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018-1054-10-100
~ O vj� 0 611 0 0 C � � Q c O y m 3 aci 3 N N N O M mo (D �p O Z N c Z o o Z m LL c a)- LL c �N C !6 0 <1 W f-- Q w N M N M 0 0 Z y Z tli E 0 w E E w UM) cn :s °o :: °o as w E 3 (D 0 , L N z a m a m -!^ E CL 0 Z a m o ,L� 0 V 3 N N O C O 4) Z �' W C C 7 3 0 0_ fA F- •' N E O)(D-- O N CL C14 C) N 4' V a'O Q l0 O C L y � y O •N C L N t 091.2.N N V 0 O N 0 Z O Z Z Z Q N 7 O)> V) O w 0 O Z Z o M t6 E N O U O G! J (D E d IL d a .. O ,n c d LO H d -! N ~ 2,0 d N N G o d �I o) C3 0 a E Q o N N N co N co N 7 0 N z � > 3 � O O a � I � O O � a m I •N � aaa Imaaa a m I •� I 7 p V) N v v y Oo 0o y O U) N N } ` L Z _ Q a o _N �%1 L N N S p N _ O O O 1[1� O O O N Q a ems- N O O O N lt oo O m ,� m •- m N (D 01 >. V 2 Q Z co U d Q A V} m 2 N C c H E c °a O O O 15 a O M w N to 0 c co I- u a�i c c (D a� c u d °o °o 0 0 1 M •� O O c N N N N O 0 w + N �0 N ` y c c 7 N N ci E ? N to N C C H N w U) C 0) O co Y�I OD N E N N Cdr 7 m m �' .�0+ 7 'O c L m 7 n O N >. T 17 n O N O O U • O N 2 Y Lo O Z 2 m M O Z 21 W 2 w 3 .Q :: ate (L E v '� c :: c c wt c rw t A cin.2 0 (1) L)) l0U) (L) i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safely and Building Division INSPECTION REPORT Sanitary Permit No: 572827 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Kusilek, Eric& Mandy Hammond,Town of 018-1054-10-100 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: At> -Ilyik GL 24.29.17.376B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 2 . 3Z/6Z•3 /da Septic Benchmark ns rrl, /6CD Dosing i o � Alt. BM z 3 Aeration 160 1 1 Bldg.Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent Air Intake ROAD Dt Inlet Septic 7 / - '75 D *77\ r. Dt Dt Bottom /Z q Dosing 7 /� ; f- �' Header/Man. 3, Aeration t fist. Pipe • Z s 9g' 67 Holding Bot. System 5 g, .s s 3.1z q�S PUMP/SIPHON INFORMATION Final Grade ?•zS pt) ,b-7 10 Manufacturer Demand St Cover GPM Z AD Model Number 13-7 TDH Lift Friction Loss System H ad TDH . �- Forcemain Le I Dia.2 i f Dist.to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length�� No Tren s PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth 1 DIMENSIONS // `� SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR TypMotem: �µ ' 5 UNIT Model Number: �V DISTRIBUTION SYSTEM a Header/Manifcd i Distribution / !� Ix Hole Size 7 i Ix Hole Spacing Ve o Air In ke Length_Dia Length Dia b�+ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems OnlylJ �. Depth Over Dpth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center ' S� IB:d r l ranch Edges Topsoil ` es No Yes �[,] No s COMMENTS: (Include code discrepancies,persons present,etc.) Inspection#1:®®Ib / Zy/ l Inspection#2: Location: 849 200th Stree�aldwin,WI/54002(NW 1/4 SE 1/4 24 T29N R17W) NA Lot 1 X 7 �m /I Parcel No: 24.29.17.376B 1.)Alt BM Description= ' `� C�L1�Yt� /G��ID�J k' 2.)Bldg sewer length -amount of cover Plan revision Required? Yes � No F/6T21 1 Use other side for additional informat on � _ — -- Date Insepct Sign Cert.No. SBD-6710(R.3/97) ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I le inspected the septic tank presently serving the & I r-T — residence located at: 1/4, S'� 1/4, S�jction �?� , Town 9' N, Range�W, Town of ��rr�� L , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes No 'C (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer (if known): / ;L s Age of Tank (if known): (Licensed Plumber Signa e) (Print Name) (Title) (License Number) MP PRS (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) � .5af�de./4afion�;E OT —PLAI� dl# ACP�.49:"' o.�o�y�P3 me• /off/ .4 7o.dcd d 6r-il%y, 0 e-�'lcJ�T.ape h&-4,f AD) Co. • open 14w ti pcJ. oil ios t3�.ftcd 21ec :c p"'me srtuu Ioc4bLj an Q Well A&rtf,S:deof de PC �ra are/ei'ivccvay, �F ,rof r5� C i P�[eas� Gwcret / jErr a 3.'�opt/t L<. r sr ° �I I i ( �SfePC c g�rU4f, •f�'.ccs +3 a 1.1.�� G•'1'7 z 30 bed, 5ys�.lm e4w5&uc•l=td M124W, di 37 ec'Vos�cG. oCr c z 'a -92.1,-STL 2uigs9l ITOS s, ua4s' ITOH dBS -bO b 61 400 Oct 21 14 03: 18P GHollister 's Soil Testing 715-426-1775 P• 2 V ��•""-'"rr Industry Services Division Cowrty r�r� 1404 E Washington Ave ;/I- CKy)( ' P.O.Box 71622 Sanitary Permit Number(to be filled in by Co.) MadisqN r7W7 77— IK Z —7 na 10 StateTrat>saaicnNumber ltary Permit Applic f In accordance-4d03831)(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior 4o obtaining a sanitary permit Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Services.Personal information ovide may be used for secondary, in accordance with the Pr' law s.15, I m,Stars. 164� «.— '�/ �} I. Application Information-Please Print All Information !�(� Property Owner's Name Parcel# F—R lc. D. Map K. 0 Is_ Property Owner's Mail- Address Property Locatit n / 949 20 0 ST' Govt.Lot= 37(-- City,State Zip Code Phone Number ly W 'fy—5 %, Section Zq $Ai.uw!)d vvi 'SO 50 (circle one H.Type of Building(check all that apply) Lot# T N; R�E orb 'I I or 2 Family Dwelling-Number of Bedrooms Subdivision Name j4u-'�C,.(i Block# " -- ❑PublieNCommercial-Describe Use �. ❑City Of- 0 State Owned-Describe Use 4 CSM Number U ❑Village of_ 75 ><- (a6 Me v^P V)14 t P 3397 J(Town of V6MM 01'k-D... III.Type of Permit: (Check only one box ou line A. Complete line B if applicable) p A. ❑New System )(Replacement System ❑TreatmenUHolding Tank Replacement Only ❑Other Modific noon to Existing System(explain) S• ❑Permit Renewal ❑Permit Revision ❑Change of Pltanber ❑Permit Transfer to New List Previous Per.nit Number and Date Issued Before Expiration owner 37y IV.Typt of POWTS S stem/Com oeent/Device: Check all that apply O Non-Pressurized ln-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound?24 in.of suitable soil KMound<24 i t.of suitable soil j ©Holding Tank ❑ r Dispersal Component(explain) "' ❑Pt ttreattnent Device(explain) V.DisvenalfrreatAtut Area Information: Design Flow(gpd) Design Soil Application f) Disperse(Area Required(st) Dispersal Area Pro System Elevation Q.4 t I Z5 11 12-: k ?,q. 2; Vl.Tank Info Capacity in Total #of Manuthcwrer 01 a Gallons Gallons Units /f� L' c New Tank* ExistirtgTanks r - �^q ��! 4 O n Z Z W �V rn y :n t+.C7 P. (� f IWI p 1 Dosing Chamber �S' - VII.Responsibility Statement-1,the undenigoed,as me responsibility for installation of the POWTS sbmrn oa be attach-d plans. Plum 's Name(Prins) Plu Signature "N= Basin Phone Number Plumber's Address(street,City,S Zip Coda) is - *-ey �0 VIII.Court /De rtment Use Only roved ❑ Permit Fee ly Date sued f� issuing Signature ❑ Gi eason fa $ ��✓ CU 10 Z7 // IJ{.Condinsons for Disapproval 1 '8eptic tank,effluent filter and L- (�/ ' e dispersal cell-must all be servIces/maintained �i; 1°:,N >��- j (,t�! l" Cl �t^ at per management plan provided by plumber. 2. AD's6Q*ck;regi#rements must be msin8tlid or mAttach to tap sysims and submit to the County only an paper not Im than S s 11 es to s SBD-6398(R.08/14) MARY JO HUPPERT Page 2 10/20/2014 r • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis. Stats. • Inspection of the POWTS installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stat • SPS 383.22(7)A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4)shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, d-harles L Bratz Please Include a Copy With Your 199. 'S Reviewer 2,Integrated Services Pa y ment Submittal. (608)789-7893 ,7:45 am-4:30 pm Monday-Friday WiSMART code:7633 charles.bratz@wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm oa4TU� DIVISION OF INDUSTRY SERVICES T 3824 N CREEKSIDE LA 01P ' �C, 0 HOLMEN WI 54636 Contact Through Relay K — www.dsps.wi.gov/sb/ w www.wisconsin.gov SSIOtZA� Scott Walker,Governor Dave Ross,Secretary October 20,2014 CUST ID No. 224832 ATTN.•POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING&DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 10/20/2016 Transaction ID No.2468314 SITE: Site ID No. 807248 Eric D&Mandy K Kusilek Please refer to both identification numbers, 849 200TH St above, in all correspondence with the agency. Town of Hammond St Croix County NW1/4, SW1/4, S24,T29N,R17W Lot: 1, Subdivision: CSM Vol 14 Pg 3$87 FOR: 3881 Description:Mound/Three Bedroom/Sloping Site Object Type:POWTS Component Manual Regulated Object ID No.: 1508963 Maintenance required; Replacement system; 450 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; System:Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12), Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01 101,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. CONDITI No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APPR stats. DEPT OF S The following conditions shall be met during construction or installation and prior to occupancy or use: PROFESSIO Reminders DIVISION OF IND • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. .2i2 SEE"rn • The existing septic tank must be inspected for structural soundness,size and baffles and must be brought into conformance with the requirements of ch. SPS 383,Wis.Adm. Code.If it does not conform,a state approved tank must be installed. • Per manual cited above,limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction,excavation,vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank,and a minimum of 50 feet from the absorption area. chs.NR 811 &812c MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application CCENE y INDEX AND TITLE PAGE OCT 13 2014 Project Name: ERIC D. &MANDY K. KUSILEK Owner's Name: (same) Owner's t.ddress: 849 200th Street Baldwin, WI 54002 Legal Dee-cription: NW 1/4 of the SW 1/4, Sec. 24,T29N, R17W Township: Hammond County: St. Croix Subdivision Name: NA Lot Number: 1 Block Number: NA Parcel I.C. Number. 018-1054- 10-000 Plan Transaction No.: Page 1 Index and dtle Page 2 Data entry 3' Page 3 Mound drawings MARY OK = Page 4 Lateral and dose tank s' = tium- :T a Page 5 System maintenance specifications D 1859 Page 6 Management and contingency plan Y *.RIVER FALLS,r Page 7 Pump curve and specifications JVEI) ED ' Page 8 Plot plan IFETY AND deS1 AL SERVICES USTRY SERVICES Designer. Mary Jo Huppert License Number: 1859-007 Date: 10/08/14 Phone Number: 715-426-1775 6�IVE)ElyCL= Signature:: /OJ' Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P(N.01/01),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 S8D-10706-P(N.01/01) Version 7.0(R. 03/2)12) Pagel of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) F; Residential or Commercial Design Note: Sand fill(D)calculations assume a 300.00 Estimated Wastewater Flow{gpd) Table 383-44-3 in-situ soil treatment for 1.60 Peaking Factor(e.g. 1.5= 150%) fecal c ohfortn of 36 inches. 450.001 Design Flow(gpd) 4.50 Site Slope(%) 96.23 Contour Line Elevation(ft) .._.......... 12.04) Depth to Limiting Factor(in) 0.411 In-situ Soil Application Rate(gpd/ftz). Distribution Cell Information 60.00 Dispersal Cell Length Along Contour(ft) = 7.50 Cell Width(ft) 1-1 1.0) Dispersal Cell Design Loading Rate(gpd/fe) I Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) D Center or End Manifold 2.5 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. _ 0.153 Orifice Diameter(in) 3.0D Estimated Orifice Spacing (ft)= 7.50 fe/orifice 2..00; Forcemain Diameter(in) 136.00 Forcemain Length(ft) Does the forcemain drain back? Y 92.30 Pump Tank Elevation(ft) Enter Y or N [E E554 5 System Head (ft)x 1.3 22.18 Forcemain Drainback(gal) Vertical Lift(ft) 55.93 5x Void Volume(gal) 3.02 Friction Loss(ft) 78.12 Minimum Dose Volume(gal) 0.00' In-line Filter Loss(ft) 32.31 System Demand (gpm) 13.12 Total Dynamic Head(ft) Later~I Diameter Selection Manifold Diameter Selection in. dia. o ns choice in. dia. options choice to _T 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 x 1.50 x 3.00 2.00 x 3.00 x _ Gallonstinch Calculator(optional) Treatment Tank Information Total Tank Capacity(gal) _1 00 Septic Tank Capacity(gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 650.00' Dose Tank Capacity(gal) PolyLok Filter Manufacturer 17.00 Dose Tank Volume(galrn) 525 Filter Model Number Weiser Manufacturer Project. ERIC D.&MANDY K. KUSILEK Page 2 of 8 Mound Plan and Cross Section Views 1/10 B ': . . . . . . . . . . . . �••��' ' J Observation Pipe :ll) FK .s,:-�:.,.;t :s::: s:s.fn:•. ..,..r...:. �a rnao;ra; :aa T r r''�� r.r r r r r r r r r>a• r i�e r- -sr rtrrprrr r w•t Po R.;:.y°R.9. ,..e ,b tie e�.^r f J'e:a: r Po .r.1'.!'..nr.J. eJ`e.. 1. .v-.(, I'. i. B �{• I •'� L Mound Component Dimensions A 7.5D ft E Elft in H 1.00 ft K 11.82 ft B 60.0. ft F in 1 12.51 ft L 83.64 ft D 24.OD in G J 8.65 ft W 28.66 ft 450.& (fe) Dispersal Cell Area 1200.87 (fl?) Basal Area Available 7.50Pj(gpd/ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.02 (ft) -------► .,,,,,...,.... ♦ H Gj I F Dispersal Cell 98.75 (ft) Lateral 98.25 (ft)—► Invert Dispersal Cell ] ' Elevation : � ' :::•. a 4 Q"IM 96.25 (ft)Contour Elevation 4.5 %Site Slope —� Geotextile Fabric Cover Shading Key _a I — Dispersal Cell See lateral details on 1� Topsoil Cap a 1.5 ft Page 4 for number,size, Q Subsoil Cap 6 and spacing of laterals. ....... si Laterals are equally ASTM C.3 Sand r F spaced from the Tilled La er Typ�ai Lateral c 0.5 ft r e r distribution cell's a£$:'r•r Aggregate �o � " r ?'' � centerline in the distribution cell(Ax6). Project: ERIC D. 4 MANDY K. KUSILEK Page 3 of 8 End Connection Lateral Layout Diagram C*nt*f 41'-tb lat"Als C 14W chrA&849M"eian •w Turn-up w4ball valves Hof Olaanoutptuq 4- P All laaevalS we i4evntloal 1F X--'1l Ac is erased on the bottom of the fuMral epwuy spaced Leteras&f weer+aain Sch 40 PVC per SP Table 3e4,30-6 IS Fotoe M4 in aonneotion via we or*sass to mani old at any point. Number at Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing(X) 3.08 ft Lateral Length(P) 58.52 ft Orifices per Lateral 20 Lateral Spacing(S) 2.50 ft Orifice Density 7.50 fe/orifice Lateral Fltyw Rate 10.77 gpm Manifold Length 5.00 ft System Flow Rate 32.31 gpm Manifold Diameter 1.25 in Total Dynamic Head 13.12 ft Forcemain Velocity 3.30 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and "--� SPS 316.300 WAC Disconnect 4 in.min. -------- Tank component is properly vented '4 Alternate outlet location Forcemain diameter Weiser Manufacturer T_ 2 in. Ca acit 0.00 Gallons Vo{urns gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.74 352.58 C B 2.00 34.00 Pump off elevation ft C 4.60 78.12 93.21 D 10.90 185.30 D Totat 38.241 650.00 Ea Dose tank elevation(ft) 3" Bedding uncTer tank. 1 92.30 Alarm MEnuafacturer ,SJE Rhombus Note: Switches Alarm Model Number Tank Alert AB containing mercury may not be used in Pump Manufacturer Zoeller this system. Pump Model Number 137 Pump Must Deliver 32.31 gpm at 13.12 ft TDH Project: ERIC D. &MANDY K. KUSILEK Page 4 of 8 Mend System Maintenance and Operation Specifications Service Provider's Name Ron's Sewer Service Inc. Phone 715-749-0153 POWTS Regulator's Name St,Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design F ow-Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 300 gpd Maximum BODS 220 mg/L Septic Tan'<Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Comprment Size 450 f:2 Maximum FOG 30 mg/L Type of V1,'astewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freguency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump an I Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i),Wis.Adm. Code. 3. All gravity and pre,sure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .•..