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HomeMy WebLinkAbout020-1470-04-000Wisconsin Deiaa!tment of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Gansen, Chris City Village X Township Hudson, Town of CST BM Elev: Insp. ~~ BM Description: C _ C7 TANK INFORMATION TYPE MANUFACTURER ~~~ CAPACITY Septic / ` ~ /Z/ T Aeration Holding TANK SETBACK INFORMATION TANK TO ~P/~^ WELL BLDG. Vent to Air Intake ROAD Septic Z 7 ~ ~ ~Z 7 5b • Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain L Dist. to well S[lll ~RSnRPTInN SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 514968 0 State Plan ID No: Parcel Tax No: 020-1470-04-000 SectionlTown/Range/Map No: 24.29.19.2987 STATION BS HI FS ELEV. Benchmark ~ • t~~ /Ql • ,/C~ Alt. BM (~ ('~ /O b~ t'GV c~tb ~6. /157• Bldg. s er ~j'.a 97.3 7 St/Ht Inlet (p.3 ~'~ • SUHt Outlet ~ •'J ~ • ~e o Dt Inlet ~~ 'y Dt Bottom _~ ~~ Header/Man. ~ g3, ~S J Dist. Pipe `I~`~3 g3.ar Bot. System /a• 73 7 ~Z • ~` Final Grade 5.3 ~ ~~ /~ St Cover BED/TRENCH DIMENSIONS Width / ~ Length '~$ No. Of Trenches '7 ~ K~ ' V L+ G3 ~ ~ PIT DIMENSIONS ~ No. Of Pits ~-- Inside Dia. ~ Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG E L L W LAKE/STREAM LEACHING CHAMBER OR Manutactur ~ ' ^ /~.~• / P7 Type Of System: vZw~'-1' ~ 1 L /~ ~ ~ / ~~,/ UNIT Model Number: ~~ ~ ~ ., DISTRIBUTION SYSTEM Eggj~-- GG-I•-GC -_ HeaderlManifo}d ~~ C Length J Dia ~ Distribution Pipe(s) \ \_ ~ Length Dia Spacing x Hole Size ~ x Hole Spacing _~ Vent to A' nt~ ~ra, a ~-+ c C(]II C[7VFR ~ Y D.n«..rn C~•c4umc Anly YY Mn~.nr1 nr D4-(,radP SvStBIr15; OnIV ~K/' Depth Over Bed/Trench Center ~ ~ i3 Depth Over - Bed/Trench Edges ` xx Depth of Topsoil `~~ xx Seeded/Sodded L Yes L;<3il No xx Mulched ~~es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / udson, WI 54016 (NE 1/4 SW 1/4 24 T2 Lane Location: 839 Wyldwood Wyldwood Ridge Lot 4 9N R19W) Parcel No: 24.29.19.2987 ( H c ` l ' ~v'~'~ ~ ~ ~ ~ ~ 5 •~ 1.) Alt BM Description = t ~^ ~ 2.) Bldg sewer length = yZ / `--~ ~,,,, / « 5~ fela5 d~ ~ o.~...~.e~'+~- - amount of cover = ~ o +~ Plan revision Required? [~a] Yes ' ' No ~ Zb Use other side for additional information. ~! Date Insepctor's gnature Cert. No. SBD-6710 (R.3/97) ~' GommerCe_tui.gav Safety ~ ~ 2 W County ~ 01 . Was ngton ,~~ ~ ~ ~~~n~~ ~"~ Madi n, WI 53707-7162 (to be tilled in by Co.) Sanitary Permit Number Qepartmerit ~ t:omtnerce ~ Q S f ~ ~~ L, Sanitary Permit Applic t1UII State Transacti n Number o / ~ ' ~ In accordance with s. Comm. 83.21(2)_ Wis. Adm. Code. submission of this orm tcBtTiet3'~ili(i~j~9~Fr}tnental / ~/+ unit is required prior to obtaining a sanitary permit. Note: Application forms f~ti+tr~~WTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you prow, u oses in accordance.vith the Privacw Law. s. 15.04(1 (m). Stats. ~ ~~ ~ ~ ~ ~~, t. A lication Information-Please Print All I r ation Property Owner shame / / Parcel # - aZ0-/Y o„ 04 -rs~ Properh~ Owner's Mailing Address Property Location / Z ~$ C ~ O Govt. Lot Cit<. State Zip Code Phone Number ~ , ~,. / , -~ ~f /a .~1~ /., Section -6~~-F s ~ - 7 trcle one T~N R~E ~ It T f B : o . ype o m ding (check all that apply) Lot # ~ 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # d - ~' ^ Public/Commercial -Describe Use ' ~- ^ City of ^ State Owned- Describe U s e CSM Numbe Z 1 ~ ~ ^ Village of / ~ _ ~ f ` ~ ( Town of t C..G e.