTICAL LIFT CORRES ONDS T0, / APPR VEDPLANS 2 i';p + ft tr CEf YES ❑NO Tvo j-~ ,z'gPd❑YES IiO COMMENTS: PERMANENT MAR ERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: B DING: FEET FROM LINE: / YES ❑ NO YES ❑ NO NEAREST-* L/ //p S><'.:. t JZC" L r • v~®,' d' _`G.-.C-l '~9 fJQ J%- olry '(.-G~ ~Q~ - Jar , ~~-j~ 47 /Lr*)CV 00 A T 5 C c~► c/a .7 aS = l (o • 8~ /;/5 , ~`o-t'1 c~~....c~ ~1> rti~y~,<J U_,~~ G`!,~- Gta,~ y l/ Q z~a S c T e), Sketch System on R ain in county file for audit. Reverse Side. SIGNAT E: TITLE: I SBD-6710 (R. 06/88) HR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code -Attach complete plans (to the county copy only) for the system, on paper not less than STATE SANITARY PERMIT # 8% x 11 inches in size. /~~v o-See reverse side for instructions for completing this application. check it revision o previous application STATE AN I.D. NU/MpBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER ~V v v PROPERTY LOCATION %a,s,r %a, S Tit , N, R 16 E (or)(0 PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 114 0 S7 410.1 d", 1; 1 W w 1` .L-CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER S t'a f ; II. TYPE OF BUILDING: (Check one) ❑ State Owned JCITYi4GE NEAR ROAD t ❑ Public ffrr~~II I1 or 2 Fam. Dwelling-# of bedrooms PARCEL NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) 2c 00~ - /Oq7 70-00C) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 0 New 2. ❑ Replacement 3.E1 Replacement of 4.E1 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ® Mound 30 ❑ SpecifyType 41 ❑ Holding Tank 12 ❑ Seepage Trench 220 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION CITY l 3 c 3 Feet 19• SSFeet VII. TANK in al CAPACITY Total # of Site INFORMATION Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holdin Tank Litt Pum Tank/Si hon Chamber Szr VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MPRSW No.: Business Phone Number: GtJ~ ll `a ~ SGtiu,X•-dlr-~,,~ ~~,1' ~2 3 tit= .~/o? 1 Plumber's Address (Street, City, State, Zip Code): / IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater ate issued issuing Agent Signature (No Stamps) ❑ Approved ❑ Owner Given Initial Surcharge Fee) A )etermination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, f308-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new, and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon, tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequaoies will only result in delays of the permit issuance.' Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property _ 1411 Location of Property Section T N - R /lv W Township* Mailing Address 16 `I/O Subdivision Name Lot Number Previous Owner of Property 3e i / VOr le Total Size of Parcel ~Xr- Date Parcel was. Created _ Z_G> Are all corners and lot lines identifiable?_ Yes No , Is this property being developed for resale (spec house) I Yes No Volume Z/ and Page Number J~3 7 as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3.• Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of 4he reviewing.process. If the deed description references to a Certified Survey Nap, the the Certified Survey Map shall also be required. PROPERTV OWNER CERTIFICATION I (we) CVW6y that att s.tatementa on athiz 6olun ane tnue to the beb-t o6 my (oun) . hnowt-edge; that I (we) am (ahe) the ownen.(s) o6 the pnopeAty ducAi,bed in .th,ib .in6ohmatti.on 6o%m, by v Atu•e o6 a waAAanty deed %ecotdvd in the 0,16ico o6 the ..County Reg.c.steA 06 Deeda as Document No. -Xff ~ S ; and that I (we) pees enemy own the p.kopos ed site 60n the sewage pos s ys.tem (an I (we) have obtained an easement to h.un with the above ductibed pnopehty, 6on the const~cuCtion 06 zaid~system, and the dame has been duty necakded in the 066ice 06 the County Reg.csten o6 Deeds, as Document No. ) , K : rrk~` T -NNW 1WW t a A& A t/'I_ BtX: Nortis....., 1~Or JUN 1 f, a„"'y* and warrants to ..Michat:el. J.. -F ns~tervalder_ and el 11z0A !l xi.l... husband.. Iiia, hoiding...aw..su>cxiYOrahip. ~nnritml, ..propestY . . eT ow following described real estate in St., _c.r.Qi.X ...County, ' State of Wisconsin : , Tax Pared Ne:............... A parcel of land approximately Five (5) acres, more or less, a pact of Southeast Quarter of Southwest Quarter (SE% of SW%) of Section Twenty (20), Town Twenty-nine North (T29N), Range Sixteen Most isid"v encin at the Southeast (SE) corner of the Southeast ouartor cos~ g of the Southwest Quarter (SEh of SW of Section Twenty (20), Town Twenty-nine North (T29N), Range Sixteen West (R16W), thonco Mkt along the South line of said Section Twenty (20) a distance"of 31= pnadted Fifty-seven (6579) feet, thence North a distance of Thsoo Hundred Forty-eight (3489) feet, parallel to the East line of Section Twenty (20), thence East a distance of Six Hundred Fifty-es (69379) feet parallel to the South line of Section Twenty (20), t South a distance of Three Hundred Forty-eight (3489) feet along thl!- East line of the Southeast Quarter of Southwest Quarter (SE% of SWU of Section Twenty (20) to the point of beginning, except the East Thirty (309) feet thereof. FEE This.is. not homestead pmrert;'. u (i's not) Ifxeeption to warranties: Easements and restrictions of record. June 8Q Dated this . day of IJ O SEAL) 4SEAL) r. Bet ulin i SFAL 1 . tSZAL) AUTSENTICATION ACKNOWLEDGMENT Silrtiatureh) STATE, OF WISCONSIN - ~ _ j z~► Sit. Croix - County. authenticated this ......alas of... _ - 19 Prrsnnnlly came ht•forr me this June . 19 8 8 the w. . Betty Julin, fka Betty. Aor t TITLE: MEMBFR STATE RAR OF R'IcrOVci\ ft (If tot.. . - . authorised by 7Mi.W. Win. StA".) to nip knnwn to he thr nn _S. who exreuud the foretnin • ' tram t n d ack edtte a same. T• :S 1NSTR1)MEN7 WAS ONAF. EO P.V Thomas A. McCormack Brent Wernlund Baldwin, idZ 54002 ~ntn•,- Pcthiic St. Croix trnunty. Wig (9brnatures may be authenticated or Rek-wit-l-Vend. it ~t • i'.,mmi jinn is nrrmar,, n•. d not. state evoirotien arP not neaPasarv.) date - March 19, 1989 ~f PNoom or Nre,04 swahe in any ranuitr -1..... i b.•.t., , r:nt•d 1...i,K th.,r •r.. . V►aRN#N" 9988 gTATtt e,AR M Y,'1SCoNsi i Xi+'+k _ Rdrt • . i • H z H ST C- 105 r' r SEPTIC TANK MAINTENANCE AGREEMENT ry+ St. Croix County z d 9 OWNER/BUYER ROUTE/BOX NUMBER /V-~/D/>,-~~C~ ~f Fire Number CITY/STATE ZIP _j yOO~ PROPERTY LOCATION:SW 14, S(C~ 14, Section 70 T 9 N, R W, Town of 1F~(Jz,-),'/J , St. Croix County, Subdivision_ Lot" number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- ►Hu ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED` DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY BUILDINGS INDUSTRY, DIVISION U PERCOLATION TESTS (115) P.O. BOX 7969 ,HHUMA MAN RELATIONS 1 / MADISON, W1 53707 (1-163.090) & Chapter 145.045) LOCATION- S- SE TON: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISK N~VAME: _5'Z' '/4 D/4 2a /T29N/R141(or W /3Q zew -2 1114 COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE- NO =BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 13 AX /J New Replace _ ~O ~ /Z/_~F RATING: S= Site suitable for system U= Site unsuitable for system 0 a Q CONDVENTI., IVl_ N~, ❑U IN GROUNDPRESSURE: SSTEM-I®ILLHOLD ING TANK: RECOMMENDED SYSTEM: (optional) ® S U YS U S 19E u If Percolation Tests are NOT require DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: O Floodplain, indicate Floodplain elevation: A/W. a PROFILE DESCRIPTIONS I BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH OBSERVED EST. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 9~ / 110n6_ > it B- Z 3,33 /vo n f ~~30'' "Q/s ' • e131 7 s,/ `I B-3 2•0 99,2Y /(Ion 2'~ '7''lS/s.' • /'7'' s' B- T B- 5 B_ x/. PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER A ES' AFTERSWELLING INTERVAL-MIN. PERT D 1 PERIOD 2 PER PER INCH P_ Z 7" P-._ P_ ) P- PLOT T PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference` points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ~oZ - Z3' AFT I I +3 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. t NAME (print : TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: (PHONE NUMBER (optional): i f : a - .SyD 7/S r4l - i CST S GNA I URE: t DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 'To-be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is.a residence or commercial project;' 3. MAXIMUM,number of bedrooms or commercial use planned; ~4; Is this 6 600 or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here: for writing profile descriptions and completing the plot plan; 7. MAKEA' LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be r.ised