•�......... ............... Grade 6-8"Diameter Lawn Threaded Cleanout Sprinkler Valve E3ox Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: ERIC D. &kANDY K. KUSILEK Page 5 of 8 .. ' ���V Y��Y Vra7 Ki��� ■��G��G�Y���v��b■ ■w�• Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be opeCJted in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[SBD-10691-P(N.0:1/01),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N. 01/01)]and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abt ndonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessrrient shall be seated watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental )r unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Slats. The contents of the septic tank shall be disposed of in Gccordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every:3 years by inspection. The outlet filter shall be(leaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced ff the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall hate its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tFnk are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biologicai or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they shall be apprated for septic tank use by the Department of Commerce. Pumg)Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution SYstem No trees or shrubs shoulc be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as nectissary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched a s protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5,150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 1 04 cfu/100 ml-for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this;installation. The pressure distribution aystem is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within tie dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any o"'its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,oump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present locati.)n by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,ar4 replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan fcr the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separa ie documents and are considered part of the overall management plan for this system. Project: iG AAA Page 6 of 8 HEAD C�PA URVE MODELS=139 4 13/16 r 7 7/16 MODEL 137/)39 Ft. meters Gel. Lb-- 6 /8 5 1-52 93 352 10 3.06 79 299 15 4.57 64 242 4 13/16 2 20 VO 36 . 136 1251 7.62 8 1 30 1 Lock Valve: 26 fl. to 2— IF s. t'a do 46 5) so io Auows 1 100 ono J TERS 06 1;0 2�O 3iO 400 0 FLOW PER MIWrE iV CONSULT FA.CT0RY 'FR'*)hR SPKEGIAL • Three phase PxT@s are avabW it 20MV,230V or 460V. • Varletlle level control switches;are avallatile for cmtrang single and three • Electrical afternalms,for duplex sl titem,am available and suppled with phase MOM an alarm. • Double pWxick variable WM float switches are available for variable • Meftnical allemaliors,for cluplexty. stem,are avallaw with or WMWt level long cycle mWols. alarm switches. • Over 130°F.(54*C.)spedal quotation required. • Siff#)kx Panels are avall"for 3 lihale pumps. • Refer to FM0B06 for 200°F.appkations. • Conkol alarm system are availab tj for I phase pups. 137 Series- 17 lbs. 139 Series-51 lbs, SELECTION GUIDE 0, 0, 1- integral Bost operated 2-polemecharkalswitch no external control required. voks-ph 10041111 1111110111% Dupkx C&A UL M1371139 115 1 kub IOL7 larill,l) — Y Y 2. SWOR piggyback variable WM float 3wkch or double piggyback variable krM N137lI39 115 1 ft 10.7 2or287 3or566 Y Y float switch. Refer ID FW477. DNIM — 115 1 -W— ju — Y Y 3. Mechanical aternaw M4'ak 10-0072 or 10-0075.Refer to FM0495 01371139 Mo I WICI 5.8 1 or13 8 — Y Y 4 Smou three phase control panel Refer to FMI228. E1371139 ZIQ I _t_o 5A 2 3or586 Y Y I H1 37M39 MO-208 I ALM 62 Us — Y m 5. See FW712 for cm7ed ffeft of Electrical Abritator E42aIL 11371139 — 2QD-M I '4on 6.2 237 3orS66 Y N 6,variable"control switch 104M used asa contrial acavator,spa*duplax JIVII39 2WIM 3 4M 2.e 4 WorSW Y Y (3)or(4)fog systarri. F1371139 230 3 AM 2.6 4 3164or596 Y Y 460 3 1.4 4 3&4orSM N N 7. Four(4)hole 34%k.jurictim box. for w&WW connection for hammed ''I%i 1 460 11�ion IA 4 1 M4.5116 N N soplax operavort,10.0001 No molded PkI9 -skqb F W),-Ik&4 ch 8. Two(2)hole J-Pak.for Watertight hardwired Ficonneclort or spice,10-M. Pun p muettismainled in w"paslim C.A111 ION InM pheiieuriftMQW880MW W#A loop xiotiiianeftnel 09-111,- lap M All installation of controls,pretection devices and wiring should be done by For kdmg.w on on adabol Zoeller produck rVW to cet*Q on PWback VWWft Uwd FIM a quaiMed licensed electrician. Ali electrical and safety codes should be t National Electric Code(NEC)and ft Switilm FMO477 Butrics!MwwW FM04 n Ailechar"Ab=lar ROM AWm Packap bHowed including the most recant FMDI32;ardSwn0SewW8sft,F610487. Occupational Saii.-V and Health Act(OSHA). RESERVE POWEIREL"'i' DES'!`G,."`.: For unus Ltal conditions a reserve safety ftK*)r is engineered into the design of every Zoeller pump. MAIL M AQ SOX 1047 Z z Loutitft KY 40256-0347 &W TO.360 Cw*Run Road 0 LaAr^KY4GVl4961 z6ury ANAW S. ffff' ffia 778-2731-1(8"928,100 FAX(Wj 7743624 ERIC 1J. AAAVI' IAS 7 Of • � Jra��de../aa fon p:E -PLA oo! 8�9.L ..�o. ed 1t gr�e�.y Q �i7vJ�7�i�.aF h�e.w+►lo'n D� Co. a ^4 A& -Ole) �.�;ed ele :t t plvne Exo&A Srr'nu /0c4AM.d an Q wed/ AortL.S:dcof d��°t. �K CeecrLbc v ✓t , r f/C W Ay Res Vrame of 63 � �o1CGric'��E� O � " � ��c'�j Lzi�ufly ��►G�W�'Urf / fir I t s 1, gpr�.cc �.cc� a A��$�.'oVorh�.aV4B dVvta/CII Z"4-5 D ve-! bed, Sysjf,n e'ao�flue'l=�d/n/.20,100, �vs�.►4:I- ;-,4saec'y/os/cam. 2 "d SL,�T-92-11-SIL 2u14sal t TOS s, Ja4si i i0H d6S =t,0 t,1 6i 400 1 998422 BETH PABST REGISTER OF DEEDS State Bar of Wisconsin Form 1-2003 ST. CROIX CO., Wi WARRANTY DEED RECEIVED FOR RECORD 07/10/2014 10:57 AM EXEMPT # N/A Document Number Document Name REC FEE: 30.00 TRANS FEE: 795.00 THIS DEED, made between Timothy C. Doherty and Monica L. Doherty, PAGES: 2 husband and wife("Grantor,"whether one or more), and Eric D. Kusilek and Mandy K. Kusilek husband and wife as survivorship **The above recording information marital prope Gran ee,"whether one or more). verifies that this document has been electronically recorded Grantor, for a valuable consideration, conveys to Grantee the following &returned to the submitter described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St Croix County, State of Wisconsin ("Property") (if Recording Area more space is needed, please attach addendum): Name and Return Address SEE EXHIBIT"A"ATTACHED HERETO Edina Realty Title 400 South 2nd Street#115 Hudson,WI 54016 018-1054-10-100 Parcel Identification Number(PIN) This is homestead property. (is)(is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrance except: None Dated 7 V C (SEAL) ` L� �"' (SEAL) Timothy C. oherty Monica L. Doherty AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin SS. authenticated on St. Croix County Personally came before me on 2� 4- , * the above named Timothy C. Doherty and Monica L. TITLE: MEMBER STATE BAR OF WISCONSIN Doherty, husband and wife to me known to be the person(s) (if not, who executed the foregoing and acknowledged the same. authorized by Wis. Stat. §706.06) THIS INSTRUMENT DRAFT. B;HEF11 Gregory Booth,Attorney at Law P-1 Centerville Circle $� ARYpjjgUC Notary Public, Stat�o?� IAJ tSCoY1SiV) GRs Vadnais Heights, MN 55127 �UVI$CpN$ My Commission Expires: ail f� (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE:THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM NO.1-2003 *Type name below signatures. Page 1 of 2 File No.:28366 St. Croix County 998422 Page 1 of 2 EXHIBIT "A" LEGAL DESCRIPTION That part of the Northwest Quarter of the Southwest Quarter(NW 1/4 of the SW 1/4)of Section 24,Township 29 North, Range 17 West, described as follows: Lot 1 of Certified Survey Map record in Volume 14 of Certified Survey Maps, page 3887 as Document No.625697, St. Croix qty,Wisconsin i (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE:THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM NO.1-2003 *Type name below signatures. File No.:28366 Page 2 of 2 St. Croix County 998422 Page 2 of 2 G25697 N � z ® ce o BEARINGS ARE REFERENCED TO THE o o r Ao o m WEST LINE OF THE SW1/4 OF SECTION s cn 3 N A r'i ran _ 24. ASSUMED TO BEAR SOO'18'50"E m° °z ni z° ti 'O z Z ��+� rru o m Ln u, Q a M t[�.JpL�Lla.44GDD C�LIG:I DDS o''' o r; < y m zco zru0 O a Q� v C v'vC z p --.o z z ti O m D 0 4G�1�4G°3CC4—� m e m C7 _ r o C> ro 8 cn N S00°18'50"E a, S00°18'50"E 270.1 O' m a r 66.59' WEST LINE OF THE SW 1/4 � ;0 _ a z 0 S00°18'50"E 270.10' N Q m ry C $ $ C) CD N O O rn O I� z D z ° —1 ° Z . . . . . . . . . . . . . . Mm 05 _� z O � • J �N ► C�g So � � Q ► ► Ial� o ° � o0 D a ZIP tj 0 �o O Flo -:�g ffA °mDVa a I�In � .P V! ID m co M GO B m .omrvr'i H y � � I�I� p y omfl� j y 0 7q C3 m x E C fn z � D ► o • ® <` o n, IT1 C-) S 1 N o FILED o z L JU'V 3 02 coo 2 z ru rri rmn KATi$EEIV H.NJALS}I ryr ? m m N o m he�ssterotDeeds i u� Z` X °a !