~ LZ'~ Z Z Q ~ III. Type of Permit: (Check only one b on line A. Complete line B if applicable) A. ~Ne~System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner --~`/ ~ ~~_ IV"_ Tv e of POWTS S stem/Com onentlDevice: Check all that a Iv f Non-Pressurized In-Ground ^ Pressurized in-Ground ^ At-Grade ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersallfreat ent Area Information: f Design Flow (gpd) Design Soil Application Rate dsf) Dispersal Area Required (st) Dispersal Area Proposed (s System Elevation V'1. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ~ ~ o v & . New Tanks E i ti T k ~ x n¢ s an s ~ / r~~ / _ / _ ~ o Y ~ v y D r iL C7 ~ n C / r U ~ y v~ , Septic or Holding'T'ank ^_ / Dosin_~ Chamber i ti ti. Reapo sibilih Statement- I, the undersigned, assume respo sibilit y f o r installation of the POWTS shown on the attached plans. °i::-n8~ "_ . amc ( int) ~ ~ Plumber' , ign re , / ' ~ MP/MPRS Number Business Phone Number (.~/ " ~ ~ ~ /5 ~ S~ :~ . ::r~s : ddrss ( tree _ City, State. ip ode) ./ / ~°~ ~ 111 ~ountv/De artment (Is nl \rrm~ ed sapprove Permit Fee $ ~~ ~ Doate 1 ~s7u/ed ~Q Issuing nt Signature ^ wr,e en Reason for vial ' p G1A UO - 1.\. C.onditu-o~~~MnrnvalQ2easons for Disapproval f / // 1. SeptMic~t3aWnklYEefRFl~UZmt filter and v dispersal cell must all be servk:es /maintained as per management plan provided by plumber. 2. AU selbackfequitemen~ must be maintained Attach to complete plans for" the system and submit to the C"ounh~ only on paper not less than 8 I/2 s t t inches in size ~~~ ``~:'-`_ ~~ R. 01 '0-) Valid thru Ol/09 ~~~ /~ f~~5 ~~'f~ie /~ r~ ~,~r~s ill-a~q~- l ~~i_/~s- ~- 3X9 °5~`~~'~S, ~o~g ~ ..~ ~caly~ ~t3 A ~s- / ~; ;, .i = .~ s~, -C .~~~'~ a= ~'~.o.s~,,,1 %~ /~~ ~.~'~;~ i~ ~K l~~r~s i~~~r~ I G~,~/~- ~- .3X9 ~~~~~s. ~o~~ ~ ,~d ~r~c~1 ~!~ ,~ ~caTu( ~!; ~~ ~s- / P ;, ~ = -~ s~. _~ ~~°~s a= Wisconsin Department ofComm~~~--,+"+"'SOIL EVALUATION REPORT Page~,of~ Division of Safety and Buildings ~~~,Jp.aoeervance vwrn t,omm aa, vws. rwm. ~.oae COUn ty Attach com lete site lan on er not less than 81/2 x 11 inches in size Plan must a p p p p . indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all ie~formation. Revi by Date Personal information you provide may be used Law, s. 5.04 {7j (m)). S Z('p (~ Property Owner P perty Location ~ ~ G vt. Lot 1/4 1/4 T N R E (o Properly Owner's Mailing Address ~ L # Blodc # Subd. ame or CSM# d Ciiy State Zip Code Ph OFFICE C' ~-la a Town Neatest R d riY ^ 9 Z , New Construction User Residential / Number of bedrooms Code derived design flow rate lP~ GPD ^ Replacement ^ Public or commercial -Describe: Parent material s:~T l~Tt/ Flood Plain elevation if applicable tt. General commentss and recommendations: Si~~ / Boring # ~ Boring pit Ground surface elev. ~ ft. Depth to limiting factor? ~ ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl? in. Munsell Qu. Sz. Co t. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ? s ~ -S~ e c, q 9 Boring # ~ Boring pit Ground surface elev. _~~. ~ _ft. Depth to limiting factor y~ in. Soil lication Rafe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell (]u. Sz. nt. Color Gr. Sz. Sh. *Eff#1 *Eff#2 - ~,- ~ d ~ J ~ t ~+ '~ J y / R 9 ,_ --. 4 9 ~ P Efti nt #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #Z = BOD < 30 mg/L and 15S < 3u mg/L CST Na ase ~ _ Signature CST Nurr>ber ~ , 1 Address Date Evaluation Conducted Telephone Number ,~ ..,,., ~,~~ m,,..