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HomeMy WebLinkAbout020-1433-10-000 Safety _._'tII iviWi0 i uuntY -- — - - -- -..__ 201 w, washutg e- / K 4 r l c \ 1o.�3 y - -- - - ��`�� Madison.Ib11 _ r l K Sanitary Permit Numbt,•r be.ftllhf -n b} - Co -- i. Qepartment of Commerce (608) Sanitary Permit .t� Hca n Q m i p S Planl.D. Nu !n A accord wi th Comm 83.11, Wis. Aden. Code, persoml inforrpa on yo�y� do � j- may he used for sccondtuy purposed Privacy Law, s15. (1 (at" v t' A r L ____ �' ) J 2004 i ect Address {if ' ferent than mailtrig aa dreda, 1. Appiicatlon Inforteat{on - Please Print All Wormatfon U �U -7 ' � 3 �t�(/hQ i ZON1NG Nr >- Property Owner's Na the _ � J''Q �- areal N —`(.; -- -- - lilcxk #- t t C Ye/ Property Owner's M atung Address f Property Location c -t Z 6S / 1 L 1� �J �ip Code Phone IYumbrr .Secrion �` 'circle m / u II i , Type of Building (check all that apply) /4tRvr, jam T �'�; R II l o 3 •, _ or 2 Family Dwelling - Number of Bedroot d4 Subdivision Name CSM Number El _T � _ I Public/C - Describe Use - � -- - -• _ _ •- -• A0 Q State Owned - Describe ❑CiryYiJ ?sae DTnwnship of _ I t III. Typo of P ermit: (Ch eck only one bo on line A. Complete lines If a1H,licabir± f A -- _ _ __ ----± i WNew System f a Replacement System i7 Treatment/Holding Tank Replacement On!) ❑ Other Modification to Existing System. i � f +� r• M- - List Previous Permit Number and Daw Issued B. ❑ Permit Renewal Permit Revision :_ Change of I �. Permit Transfer to New Before Expiration Plumber ! Owner + IV. T�pt of P Sys (Chec all tha apply) - -- j Non - Pressurized !n - Groun ❑ Mound > 24 in. of s uttAble sail ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Singie Pass Sand Filter I ❑ Consmi ted Wetland 0 Pressurized I round ❑ Holding Tank l.j Peat F J Aerobic Treatment Unit D Recirculating Sand Filter O Recircula ' Synthetic Media PH hi r u Drip Line � Gravel -less Pipe (explain) � V. Dia rsal/Treatment Area Information: Design Flow 40) Design Soil Application Rate(gpdsf) Dispersal Area Required Of) Dispersal U �cd f) System Elevat on d C a pac ity In Tote? Nurztzr� Manutitcturer -`-� Prefab Site Steel Fiber i P12StiC VI. 'rank Info �' I Gallons t3a11cros of Units Concrete Constructed Glass New IsxlstinQ I Tank- Septic or Holding Tack _� - '--1 Aerobic Tratinant Unit � Dos ing i pos Chamber VII. Rat: bility Statement f, t anders i3ned, tas surne responsibility for ' Uati of the P_OWTS sbown on the Attached plans. Plumber's Na me (Print) Plumber's Si griature PrtS Nutntxr Business Phone ��n:cer i Plumber's Addre ss (Street, City, State, Zip Code) I VIII. t /De rtment 11se Ont =De1n1W L �. - nt Sanitary Perrin Fee Groundwater to {sued Issuing Age J n re ppro4ed C Disapproved Surcharge Feel l �jy -b _ - L00 ] O wner Give Reas IiX. Conditions of Approv ason ' for Aisappr� S STE 1�lEB: �'/yf �, �• 1 d as per management plan provided by plumber eptic tank, effluent filter and I /y� ispersal cell must all be serviced I e ;1,4 �sys� Z j C 2. All setback requirements must be maintained Lit � t I as per applicable code /ordinances. — - h .tom« 4 ktwb toM*te ptaas (to the Couru only) for she xysu UT CROIX COUIN'L'T SEPTIC TANK MAINTBNANCE AGREMSW AND . OWNERSHIP CERTIFICATION FORM Owner/Buyer � c��src� .fie ey - Mailing Address , , .,'mod C d 4 ifj Property Address (Verification tegttirn from Planning Department four new construction) city/State if , Parcel Identification Number . 0 -2 o 4 7 ( _ 3 - 3 — Lo — G Y.Zj LEGAL DESCRIPTION , a6P9F Property Location r/s, W1' %<, Sec. I/ TAN -RAW, Town of 1-/ sCA , Subdivision m� P- &d V e d) i� .s' . Lot # 4 Certified Survey Map # . Volume . ,Page # Warranty Deed # &64- ' , volume ��a page # Spec M(Y yes O no Lot lines identifiable 0 yes O no Itnpr+opec use sad makdeaance of your septic system could result in its premature failure to handle wastes. Proper maintenance ooadsts of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system ca affix* the iimcdort of the septic tank as a treatment sage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a =0= 600 form, signed by the owner and by a mssW Vb=ber, journeyman plumber, re rtrictedpium'ber or a licensed pumper valf�►ing that (1) the on -site wastewaW l system Is is proper operating condition andlor (2) niter Inspection end pumping (if ruooessary), the septic tank is lean thaw 1/3 full of sludge. yw,, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set f basin, as set by the Department of Commarae and the Dapattrwnt of Natural Resources, State of Wisconsin. Certification stating that your septic system bas been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of flue three year expiration date. siaNATURE OV APPLICANT DATE ,02 = - A TION I (we) certify that all statements on this form are true to the best of ray (Our) knowledge. I (we) am (are) the owne of the property described above, by virtue of a warranty decd recorded ir. Register of Deeds Office. DATE SIGNATURE OF APPLICANT bei « « « ««« ••s••• Any information that is min - represented stay result in the sanitary pe miit �$ revoked by the Zoning Department. •« Include with this appHeatlon: a stamped warranty deed from the Register of Doak office a copy of flu certified survey map if refbrertce is trade in the warranty deed • POWTS OWNER'S MANUAL. & MANAGEMENT PLAN )sage /, of 2/ FILE INFORMATION SYSTEM gpECIFICATIOW owner A Septic Tank Capacity ga l D NA Permit # 3 l Septic Tank Manufacturer , ❑ NA hl:SKfN PARAMET Effluent Miter Manufacturer g O NA Number of Bedrooms i{ 0 NA EffkJent Filter Model 0 NA Number of Public Facility Units O NA Pump Talk Capacity al D NA Estimated flow (avers") 4 1 00 _W_d4t_ a&U dsy Pump Tank Manufacturer ie le ❑ NA Design flow (peak), (intimated x 1.b) Ga o w/da Pump Manufactrxer G..�/ DNA Sop Application Rate alld /ft: Pump Model ❑ NA Standard lnfiuent/Effiuent Quality Monthly averages Pretreatment Unit NA Fats, Oil & Grease i ) 00 mg/L 13 SandMravei Filter 0 Peat Filter Biochemical Oxygen Demand (300 5220 mg /L ❑ NA O Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5160 mg /L ❑ Disinfection O Other: Pretreated Effk»nt Quality Monthly average Dispersal Cents) O NA Biochemical Oxygen Demand (BODj 930 nWL round (gravity) 0 in- Ground (pressurized) Total Suspended id ded Sos (TSS) S30 mgA NA At -erode 0 Mound Faecal Coliform (geometric mean) S1 ❑ Drip-Line . t7 Other: Maximum Effluent Particle Site K in die. iD NA Off; 0 NA Q f7 NA Otlwr. O NA O NA "Values typical for domestic wastewater and septic tank effkvft Other: WlAIAlTEi1tANCE SCHEDULE Service Event Service Frequency s Waximm 3 yam ❑ NA lnspect condition of tank(s) At least once every: s Pump out contents of tank(s) When combin sludge and scum equals one -third (Ya) of tank volume ❑ NA p nUmmlel ls) {M Irnuln 3 years) O NA Inspect dispersal oeil(sl At least once every ❑ NA Clean effluent filter At least once every: ar(s) month(s) 0 NA Inspect pump, pump controls & alarm At least once every: p arts) taonth s) 0 NA Flush Isterala and pressure test At Mast once every: p s) monthls) E3 NA Other: At least once every: p s) Other: O NA MANCIVIANCE MISTRUCTtONS Inspections of tanks and d(apmai cells #hail be made by an individual carrying one of the following license* Servicing Ope Tar aster, M pkimber: Master Plumber Restricted Sewer; POWTS Inspector: POWTS r brok en hardware, inspections must Include a visual inspection of the tank($) to identify any missing or brokdware, Want" any cracks or nd sur aki messun the volume of combined sludge and scum and to check for any back up or ponding of effluent on the grou The dispersal call(s) shalt be visually inspected to check the effluent levels in the observation pipes and to check for any pander W and requires of effluent on the ground surface. The pondkng of effluent on the ground surface may Indicate a fsilkV cond ff tF immediate notification of the local regulatory authority. When the oombined accumulation of sludge and s Op q ua l a - third dispo socardsnae t itfi chapter a11' contents of the tank shall be removed by s Sept a g s Servicing Wisconsin Administrative Code ents, Pfetreattr+a of effluent All other services, including but not lit S12 month S a be performed s certified pO, mechanical Or Ms P � units, and any servicing a t intervals o the local regulatory authority within 10 days of Completion Of any service event. A service report shalt be provided to START UP AND OPERATION ti oducts or other chbmicals For new construction, prior to use of the POWTS check treatment tank(s) for the presen trrat on ar d have the contents that may impede the treatment process and /or damage the dispersal califs). If high cone c n of the tank(*) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface- During power outages pump tanks may fill above normal highwster levels. When power is restored the excess wastewater will be of discharged to the dispersal callis) in one large dose, overloading the cell {s! and may result in the backo erator or restoring effluent. To avoid this situation cunt contac a Plum or POWTS Maintainer tainer rem too assist in ue peratl g the pump controls to power to the effluent pump or restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over. o r otherwise disturb or compact, rtes area within 15 feet down slope of any mound or at -grade soil absorption area. the ion or elimination of the following from the wastewater stream may improve Reduct the performance pProlo ife disi ►t8f fat PO antibiotics; baby wipes; cigarette butts; condoms; carton swabs, g i e scraps; medications; oil; foundation drain (sump pump) water; fruit and vegetable peelings; g as oli ne ; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT rm anently , taken out of service the When the POWTS fails and /or In com iance with chapter Comm 83 33�iWisconsin Administrative Code: inaure that the system �s property and safely abandoned P • All piping to tanks and pits shall be disconnected and the abandoned pipe opening* sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. e After Pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN N the CONTINGENCY fails and cannot be rap r� the following measures have been, or must be taken, to provide a cads compliant replace aY�n"� A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement 08 should be protected from disturbance l and wells. o Failure infringed e to protect the replacement area will required setbacks from existing and proposed structure, blish a suitable replacement area. Replacement systems must result M the need for a new soli and site e valuation to eats comply with the rules in effect at that rims. Q A suitable replaroment area is not ava a last resort to setb repl d he fat 307 led POWT a. Barring advances in POWTS technology a holding tank may be testa d site tank AI e al of C3 Mound and at-grade soil absorption systems may be reconstructe place + at�that tima,the biomat at the infiltrative surface. Reconstructions of such systems must comp Y iW h OXYGEN. 00 NOT < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MA K UND ANY HAL ASSES AND /ORR I NS�UFF C R SULT. RESCUE OF A ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. AppI 30NAL COMMENTS POWTS INSTALLER pOWTS MAMTAINER ��, � llama ` Name , ��� Phone Phone 7 l , ? ,g' ,;t sEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY i Name 1 1 ±- 31 , - -= Nome Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(11(4M(f) and 83.5MI1, (21 & (31, Wisconsin Administrative Code. Z r, JvT -ra SCAL -- � t x b \� l !� f Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463193 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: Beer, Richard Hudson, Town of 020 - 1433 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 11 11.29.19.2698 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ± 5 /Z 5 Benchmark G-3 163.1 c .7 ct BM L� i J 3 gs c 9. Z �j Aeration Bldg. Sewer $.4L 951. toS Holding St/Ht Inlet 9.33 g3 • 7 TANK SETBACK INFORMATION St/Ht Outlet q3. 3Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 17 1 1-7' 1 1 Dt Bottom Dosing Header /Man. 16.y5 gz.c�S Aeratio Dist. Pipe 3 / Holding Bot. System PUMP /SIPHON INFORMATION Final Grade S • Z 17 4* 7 Manufacturer • De St Cover G PM 3,75 9 3S i Model er TDH Friction Loss Syst ead TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width • / Length i No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. uid Depth DIMENSIONS 3 co Z 4" Z — ` j �-�a eJ v "1., *1-1 \ Liq SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer , INFORMATION CHAMBER OR f, 1 a r Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold �� Distribution x Hole Size x Hole Spacing Vent to A � i l l � Intake ncJ�- Length /6 Dia Le (s) ` Dia ` Spacing L Ito-_ SOIL COVER x Pressure Systems Only xx Mound Or At Grade Systems Only nr, Depth Over IDepth Over xx Depth 1 xx Seeded /Sodded xx Mulched Bed/Trench Center '7/ L Bed/Trench Edges ` Topsoil Yes N No N-Y-s No COMMENTS: (Include cod ee discrepancies, persons present, etc.) Inspection #1: / I Inspection #2: I / Location: 773 Mound VP oo, �t d� � ad Hudson, WI 54016 (SW 1/4 NE 1/4 11 T29N R19W) Mound View Estates Lot 10 Parcel No: 11.29.19.2698 ` n " r. 1.) Alt BM Description = d� �- C V'- - - o 2.) Bldg sewer length - amount of cover Plan revision Required? Yes XNo Use other side for additional information. SBD -6710 (R.3197) Date Insep is Sign re Cart. No. Wisconsin Department of Corr %merce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 463193 0 GENERAL INFORMATION 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: Beer, Richard Hudson Township 020 - 1433 -10 -000 CST BM Elev: Insp. BM Elev: T Description: Section/Town /Range/ o: 11.29.19.2698 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELE Septic Benchmark / Vr Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil T Yes E No D Yes LJI No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 773 Mound View Road Hudson, WI 54016 (SW 1/4 NE 1/4 11 T29N R19W) Mound View Estates Lot 10 Parcel No: 11.29.19.2698 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? [ Yes E] No — � I Use other side for additional information. SBD -6710 (R.3/97) — Date Insepctor's Signature Cert. No. #, S afer anti W 201 N nig < - 0. 7 _ --�' �r�! seam Madison, Pi - onsin Sanitary Permit Number (to be filled in by C�). artment of cqmmere P De (608) L�O 3 Sanitary Permit At ati Sta Plan --f -- ___ .