„Ate*+c Z \L j\ SL Croix z cr rn a 70 m D m m rZi m m r.��- C> � �m mm pNV r o_ rm„o N00-11 W50'W 270.1 O' z g= m z r p :U OX ga 0-N z ^' O�[vn]C© C31 P[�L144CG m o n' O p A p Vol.14 Page 3837 HP LaserJet P4014 Printers Paper est Copy 49 01500 Source: Tray 2 Destination: STANDARD TOP BIN Input Trays Output Bins Tray 1 Size: ANY SIZE STANDARD TOP BIN Tray 2 Size: LETTER Tray 3 Size: LETTER I Oct .21 14 03: 18p Hollister 's Soil Testing 715-426-1775 p.3 ST.CROM COUNTY SEPTIC TANK MAIl MWANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t C b M A g r- K u,.5(Lt 1 - 1"ing Address .i Properly Address 4$ `l' `5TKw-=T eriScodon from P &Zoning I meal for now co on.) {V rte. City/state 6A i-DW 1 Al W Parcel Identificsoon Number aJS- A-54)- 0_ Del LEGAL DESGRII'TION Property Location '/, '/+,Sec. '} ,1"_2�LN R I I W,Town of-A!MM D:�t Subdivision Plat; "" ,Lot# Certified Survey Map# Z (O / ,Volume Warnoty Deed# 0 y 2- � (before 2007)Volume_ ,Page# Spec house U yes Wto Lot tines id ble)(yes U no SYSTEM MAIN NANCE AND QWM O&IMICA M IWoper use and mamtouance of your septic system cooker result in its premature failure to bandle,4=tes. Proper mare eomdts of pampiog out the septic tank every&=years or sooner,if needed,by a lid pu uper. Wtut you pu t ittt the system can affect the Ruction of the septic teak as a treatment stage is the waste disposal system. Own:r maintenance re"nsibilities are specified in§Comm.83.52(1)and in Chapter 12-St Croix County Sanitary Office. The property owner agrees to submit to St Croix County Plarning&Zoning Department a certifie c ition form,signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying thy,t(1)the oa-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if nee!ssmy),the tic tank is lea than 113 8tU of sludge. i Uwe,the wed have read the above requirements and agm to maims the purtvate sewage c wposd system with the standards at forth,herein,as set by the Dent of Commerce and the Department of Natcual Resau=,State of Wisoattsin. CArtificetion stating tbat your septic system has been maintained must be completed and retuned.to the St,:roue County Plammtg& Zoning Department within 30 days of the three year expoibon date_ IhW certify that all statements on this arc true to the best of my/our knowledge. I/vwe am/mm he owtux(s)of the property desmilmd above,by virtue of a deed womv ed in Register of Deeds Office. Number of bed 1O fl_ TURF OF APPLICANTS) DATE ***Any kkfinwation that is misngxese oted may resndt in the sanhny permit being revoked by the Pb mWng I Zoning Deparmumt••• Include with this appheadon a recorded v4wa ty deed from the Register of Deeds Cie and a copy of tba:artif ed survey map if rtforcom is made in the wa m mty doe& (MV 1 2366 Wisconsin Department of G�O�O ��-OPM� Sbl )EVALUATION REPORT Page 1 of 4 Commerce in accordance with Comm 85,Wis.Adm.Code A.C.E.Soil Site Evaluations _r�_A_...._�n 51 �\ County Attach completer a plan on paper not less than 8'/h x 11 inches in size. Pla St. Croix include,but not limited to:vertical and horizontal reference point(BM),directio Parcel I.D. percent slope,scale or dimemsions,north arrow,and location and distance t( 018-1054-10-000 Please print all Information. Reviewed Dat Personal information you provide may be used for secondary purposes(Privacy Law,s. C� t 0 "� Ig Property Owner Property Location Tim Doherty-Eric Kusilck, Buyer Govt.Lot NW 1/4 SW 114 S 24 T 29 N R 17 W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 849 200th St. 1 na CSM Vol. 14, Pg.3387 City State Zip Code Phone Number City I Village ✓ Town Nearest Road Baldwin WI 1 54002 1 (715)928-2450 Hammond I US Hwy. 12 New Constructior Use: ✓ Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD ✓; Replacement Public or commercial-Describe: Parent material Glacial Till Flood plain elevation,if applicable na General comment:: and recommendations: Site suitable for mound POWTS with 24"of ASTM-C33 sand placed on recommended contour of 96.25'. System elev.to b--e-9-8—B'. /) 7 J Boring# Boring ✓': Pit Ground Surface elev 96.23 ft. Depth to limiting factor 16 in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/fN in. Color Qu.Sz.Cont.Colo Gr.Sz.Sh *Eff#1 * 2 1 0-6 10yr3/3 none sil 2fgr mvfr cs 2fl me 0.6 0.8 2 6-16 1 Oyr4/4 none sil 2fsbk mfvr cw 2f1 me 0.6 0.8 3 16-24 1Oyr5/4 c1d7.5yr5/8 sil 1fsbk mvfr cw 1vf,fm 0.4 0.6 4 24-36 1 Oyr5/4 m 1 d 7.5y4/6 sil 1 csbk mvfr cw 1 vf,fm 0.4 0.6 5 36-42 1Oyr4/3 m2p 7.5yr5/8 sicl Om mfr - 1vf,fm 0.0 0.0 2] Boring# Boring ✓? Pit Ground Surface elev 95.17 ft. Depth to limiting factor 28° in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD! : in. Color Qu.Sz.Cont.Colo Gr.Sz.Sh 'Eff#1 'Eff#2 1 0-8 1Oyr3/3 none sil 2fgr mvfr cs 2vf,f 4.6 0.8 2 8-17 7.5yr4/6 none scl 2msbk mfr cw 2vf,f 0.4 0.6 3 17-28 7.5yr4/6 none sl 1 msbk mfr cw - 0.4 0.7 4 28-35 7.5yr4/6 f2d 7.5y4/6 scl Om mfr - - 0.0 0.0 *Effluent#1 =BOD 30<220 mg/L an I kTSS>30<1 mg ffluent#2=BOD5<30 mg/L and TSS<3P mg, CST Name(Please Print) Signature CST-Number James K.Thompson 3602 ) 3C Z Address A.C.E.Soil&Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane,Osceola,WI 54020 7/24/2014 715-248-7767 Property Owner Tim Doherty-Eric Kusilck,Buyer Parcel ID# 018-1054-10-000 Page 2 of 4 a Boring# Boring ✓`; Pit Ground Surface elev 96.02 ft. Depth to limiting factor <13" in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boun ar Roots GPD/ft: in. Color Qu.Sz.Cont.Colo Gr.Sz.Sh *Eff#1 *Eff#2 1 0-14 1 Oyr3/3 none sii 2fgr mvfr Cs 2f1 me 0.6 0.8 2 14-21 1 Oyr4/4 m1 d 7.5yr4/6 scl 1 csbk mfr Cw 2fl me 0.2 0.3 3 21-34 7.5yr4/6 m2p 7.5yr5/8 fsl Om mfr Cw 1Afm 0.2 0.6 4 34-40 1 Oyr5/4 m2p 7.5yr5/8 fsl Om mfr - 1vf,fm 0.2 0.6 Redox extends into A horizon to aprox.12"from ground surface. Free water observed at 34". Location unsuitable for mound without further evaluation. F Boring Q Boring# V PR Ground Surface elev 96.53 ft. Depth to limiting factor 12" in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft' in. Color Qu.Sz.Cont.Colo Gr.Sz.Sh *Eff#1 *Eff#2 1 0-6 1Oyr3/3 none sil 2fgr mvfr Cs 2vf,f 0.6 0.8 2 6-12 7.5yr4/6 none sil 2fsbk mvfr cw 2vf,f 0.6 0.8 3 12-23 7.5yr4/4 f1 d 7.5y5/8 scl 1 msbk mfr Cw - 0.2 0.3 4 23-33 7.5yr4/4 c1 d 7.5y5/8 scl Om mfr - - 0.0 0.0 ❑ Boring# Boring ` Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Bounder Roots GPD/fE in. Color Qu.Sz.Cont.Colo Gr.Sz.Sh *Eff#1 *Eff#2 *Effluent#1 =BOD 30<220 mg/L and TSS>30<150 mg *Effluent#2=BOD 5<-�0 mg/L and TSS<30 mg. 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. SBD-8330(11.07/00) A.C.E.Soil&Site Evaluations PROPERTY OWNEfRa,Doherty-Eric Kusilck.Buyer SOIL AND SITE EVALUATION 2366 Page 3 of 4 PARCEL I.D.018-1054-10-000 A.C.E.Soil&Site Evaluatia REPORT MEMO Onsite soil verification completed with Pam Quinn of St. Croix Co. Planning&Development Dept. 7/24/2014. Soil conditions dictate mound component with 24"of sand lift placed on 96.25'contour. Contour length limited to 75'due to limiting soils at B3. Install mound as far south as possible. Construct mound uphill of B3 to avoid compaction created by At-grade construction.Additional fill should be added or curtain drain installed at upper edge of mound to divert surface water around and away from system area. Existing forcemain appears to be located near B3 paralleling driveway and not on south side of property as original design indicates. r .Sa/ ¢Ac/u4 ♦ EX.s A-"4) e/e(' m Er':c .tJ►�s f�.Cdcv:n,v�� Ss�iZ 3607 y.Scc, Goode eC �j!w shy JP 7-n.of!�(a•r►»Zan d, C Cp �J/• as pe',/a w n Pc/io 0 d-•mss -•o-cao � �•r,cd ectc,�'�e.s pl.,.,� Ew s E'er Scr Ji U /o ca,-bad o n 6cJQif Aol,�i iGk o•f dr i 0l. �K Coacoebf �/''yc ► w a y Risa/i.