~.,,, Property Owner l ~~~~/ Parcel ID # Page ,~ of ~ Boring # ^ Boring ® pit Ground surface elev. _~_ ft. Depth to limiting factor ~/~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f1Q in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 4 P r1 ,f ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etl#2 ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 a 220 mglL and TSS >30 ~ 150 mg/L * Effluent #2 = BODE a 30 mglL and TSS < 30 mglL 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 (R.07/00) Property Owner (_~ S ~ .~ ~:a~ Parcel ID # Page ~ of t~ J i t~ 1~ Boring # ^ Boring ®pit Ground surfaoe elev. ft. Depth to limiting factor zJ ~.~ in. , - Soil A licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl? in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Etf#2 j ~ p I ~1 /1 q I ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor rn• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eif#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Sure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 * Effluent #1 =BODE > 30 < 220 rr>gll.. and TSS >30 < 150 mglL * Effluent #2 = BODE s 30 mglL and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and~employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sao-aaso (re.mroo> ,~ ~~^^• S lp~JS~iJ ~~I7S' .i.~.s J, ~~ ~~~ 5..5'33 7 -/~ / ~s ~~ !d0 ~3e~'3 i"5'N.OSa„I -f-- _ __ ~,~,;~,.~.~y t---------- _ ~~ aj ~1~~~~ ~~ ~a ~ se,~l.E~ .~~ ~®~ ~ ioy~ ~~~ z~~ ~~ --~-___ ;~ 1 ~-___ ao ~~ ~ "~ v ~~ v ~~ ~; 'r, ~~ ~L~ N \~~rf V I V ~.~ ~ ~~ z .~ ~v ~ (~ ~ II II -~ ~ ~' ~ II ~ Y7 1J L ~ ~ > C~ ~ p ~ o U w N C •~, ~tT O l~ ~ ~~ Ci i ~ ~ ~ ~~ ~ ~~ ~~~ ~ ~ ~ ~ ~ ~ a ~~ ~~ o ~ ~ r O "~ o ` > ~ ~ ~ ~~ i ~ ~ ~ ~ ~t S? 4 ~` ~~~ ` h. J _ . . f 1 /~ ~ 11 0 ~ ~ a v o ~ v, . l~ If Q U 0 Li.. II~ ` ~~ •\ I .r rt ~ ~ ~~ . ~ ~ •. ~.' , ~ ; .~ , ti ' ~ .... . , • . ti ; '"` ~ • t ~ , r .. • • ~~ b; j~' ~~~ ~, . • .. , . ~ ~ ;~ .. ~" . C ~.' '. ~ •: ;. .•, - .. ;, r~'~~• .~~ ,.. ~- . .J 0 ._ L 2 Q1 S G .~ 43 O b 0 1.. a a O -~ Q 4 C V b Q 'q V 5 G O V U .~. c~ N a 'a. v ~~ l ~ .~ ~ ~ L D II v ~ - Q) ~ ~ ~ ~ o > .' o Q! . ~ ~ ~ _ ~ , ° o ~ Q~ ~ N ~ ~ p i . i ~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of FILE INFORMATION i < r 4` Owner ~ ~~" " Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ~ Nq Estimated flow (average) gal/day Design flow (peak), (Estimated x 1.5) ~ gal/day Soil Application Rate gal/da /ftz Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) <_30 mg/L ~ Biochemical Oxygen Demand (BODS) <220 mg/L ^ NA ~ Total Suspended Solids (TSS) <150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODS) <30 mg/L Total Suspended Solids (TSS) <_30 mg/L ~ NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size %8 in dia. ^ NA Other: ^ NA "Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~ gal ^ NA Septic Tank Manufacturer ~ ^ NA Effluent Finer Manufacturer - T ^ NA Effluent Fitter Model _ j ^ NA Pump Tank Capacity al -Cl~IVA Pump Tank Manufacturer ,~'NA Pump Manufacturer ,~}.NA Pump Model I~NA Pretreatment Unit NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dispersal Cell(s) ^ NA ,t3(In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once eve ry' ^ month(s) ~ ear(s) (Maximum 3 years) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (%) of tank volume ^ NA !aspect dispersal cell(s) At least once eve ry' ^ month(s) ~ year(s) (Maximum 3 years) ^ NA Clean effluent filter At least once every: ^ month(s) ,~ year(s- ^ NA .'ns~~ect pump, pump controls & alarm At least once every: ^ month(s) ^ year(s) NA FiusEi ~ate-als and pressure test At least once eve ry' ^ month(s) ^ year(s) NA ~ v-Jrer~ At least once every: ^ month(s) ^ year(s) ^ NA OtJl,er.' ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined .accumulation of sludge and scum in any tank equals one-third (%3) or more of the sank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of _<12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event START UP AND OPERATION Page ~of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) 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 highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore. normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • 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 POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will 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. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a fast resort to replace the failed POWTS. ^ The site has not been evacuated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER / Name Phone ~ ~-- ~~ S- POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ! f Phone ~-, ~ ~-~, This document was draft;=_~ `- ~_-c ance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. START UP.AND OPERATION Page ~of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell{s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shat( not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one Large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain {sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • 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 POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, .lot lines and wells. Failure to protect the replacement area will 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. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement .area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Phone ~ l S- SEPTAGE SERVICING OPERATOR (PUMPER) Name Phone POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Name. Phone S~-~ This document was drat;=~ '- ~_-.:.Nance with chapter Comm 83.22(2-(b)(1)(d)&(f) and 83.54(1), (2) & (3-, Wisconsin Administrative Code. sT. cROix covlvT~r SEPTIC TANK MAINTANANCE AGREEMENT Owrtet/E t..tLr~l Mai{ing Property (Yariticatioa tl^gttired tt~ota Ptaattittg Dep~tttnent for aew eatfstittaion> City/State ~La~~n lL}..~- Parcel [derttific~tion Number LEGAL DESCR1PfiON ~: Property Location`/~ ~~ Y. Sec.,~T~N•R~W, Town of ~~ II~SC~ Subdivision~'L~~ ~~~ : ~G ~ Lot# ^~ Ccrdfied Survey Map~# , Volume Page i Warranty Deedll L~ , Voiume Page Spec house yes ~no Lot lines identifiable yes no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result iu premature failure to handk wastes. Proper maintenance consists of pumping out the septic tank curry three years or sooner, if needed by a licensed pumper. What you put into the system cart affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St Croix Zoning Department a certification form, signed by the owner and by a masterpiumber, journeyman plumber. restricted plumber or a licensed pumper verifying that (1) the on- site wastewater disposal system is in proper operating condition andlor (2) after inspection and pumping (if nt:oessauy). the septic tank is less than I/3 full of sludge. Uwe. 