if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; Make Sign,the form and Ieaot dy ALL certification SOILt TESTS MUST BE F1.2., gible copies and distribute as required. ILEQ'VUITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR Bedrock cob - Cobble (3 - 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone *s - Sand HGW - High Groundwater cs - Coarse Sand Perc - Percolation Rate med s - Medium Sand W - Well fs Fine Sand Bldg - Building Is - Loamy Sand > - Greater Than *sI -Sandy Loam Less Than *i - Loam Bn - Brown *sil - Silt Loarn BI - Black si - Silt Gy - Gray *cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay vv/ - with sic - Silty Clay fff - few, fine, faint *c Clay ce common, coarse pt - Peat inrn - Many, medium m - Muck d - distinct p - prominent HWL - High water level, * Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application WLISI: be sr hr Mittecj to the appropriate local authority in order to obtain a permit. The sanitary permit musi. be obt<airred and posted prior to the start of any construction. J, a I.L.H.R. 83.08(2) - PROJECT INDEX SHEET Owner: Address: le;)40 57- S' 5/00 Site Location: s~ sw ,y s.~o - Z o , -r z of Bh LLX4J1,,0 sr• cQo iu coup ry Project Description: 4 N.u(j 3 If ZZ M . 46,l-t E- 1'.5 ~ J. A~uA.) c D ('S?irA(T-eD Y-5-o sa-JO` a. A 14100tia S y sTC-.c-1 1's p 12o p o S e~D Page 1. PLOT PLAN VIEWS 890.4060,0 Page 2. MOUND CROSS SECTION & SYSTEM PLAN VIEWS Page 3. PIPE LATERAL LAYOUT Page 4. DOSING CHAMBER CROSS SECTION Page 5. PUMP PERFROMANCE SPECS PLUMBER: 'W,Wl - SC,. 014,4 e P, DATE: SITE EVALUATER/ DESIGMER SIGNATURE HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRIGHT ."/IS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. "INN. INSTALLER & DESIGNER LIC. NO.00669 r c~i t i p,G~. SYgj~N' i SO ~ i 014 N rat 44 Can ~ 'v tjk t .r•,,~yj~ t t • ~ ~o m \ V rn ~o d~ c r ~ y -T) a F \ -L ~l'\ L~ d W ~ s i ts' / 16.20 1 N ~ ~ D O t 1E CS m0 6 R't ~ m m G, R~ y Ir, to Zr p `1 m c ° 'A o Ri m a ?b o ~m ~ oZrotih Q ark o H A Page ? Of Synthetic Covering Distribution Pipe Medium Sand Topsoil G sV fr&M Ef6VATIOM 3 E p /00-3 jr IT % Slope Bad Of 2" Force Main Plowed Aggregate Layer D Ft. Cross 'Section Of A Mound System Using E Z Ft. . 7S Q,tiTE'" A Bed For The Absorption Area F Ft. G /0 Ft. OV A Ft. H /-s Ft. p,St0 S B 17 Ft. ~,3ilr• ~ ~a. N K /0 o~ . Ft. L Ft. p"P cy~ J, ,•TZCE Ft. Ft. Force Ma i n W Z Ft. S Observation Pipe B K A ~o o W j----- " ----------------------•I • Distribution Bed Of %2 N Pipe I Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area . _ X Page 3 Of FT ~F 2 ~'uc ~oRc~ • ~i o /vti ~o,P 130 ~P/,Kf /AS r ' "p49- Perforated Pipe Detail uP kl'Gti T AQ'k M v,*tE - VAC U A i I'oA.) End Via- End End Cop) 0 PVC Pipe 1 0'. Holes Located On Bottom, Are Equally Spaced R Q - L,<u~tTi o,J A OF 2 PUG. * PVC Force Main CEaT RA L.. w "66 149 Q PVC Manifold Pipe Alternate Position Of Oistribulion pipe Force Main Losl Hole Should Be M Neat Tq End Cop + • Skj~ St~~ Cop isiribution Pipe Layout Z Z- Q1~ , . a P Ft. Cov, 100as i,790.' 40600 _ ~ F, G X Inches Inches 9~'ed a Hole Diameter ~ Inch Vol 5 Lateral i Inch(es) License umber: Manifold Z Inches Date: Force. Main 2 Inches # of holes/pipe (o Invert Elevation of Laterals Ft. P) 7`R1'13 u7-/oA) pli5el4ee e ~P~`JTE ~Ok E~} c~~ ~~TER/>~~ 7. O Z. 5~ ~ wv ?.eiL„ O T i S c Z 7, ,/7 y hM /ee- r~ • To T~ ~ '17i s T R i /3 U TIO.J ~ /'S G!1 ~1 GE" ~~TE"~ ~ ~~~lvO,P/~ Z~. ~ . ~E~tp 1 PAGE OF ' PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKIMG JUMCTIOW BOX MANHOLE COVER 25' FROM DOOR, 411 4VIVAPIA)6- A/ Se/ t WINDOW OR FRESH 12'MILI. AIR INTAKE ipDe /E1,411%1 GRADE I WAIN. ~ CONDUIT INLET PROVIDE AIRTIGHT SEAL I III / APPROVED JOINT A I I I APPROVED JOINTS I II ~ v W/C.I. PIPE .~n0►'~1 c 9D I III W/C.I. PIPE CXTENDING 3' w g 7• I I I EXTENDING 3' ONTO SOLID SOIL 6 PC I I ( ALARM ONTO SOLID SOIL ~ Q•~ lasi flpa i 1 LLEV. FT PUMP ~ OFF D 17, aV Jl ,fAtt mf I CONCRETE BLOCK . /E RISER EXIT PERMITTED ONLY IF TAIJK MANUFACTURER HAS SUCH APPROVAL SEPTIC F SPECIFICATIOUS S 9 u40600 DOSE 440WESTEko,, Aere4ST- TAWKS MANUFACTURER: I.JUMBER OF DOSES: PER DAy TAMK SIZE: 7S GALLOIJS DOSE VOLUME p ALARM MANUFACTURER: LEVY ff1"} O'Af Cp INCLUDIMG BACKFLOW: GALLONS MODEL NUMBER: U ' CAPACITIES: A= INCHES OR '3 00 GALLONS SWITCH TYPE: M E f' C L1 RyIOh T- g = 2 INCHES OR GALLOIJS PUMP MANUFACTURER: C = 9' / INCHES OR / GALLOWS MODEL NUMBER: 771 ya 115' VOII's 2y/ D= INCHES OR GALLONS SWITCH TyPE:'PL gYd'~Ck 1tiI:Rc~.