___. _._. -� ii — tc i n I. D, lumb In accord ' with Comm 83.21, Wis, Adm. Code, personal infor cm y -,. ) ide ' , m y be used for sCQ Purposes Privacy L s15, (1)(PMV , 1 ,6181 for2 f. 4 FV0.1ect Address !if t I I. Application jt_j�n - Please o ii ii a . - 7? 3 Property Owner's Na me - N G DE arcel # U Block if do- r �PropeM Owner's M ailing Address Property Location //L5 � , City. State 2 - APO Zip Code Phone Num_b � I ,� (Jn- �i'Nt7l, -C-� �� L:5 4� "i! C e 0 11. Type of Building (check all that apply) 3 T 2Z N; R /?E $4 or 2 Family Dwelling - Number of Bedrooms ' Subdivision Name CS&I Number Public/Commercial - Describe Use A 13 State Owned - Describe Use A2j� ❑Ciry J&WaLe - (if 111. Type of Permit; (Check only one box an line A. Col; _H-r if r i f i New System Replacement System L Treatment/Holding Tank Replacetrenz Only ❑ Other Modification no Existing Sy stem ust Previous Permit Number W Da Issued Permit Renewal [1 Permit Revision e of Permit Transfer to New Before Expiration Owner T3vt of POWTS SvFtem: (Check all that . apR!X) Non -Pressurized In-Ground Ij Mound > 24 in. of suitable soil Mound < 24 in of suitable soil 11 At-Grade ❑ Single Pass sand Filter Commicted Wetland D Pressurized 1111-Ground ❑ Holding Tank _j Peat Filter _j Aerobic Treatment Unit 71 Recirculating Sand filter Fj ptecir ulating Synthetic Media Filter r Drip Line Gravel less (explain) c /-k-Lca hing essi Pipe . L ht: V. Dta rsal /Tr eatment Area information. � syste Design flow (gN) Design Soil Application Rate(gXsf) ,Dispersal Area Required (sf) I i persal posed s , System I Fievat C"ll Steel Fiber pl�SEIQ Capacity in Total NUYAlx-r Prefab Site VI. Tank lufo Gallons Gallons Concrete Consaucted N Ex isting Tanks Tanks Septic or Holding Tank L Aerobic Treatment Unit Dosing Chamber A,/ f the POWTS sbown on the a ttached plans, 5 1 grit ,d, kssu re sponsibility for flati — ------- r _ _ --- __ , H Phone Numl)el Beta risibility Statement- 1, the under 2 _ P l umber's Plumber' Si gluture IPRS NLIMber urnber, lumber's Na me (Print) City, State, Zip Code) 0afin /De runent 1, Only VIII. sg�u Parrot Pee (includes Groundwater Date Issued Issuing A gent - n re T_ pprov4d C Disapproved Surcharge Feel f D owner Given Reason for DeDiAJ for Disal pprovw X. c of App � rov �qwo W �; SYS T E M Al a )Septic tank, effluent filter an 'dispersal cell must all iced e as per management p 2. All setback requirements must be maintained as per applicable code/ordinances- "I n l y ) or tic Atiicb toatplrte Mans (to the County a.zOLV /41-1 � ,JvT Ta scaL -- l� p e- �Q S x .�Y /veG�Ja- r A ,40 1,)o-r -To scAL tlj /J QUS� o ST CROW COUNTY SEPTIC TANK MA - TMNANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address I / �d C e ,�� Property Address :Z:2 a A Li, ild U') (Verification required from Planning Department for new construction) City/State Parcel Identification Number ()-2 a ' / y 3 . 3 -- L — a b MAL DESC-RIPTIi2N 0 '-�2lv 9 Loca tion � r/< ' . a -R W Town of � Property Lora �.... � 61� / <, Sec / �, TAN .,,� —. lf"Al .�� Subdivision x'16 �--U� �, :° G� �'s Lot # 114 Certified Survey Map # volume ..Pap # r� W amaty Deed # a Volume d . Page # Spec house M(Y ® no Lot lines identifiable 0 yes Q no EYE= MMUZEMCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance oonsim of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affeat the fttnotion of the septic tank as a treatment stage in the waste disposal sylw= The property owner agrees to submit to St. Croix Zoning Department a ccrtlficatiOn farm, signed by the owner and by a plumber, journayman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if nocessaty), the septic tank is less than 1/3 full of sludge. thee, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and resumed to the St. Croix County Zoning Office within 30 days of the three year expiration date. L SIt3NATURE OV APPLICANT DATE pOMM CEI�t=CATION I (we) certify that all statements on this form are true to the best of ray (our) knowledge, I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIONATURE OF APPLICANT ATE •. «ss« Any information that is mfa- represented may result in the sanituy pennit being revoked by the Zoning D%mlmeat •« from the Register of Deeds office • s watran deed h3� ashen. a s ap h' Include with thi pp a copy of the certified survey asap if tefemnce is made in the warranty decd POWTS OWNER'S MANUAL & MANAGEMENT PLAN page J of � FILE INFORMATION SYSTEM SPECIFICATIONS Owner � Septic Tank Capacity ga l _ DNA Permit # [� fa3 Septic Tank Manufacturer O NA ONION PARAMETERS Effluent Filter Manufacturer e ❑ NA Number of Bedrooms e{ 0 NA Effluent Filter Model �rf ❑ NA Number of Public Facility Units O NA Pump Tank Capacity Q of NA Eatimated flow (averagel 41 gC¢ _ stlda Pump Tanis Manufacturer a ; e t v 0 NA Design flow (peak), (Estimated x 1.6) ':;�e ey g al/day Pump Manufacturer t.w.411 ❑ NA Application Rata et /da /ft t Pump Model ❑ NA