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 th Department ofCommerce and use the Department ofNatural Resources, State of Wisconsin Certification stating that your septic system has been maintained must be completed and returned to the St. Crojx County Zoning Otiice within 10 days ot'the three year expiration date. ,. NATURE OF APPLiCAI+IT ~/>3~e~ SATE OWNER CERTIFICATION f (we) certify that all statements on this form are true to the best of my (our) knowledge i (we) am (are) the owners} of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. f~~~~ SIGNATURE OF APPLICANT 8~~~~~ DATE •••••• Any infomntion drat a atiuepreseated nt•y result in the >•rtitnry permit beitt~ revoked by theZoairt~ DepRme~••••• •• tncluda with this apDliwttaa ri sgrttpeA wamnry deed ~ the Resiuer otDeedt- offtoe . aoor of rue certiiled stuvey trap itroferettee is tattdf is rue warr.aty deed. AND OWNERSHIP CERTIFICATE FORM ~~ ~:~ ors ~~ ~~i~t o `~~, ~ ~~~ s~ena+as*swlrae„ IDY BRR~ --,~ I.0T1 ~ ~ ~ ~ ~ ~~ ~ ` ~ \ _ ~~ ~~ ~~ aoam+i co~mrw.~ro~: W+~j,pW,~D RIDGE LOCATED !N PART ~ THE NEI/4 OF TIG: StYI/4 AND p~ PART OF THE sET/4 ~ ~ sqn/4 of S~ECT~i 24. TzsN. Rt9iY, TDNIi ~ HI~~1. ST. CROIX CDtRr1Y. iNSt~IS41, BEING LOT 4 OF A CERT~D SIA2bEY iiAP NI Vpi.LNtE M18, PAGE 4764 AT THE ST. CRppC COUNTY REGlS1ER ~ 0EfD5 ~{CE. .:~ r ~~/ , i //~/ ~ '~~/~ ~ 1(090 ~a~'iwr°'Rier ~ ~r~q~11[ N • v<~~ ;s1~'~.r..~ «~~..K..a..~~ m •.~..m....~. ~~ ~ RO~Im'Y~~o' ~~ Mas.w'ierp ~E b ~ tia ~ ~i l/ / / I. ~~ i i ` ~ / /J, /~~~ / /'/~ / /~'~ ~ - i~ / ~. ArcIMS Viewer Page 1 of 2 http : //www.l andinfo. co.saint-Croix. wi. us/website/LRPortal/ State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number U Docwr-ent Name THIS DEED, made between Steven A. Jacobson and Laura A. Jacobson, husband and wife ("Grantor," whether one or more), and Christopher N. Gansen and Susana Riveaa ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Propel'tlr') (if more space is needed, please attach addendum): Lot 4, Plat of Wyldwood Ridge in the Town of Hudson, St. Croix County, Wisconsin 84c'9~IttZ1 xATHLEEH H. IiALSH REGISTER OF DEEDS 5T. CRdI}t CEt. , MI RECEIVED FQR RECORD 01/22/2087 10:10A?l MARRAHTY DEED EXEMPT # REC FEE; 11.00 TRANS FEE: 517.59 COPY FEE: CC FEE: PAGES: 1 Reco~ing Area Name and Return Address River Valley Abstract & Title, Inc. 1200 Hosford Street, Suite 201 Hudson, V/I 54016 File #: 2b92081 Part of 020-1066-10-100 Parcel Identification Number (PIIV) This is not homestead property (16) ~I B nOt) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of--way of record, if any. Dated January 'r bet'N ,_007 (SEAL) AUTHENTICATION Signature(s) _,,,p< authenticated on ,.mot ~~ ~~~~n~~ ~,~G~ * ... O TITLE: MEMBER S1~'1? BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Attorney Doug Berg Not Public, a of Wisconsin 1200 Hosford Street, Suite 201 Hudson, WI 54016 My ommissl is permanent) (expires: -' ) {Si~uahves may be anthenticaled or aclmowledged. 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. 