�ce 0.58 ��• � ES3 , f �-•�'� � 84 EXi�r�y /�1.dcvcsY'�rn l8neeAs art,:e,:.T. ,06 g„6c/A.,ao Pf'/u ,wZ 3ys2 wn a+ oy 81 /at Z xc 8o`.47• 5pracc t�.c<s EXi in ,4t'9ra►dC d,,vA/Ja./Cc// bed. 5ys�•� c'on,�f/ucfcd/0/2%0 913-7,lffs;155 u c d 9/or/cam. ��. l ~: Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety end Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) ' Personal information you provice may be used for secondary purposes [Privacy Law, s,15.04 (1)(m)1. Permit Holder's Name: ^ City ^ Vi e To of: ~~m~f on~`~'ownship Burr, Jamie CST BM Elev-:- Insp. BM Elev.: BM Description: lb0 /d a;~ 5` TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ .rti r ~ c ~c UO U Dosing v Ho TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic >~ab ~ -r ~s 3U ~ 3 NA Dosing >/~a r ± -~ ' 3 ~' NA NA Hol Ing PUMP /SIPHON INFORMATION ~~ Manufacturer ~ ~ k Demand Model Number 13 Z (~ GPM TDH Lift ~,~ LrictionZ ~ System TDH (p Ft Forcemain Length ~ ~ Dia. .Z ~' Dist. To Well SOIL ABSORPTION SYSTEM r~ f ELEVATION DATA untySt. Croix nitarxP.~er~~tNo ate Plan II FD No44.: reel Tax No.: STATION BS HI FS ELEV. Ben~lti Z.'~ r7Z. / Bldg. Sewer * d~" ~! Z3 Ht Inlet ~ ~, fl' ~- , lF Dt Bottom >r' ~ 3 Header /Man. d (,, 3g qS. ~ ~ Dist. Pipe Q •37 y ~JS_z3 q Bot. System 3 jy, ~9 Fin~(C¢> ~ ~o rL ~ • ~ ~d .~ w~ , G z re/. 6 BED /TRENCH Widt i' ~ ~ Len th ~ ~ ~ No. Of Trench s PIT No. Of Pits Inside Dia. Liquid Depth DIM N I N ' p DIM N 1 SYSTEM TO P/L BLDG WELL LAKE/STREAM LEA Manufacturer: SETBACK INFORMATION TYpeO ~ , / CHA ER Mo a Num System: .~ - ~ ~ I - Z3 S 7 Z.SU OR NIT DISTRIBUTION SYSTEIV~ Header / Mani old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length /v~ Dia. Z ~ r Length ~~~ Dia. Z ~~ Spacing ~ ~ ti 2 v SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes S^ No Yes No CC},I~(T~~~1~6~}4f~~,lc~i-df~',`~- ~~f#~L's(~~~/t4 'li/4 'l4 T29N R17W) - -Lot 1 1.) Alt BM Description = ~ ~.4' ~ Lld~ 2.) Bldg sewer length = 3 0 -amount of cover = ~ yZ ~~ ~, 9~ 1 ~ 3 ~ c~.,~P-4 ~,,~ ~ F i~ ~ -a, ~!, ~ ~ S~ Scy/S~,rw.- WaS CGcrv~ 5/'y~/y ~b `f~~l (.(nc.~("~r w~ c~D~lr/~~ ~g Plan rcvlslon required? ^ Yes ~' No Use other side for additional inforrr(a`tion. U L ~ „ SBD-6710 (R.3/97) Dat Inspector's S nature 5 ~O ~ Cert. No. Sanitary Permit App}ication Safety & Buildings Division [n accord with Comm 83.21, Wis. Adm. t;ode 201 W. Washington Ave. ~~SC~»s~n Scc reverse side for instructions for completing this application PO Box 7302 Madison WI 53707-7302 t]epttrtment of Camrrierce Personal information you provide may be used for secondary purposes [privacy Law, s. 15.04(Ixm)} , (Submit completed form to county if not state owned. Attach tom f ete fans to the coon co onl forth r not less than 8 -1l2 x I 1 inches in siu. C~~jY State Saa um ^ i application State Plan I. D. Number L A lication Information -Please Print all Information y' Location: e ~,~~~~ ~;. Pro Owner Nam Property Location 1 .L u-'Y' t^ ~ S-~R Sc.~, f 055 r ~'I`~--~ 'Yt1 I E ~ W 1/4 SE l/4, SL'{ T z9 ,N, W9 or . t,..i Property thvner's Mailing Address `- ~~ Lot Number Block Number ~ ~'~~ t~~~ ~`,~ . -~ ~. ac 5; ~R 400 z 1 +s ra . City, State Zip Code ~ ~ ~ Subdivision Name or CSM Number ~'1~~ ~ •n `~I,)1 .5~ ~ C ~.. a. 7 I ~ ~~'~ . ~ 6 ~ 5 w 9 7 II. Type of Building: (check one) 3 ' ^ C'ty ^ Vi18g~ ~ . ~ ~ ~ 1 or 2 Family Dwelling - No. of Bedrooms : ~- ~ Town of ^ public/Cotnmercial (describe use):_ ^ State-0wned n"1 rno Nearest Road (~ _\ _ _ ~}- , I. 2~ l ~ ~~ ~ tluli l ` -J i' '~ Parcel Tax Number(s) }~.-1~5~-10 -CXX~ on line A. Check box on line B if a livable i ! one box Check o n er mit I e of P p) 1. ~J New 2. ^ Replacement 3. ^ Replacement of 4. 5. = 6. ^ Addition to S stem S stem Tank Onl Existin S stem B) Pemtit Number Date Issued ^ A 5ani Permit was reviousl issued IV. Type of POWT System: (Check all that apply) ~' ( ^ Non-pressurized In-gro d ~T~~^ Mound ^ Sand Filter ^ Constructed Wetland i Li ^ Dr p ne • (n_gro~ ~ ~ 1 ^ Holding Tank ^ Single Pass ^ Oth i l 8 ~ ~ ~ er: at n ^ Aerobic Treatment Unit ^ Recircu ~ ~1 At- d V. Dis ersaUTreatm i. Design Flow (gpd) t Area Info ation: 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday/sq. R) (Minl-nch) ~ Elevation ~~ , ~ - ~~ ~ , ~ ~ 9©/ - VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass Crete strutted New Existing Tanks Tanks ~~ ~ OC~O dGL~LL~L.]~L'G' t ^ ^ ^ ^ CSC' - ~.SL~ ~ ~j ' ~E~-r VIII. Responsibility Statement I, the undetsitmed, assume res nsibili for installation of the POWTS sho the attached fans. Business P e Number Plu bet's Name (print) Plumber's (n ps): /~_ -~ 75 '7/~ ~~~5-- 6j ~. _~tar~D... State, Z' e) umber's Address (Strut, City j /(^ t- ~J' / nty/Department s Only IX. Cou ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date lssucd Issuing Agent Signaturo (No stamps) A roved ^ Owner Given Initial Adverse Surcharge Fee) ~/ / Q~ Determination X. Conditions of Approval /Reasons for Disapproval: its ~ Fl~tsd~Olutti-- .-~/k,~~maLL _ (~ - ~ s r ~ ~ iscons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary August 26, 2000 OUST ID No.260751 JACK BOWMAN BOWMAN PLUMBING INC 2819 KNAPP ST MENOMONIE WI 54751 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/26/2002 ATTN.• POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Site ID: 197094, Jaime Burr St. Croix County, Town of Hammond NW1/4, SE1/4, S24, T29N, R17W FOR: Description: Three Bedroom At-grade System Object Type: POWT System Regulated Object ID No.: 756009 Identification Numbers Transaction ID No. 414354 Site ID No.197094 Please refer to both identification numbers, above, in all corres ondence with the;,a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At-grade Component Manual Using a Pressure Distribution System for Private Onsite Waste Treatment Systems" SBD-10570-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the at-grade component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Aseptic tank filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. JACK BOWMAN Page 2 8/26/00 Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, ~- Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:15 AM to 4:00 PM j swim commerce. state. wi.us DATE RECEIVED 08/07/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DLJE $ 0.00 WiSMART code: 7633 4 ., ~F At-Grade system Vi9~ ,9~ ~~, ~ ~ `F ~%~,,p ~ O Residential Application ~1' ?00 INDEX & TITLE SHEET ~~Q O Aso Burr / GAH '~ Project: • Qwner: ~ • Jamie Burr Address: 840th 10th Ave. Apt 201 Baldwin, WI 54002 Legal Description: Nw, sw,~2~,~~9, i~w Township: Hammond Subdivision name: Lot number: Parcel ID number. N.A. County St. Croix t;s ^(,S- i `EFtCE N. A. a ~' ~04 CoM gUU.p1N~S tppFl'~M~N ~j o . ~s~i ~ ~( A /Vi Plan transACtlon number: site plan pg~ 2 of 8 cross & plain view p~~ of 8 distribution pipe p~ 4 of 8 ~.gp is/ate tank PBg~C 5 of 8 pump curve p~ 6 of 8 filter information p~~o~ 8 __ iYianadement manual page 8 of 8 nt:+_ar mPnt (~~r.l test to pAgC the state's plan) pgge page Designer; loretta /Jack ~,. Bowman Ll~nse Number: I"~ 222839 Signature: ._ Phone Number: X715) 235-4634 Date: Atr~,ti~t ?, ~nnn ~~~ SITE PLAN . BM: 30 .' nail on side of tree with orange spot Scale 1"-40' except wher ~ p ~Z indi ated ~- c,~lta.a_. `'° Z n'"~ n~~ p'~~ 5 ~•C. p~~ 0-pits System~Elev~ 94.7' on contour 94.2' NO e 8 ~~ 3 l r o_ ~ e~ . 13vn~ ~ ~ ~ 4~ P~ Z o ~ g ~.. ,~ ,... ~o -1070-t' L1~•61g9 L I I 1 W A D 1/6 B A=$_~ft E_ 5 ft B=~_ft F= c~83 ft C a ft G= ~~~ ft p r ft H I-33 ft ~,,, .Fabric-~ Observation ,~, . Well- ' ~• • ,~ A.~•, ~.: .., . ;.., . •~r~'. D 1/6 B I I I = ~ ft L ~~p ft 1/6B (~a~n ft w = ~?, 5 ft '~50 p ~ 400m u{• .xa.gu.c~.r~ .awe -----6 ~ q4. Z Distribution Lateral ~- Soil Cover 12" ~ ~ ' r-~ r ` ~~ '' ~ ~ •6~~ • •, ~~ ~\ A C Plan View and Cxoss Section of Wisconsin At-grade Unit with a Single Absorption Area on a Slopur~ SSite F ~'~ ~ , ~~.