Soil Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA Fate, Oil & Grease t ) S30 mg/L ❑ Send /Gravel Filter C3 Peat Filter Biochemical Oxygen Demand (SOD 52201 mg /L Cl NA © Machanicai Aeration ❑ Wetland Total Suspended Solids (TSS) 5160 mg1L 0 Disinfection C3 other. Protrested Effluent Quality Monthly average giepereal CeUisl O NA Biochemical Oxygen Demand (BOD X30 mg/L •Ground (gravity) ❑ !n - Ground (pressurized) Total Suspended Solids (TSSI S30 mgiL NA At -Grade C] Mound Fecal Coliform ($eometrtc mean) 51 • f ❑ Dtip - Una 0 Other: Other: [3 NA Maximum Effluent Pardole Size Ys in dia. ❑ NA Oth*r: ❑ NA e'er: ❑ NA Off: ❑ NA " Vsluss typical for domestic wastewater and septic tank effluent. M E SCHEDULE Eerviw Ewrrt Service FrequencY Inspect condition of tank(s) At least once every: 3 ear e $ (Mau imm 3 years) 13 NA Pump out contents of tank(s) When combined sludge and scum squats one-third (�) of tank volume ❑ NA k month(a) (M,a 3 years) ❑ NA Inspect disperse' cell(sl At least ono$ every:( _... Clean effluent flier At least once ovary: mof>(sl 13 NA months) ❑ NA Inspect pump, pump controls & alarm At bast once every: --- ❑ year(s) month s) ❑ NA Flush laterals and pressure test At least ono* every: Other: At least once every: ❑ u O s! C3 NA . o NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carryinii one of the following licenses or certification Master Plumber; Master Plummer Restricted Sewer; POWTS Inspector: POWTS Meintalnsr; Septego Ser operat or leak inspections m ust Includ a visual inspection of the tanks) to identify any missing or broken har o1 effluent if the ground surfa measure the volume of combined sludge and scum and to check for any back up or Pon g Hair The dispersal WI(s) shall be visually inspected to check the effluent levels In the observation pipes and to check f end req ir uires ti of effluent on the ground surface. The ponding of effluent on the ground surface may Indicate a failing conditour+ immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y,) or more of the tank volume, the anti contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11 Wisconsin Administrative Code. er n s , pretreatme All other services, including but not limited to the Servicing of effluent filters, mechanical ar pressurized Qomt�n units and an y Servicing at intervals of 512 months, shall be performed by s certified POWTS Malntalner. A service rapers shall be provided to the local regulatory au thority within 10 days of cornpletion of any service event. i Page _ 2 di ?i START UP AND OPERATION oducts or other chemicals For new consed e t he tr eat t rne nt process and/or damage the dispersal cell($). if h c oncentrations n; a a detected have the contents that may imped p of the tank(*) removed by a septaga servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative s urface. u face. is restored the excess wastewater will be During power outages pump tanks may fill above normal highwater lev po Servicing Operator prior to restoring discharged to the dispersa4 cell(*) in one larg ank by a ptag m the backup or surface discharge o effluent. To avoid this situation have the co ntents of the Pump t ly o perating the pump controls to power to the effluent pump or contact a Plumber or POWTS Maintainer to ass's$% in manual restore normal levels within the pump tank. the area Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, within 15 feet down slope of any mound or at -grade soil absorption area. I prove Reduction or elimination of the following from the �ogdorr►sL tan swabs; doe ease perfo s; enta diapers; disinfectants; fat; t ass; and prolong the life o the POWTS; antibiotics; baby wipes; cigarette bu tts; s wabs: geese; herbicides; meat scraps; medications; oil; foundation drain ( SUMP PUMP) water; fruit and vegetable peelings; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or i per taken ou t of hooter Comm B3 33, Ad n Code; ensure that the system is properly and safely abandoned i co mp liance e All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. e The contents of &Il tanks and pl shall be removed and properly disposed of by a Sep tage Servicing Operator. a After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWT falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacem system: able rep A suitable area has been evaluated and may be utilized for the location of a replacement soil absorption upon by system. The replacement area should be protected from disturbance w e lls . m Failure to p r o tect t he r eplacement area w t required setbacks from existing and proposed structure, i result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. or O A suitable replacement area is not available setback the fai so led POWYS Barring advances in POWYS technology a holding tank may be installed a s a last resort to d site an boon Bosom k hg1digg tank o f ant arm Al a e ce nAkArrC C3 Mound and at -grade sail absorption systems may b must comply tild in tha os sneffe following at %lime, the biome% at the infiltrative surface. Reconstructions of such systems < < WARNING > a 00 NOT SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY ONTA ANY HAL Q STANCES. DEATH MAY RESULT- RE C UE OF A ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. AD DITIONAL COMMENTS POVYT8 INSTALLER POWTS MAINTAINER / �� , �.Q Ir Nam Name e , Phone Phase ? r s ? -- .