1of1 ~ (SEAL) aura A. Jacob on ACKNOWLEDGMENT STATE OF WISCONSIN } ss. St. Croix COUNTY ) Personally came before me on January , 2007 the above-named Steven A. Jacobson and Laura A. Jacobson, husband and wife tq,me known to be they~rson(s) who executed the foregoing ~ ~~~^'~~ ~ ~ ~ a SNOLLVl13'13 s~sf ~a m~~'maiAx"` ~ 3~N30 Sad N3SNHJ N.: ,, ,. 5~i~+~~~f~ S3WOf-I Nb`W12fd1-i ~ g ~ ~.~,~~,~~,~ dO1d31X3 o _ '1`•~~~ '~9iud° °tJ3OlIf1B ~~ ~ ~ '1~31'021d 91111133H9 .~. f g~ ~ 4 p4~°tl oeruskwd 8 8 8 ~sruckWe _ 9 `~~ 4~s~f;~~$ m'~~'° ~"~~ ~ ~ ~ a ~~w~•,o,~~wd, SNOLLW1313 ~ Lfl ,s ,~~~~ S~WON N\fW1?1dU ~ ~ ~ 3~N3aIS3fi N3SNFFJ aO1d3.1X3 m - ....A9IBRDX111116'®A@30 ~101~ lOl~U ~ j° SE;a° ~rsavne 8~ y n `1J31'OMd 3'LLI1133H9 8 s _o ~o ~' o~~~~ ~~ ~~ ~~~~~~ go ~a~ ~g~~p¢p ~~~z~'2 ,row ~m g !! ..oww.w~w.wew t~~~ eC~ oei-us6Wa ~4 ,..... js~(E~~~~ owrsw I~r~ E~Elf a$ mi auie •xowrum 1 - ,~g,~~~~ S~WO{-l N1>YV12{d(-i ,,... j°R9::ae ~mmme 8 $ a ~ ~~~,•~,~,~., NVId aooi~ ~ K ~ ~ 3~N3UIS3a N3SNtlJ ~3n31 a~ N ~ aOJA91B1I0%31Y6'~fY213p11Igl®Yl y ~ '1~7fO2:ld •311111.33119 ~`ay~; ~~-u~skWe g 8 ~° o.~...,e,,..~~„»~ 4~~~~$~3` m ~~"~"»~ a ~ ~ ~ „•~,~~ N'd'Idl~OOld ~~•~- ;-~i~~~~ S~W04-1 NHW.L2lb'{-I K ~ ~ 3~N3UIS3d N3SNVJ TdA31 NNW m gg iRf4~B1!®311B'~~tllllOlBlCI >a~~ (~ ~ib1e r~l~~ ~ ey o ~I~~L~d '3111 L~Hg ~ 1 Wisconsin Department of commerce IL EVALUATION REPORT Division of Safety and Buildings ~ ,~ Page 1 of 3 al n~ m ~nnn oa, vv~. Hain. ~.wa COUr~y St. CTOIX Attach complete site plan on paper han x 11 inches in size Plan must include, but not limited to: vertical and ri l l . zo ference point (BM), direction and Parcel I.D. Q Z percent s ope, sca e or dimensions, north anon a_nd distance to nearest road. .,..... 0- Please print _.._.,. C~ ~ r ll JnfCf7~pactc~T.~~'~~? R by Date Personal information you provide may Ue used f r secondary purposes (Privacy Law, s. 5.04 (1) (m)). ~~- • f y, Pr , rty Owner r s ,.' Ir ~? +, P party Location r LG~~ © NE 1/4 SW 114 S 24 29 N 19 E (or Property Owner's Mailing Address U h ~ r~urvr•~ F I^ o., ~~ 1 sued sM# ~~ 846 Badlands , _ ~ ~ _ ll ~ _ __ 4 .~ _ ,~ ~ _ ~ ~ ~~ City State p Phone um r Village • own Nearest Hudson WI 54016 ( ) Wyldwood Lane 0 New Gonstruction Use Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Replacement a Public or crommerdal -Describe: Parent material Loess Over' outwash sands Flood Plain elevation if applicable ~ ft. General commerrts and mm_endafions: ' ,, This site is suitable f~ a below grade conventional system (-DT-4~ oc?~i~ S^ Gc ~~.''~lrvr- ~ vbc,. `f ZaD 1 . ~/ t4 Boring # ~ Q Pit Ground surface elev. 99.56 ft. Depth to limiting factor >100 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GP D/ft° in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •Etffil •Eff#2 1 0-7 10yr3/2 - sil 2msbk mfr as 2f .6 .8 2 7-30 1 4/4 - sicl 2msbk.. mfr ~, if .4 .6 3 30-37 7.Syr4/4 __ st lfgr mfr cw - -- .4 •7 4 37-100 7.Syr4/6 - s Os ml - - .7 1.6 2 Boring # ~ ~~ 98.54 >100 Pit Ground surtace elev. R Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Desoription Texture Structure Consistence Boundary Roots GP DHF in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •EigE2 1 0-8 10yr3/2 - sil 2msbk mfr as 2f .6 .8 2 8'20 1 4/4 sicl 2msbk mfr cw if •4 .6 3 20-29 7.Syr4l4 - is Osg ml cw _ .7 1.6 4 29-100 7.Syr416 - s Osg ml cw - .7 1.6 'Effluent #1 =130D > 30 < ~0 rnglL and TSS >30 < 150 mgJL • Effluent #Z = <_ 30 rrrgtL. and T55 <_ 30 rrglL CST Name (Plegse