~Y ~~vhT"S MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 2 GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET -rA4L : PPEcs f MIAIIMUM WETWORK SUPPLY PRESSURE . . . . • , 2.5 FEET EA C. In, O~- -,'D4E P-ff- + / 30 FEET OF FORCE MAIN X FT~c~FRICTIOW FACTOR.. ~ FEET ~OA~S ~JC A/ p Y ~!T IS• = TOTAL DYNAMIC HEAD FEET INTEQklM:Tflf'$"AW WaRiM LF-KIGTH ,WIDTH ;LIQUID DEPTH ~a (fonthliona1 SIGNED.- LICEIJSE DUMBER: DATE: a Rt' A puc- Lhri'ri , ; ',tl, N L~ R p01,~4T E f-ft i CT-'0lJ f At-V , `I ~-A-1 i!- OF S AF _ SEE ;iGf' ES" t3 .:EN"CE 30 SAM= /sy 1 HEADI F W W CAP 115 ~~Y 34 110 32 105 - CUR VE 30 100 _ 85 I 28 90 26 a5 EFFLUENT 24 80 MODEL I and Q 75 MODEL _ 189 DEWATERING = 22 70 165 V 20 Z 18 60 55 J 16 Ia SO MODEL O 163 H 14 MODEL 45 - 188 12 40- 35 10 MODEL SEWAGE and 30 137.139 MODEL e 25 1es DEWATERING 6 2a MODEL 15 MODEL 161 4 U) 97 10 _ F ~ 2 MODEL 53, 55, 57,59 0 24 80 GALLONS 10 20 30 40 50 60 70 a0 90 100 110 75 LITERS 0 80 160 240 320 400 22 70FLOW PER MINUTE 20 65, p 16 Go-- MODEL- I - W 55 295 - - - - I 16 - U so 9 14 45 MODEL z 294 - - - p 12 40- 1 a 35 MODEL - - H - ? 10 293 0 30 I MODEL 2B4 - t 8 25 - f MODEL 6 20-- I 2a2 - - I J 9 0 4 0 15 4 F 10 MODEL - - Zffllz J9, 2 267, 268 5 0 , 3280 GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 P0. BO ~ um Lane LITERS 0 80 160 240 320 400 480 560 640 720 502) 778 2"6'I1fYCllfy 4016 FLOW PER MINUTE I i i 6'97" Cast Iron Series CAPACITY HEAD UNITS/MIN • Automatic or Non-Automatic. Feel Meters Gal. Ltrs. = • H.P., 1 Ph., 115V or 230V. 5 152 57 216 10 3.05 51 193 3 0 Non-clogging vortex impeller design. is 4.57 43 163 ! PaSSes"lh'- sphere). 20 6.10 27 104 • 1'12" NPT discharge. Lock valve: 24.5' • Float operated submersible (Nema 6) mech- anical switch. 97 Series • Automatic reset thermal overload protection. listed ' SC-2226 • Stainless steel screws, guard, handle and arm and aN.as. seal assembly. • Watertight neoprene "0" ring between motor and pump housing. Canadian Stanaants SA Assoc Approval N97, nonautomatic, available packaged with a available float switch. piggyback mercury asssss:j 'DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION ftAF201 f§~lll4"TT 9 - R16 State Plan I.D. Number: 0 f 1 Baldwin El CONVENTIONAL El ALTERATIVE (If assigned) Town o T 80th Ave. ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Mike Finsterwalder 1040 Florence St.,Baldwin, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Dale Hudson 6629 St. Croix 128724 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: JPUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) 1 ❑ YES ❑ NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR. PIPE SPACING: COVER INSIDE DIA.: 0 PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH IFILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: F-1 YES ❑ NO ❑ YES ❑ NO ❑ YES El NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: DIMENSIONS TRENCHES: MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710 (R. 06/88) {"-SANITARY PERMIT APPLICATION COUNTY y U 0 LHR In accord with ILHR 83.05, Wis. Adm. Code C,-a' ~ STATE SANITARY PER MI # -Attach complete plans (to the county copy only) for the system, on paper not less than STATE Pl~4N I. . MBER 8'/z x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ,f%~1` NO PROPERTY OWNER PROPERTY LOCATION i K (f- .T"I2.5-le Y .v e? 41 el Sf % -5Z-V /a, S l O T N, R (or W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDI717 AME /O -Yo CITY, S TATE 7 ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK VILLAGE : gr e_ a C1~ Y1 G(/ 5`100 Z- 1 715 t ❑ 19 TOWN OR zey 11. TYPE OF BUILDING OR USE SERVED: w)C4ace a X Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): /VX ,wder 2W.5 III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. ❑ New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. E1 Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. 'X Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy er~l Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. 