�' .�' sEPTAi2E SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone t <_ -3 Phone 83.54111, 121E 131, Wisconsin Administrative Gads• This document was drafted in compliance with chapter Comm 83.22(21(b)(IW1 &(f1 and — —• / 33 Ser5r33w 423.46 w e0 amts ® I LOT 6 �+ TEMPOaAgV 2.29 ACRES CLIL -DE -SAC ® ® g 9,780 SO. FT.) . EASEIr W d �4.51'AZ^1'1 � \ ,� •• ® 3.51 ACRES m (152,714 SO. FT.) • LOT • 2.60 ACRES � L.B.O. - — — — LOT 7 \ (113,063 SO, FT,) 917.0 ® < 2.22 ACRES \ L.B.O. - e17.o (96,714 SO. FT.) I N gig \ ` 1 LOT S ` �2 11 5 56.62 295.7p I 2.44 ACRES \ (106,062 SO. FT.) Of ® 1 ` H.W.E. - I , • ® 915.0 / d s 1 2°CRE S (135,727 SO. FT.) ® _ (� • L.B.O. - 917.0 M �aD�3 LOT 9 a O 4 O 2.61 ACRES \ d l l o�M�D oarp �, (113,770 SO. FT.) a ® I 1 Z P) Lis O D � r @ I LOT I ` O D I p Li 2.04 XB RES H.w.E. - )PA J • (88,704 SO. FTp 915.0 s� W L.B.O. -917.0 LOT 1 I 2.40 ACRES (104.397 SO. Fr.) I ,2 1• "j L.B.O. 917.0 54.9 7 m p SO4 °06 66.17' EAST tf9.94' . ® • , y ' . 01 I LOT 10 \ • �'� °� C( 2. ACRES / (105, ,77 65 SO. FT.) DI I ° L.B.O. - 906.0 ' ` 40 o / S, BENCHMARK: x \ 12 E OF IRON PIPE ELEV -916. 3373.21' EASTVEST1�411�E 9 °52 3" 569.0W MMP(s WV%D M MDD @ @W101915) DS7 WHIM -- �Ser5223w 5257.x' I 7M *67MAEN1 DRAF= BY &MAIN 085MM J09 N0. 9125 -M WE 0.7/00;2003 er _.... ( /l AND SPiClFICA7i Ss.PTIC TANK E PUMP CHAM BZR CROSS ��,,._-'� CZ VENT 1 PIPE 1 2 " Mf M. `A$OV E GRADE JUNCTION BOX APPROVED > 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W1 PADLOCK & WARNING LABEL FINISHED GRADE 7 4 " Cl RISER MIN. Zg" IN. 6" MAX. N LET WATER TIGHT SEALS GAS- TIGHT PROVED A SEAL JOINTS WITH �..,. ; ALM APPROVED PIPE B 3' ONTO 1PE 0 ON SOLID SOIL NTO SOLID C ! ' OFF RISER EXIT OIL PUMP OFF ELEV . _ _ FT PERMITTED ONLY D IF TANK MANUFACTURER HAS APPROVAL a ll APPROVED. BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: /.)�'c s Gr� TANK_ SIZES SEPTIC j Dd GAL. DOSE VOLUME FN LURING GAL. DOSE G� GRL. , f ALARM MANUFACTURER: / /l -/&w -i CAPACITIES: A = INCHES = 3e�l GAL. MODEL NUMBER: � i 8 2 INCHES = 32 GAL, SWITCH TYPE: a'^ �, � C = , $ INCHES =�GAL PUMP MANUFACTURER � MODEL NUMBER: e D z INCHES SWITCH TYPE: REQUIRED DISCHARGE RATE _ GPM PUMP E ALARM WIRING AS PER I LHR 16.23 WA( VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE • - F EET + MINIMUM NETWORK SUPPLY PRESSURE . • • • . • • ' ' ' . FEET + FEET FORCEMAIN X f�, FTJ100 FT.OTALIDYNAMICAHEAD .r. FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH i D " I�AMETER,., LIQUID b� le /,�.�x rr SIGNED: LICENSE NUMBER: , ?S''�'O DATE —i�� [q GOULDS PUMPS Submersible nt Pum Efflue p ©1 1 �. ZA EPO4 3871 EP05 II W 'Am APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- i heavy Up and lower grade turbine oil for tic enclosed design for duty bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion canadim standards Assodadoa • Auto- Waal ration. A Farms ma � resistance. • Heavy duty sump matic models include a Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Floats Switch for efficient heat transfer, in "F" or "C ".) • Dewatering assembled and preset at the strength, and durability. SP ECIFICATIONS factory. ■ Motor Cover: Thermoplastic Goulds pumps is iso 9001 RegMe FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/4" maximum. ■ EPO4 impeller: Thermoplas- m Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: u to 3i feet. um ota p pump out vanes for mechanical • Discharge size: V/2" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104°F (40 continuous 140OF (6(601,C) METERS FEET ) intermittent. io • Fasteners: 300 series stainless steel. 9 30 ., • Capable of running ~` dry without damage to $ zs Fr t components. 