Print) Signature ~~- CST Nurr~er Thomas C Nelson ~`"'°'"" 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 9/27/05 715-246-2454 Property Owner Steve Jacobson Parcel ID # Pending 2 3 Page of _ 3 („~ Boring Boring # ~ Pit Ground surface elev. 98.11 ~ Depth to limiting factor >100 in. Soil ication Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GP D/fl~ in. Munsell Qu. Sz. CoM. Color Gr. Sz. Sh. "Eff#1 `Eff#2 1 0-12 10yr3/2 - sil 2msbk mfr as 2f .6 .8 2 12-26 1 3/2 - sicl 2msbk mfr as if .4 .6 3 26-37 7.Syr4/4 - is Osg ml cw _ .7 1.6 4 37-100 ~.Syrd/6 - s Osg ml - - .7 1.6 Boring # ~ Boring P8 Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Boats GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#'1 `Ef#k2 ^ Boring # Boring Pit Ground surface elev. ft Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eft#2 'Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mglL • Effluent #2 =GODS < 30 mglL and TSS < 30 mglL 'The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access serv%ces or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBL)-8330Test (8.07/00) .'R(.ilie ~ w s ~~ BM1 TOp of iron pipe 100.00' BM2 Top of iron pipe 98.6Z' 8198.66' BZ 9a.64' 83 9a.~t' NW lot corner lfiomae Neteor~ ~ z~~7 Steve Jacobson roe a i 7OlIN Of 8GD8'ON A A PRELIMINARY PLAT OFt WYLDWOOD RIDGE LOCATED IN PART OF THE NE1/4 OF THE SWi/4 AND IN PART OF TH6 $E1/4 OF THE SWi/4 OF SECTION 24, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. SlCTION 44, T28N, RtBW roru aeu . sssao aoess ZOM~D A0/11q O 2 tV ~ ~ O W c.1 x W `_" ~ ~ ~ M...y f1.Magy. ~ /~ / ~~M~I ~% ep0 ,: •._ ~'a'n~c ~e~are w8fema°",va wrs~ m°N.em,r rA. au w~ m~m~r A ~ n°Na m sa°VPpA°is a niYOS "osauw~ o m s"ssa~"r amain iwawmas N ~_~ cunve rae~e~ ....« IItlM YMM fffAO f.,....f..f~.,,> aw«....,~, ,...a ... ~..ne na.a T.n,Mlb fOHf'0ff Tmf.nlM f.apHN LEGEND B s[anax aa~ r • roue t• ands ouunai fnu rrc s .afro >- «~ a~ ~ ..~ m rouio sµ• sans -._--- ,s Bros unnT asom/r . _ susos+o fev~ac car ~~~» 'Aarcel #: 020-1470-04-000 12/31!2007 11:50 AM • PAGE 1 OF 1 Alt. Parcel #: 24.29.19,2987 020 -TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/28/2006 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -GANSEN, CHRISTOPHER N CHRISTOPHER N GANSEN C -RIVERA, SUSANA SUSANA RIVERA 13204 ELM LN BURNSVILLE MN 55337 Districts: SC =School SP =Special Property Address(es): ` =Primary Type Dist # Description ' 839 WYLDWOOD LN SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.678 Plat: 11-001-WYLDWOOD RIDGE 020-06 LOTS 4!6 SEC 24 T29N R19W PT NE SW WYLDWOOD RIDGE Block/Condo Bldg: LOT 04 ' 06) LOT 4 (3.678AC) ( Tract(s): (Sec-Twn-Rng 401!4 1601/4) 24-29N-19W NE SW Notes: Parcel History: Date Doc # VollPage Type 01/22/2007 842980 WD 06/10/2004 765505 18/4769 CSM 07/23/1997 2000!329 WD 07/23!1997 955/586 more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 205416 100,000 Valuations: Last Changed: 06/05/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.678 91,700 0 91,700 NO 05 Totals for 2007: General Property 3.678 91,700 0 91,700 Woodland 0.000 0 0 LOtter~! CreC~lt: Claim Count: 0 Certification Date: Batch #: Specials: ' User Special Code Category Amount ' S ecial Assessments S ecial Char es Delin uent Char es Total p 0.00 P 0 00 9 0 00 4 'L ~ S133HS ~ 30 l 133HS dlva o3oaoo3a ~.nsnoln3ad ( ) 3dld NONI a313Wb'IO 301S1n0 „b/l-! 