~ . Note: His measured from directly below _ _ the lateral to finished grade. ~o ~•ec-~' ~ tar r ~ ~ A N Page ~ of $ ' ~ O Bowman Plumbing, Inc. Master Plumber No. 5875 ~~ s ~ S 0 2-~~. 1'- n ~ ~~~~ y 2819 Knapp Street Menomonie, WI 54751 (715) 235-4634 FAX (715) 235-3650 PERFORATID PIPE DETAIL and DISTRIBUPION PIPE LAYOUP / ~~ eh V..... _ 1 ~ 1 -~ _ Lod p --- -- --- feet x --- Z~-- inches y --- ~2t~ inches. hole dia. 1 ~ inches lateral dia. - ~- inches force main dia. ~ -inches --~~-~-- holes per lateral -q~-~ - ft. Invert elev. of laterals page - ~- of - 8_ COMBINATION SEPTIC TANK/PUMP•CHAMBER (No Scale) ,Approved Locking Manhole Cover `'Q0 '~° °'^ `I ~, With Warning Label Attached Qr 0.bOV £ Warning Label---t ~ U - Final Grade-~ - 18" Minimum Weatherproof Junction Box Baffles ~ ~~proved Joint ~_~ ~ ~~ ~ Pv ~ Pipe ~~ ~ I .~ _. !- _ ~ extending 3' R--1~© ~I~EaR. T __ ' Alarm ~ :into Soli d Soi 1 On 6 i Off 6' 3" of Bedding Under Tank Conc. Block `~•~. Note: Pump and Alarm Are On Separate Circuits Number of Doses: ~j Per Day Gallons Per Day/~ o~Doses: qo•o Gal 1 ons t~'~,z•e ~.ibs = z-~~ Volume of Backflow:.......+ z.7-- Gallons Tank Manufacturer: ;~ ~} 1~~. Total Dose Yolume:........_ qi•7 Gallons Tank Size-Septic/Pump :_ 100~0~ bS o GaT ons Alarm Manufacturer: S, s, ~Eo Model Number: .S - z ~ Capacities: A 5.5 inches or y2~.~} Gallons Switch Type: ,~,,,,,,r..ti. inches or 33, (Gal l ons + B~ _ Pump htanufacturer:~' ~~4 0~,~. _ + Chi nches or ~ i ~ c~ Gallons Model Number: ~ ~ + D~_~nches or •b~, a Gallons Minimum Discharge ate : a-(o Total ..... = 38.5 inches or~~,go Gallons 14~g 3°A ~`"" Vertical Difference Between Pump Off and Distribut ion Pipe: Q.o Feet ~ Minimum Required Supply Pressure :............... ......+ o Fo Feet p3`~6z" x .~e3= ~~..-,s ~ ~~O Feet of Force Main x 1.39 Friction Factor/100 Feet: +3.~5 Feet ,,,,-,~ x s - s3.9 ~.~ 2 Inch Diameter Force Mai n Total Dynami c Feet $g ~ "'""`D ~` "~- Head :... = 19.'7 4" Vent Pipe with Approved Cap, + ~ From Buildings Approved _ Yent Cap ~~ 12" Minimum 4~Minimum Quick Disconnect 1/4" Weep Hole A • B Approved Joint w/C,I. Pipe C Extending 3' Onto Solid Soil Internal Tank Dimensions: Lengthl2~2~; Width ~~O"; Liquid Depth 3 8•S "53" CAST IRON SERIES* ~ "57" CAST IRON SERIES t~ eNS3 BN/BE Models available packaged with a rlcu,ree piggyback variable level float switch. • .3 H.P.,1 Ph.,115V or 23OV. • Non-Clogging vortex impeller design. ~ Passes'/:inch solids (sphere). • 1'/:" NPT discharge. ` • Automatic reset thermal overload prot 'on. • Stainless steel screws. • Cast iron switch case, motor pump housing. • Engineered, glass-filled i Iler with metal insert (Model 53). Glass-filled polyprop ne base. (Model 53). • odel 57 all cas ' n construction. • III 'ctart 3- 15 ff ctanrlarri rnrrt "9S" CAST IRON Moaa ~~ BNBE Models available packaged wl'ttre-_ Plaaea piggyback variable level float switch. • 'h H.P.,1 Ph.,115V or 230V. • Non-Clogging vortex impeller design. • Passes'/:inch solids (sphere). • 1'/:"NPT discharge. (1'/:" X 2" PVC adapter c«teaa~t srrdraa C ,n1.el. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING 53-55 MODELS Ft. Meters Gal. Ltrs. 5 1.52 !3 163 10 3.05 34 t29 15 4.57 19 72 Lock VoNe: t9.25~ oo9e97a • cas~ironmoforlausug.p~A~+g^8a/MSwifcncase. Glass-tiled polypropylene rnpeper and base. ~': TOTAL DYNAMIC HEAD/CAPACITY ` ' PER MINUTE FFFIIIFNT ANn r+FWATFRING • Automatic reset them~al overtoad protection. • Stainless steel screws, guard, handle. • Watertight neoprene'l7' ring between motor and pump housing. MODEL 98 60 CYCLE Meters tiOllpns Liters S 13 72 273 f0 ~ '231 as 170 io ~ a.+ n as Lock valve: z3' • UL listed 3-wire 15 R. standard cord. X7+8 "137" CAST IRON SERIES • ®/BE Models available packaged with a piggyback variable level float switch. • . Durable cast iron consUuction. • 1 8 3 Phase models available. (115, 200-208 b 23OV -1 Ph). (200-208, 230 ~ 46OV - 3 Ph). • Non-Clogging vortex impeller design. • Passes 518" solids (sphere). • 1'/:" NPT discharge. (1'/2" X 2" PVC adapter fitting included with BN and BE models.) • .Automatic reset thermal overload protection. • Stainless steel screws, bolts, guard, handle. • UL listed 3-wire 15 ft. standard cord. C "'`°''ro'"'"' TOTAL DYNAMIC HEAD/CAPACITY PER ,MINUTE EFFLUENT AND DEWATERING MODELS 137 Ft. Meters Gol. Ltrs. 5 13 93 - 352 10 3.1 79 299 15 4.6 64 2!2 ~ 6.1 36 t36 zs z6 a 30 Lock VoNe: 26' • ooss219 NOTE: No UL Fs&tg hlr 200.208HPo. pumps. J 1 z d 0 O CAUTION Model 185!4185 should not be subjected to less than 30 feet TDH. Y.~ U. ~~ 80 160 240 320 400 aB0 560 640 0 FLOW PER MINUTE 009822 TOTAL DYNAMIC HEAD/ FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL FT. 4. 5 1.52 53,55. GAL. LTRS 43 163 98 CAL. LTRS. 72 173 137 GAL. LTRS 93 J52 140, 4140 CAL. lTRS. 91 344 161, 4161 CAL, LTRS 100 379 163, 4163 CAL. LTRS 61 231 165, 4165 GAL. LTRS 61 231 18 4185 CAL. LTRS. 186, 4186 CAL. LTRS. SB 220 188, 4188 GAL. LTRS. 145 549 189, 4189 GAL LTRS lay Sag 181 CAL. LTRS. a5 170 10 3.05 34 129 61 231 79 299 ea J18 93 352 61 229 61 231 58 2I0 140 530 1s0 530 45 170 15 a.57 19 72 a5 170 6a 242 76 288 85 322 60 227 61 23t 58 220 134 507 135 511 45 170 20 6.70 25 95 36 136 68 257 79 299 59 22] 60 22T SB 220 128 481 131 i96 45 170 25 7.62 B JO 59 223 70 265 57 216 59 223 SB 220 122 462 125 473 45 170 30 9.14 s9 185 62 235 55 206 SB 220 85 ]22 58 220 116 439 120 454 a5 170 40 12.19 21 79 a5 170 46 172 55 206 70 265 SB 220 10a 394 109 al 45 170 50 15.24 20 76 }} 125 50 189 51 193 SB 220 90 Sat 97 367 _ IS 170 60 18.29 15 57 39 148 32 12t 58 220 71 269 85 322 45 170 70 21.34 23 B7 9 34 52 197 51 193 69 261 a5 170 80 24.38 10 3B 45 170 28 106 51 19} 45 170 90 27.43 31 117 2 8 34 129 45 170 100 30.48 16 60 17 64 40 151 n 0 32.00 a 15 JO 114 t 20 36.58 20 76 130 39.62 10 38 LOCK VALVE: 19.25' 23' 26' a6' S6' 66' 86.5' 73' 714' 91' 110' 137' ~~~' ~' ~ SSPMA MEMBER ~ ~ .. a ~ U ~L ~ ~ s~ ~ .~` AND SEWAGE PUMP MFRS. ASSN. HEAD CAPACITY CURVE EFFLUENT MODELS ~ 4 uo a2 135 40 130 125 }8 120 ~ IIS 191 34 110 105 }2 100 30 95 28 90 186 , 26 85 a18 6 80 24 165, 75 416 5 22 70 ~ 65 ~ 163 , 18 x163 1 89. 55 I1B9 I6 50 14 45 13 1U lw, 18 6. 35 s1a0 I 1 10 i B5, g 25 N 85 6 ~ 15 a 10 2 5 I 161, x161 53.57 96 0 5: GALLONS 1 0 2 0 30 w S O 6 0 7 0 8 0 9 0 10 0 11 0 12 0 13 0 Is 0 15 0 16 0 .,\ , 1 -- ". _4' ,~ r' S., ' c..~ ~;: , _ .. ~~a-i 2'iD 5'GD . ir'-i -_ - _. t. Y, -_- ~- 1376' DIA ,~_ _- n___.. -- 3-9'16' - i -__ t 1 ~YE' DIA.'-' ~ ~~~ I d~12"LD. 6'O. D. ~, - --t _ ~ ,~~ I.I -- F1~3/16' I It- 11-13/16' --I I DIA t ~ ~ 3-9116' d-y4 Zabe!""' Recommendation: Any configuration of Risers used should not exceed 48" in height. The product(s) shown are covered by one or more of the following patents: U.S. 5,382,357, 5.482,621 , 5.683,577, 5,580,453, 5,582.716, 5,591 ,331 , 4,710,295, 5,593,584, U.S Des. 386,241 ,34906'. 4605501 .5098568. Des. 309007_ Canadian: 2,135,937 New Zealand: 264824. Other Patents Pending Call for a free ZABEL ZONE" A~~ Onsi!~~ Wastewater Magazine 1 -800-221 -5742 • Website http:%%wvvw.zabelcon~ ~? c ,(~ ,~ A100-HIP ZabeITM A100 Series Commercial & Residential Effluent Filter Product Specification 1. Product Name: ZabelT"" A100 Commercial & Residential Effluent Filter, U.S. Patent: 4,710,295 2. Model Numbers: A100 Case & Cartridge; A101 Cartridge Only; A100-HIP Case & Cartridge; A101-HIP Cartridge Only 3. Applications: Apartments, trailer parks, schools, churches, shopping centers, and offices; Septic dump statioris and community treatment plants; Single and Multi-family homes 4. Performance Specification 4.1. Model A100: 3,000 gpd 4.2. Model A100-HIP: 4,500 gpd 4.3. Multiple filters may be installed in manifolds to handle larger flows. Use a Zabel Flow Control Plate Model FC100 to set the effluent flow to predetermined limits. 4.4. TSS: Reductions in TSS within six months of installation - 50 to 90 percent. The higher the pre-filtered TSS the greater the percentage of reduction. 4.5. BODs: Reduction in BODs within six months of installation - 20 to 45 percent is dependent on the make-up of the wastewater. 