25 A 7 Motor: s • EPO4 Single phase: 0.4 HP, 6 20' 115 or 230 V, 60 Hz, 1550 5 RPM, built in overload with automatic reset. a 4 EPOS • EP05 Single phase: 05 HP, a 115 V, 60 Hz, 1550 RPM, s built in overload with EPO4 automatic reset. z - • Power cord: 10 foot 5 _ standard length, 16/3 i S)TOW with three prong grounding plug. Optional 20 0 % io 20 3 4o so GPM foot length, 16/3 SJTW with three prong grounding plug 0 2 4 6 8 io 12 m'/h (standard on EP05), CAPACiTv Goulds Pumps ITT Industries ®2000 Goulds Pumps <& Effective February, 2000 B3871 q u ick4 � STANDARD CHAMBER Quill Standard Chamber 48" __ f (EFFECTIVE LENGTH) C--] e SIDE VIEW SECTION VIEW MuffiPort End Cap 16" 1 � l _ AL No SIDE VIEW TOP VIEW FRONT VIEW call rR1 Uii MOM M i-�Ivlwt lr�,Un-jtfli N om ina l 96111call i 12" '34 W X X 52" X 12 Size Size x Cx'�i S Effective Li 48' Invert Height 8' or 1.25' Invert Height 8" jNjjLMjQR _Sy M -i LIMITULWA-RRANlY $j"_JN_Q, STANK) (al 7na stfo local integrity of earti chamber. en j {slate, wedge and other aCbe,—I'V hol-t-liured by fill I 'Lli when install and "Ps"a"id C %. instill is �arwtaf � the ow-a P-Grialloor 'il Cell in a leacnifield of an onsil alplic system m acOml man hill FA t — — hiatil and lorkma,simp for one year i "Ie Call Mail the aPolc F-lind -- --'J h� th- serl(o` sy " ) the Unis. ( - ­lded. howal chat I : ' a Sepal p b W requved to apiplicarta law, the warranty period will i ion In, date inill insisiatiorl line soll sysienn cornilleni -1 jsl no I T 10 egol as wal'T-Ity ';q'As H, tq IbiltalT.111—t-ni fifteen 0 City, of Ithe ofell too , supply Jn'ls in, Units by 4 olil 0 be Cowed by this Lil vva'Fanty. Al infill I s infiltrak9sillalholitY 5 def, tkok the Cost of .0m �.! ardit., installation 01 the Unit,, OJHF. F1 ANTIES WITH RESPECT g. ti,) T'IELIM[rr-VYVARRANTYAN.-)Fia,4F.�-SINSL;13PARAGRAPH, ,,,)ARt- 1:X0LL)SlVt JlJF-RCAnEtji I'M �SU. SYSTEMS INC TO THE ll NUILIDiNG NO iMPOEDOVARRANTIES01' MERCHANTA01-t OR FITNESS FOH A PARTC�Jl PUl (i I lus Urnited Wati shall be void it any Da d of Fite Chamber system 6 than dal ov it vol oln..lr than ;iitti The i Wanal does not e:r!end In ana ll Cr q dol Enlifokonmeral o nsi t e wastewater Solutions' irvAl "."etwel spatsal or indirect damages. Inil shot not om liable lor i ncluding loss, Ol pool and Droll si and materials, 0% CM , 01 01ror l o s ses a i Holder $os i a ny Call ,a by the Hol r a a t hird twfy Spoi V e,,cowfed from boreal W,.rranty coverage w l e da to the Units due to ordinal West al WT, afteral '01), irc4l rnisuw abusc or nal of If* Units; the Units tong subjecti to � ti n, other Conditions which arf i permilleo 0y IhR 11`11;�,ailal lnoqttjchons; ball to maintain the 6 Business Park Road - P.O. Box 768 mirimu',t i covers Sal forth in tho;nalffigion iratirUCtil the p�acal Of ifnicloril malai.as into the system ountanoi Units: failure Of installation third a 11 a i due to i l the septic syslari improper improper ailing improper r sizing, t;s, wale. i d ;ve a Impro;cel grease di or improper oparal OF Old Saybrook, CT 06475 ;,,y other ervent hot cal by Infiltrator. This Limited 'P&�rahty shal C�, �[d it no e Holder fools to roon0i with all Ol terms set " in this Limited -577-7001 V'.'a'ty e ce 860-577-7000 - FAX event Ia for any C- c, damage . Hold., th, tints, Or n i wolinU from allation or Ship. Or li any p,.d.,t fall "I [HOUaro,artylinwopany 800-221-44 36 -On alt site conalt— racti by state and local "Je&, all othoo apwcabio .3w,%,,jr0 toll Nn raprasor:lalivC of UUJImW: nac line authority to clwnyn or vxter:o ens Linlilarl Wanaely tJC wananly;yylirav to eny Lary nihnr than 11"y dkdi- nal Holder. The 'i rapoefuntc the Standard ijrntl Warranty offered by Infilloratoir P. of in.rhijeo of slates and ",Ofitas nal ddfae,,t warranty iaq.he- "nonis. Any porchastifir o(i should contact Nitral Col i4eadquanews in -Xid Saybrook, Conrial i to suoh;xwcil is obtain a copy of the app':Cabifa wwarly, and should carell lead that wahi i to ti purchase Units. lcoler!s, Canadian Patent$: 1,329,969; 2,004,564 Other patents peni nii-LralLx,EqLlaGZerdW, a trademarks System, linc. Infiltrator is a ri;42tarold tradenik in Fiance. Infiltrator Systems Inc NrCYCLED Pi - ---1, it 0- (�—vn- Contour Swivel Connection, Wfol-eal PaYTul Snaipl-ock ChambetSpacil Posit-ock, Quicki Outickli "I' I \ SOIL EVALUATION REPORT Page 3 whsconsih Department of Commerce Division of Safety and Builds in accmdance wgh Comm 85, wts. Adm. Code Attach complaw site plan on paper not less than 81/2 x 11 inches in s¢e- Pion must include. but not limited to' vertical and horizontal rolarence Point (BM), direction and Patoel I.D. percent slope, scats or dimensions, north arrow, and location and distance to neared road. Data please prix ap irdoraudbrt. R PersonW kdormation You Provide may be used Law. x.15 Property Owner KIC Lot 5hl 114 /llE1l4 S f1 T 29 N Rig E( 81odc # Subd Name or C%* Property owner's IAddress %D Mo L nd V) nj C S4Q 5 state Code p ❑ (RTawn Nearest Road c 2� New Construction Use 1 Residential i Number of bedrooms Cade dared design flow rare y. GM Replacemerft ❑ Pubic or commercial - Describe: Food Plash ttievation i7 applicable ft. Parent materiel 6 () �AJ Q — "� kl Q BZ a ,s 1-e v, � 93. 