9See a e Bed b. ❑ Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 375 ,Z.5 Feet Private ❑Joint ❑ Public 3~4 /0 2 VI. TANK CAPACITY Site in gallons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank Q Q Lift Pump Tank/Si hon Chamber (JQ 00 f / ❑ ❑ FH ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: .DLT lc F , ~ SQi/ k . , ez-G % /S a'1-Y.?'7f Plumber's Address (Street, City, State, Zip Code): Name of Designer: r f / v ' Cli~ : ~~OD~~ Sa VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # ~lC SDI 22Z I I CST's ADDRESS (Street, City, Sta~Zip Code~ ~ Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater E te Issuing Agent Signature (No Stamps) IXApproved ❑ Owner Given Initial Surcharge Fee A dverse Determination V 11", e , X. COMMENTS/REASONS FOR DISAPPROVAL: ' SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 yE:ars; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; 11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling, III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from IDILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 83% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; close volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATEIR SURCHARGE - On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground udater - - included the creation of surcharges (fees) for a number of regulated practices which Wisconsin*s a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The n-ionies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- 1?~ \,vate,-, groundwater contamination investigations and establishment of standards Groundwatr; J ill's worth protecting. S3D-f:398 ;8.03/86) DE'R~IMENT°F REPORT ON SOIL BORINGS AND SAFETY IN"utJSTR Y, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 .HUMAN RELATIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: ZzeTroffT. gOWNSHIP/MUNICIPALITY: ,~LOT NO.:BLK. NO.: SUBDIVIS7 fVAME: S~ 1/4ZOI/a 2a /TZ90141 (or J !ll/' V/JQ 'I, COUNTY: OWNER'S/BUYER'S NAME: I MAIL N ADDR SS: USE DATES OBSERVATIONS MADE PERCOLATION NO.BEDRMS,: ICOMMER IA DES RIPTION: PR FI NS: TE TS: Residence ,•.-'New Replace .5-12" S00 ~ 1l~(_W 3 A/4 RATING: S- Site suitable for system U= Site unsuitable for system 9 q 0 CONDVf NT© ,V MOUND: EJU IN-GROUNDPRESSURE: ISYSTEM.-IN-FILLHO~LDSG TANK: RECOMM NDED SYSTEM:(optional) S U ®®SS SS UU SS UU U f If Percolation Tests are.NOT require DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: O Floodplain, indicate Floodplain elevation: i PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH F$ ELEVATION OBSERVED ES IGHE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- Z 3.33 , / /vo n r- f a><3o'' y ',Q/s ' • s X' X, B ~ B-3 2-0 99,2Y /vo z'0 '7 'ls/s. ' B- ? B- ,r t ( t B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES `f NUMBER JLIG--I AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PER INCH P. Z•d' n -30 P- Z P- A".. 27 P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference` points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent .i of land slope. s SYSTEM ELEVATION Paz - Z3' I - i TN IN I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. ( NAME print : TESTS WERE COMPLETED ON: 067 j -tea e S- 0 } ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): ox J~l Z' 4el? CST S GNATURE: i DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBO.6395 (R. 02182) OVER - . INSTRUCTIONS FOR COMPLETING FORM 115 - SBD 6395 \To-pe a complete and accurate soil test, your report must include: 1. Complete legal description; The use'secfion must clearly indicate whether this is a residence or commercial project;' 3.:MAXIMUM number of bedrooms or commercial use planned; fl 4. Is this anew or replacement, system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE"A'LEGIBLE diagram'accurately,locating your test locations. Dravving to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 1 t• Sig . t, r~ he form and place your current address and your certification number; ._12.-Make. 4ble copies and distribute as requil'Od. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR Bedrock cob - Cobble (3 - 10") SS - Sandstone gr - :Gravel (under 3") LS - Limestone Sand HGW - High.Groundwater cs Coarse Sand Perc, Percolation Rate med s Medium Sand W - Well fs Fine,Sand Bldg - Building Is - Loamy Sand > - Greater Than *sl - Sandy Loam < - Less Than *I - Loam Bn - Brown *sil - Silt Loam BI - Black si - Silt Gy - Gray *cl - Clay Loam Y Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ with sic - Silty Clay fff few, fine, faint '°c - Clay cc, common, coarse pt - Peat rnm - Many, medium m - Muck d - distinct P _ prominent HWL - High water level, * Six general soil textures surface water for liquid waste disposal BM Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage>system and a' permit application must be sutrrnitted to the appropriate local authority in order to obtain a permit: The sanitary permit must be obtained and posted prior to the start of any construction. Sec. .Zo f No. /Oyp ~/OrC~'1 Cc° S~; 8013 Ave, sEi swi ~z 9N R W S8.9-00172 SO Q P30 1 lJ o u n pl go/ Are a Zo' Vlo f3f o goo s em Pump -rank /o ,pZ A16 zti' s ' ~Z shed s~ G5 za9 / A~ ~j /ooo gal~• GO' V BM - DBY10f~s BGnCn IOr f~ I SePf~'C /Q/1K B1* L7 - Dero-/e5 'S0~& fto/2S ~ 1 ,C~e I 1 P o • Denal'~.s I I r- ~ Pe r c Flo les Noc,se• o bench AO, ;s 6offon'! 9° on /Y. Gtr, C o,--n e r 13 3~ I j ~~awn ~y. L/O~ -5 C.0 I MP 660- 9 CST 35/3 go ~ ST. CROIX COUNTY ;.:.N• WISCONSIN ZONING OFFICE 798-2239 (HAMMOND) 425-8383 (RIVER FALLS) n HAMMOND, W154015 Mav 21, 158-8 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Mike Finsterwalder property located in the SE 1/4 of the SW 1/4 of Section 20, T29N-R16W, Town of Baldwin, revealed suitable soils at a depth fo 30 inches, below which high groundwater was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, "Tto hiezz Thomas C. Nelson Zoning Administrator rc t' z0 o F S Sec . Oz.) f /11; hle ,'h sf e r ~va~c~e r No. So+~ . Ave sE/ sw~ ~z9N RI~W sq ° 001` 2 83 SOS P3 0~ Arc. a 20 1 plo 131 O 8o~cT~y S BM PurnP 1~ /O o PZ S tieo~ G5 zo9 /D00 qal, ~ VBM - Deno~e-s B,. C-A Mork I Sepf't T~ B' O - Deno-'es X30 le S P'o- De.r,o/Cs Perc Noles No ce s e- . . v G~ g~S Y / NS~~CE SEW P o ~enGh ~arll is boffom L ~ d ~ 'ky pN A~1,~` HUB o p~tD ~ s Ae O/. p~ OR iNGS • lAD U1L0 pf 1N'~>>y~HY , pND 4 P►Rt~J' tVt5tQN OF SPF ~ ~ EgpON~~~C~ I g~ti GO `4j ~rawn I ~ I y" flu=~°-r`- voOf Scole ~yP6cL9 8a CSI- 3Y13 a - Page ~ Of Straw, Marsh Hay, Or Synthetic Covering S89- 00172 Distribution Pipe Medium Sand H G Topsoil F 3 c " H ONS~~~ s o p e n Bed Of 2M- 2 i2 Force Main Plowed •~IW A to From Pump Layer gig ~ pt1~ S D AO gpR 1NS . gV11.V , Ni . p~0 pJ , V 4,. ~1~ OF ;pIyOFSAfr a ion Of A Mound System Using E. / Z p1V1S F .75 SppNptrN~i~Bed For The Absorption Area G -O, E SjE GOA A_ Ft. H Sig 6 5~7 Ft. License Number: /LIp'Z9 I /O Ft. J '7. jp Ft Date: ST K Ft. Alternate Position L Ft. of Force Main W Ft. Observation Pipe-~ g K r--- A L---------------------- ( I~---- ----------------------f=orce Main W ° From Pump Distribution Bed Of 2 Pipe Aggregate • t Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area ~M Page 110fv `689- 00172 Perforated Pipe Detail End View )Perforated End Cap b\e ~6 PVC Pipe pa Holes Located On Bottom, S Are Equally Spaced P fit" S PVC Force Main From Pump PVC Manifold Pipe Distribution Alternate Position Of Pipe Force Main From Pump Last Hole Should Be Next. To End Cap End Cap Distribution Pipe Layout P '19,3 10 R .5.33 S 2,,47 X 2--51 Y Signed: x2 Hole Diameter Inch Lateral Inch(es) License Number: _ ,yam ~~~9 'fold Inches Date: Fd`rge Main _ Inches ~dE SYS ONSITE SO NS N 0 REA Mt► ND !iU p a~M~ Ol~i1S~ON OF SA RRE PONpE~yCE SEE C~ L PAGE WOF-W' PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS L~ p F 5 ---VENT CAP C 'i" C.I. VENT PIPE S89-00172 WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FRCM DOOR, WINDOW OR FRESH 12"MID. AIR INTAKE GRADE I 'i° MIN. IB"MIN. CONDUIT-- _ 11~ I INLET V I D E IRTIGHT SEAL I IiI r-T APPROVED JOIN, A n I III APPROVED JOW i W/C.1. PIPE v I I I W/C.I. PIPE EXTENDING 3' I III ALARM EXTENDING 3' oNro SOLID ai `11 t1~ oNro SOLID sole ~ N RED` I I I B HUMA AND I OA 41 AND gU1LDIN~s i I 0Q C pRtME~ t D S ONDDfS1►~~ ulvl I I O~SESpONpENCE PUMP OFF SEE C CONCRETE BLOCK RISER EXIT PERMITTED OIJL9 IF TANK MANUFACTURER HAS SUCH APPROVAL SPEGIFICATIOWS SEPTIC AND DOSE TANKS MANUFACTURER: P n IJUMBER OF DOSES: PER DAB TANK :,IZE : goo GALLOMS DOSE VOLUME: 15S GALLONS ALARM MANUFACTURER:. -~J- GEIP_r-7/~-y CAPACITIES: A= 231 INCHES OR GALLONS MODEL