5. Materials: All materials are non-corrosive. Case & Lid -PVC; Filter discs -Polystyrene; Rods and Nuts-Stainless Steel 6. New System Installation: Center the top of the 12 inch Filter Case under an outlet access opening at least 16 inches in diameter. PVC solvent weld the bell coupling to the 4 inch Schedule 40 PVC exit pipe of the tank as required byy local code. The PVC outlet pipe should extend at least 18 inches beyond the outside face of the tank wall. If required to meet depth requirements, install a ZabeITM Extension Reducer and 4-inch Schedule 40 pipe to the bottom of the filter case. A riser to grade is recommended. High performance double stack (Model A100-HIP) filters and multiple filters installed in manifolds will require additional support and access. 7. Existing System Installation: The filter may be installed in an existing septic tank if an outlet access opening ' already exists and the filter can be installed without damaging the existing tank. If a 4-inch Schedule 40 PVC pipe does not extend into the tank, the filter can be instaNed utilizing a plumbing flange. If the existing septic tank cannot be used, the filter can be installed using a ZabeITM' Container Assembly Model CA100 or ZeusTM Basin System. 8. Service: A professional onsite service company should perform all onsite system service. 9. Service Method: Grasp the filter handle and pull the filter cartridge upward. A ZabeITM 36" T-Handle is available - if required to reach filters more than 12 inches below grade. Hose off the cartridge into the tank and reinsert into the case. If required, the filter may be disassembled for further cleaning. 10. Service Frequency: The filter requires cleaning when the septic tank is normally inspected and pumped as required by local regulation. The A100s are designed to slough most normal solids off the inside of the vertical disc dam walls and back into the tank when the effluent flow is in a resting state. Installation of an effluent filter may increase the frequency of service if the homeowner discharges materials that are harmful to the system. 11. Warranty: The A100s are warranted to be free from defects in material and workmanship for the life of the original purchaser. Zabel'sTM liability is limited to repair or replacement of the part and in no event shall ZabelT"" be liable for any consequential damages of any kind. 12. Dimensions: .. i A100 12" 16" •1 /16" 596.16 in2. ,1,857.6 in2 I 198 A100-HIP 12" 26" 1/16" 1,018.08 in2 2,908.8 in2 297 53 ,• ~ ' At-Grade Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating conditions of the septic tank and outlet Slter shall be assessed at least once every 3 years by inspection. The outlet Slter shall be cleaned as necessary to enswe proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its encloswe. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-Grade and Pressure Distribution Svstem No trees or shrubs should be planted on the At-Grade. Plantings maybe made around the At-Grade's perimeter, and the At- Grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the At-Grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the At-Grade and snow compaction in the winter will promote frost penetration Cold weather installations (October -February) dictate that the At-Grade be heavily mulched for frost penetration Influent quality into the At-Grade system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occiured and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [ SBD-10570-P (R 6/99)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 833.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failwe must be replaced. Exposed access openings greater than 8-inches in diameter shall be secwed by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contin¢encv Plan If the septic tank of any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the At-Grade component fails to accept wastewater or begins to dischazge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal azea if tce leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary as deemed necessary to bring the system into proper operating condition. Questions on the operation of maintenance of this system should be directed to yow county zoning or health inspector. ~,~~~-~ emu,",. ~ ~ ~ ~ ~- `~~ $ a~ ~ Wisconsin Department of Commerce SOIL EX.~ltt1A~'f1C3f~1. REPORT Division of Safety and Buildings d ' '~ Page ~ of ~~ In actor ante wdh Corpfrr.85,. Wls. Adm. Code f/~., ~ , , :.. County ii /~ Attach complete site plan on paper not less than 8 1/2 x 11 irr6hes>ln sire Platy IM~~t ~C. l ,r.~~ v inGude, but not limited to: vertical and horizontal reference ' ` ' (gM), ~,~ hand Parcel LD - . percent slope, scale or dimensions, north arrow, and locati _anb distance to nearest. ~ t~, Please print all informatio~:~ - ~, ~ ~ ' Reviewed by , i_ ate _ ` - rt i, Personal infomlation you provide may t>e used for secondary purpo ~sjP`Rvacy Law, S77 ~y~ ~ ~ g_Zq` Property Owner ~ . ~ ~,{ ocatiGm , ti:' a._.. .. ,, r. ~~ ,' Govt. Lot t 1 /4 j `V1 1 /4 S ~ T ,~ N R ~ (or W i Property Owner's Mailing Address o # Block # Subd. Name or CSM# ~ ~ ~ ~ ~ 7 City S ta te Zip Code Ph ne N U m ber ^ City ^ Village ~ Town Nearest Road , ` I C ' ^ ® New Construction Use: ~ Residential / Number of bedrooms ~ Code derived design flow rate _ ~ ra ~ GPD ^ Replacement ^ Public or commercial -Describe: -fl_c~. Parent material --~~ s1~k -~; Lj, ,L Flood Plain elevation if applicable fv. ~ : • ft, General comments v and recommendations: ~ i l ~ ~~ 1 c fie,:...' [:.2.q :"kfL. i< ~.-t2 ~~ ~ ~ ~~ L - ~ ' :37,~ ~ ~.:,C..t.li--ice %2C. "I~J ~GCjz~ ~-..,33.~ X~'*~ YC~ ^ Boring v Boring # ® Pit Ground surface elev. 9 ~ ~ ft. Depth to IimiGng factor 3~J `~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~' ~ 7 ~n yf r 3~ r r _~ / u r' 0 . t -z~ ~sr ~ ~ `~ !y; v -`7"~/S 7.5 y/f' ~%a/ ~ ~~l ~ ~ nbiC v _r - ~..L~ • ,,. i ~ `v ~~ ^ Boring ~ ~: 2 Boring # ^ ®Pit Ground surface elev. y~. b ft. Depth to limiting factor ~ In. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~_ ~. ,~~, . ~ 3 S,r' ir7 c~k r~?r C .S ~ ~ d? S y. S ,~ - ~~ ~~ r S l~ g ,~ ~~ ~; - Vic: z~. ~ ~~ ~~ ~~> ~i' ~ ~~ !.~, :u _ ~~yr1~~'- ,~ Q ~; i ~~.r,~hk ,~ n~t~ -- - ~ ,~ -...-~...... .....s - .... - w n,y.~ o~n. ~ vv •vv ~ wv n~ai~ unucni rrc - ovvs ~ vv rngrL ana I JJ ~ 3U mg/L CST Name (Please Print) Signature - CST Number Ms. I~retta A. L ~, ,i,~,~~=~ ,-~t,~~%,-, CSTM 2245$0 N2089 Cty. Rd. Y, Menomonie, WI 54751 715/235-4634 wk r Property Owner,~,`,l..rn~ ~ ~~vt Parcel ID # ~` f ~; ie t,n L,~ ~~ Page 2 ~ of ~ ,~ _g' Boring # ~ ^ Boring ~ pit Ground surface elev. 9~. 9 ft. Depth to limiting factor '~ n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 q / =~ Gam. ~, G-cr_ ~. ~~ ' ~~ ~ ~'/~ ~ ~L -. ,s. ,; ~' ,._ r~~, . .~. ~ .._,._ ~'' _ M r ahK _ r M 7 r' _ L e ,^~, - r,.3 ~ .• _ ca,c.ci ,_,~:_ ~.-~ v-cuc„cam-t-.~ //lpc.J.C1;:,,~..~ G-~') ~tJ=~'~~.. Boring # ^ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 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 Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 4' 7 _ ~ / /s q lv ~/1 !f V ~~/ // ~. ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODs < 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 conta^t the department at 608-266-3151 or TTY 608-264-8777. SBD-6330 (86/00) Page 3 of 3 SOIL AND SITE EVALUATION REPORT s~ ~f NW, STS, 24 , 29 ,14W Hamm~nd township St. roix county to etta larrabee CSTM 224580 .~~ ~~v, ax ~, 5 ~ ~G . patcs~ ~ LEG '7 ~`~`, Scal 1"-40' except whe e indicated X-pi from previous 0-pi s from soil tee NO C mm 83 problems s ~, soil test 3/16/2000 ~t 7/7/20~Q~' ~ ~ (setbac~ks~) ~~ 6~ ~~ X ,~ i u~%' ~~~ -~i 53.M.C ioa.' n ~n e~ W ~l a n C~,~ A (~ c,~ n ~I ~~ L~ '-Wiscons~nDepartmentofCommerce SOIL AND SITEEVAL I~AL.~YI"v'/ l/,~~ 'bivis° 'n of Safe and Buildin s ~ e f ~ tY 9 ~~- Bureau of Integrated services in accordance with G_omrx~ $3,09, Wis. ~ ~~ Attach complete site plan on paper not less than 8 1/2 x 11 inches Ir7,sige. 