5 5-0 - nom � P"f -i` n' s 9�ya ` U Boft # D &wing Ground surface elev. Depth to ornittrmg factor —' -- in. E& Pit ff- Eff1*1 Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ff1f2 b - lo r� gi I 2 v�r C 1 a Si CI 2 c- C`j (O 5 S i �l ZmSbK r4r j # ❑ Boring 9 121 " Owing _ d in. r� 47 a � pit Ground sutiece elev. _... _ fL to Sol Appicallion Rate .Horizon Depth Dominant Dolor . Redox Description Texture Structure c ons - Ma nce Boundary Roots GPDIff in. Murtsep t1u. Sz. Cant Cobr Gr. Sz. Sh. •EW •Eit#2 Ov r ,3) J Si mg CS v -C . J Z 12 -40 I S� e_l 225b r C5 -- �l 7.5 s 2ms rnfc �s `f m� - 7 Z • Elituent #1 Bop j > 3o 22o mgA. and TSS >30 150 mg/i. - Eftmnt 02= BOD c 30 mglt.and TSS <_ 30 mglL CST Number CST New (Phwae Print Q aAawx G Data Evaluation Conducted elePhtxhe Numb Address �� d n ,,/ /. sy oz /z— i —dZ 71S -,?Y7 � . Parcel ID # Page 2- , Property Owner ® # ° Boring Ground su elev. - ft In i� ( J in. Sol Rate Redox Desadpti� Texture Structure Consistence Roots GPD11P 4D" Dar►inent Color Gr. S7- Sh. 'Etf#1 'Etf1�2 MunseY tlu. Sz Cant Color IQ 31-3 2 Iv mS s ❑ ' # ❑ Booms ❑ round,suriace elev. ft. Depth to 9 factor m• Pit G Sol Rate t Color Redmc Description Texture Structure Corte Boundary Roots GPDM Hor¢on Depth Dominan 'EffIF1 'EW2 in. McrnseY Qu. Sz. Cont Color Gr. Sz. Sh. EE-- Holing # ❑ Boring Ground surface elev. tt. Depth to Coming factor in. ❑ Pit Sol Rate F Horvon Depth I Dominant Color Redox Deediption Texture Shuck" Consistence Boundary Roots GPDll in. Munsefl Qu. Sz. Cant Color Gr. Sz. Sh. `Efi#1 Eff#2 * E&Mt #1 = BOD 30 S 220 mgiL and TSS >30:5 150 mglL ' Effluent #2 = BOD <_ 30 mglL and TSS <_ 30111911. The Department of CO(nrneMC is an equal Opportunity service provider and employer. 608- 2 1ifyou 1 e TTY 6 nce to access services Or need material in an alternate format, please contact the departmen s SBD41330 (R.07MM PAGE - 3 OF 3 f T N NAME: (�i e �r LOT # LEGAL DESCRIPTIONS 1/ 4 /4 �l S L Zq qE or , / ( ) SCALE: 1 ELEVATION: A m / - /0 0 . y BM I DESCRIPTION: BM 2 ELEVATION: �`j �( Q e c BM 2 DESCRIPTION t SYSTEM ELEVATION: 9 3 SG SYSTEM TYPE: 00 ✓l U e Y\.-11 a ,1 °L v At t 1 n -b 6 � � �0 �R SIGNATURE:- G7 '` DATE: DOCUMENT NO. + ) WARRANTY 8EE1 9OQ 4d, [ A ' : / STATE OF WISNNSU —FORM 9 TUN SPACE U=V FM ZWOKDM DATA �el00" -6 TMS INDRNTURE, Made by Leonard J. Beer, als 1- tL_GIS OFFICE known as Leonard Be er, a si ngl e man ST. CROIX CO.. WIS. Recd for Record t`)is_6th _- grantoc of St 1✓roix County, Wisconsin, hereby conveys and warrants day of_ Ap_'_l,.l--- __A.D.19_YO to Richard L. RPer and Phili ppine 11 Bear hnchan at -_ $OD __ _A M, and wife ac mint tenants RsR sr i s grantee s — OETOtO TO Of St . — Croix County, Wisconsin, for the sum of One Dollar and other va11iah1P consideration the following tract of hand in St ('r o i x County, State of Wisconsin; The Northwest Quarter of Section Two (2), excepting therefrom: Commencing at the Northwest corner thereof: thence South 159.6 feet; thence Easterly 40 chains to a point on the East line of said Northwest Quarter (NW4) which is 121.3 feet South of the Northeast corner thereof: thence North to said Northeast corner; thence West on the North line of said Northwest Quarter (NW to the point of beginning: also The Southwest Quarter of the Northeast Quarter (SVd4 of NE4); the Southeast Quarter of the Northwest Quarter (SE-'r of N14), except a parcel of land described as follows: CommencinP at the Northwest corner of said Southeast Quarter of the Northwest Quarter (SE4 of NW4); thence East on the North line thereof 815 feet to the place of beginning; thence South 33 feet: thence East 100 feet: thence North 33 feet: thence West on the North line thereof for 100 feet to the place of beginning; also an easemen for roadway purposes 20 feet wide on the Vilest side of said excepted parcel; also a right of way easement over the roadway as now traveled in a Northerly- Southerly direction over the Northeast Quarter of the Northwest Quarter (NEZ of NW4), all in Section Eleven (11); all of the above located in Township Twenty -nine (29) North, of Range Nineteen (19) West. also The Southeast Quarter of the SouthwestQuarter (SE4 of SW') of Section Thirty -five (35), Township Thirty (30) North, of Range Nineteen (19) West. Sub'ect t y k �d * � ��y„ fi t � x 1++'�L„ y 4 : f+ � �It � i �S '�' i.y; � ` � ' �� r u{p i i s Q • r°L .y i i : 1 r { I •H w ? T• +� F � Y,� •t - `�' •''c �VIYM.� � r L`�.�`x s _ '�•''n r.: : �` > wk�' ♦ sw:i ' -; - + t � . to ,:•1'b .;.t ,{}j ]( x", � r � y "• r 1 4 e " • j s 4 '"s � � � j � �i S � F � • � 'r t:.' '_ X ��. �° y � c• .X �f, a {i z � r� Y �. k?r".j4av ":y... - r� l %t _ •A 'v � � A ,�' �� .�' + v .. +- Sri'; � J �� �:�� ,•, ; �,�• r �. � ♦x k'c i its '� �F .yQy� ,�° i ::�p Y "w•.: � �? t•`iw•„�. .�� .. ;., r r Y ;�' ; - t' I ' " .�` L. k 'lCh, >•".' W. i F. s f d ''+" f 7" - •a - .. r. ; Y > r Y s .: a•, :.>�' 3 lN" K Y _y � —'.Y' At :'gw �w�TiFr + - i .7 a ���• {kai14' �3 . a.�.s k S' t > ec M M � � } ' r d a' � f t. tt t t i T4 n C s V U : It P Y ( s � F� yC k 11 re :.f Y' Yr i Y