KIUMBER: -9 B=INCHES OR-3- D4/ GALLOQ5 SWITCH TYPE: C/ V C 'l INCHES OR ZYY19' GALLONS PUMP MANUFACTURER: _ Crou1171 -38 5 D= /Z INCHES OR 'Z CALLOUS MODEL NUMBER: A2Ze25 fit NOTE: PUMP AND ALARM ARE TO BE SWITCH TYPE: - Rerr r INSTALLED ON SEPARATE CIRCUITS 'PUMP DISCHARGE RATE - 7e2*Z- -GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..._FEET + MINIMUM NETWORK SUPPLY PRESSURE . , 2.5 FEET FEET OF FORCE MAIN X /,t900 FOFLFRICTIOAJ FACTOR.. FEET TOTAL DJNAMIC HEAD = Sg FEET INTERNAL DIMENSIONS OF TANK: LEPIGTH ;WIDTH - ~ ~ ;LIQUID DEPTH SIGNED: lLICENSE DUMBER: ellell zq -p DATE. iI a Submersible Effluent Performance S o F S Curves Pumps METERS FEET S 8 9-- 0 0 1 7 2 90 MODEL 3885 25 80 SIZE 3/4" Solids WE15H 70 120 WE10H 60 ~ WEOTH 15 WEOSH 40 10 30 WE03M 20 WE03L 5 10 ---ffTFFFFT--::P 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I i 1 0 10 20 30 m'/h CAPACITY [qGOULDS PUMPS.INC. seECA FANS NEw vow 13448 METERS FEET 120 MODEL 3885 35 110 WE15HH SIZE 3/4" Solids 30 100 90 25• 80 70 20 60 O 50 WE05HH 15 40 10 30 20 ' S 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 m'/h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 19855 Sec. ZO No. a4/mow. ;~J zz), ; :5w o z Solt~ Ave sEi scd'! A / ~z9NR/loW 00.7 2 B3 So 4 P3 0 Flo. ~-x'7.5---- fi M ou„ d _ go, Are a Zp' P10 C31 80~ Oqa/. L S BM PIM ra /7 /O o7z S I,e,o~ eZ Of s7' G5 zo9 /ooa aal, ; o GOB 013M - De,~o~es BencA Mo, I I SePf,'c Tr►~' B# O ~ 17enof'f'.S 13o re f4o /2 S~ P#o- Denaf~,s PCrC /,~o%S I I flOUS~ t o bench AorK is boffom s~"c~.►~d on A1,6d, Corner I Sheol, /33 v Deauo^ lsy; qO' scale CS)' 3'f13 a~_ Sec . ZO OwhCr; i A e ;'n de- r wAlo% r No. '1010/orCnCG' 3n/priv~:~J 10" 5~1106 Z E s~ fe got ~ Ave sE, swi ~z9NRl~c~ o C. r- /Y- S8.9-00172 B3 Sly P3 0 { G7 5 Flo. Al oun d SD/ Are a Zp' Pao a~ 0 8o~al• S BM PurnP /u/1T /o oPz S heo~ ~s zo9 mdo gal. GO' '78 BG✓)C/1 MOrT~ I I 32PTiC Blt 0 ^ Deno/es Bow, ~oles P o - Denvfes PCrG /,lo ~c°S I 1 /~OCt S ~ L Ql o bench 14orK is boffom d s,'U~, n q on W, 0j, c o,-n e r Shad, /3 3 ~rawn ~y; y0~ Sca~e Alp66L9 csr 3Y13 Ozone, Sec. zo No. soya ~/ore/~ce St 84/~w,:~J u),' ::5y06 Z , s; fe 8o, f1 ve S~~ scv~ ~z9NR/Gw Pro e r B3 SD S8.9-00172 P3 0 90~ ~I zG' Are 70 45, ts~~ 0 800,g P2 57 G5 ' zaq /DDO ,a/, c00' 713M - Dcoo~es Ber)cA More SePf'C T/1~' ° ~ ~GJe I I P o - Den 0 I Pe rC No le- S - l Q1 o Bench Mor/1 is 6offorr) oh 41,6d, co,-ner 13 3 • ~ I ' ~ ~rawrl ~y. 410v Scale MP66L9 CSr 3Y13 • `s Sec. ZO o F Ali A ~i» S~e r wA/P'e r No. s. fe 9013 Ave sE/ swi ~z 9N ~ l~ W X72 o Er/ - Ano - B3 SO ^ ~ Flo T M oul+ d 90 v z~ Are- a 20 ai g BM Purn~ /u/1 /O oP2 `floes 27• S S tieo~ G5 zo9 Goy V BM - l7eno~es Bench Mar. I I Sept,t Tn , B*t O ' ~eno~'CS ~ o re /~/o ~2 S We ~ ~ - P o - Deno~'CS Perc /,lo leS Noose er~ JI- v S~pGE SY , Bench 1~ ;-T / o Mor/1 bof-fon, Siq~,r)9 oh /{~.GfJ. COr79er ~ ~ ~ R~'n pN0 S o pOR pIN~ Shed. I, su►~ I I pF 1N~~I~ ~F WID ~ SPON~SNCS . I ~ g~E G4R E ~rawA ~y; ci 410, Scole II So A Csr 3Y13 Page 11 Of Z Straw, Marsh Hay, Or Synthetic Covering S89-00172 Distribution Pipe Medium Sand H G Topsoil F o , 3 a E r S o QNS,~~ pe Bed Of %M- 2 (Force Main Plowed n 2 2 p,~a+te From Pump Layer N RED NNMA pt0 Dg D AO gpR ~y1N ~ 1p0'~~jR`I . AND E ~ZOV1S,ONOf o ion Of A Mound System Using SpONOE{~1~EBed For The Absorption Area F F -O, E , S E G~A A Ft. H Sig B #7 Ft. License Number: /WR eg~<09 I /D Ft. Date: d Ft. K /j Ft. Alternate Position L Z7,5_ Ft. of W 25,E Ft. Force Main L Observation Pipe A ----------------------Force Main W I° ----------•-----~I From Pump Distribution Bed Of 2 '2 Pipe Aggregate I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area t Page 11Of ul '-689- 00172 Perforated Pipe Detail l/ End View )Perforated / End Cap)) bye ~g PVC Pipe f. Holes Located On Bottom, S Are Equally Spaced P x S PVC Force Main From Pump /P PVC Manifold Pipe Alternate Position Of Distribution Pipe Force Main From Pump Last Hole Should Be Next To End Cap ~ End Cap Distribution Pipe Layout P ?30 R 5-33 S z,. ~7 X 2.