'Plan must •' County include, but not limited to: vertical and horizontal reference point ($M), directiorygpd=?^~, ~~' ~ r percent slope, scale or dimensions, north arrow, and location ar)d ~#ance to nl~aCe t~rpad-; J~rcel I APPLICANT INFORMATION -Please print all inl~p~r-~ation. , , Re • ~ vat Personal information you provide may be used for secondary purposes (P~vacy Law s ~3A4'f1'1_T,~))• ,r 9 S Od Property Owner ~, :. ' `arty Locatipn ~~~ ~ ~~r , Govt. L`ot ~~ ~~1/4SC~1/4,S ~ T~ ,N,R ~ E (o Property Owner's Mailing Address ~ ~ 4oC # ~BfgeYc# Subd. Name or CSM# Ciiy State Zip de Phone Number ty ^ Village Town Nearest Road .New Construction Use: ~flesidential / Number of bedrooms ~ Addition to existing building ^ Replacement ^ Public or commercial -Describe: c Code derived daily flow ~Q gpd Recommended design loading rate ~' 2 bed, gpd/fit J 2 trench, gpd/ft2 Absorption area required bed, ft2 3~~trench, ft2 / Maximum design loading rate ~ ' Z bed, gpd/fi2 ~ ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) ~• / ft (as referred to site plan benchmark) Additional design/site considerations Parent material ~ _ Flood plain elevation, if applicable f'-~ ~ ~ ft S = Suitable for system Conventional v-Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ S ~U.,. ~ ^ U ^ S ~dL ^ S ~f ^ S ~~ ^ S SOIL DESCRIPTION REPORT Boring # Ground s%~~v. ft. Depth to limiting cxin. Boring # Ground v. ~~ ft. Depth to limiting factor ,i ~~in. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/fit in. Munsell Qu. Sz. Cont. Color . Sz. Sh. G r ry Be d , Trench r ~ t ~ Remarks: ~ J L / ~ ./~ tyl ,,,(/~' /7'/ Remarks: :.ST Name (Please Print) Signature Telephone No. Address Date CST Number ~~ 1 z / ~`S /7 3 /- ~-~-6~~60 ,. . , SOIL DESCRIPTION REPORT '-•"~ PROPERTY OWNER Page of ! PARCEL I.D.# Boring # Ground //~~ele . VV// ft. Depth to limiting f t ~~in. Boring # ~~ Ground levr (~ ~ Sc+ft. / Depth to limiting ctor ~Q_in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 1 -y .~ f ~.r' ~ 5~ .G ~ 8?~ ~ ~~ s ~ l ~ ~; -..S". i ~ / G Z~ Z /~ ~~1.C` JL~ /~%P~ Remarks: I D- ,- ~~-v~.~- ~' ~- ,~- C~.~' w.-- ~, ~ :• Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/fit in. Munsell Qu. Sz. Cont. Color . Gr. Sz. Sh. ry Bed ,Trench Remarks: Depth to limiting factor 'n' Remarks: SBD-8330 (R.9/98) •r 4 .~^ Project NamE Address Joe Dohmen Soil Test Plot Plan Sha r 2022 Hwy 12 Baldwin Wi 54002 C M #226900 Lot Subdivision ------- Date 3/16/00 N W 1 /4 S W 1 /4S 24 T 29 N/R1 ~ W Boring 0 Well PL Property Line BM or VRP Assume Elevation 100 ft. Township Hammond County ST. CROIX Top of Nail in Tree with Orange Ribbon System Elevation 98.1 *HRPSame as Benchmark Alt. BM Top of White Stake with Orange Ribbon ~a 100.5 200th St. ST CROIX COUNTY . ,, :. - - . . _ - .SEPTIC TANK MA-INTEiVANCE AGREEMENT ~ . _ . .AND . . OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~~ t C ~ l~'`~ ~ ~~C ~ ~C~.~- b ~ S'-2. ~ Mailing Address ~ ~ d 1 O +~ ~~ - Property Address ~' ~~~ ~ ~ `~ ~'~ - . (Verification required from Planning Department for new City/State ~ Q ~ c~W ~ n Parcel Identification Number l~- I o h u -1 O -(xx'~ LEGAL DESCRIP~'ION Property Location !~ w %., ~/ 1/., Sec. ~~ T,~~N-R ~ ~ W, Town of ~ ~ ~a ~ . Subdivision 1~1. ,q Lot # ~_. Certified Survey Map # (~ `~~ (~ 9 ~ .Volume ~ ~ .Page # 3 g ~ 1 Warranty Deed # __ to a ~ 3 ~1 ~ Volume ~ ~ 3 1 .Page # , 013 Spec house ^ yes [ono Lot lines identifiable Byes ^ no SYSTEM MAINTENANCE and msatenanoeof your septic system could result in its premature far~ccc+e to boodle wastes. Proper maintenance consist of ping °oirt ~e task every three years or sooner, if seeded by a 4oensed pumper... What yon Put into the system caw affect the fimctiouaf fire septic taa]c-as ;a treatment stage m the waste disposal system. The properly owner agrees to acbmit to St. Croix Zoning Department a certification foam, signed by the owner sad by a PIP. resttictedphmiber or a licensedpemper verifying that (I) the an~tte arastewaterdisposal system is is proper operating conditionand/or (Z) after inspection and pumping (if ne~sary), the septic tank.is .Ices thaw 1!3 full of sledge. Uwe. the have. read the above,require~ment and agree to maiatia the:private sewage disposal system with the standards set forth, herein, as set by the Dot of C.oimmerce and dxa Deoartaeent of 1~Tatnral Resoaemes,-State of Plisc~ersin. Certifi~toa stating that your septic system has been maintained must be completed arbti retnnoed to the St. Croix Connty Zoning Office within 30 days of the three year expiration date.. g / Z /40 OF APPLICANT DATB OWNER CE~~TCAT~Q.IY I (wej +oettify trial all statement on this form are tore to the best of my (our) knowledge. I (we) am (are) the owner(s) of the descrtbod above,'by virtue of a warranty deed r+ecoc+ded is Register of Deeds Office. IGNA OF APPLICANT - " 1 ~C~~" DATE ««**«« Any infom~ation that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ***«s« („~ C ., ~~w~~ ~y~ ~~~a~ •* Include w[tlt this application: a stamped warranty deed from the Register of Deeds office a copy of the rectified survey map if reference is made in the warranty deed von 1531P~ 23 STATE BAR Of WISCONSIN FORM 2.1998 WARRANTY DEED Document Number 627393 KATHLEEN H. bdALSH REGISTER OF DEEDS ST. CROIX CO., IiI RECEIIIEd FOR RETARD 08-01-2000 9:30 AM This Deed, trade between Joseph A Dohsuan a sinQl• person Grantor, and Jamie D Burr and 8taav K. Sahloss•r, two sinQl• persons as ioint tenants __ Grantee. Gtatttor, for a valuable consideration, conveys and warrants to Gtatttce the following described teal estate in St. Croix County, State of Wiscottcin: Lot 1 of Certified Survey Map filed in Vol. 14, Paq• 3887, of Certified Suuvy Maps, as Doaumnt No. 625697 whioh is part of the NiwT 1/d of the Sif 1/4 of 8•otion 24, Township 29 North, Range 17 West in the Town of Hammond WARRANTY DEED E1(EMDT N CI.RT COPY FEE: COPY FEE: TRRNSFER FEE: 82.50 PAS I~t FEE: ~ .00 Area tAW OFFICE 1020 10th Avenue gaictwin, Wl 54002 Paoel Identifwtan Number (PIN) TFis is not homestead property. (is) (~ ~) Exceptions to wartattties: •as•in•nts, roadways, and r•atriotions of raord Dated This ~0'ih day of ~~_ ~ t i AUTHENTICATION Signature(s) authenticated this day of , s AUTHENTICATION Signature(s) authenticated this day of , r T-TLE: MEMBER STATE BAR OF WISCONSTN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Miahsel H For•cki Attorney of Law Eau Claire Wisconsin (Signatures may be authenticated or acknowledged. Both are pot necessary) + Joseph A. Dohtnen • ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County ) ~ ~liy came before the this ~_ daY of ~'~ „~_ the above [tamed ~~ rb,Ae~ ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. 8t. Croix County. ) ~ --~_Ppsonslly carte before the this o7~ day of '~(.~ ,~_ the above named Jos•DYt A Dolin Iv t0 me IUIOVYII t0 be the person who ~~ the foregoittt, i anent and acknowled rJ ~ s Alotay F.tbiic, Stets of Wisconsin ~ My Commission is permanent. (lf not, date: .) 62569'7 __ N ~ 0 z C m z v ~ a m D ~ D v v ~ 0 0 r ~ D D ~ .p ~ ~ m O N r ~ om ~ ~ 5 Z N O ~ z o ° I ~ .p r*t ~ °' ~ N O O O O D I~l Z rn f'T'1 II O 0 v ~' 0 0 ~ ~ m _ ~ a =gym ~~n a'D ~. o` o ~ °~ m w O G~~1 N . y co 0 0 z BEARINGS ARE REFERENCED TO THE A ° WEST LINE OF THE SW1/4 OF SECTION 3 cn ~ 24, ASSUMED TO BEAR S00'18'S0"E m ~ Z ~N~ .-~ • ~ no A ~ S00°18'50"E ' ~ 2366.59' ~ z s7 0 lm ti C_ u~ 00 C N -~ Z ~, n ~ ~~ CrJ '° p ~X C vn~ Q yCm Q Z 3 ~ 0 i$ • O~~j ~I~ I~I~ ~° I~I~ I~IO ~~~ I~ ~ 0 I~I~ M~~~~~177pMM~~ri C~~/D rd~LMa~2]D~ Z A OOUVLiVLSD ° ll OO L1WL5Q~ ~~O - ~~OZ ~ ' d ~ 0 0 4Cz] ~4G°~~G4 ~7~0C' ~~S ~~~G ~ / o~ ~ o~ W /C WEST LINE OF THE SW 1/4 ~~"', ~ S00°18'50"E 270.10' ® ~; $ $ . .~ ~ . z v - ~ ~ cn V O OV.N-.O ~ wvcn~ r w ~Of'lNy O w ~ ~, y ~ ri o Z J y x' ~ ~~'i- -i -i ~ ~ ~ ~ ~ ,~~~ ~ ,~, FOLE® 0 0 -' o h m JUN ~ 3 0 2000 ~ °_ ~+ x ~ x ,~~', ~ - KATHLEEN H. Gygt SH ~ ° ~ a ~ N ' ~ p N r ~ rn Z . 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