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''JNIA3A2lnS ONt/7 N '8 S obo'soF" ~ as-sa b log a3lHt2 ~r svlono0 s><s'os~ oo•s s lo-I 6£ 4'b L l Z9•Z Z lOl :a0A3AfiA5 8L£'88 £O'Z l 10~ -ld 'bS S3aOt/ ~ X0'1 9404SIM'NOSOnH OVOki SON`dlOV9 948 3~ev1 V3a e 10~ NOS800~f!'vanv,'83/t.31S 'NISNOOSIM =ao~ aaatid~aa :I.LNl100 X/OtlO 1S "NOSa()H j0 NMOl %V16G~/ "N6Z1 ">yZ NO/103S d0 6/LMS 3H1 d0 ~/L3S 3H1 d01Mb'd N/ ONb' >y/tMS 3H1 d0 t'/L3N 3H1 d0 ltJb'd N/ 031b'007 ddw A~nans a~~~~ia~~ ~~ ~'~ Parcel #: 020-1066-10-025 12/31/2007 11:47 AM PAGE 1 OF 1 Alt. Parcel #: 24.29.19.254A-10 020 -TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/10/2004 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O - LOWNSBURY, CHRISTO PHER M & EMILY E CHRISTOPHER M & EMILY E LOWNSBURY 846 WYLDWOOD LA HUDSON WI 54016 _ _„ . ~ . Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 846 WYLDWOOD LN SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.030 Plat: 4769-CSM 18-4769 020-04 SEC 24 T29N R19W PT NE SW CSM 18-4769 BlocklCondo Bldg: LOT 1 LOT 1 (2.03 AC) ~ ~ /4 0 ~ ~1~. ~ ., ~~ ~ ~ ~`L~ ~ Tract(s): (Sec-Twn-Rng 24-29N-19W ) 401/4 16 1 ('~ ~ ~~~~ ~`' Notes: Parcel History: Date Doc # Vol/Page Type 09(12/2005 806178 2886/431 EZ-U 12/21/2004 783066 2719/196 WD 06!10/2004 765505 18/4769 CSM 07/23/1997 2000!329 WD more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 202718 412,200 Valuations: Last Changed: 06/05/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.030 85,100 292,900 378,000 NO 05 Totals for 2007: General Property 2.030 85,100 292,900 378,000 Woodland 0.000 0 0 Totals for 2006: General Property 2.030 85,100 150,800 235,900 Woodland 0.000 0 0 ~Otter~/ Credit: Claim Count: 1 Certification Date: 06/09/2006 Batch #: 06-OQ Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSM ENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 000 00"0 sa6aeya;uanbu!laa sa6aey~ le!oadS OO~LZ ;unouab 1N3WSS3SSb' ~`d103dS iUo6a;e~ a OO~LZ lelol ~ ` ` s;uauassassd le!oadS JNI~O.lOd2~-860 apo~ le!oadg aas~ :slei~ads :# yole8 :a;ea uo!;eo!;!~a~ 0 :;uno~ ua!el~ :~Ipa.l~ /~Jai~o'1 0 0 000'0 puelpooM 009`0L£ 00L`90Z 006`£96 61L'1Z ~(~ado~d Ieaaua0 :LOOZ ao; s!e;ol 50 ON 009'0L£ 00L`90Z 006`£91 61L 1Z 1J ~`dIlN~41S~2i uoseay a;e;S le;ol anoadual pue~ saaoy sse10 uo!;d!aasad LOOZ/90/90 :pa6uey~ ;set : SUOI;StI Irz/~ 006'b0b 81b50Z :y;!M passassb :an!eA;a~~eW ~!ed :# II!8 J121t/ININfI$ LOOZ -~a~ow L5£/89L 1661/£Z/LO 985/556 L661/£Z/LO 4M 6ZE/OOOZ L661/EZ/LO WSJ 69Lb/81 905S9L b00Z/01/90 ad~l a6edlloA # ao0 ales :tio;s!H laoaed :sa;oN MS 3N M66-N6Z-bZ ~b/1091 b/10b 6u~-unnl-oaS) :(s)loe~l ~O`d6 L" Z) l l ~90 ) 9010 :6PI8 opuo~PloolB 1 L ~ 9 O ~Jal?~ a00MOlJ.M MS 3N ld M612~ N6Zl bZ OAS 9/b S10~ 90-020 ~Jal2~ QOOMa~.IM-100-11 :leld 61L'LZ :saaod :uo!;dlaasaa le6a~ 011M OOL 1 dS NOSaf1H 1192 OS ab SaNdlab'8 9b8 x uo!;d!aosaa #;s!Q ad~Cl ~(~ewiad . , :(sa)ssaappb ~(}~adoad IeloadS = dS IooUaS = OS :s;o!1;s!4 910b5 IM NOSaf1H a2~ SaNtJ~adB 9b8 NOS90~`df d d~lfld~ '8 d N~n~1S b d~l(lt/l '8 b Ndnd1S `NOS8O0b'f - O ~au~rp-off ~ua~~n~ . ~ 'aaunnp ~ua1~n0 . p :(s)aauMp :ssaappy xel 0 00 9002/8Z/£0 ad~il 3!uaaad #;!uaaad # uo!;eo!Iddy eaay sales # deW a;ep leouo;s!H a;eo uo!;eaa0 NISNOOSIM '~11Nf100 XI02~0 '1S X ;uaaan~ NOSaf1H ~O NMOl - OZO 686Z'61'6Z"bZ ~# laoJed 'llb~ 6d063Jb'd wv 1b~11 Looz/1s/Z1 000-90-OLb~-OZO ~# la~aad