~• Y Signed: Hole Diameter Inch - Lateral Inch(es) License Number: If-fp fold_ Inches Date: - a Main Inches OtAs li ID NS N1l ` ID ~ : ~ ,ON AN INOS ~ TaY, gu11A p a~M'~ p,~1S10N OE AE ?ON~EN E SEE cOa PAGE WOF- PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS [,C. ©F S • I/ ---VENT CAP S89-00172 'i"C.I. VENT PIPE -fr, WEATHER PROOF APPROVED LOCKING 25' FRCM DOOR JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE 4" MIN. 18"MIN. COKJDUIT 18"MIN. INLETVIDE I - pNS1.tE jeNxc $YS IRTIGHT SEAL I I I F14 APPROVED JOINT A / I III APPROVED JOIN i W/ C.T.. PIPE D I III WIC.T. PIPE EXTENDING 3' I II ALARM EXTENDING 3' ONTO SOLID sGIL a NaEI~►~0 I II ONTO SOLID Sol[ s ~ r~uMA AND GOpt 1A GS C Of ON OJY, gyp BUIID►N o, I I ON ~ I ERESPONOENCE PUMP OFF SEE ~ CONCRETE BLOCK RISER EXIT PERMITTED GNL9 IF TANK MANUFACTURER HAS SUCH APPROVAL 8PEC.IFICAT10US SEPTIC AND DOSE TANKS MANUFACTURER: NUMBER OF DOSES: / PER DAy TANK :,IZE : - VonT GGALLOMS DOSE VOLUME: 15S GALLONS ALARM MANUFACTURER: ~V GrIP rT/'p CAPACITIES: A= 2.3•/G INCHES OR ye"I' GALLOUS MODEL IJUMBER: A`9 B=INCHES ORSZOV CALLOUS SWITCH TYPE: /V.- r GL/rY C 11 INCHES OR ,1.1._Ilq GALLOUS PUMP MANUFACTURER: 3 0 ~S D= 14- INCHES OR oY'Z GALL01U5 MODEL NUMBER: G4/6 Ci~ ~ MOTE: PUMP AND ALARM ARE TO BE SWITCH TYPE: /fe- rr INSTALLED ON SEPARATE CIRCUITS 'PUMP DISCHARGE RATE 70 Z- GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..--// FEET -1- MINIMUM NETWORK SUPPLY PRESSURE , , 2.5 FEET FEET OF FORCE MAIN X /001 100,T.FRtCTIOkJ FACTOR. Z'oa FEET TOTAL DJNAMIC HEAD FEET INTERNAL DIMEPISIONS OF TAUK: LENGTH ;WIDTH ;LIQUID DEPTH SIGNED: LICEUSE NUMBER: DATE: i Performance Submersible Effluent 0Fs *lops Curves Pumps METERS FEET S89- 0 0 1 7 2 90 MODEL 3885 25 80 SIZE 3/4" Solids WE151 70 = 20 WE10H 60 WE07H 15 50 • 40 QWE UEO10 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I i i 0 10 20 30 m'/h CAPACITY gGOULDS PUMPS. INC. SeE{A FALLS KW )m owe METERS FEET 120 MODEL 3885 35- 110 WE15HH SIZE 3/4" Solids 30 100-A I 90 25• 80L 70 S 20- NL 60 O WEOSHH 15 40 10 30 20 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 ml/h 61985 Goulds Pumps, Inc. CAPACITY Effective July, 1 985 State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 HOMESITE SEPTIC Owner: MIKE FINSTERWALDER ROBERT ULBRICHT 655 O'NEILL ROAD 1040 FLORENCE STF HUDSON, WI 54016 BALDWIN, WI 54022 RE: Plan Number: S90-40600 Date Approved: October 25, 1990 Gallons Per Day: 450 Date Received: October 18, 1990 Project Name: FINSTEWALDER, MIKE - RES Location: SE,SW,20,29,16W Town of BALDWIN County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, GE JD M. SWIM Section of Private Sewage Division of Safety and Buildings 4PP039/0009n/18 cc: MIKE FINSTERWALDER X Private Sewage Consultant SBD-6423 R. 08/88) Sec. zo f No. 5wao Z, HI: I Sot Ave sEi S-wi -rz 9N 9 i4 w - _ _ Z, 'n e 83 Sp' P3 0 4 5-_- No. T /I ours d gp' Are a Za' pro QI O goF~_ S gM PurnP 7~~ io o vz ~z S tie 57' ~s zv9 /ago jal, p' V13M - Deno~es Benc/i Ma~~(' I Sep+~c` _Tvr ~ ° Blt D - J7eno~'L'.S X30 •-e f/o Ie S ,CJe I l P o - DenofCs Pe,~c /,~o /eS Hoare, t v a bench Aor/l is Jof I om > n9 on iV.uJ, carne,- ~ steep/, /33 I 7o/ Scale 4fp6~L9 csT 3Y13 ST. CROIX COUNTY r r WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Oct. 10, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Mike Finsterwalder property located at the SE 1/4 of the SW 1/4 of Section 20, T29N-R16W, Town of Baldwin, St. Croix County revealed suitable soils at a depth of 30" below which seasonable high ground water was noted. This site is suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator cj i I ODz-rG~v~' SW~,Sec.20 T29-R16 Finsterwalder, Mike SE4, ldwin ' 1040 Flaorance St. Town of Bat/t 80tH St. Baldwin, WI Location of site: da~z X~ _ Permit No.128830 10-31-90 Wm. Schumaker Mound--new 6 1 X29 ,R Seo. 1awiri Sy1 w Iot ~yk'e 51,~2 lae~ ' S~ ' $ S~ ' ,,,,ozence &gott ~Odwi~ , 100 Katie w dal of sire A Q Lo cation 12a~ 2~ 0 ~o• F- Y e-C:~ 3 Q dew- Q ~ 7 w U LAJ ~E~ E E wt yr O 3 = c > o o a 0 m d m ° V- N~ ui 3m' E 3 -o ' a 3 o W ~y•~ i v Ec~Y c OC _ -o o C E m v c r a~ W o f a s m m ° m s a E o o U Q O I- CL O u m m N 1 O O m?- O 12 ~J Q a„ CL y _E - of E 30 w S ~m a~ N° ti U a~ m~ .o~c mE mY ~ om LIJ w F F= F m o U d ¢ - s O a f- _ 0 Q m ~ Z a LJLJJ O w rr z z U z LL C F-- O U ° ° LL LLJ oC) 5 L > C) co U) Q z Lij cc: z cn N O O U Q = C~ O ~ O ¢ 1 ! O m LL w U m Li C/) (Ujj) m > --i x C) E w O of: u- -i C=) ao cr O O w CD w Z w m z o cn C36mo 0) J O z _ CL COOD 0 ri f-- Q