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Parcel 038-1039-90-000 12/19/2005 11:17 AM
PAGE 1 OF 1
Alt. Parcel 9.31.18.170C 038 - TOWN OF STAR PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - HEILMANN, PETER J & MARGARET M
PETER J & MARGARET M HEILMANN
2227 100TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 2227 100TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE
SEC 9 T31 N R1 8W NW SW 1.5A LOT 1 OF CSM Block/Condo Bldg:
V 4/1027
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
09-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/20/2001 654306 1703/120 WD
02/05/2001 637979 1583/144 WD
07/23/1997 1191/500 WD
07/23/1997 1064/507 TD
2005 SUMMARY Bill Fair Market Value: Assessed with:
118860 191,100
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.500 29,400 158,400 187,800 NO
Totals for 2005:
General Property 1.500 29,400 158,400 187,800
Woodland 0.000 0 0
Totals for 2004:
General Property 1.500 29,400 158,400 187,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 153
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Si. O.Li Counq, Planning mid 7 nuin
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
. Sanitan.y Penmit
State SeptX.el,-2
Township St. C~col x County
Iiti1Yt
S 40 Sec con Lot # Subdi vils-con
PTIC TANK
Size r` gaUons Numbers o6 eornpantments r
!Stance. Atom: wett Buitding 1.20 4tope
Highwaten
(MPING CHAMBER
Size gaUon4 _ ,Pump Manu6aetuhet- Modet Number
JLDING TANK
Sizegat-eons Number o6 Compa4tment4
Pumpers - Atan.m System
(stance. Oom: wett Buitding 120 4Xope
Highwaten
;SORPTION SITE
Bed Tneneh
+ titanee 6hom: Wett Building M 4.eope
Highwaten
,;SORPTION SITE DIMENSIONS
Width o6 taeneh At Requtined area 6t
Length o6 each tine 6t Depth o6 rock below tite ~n
Numbers ob tines Depth o6 rock oven tite kn
IotaX Xength o6 tines At Depth o6 tite betow grade .4.n
Distance between tines At SXope o6 tneneh in. pen 100 At I
- y
f u(.ua ~Lsv)Lpt•-'on area- At Type o6 Cove.,e: Paper on straw if DIMENSIONS
Numbe.n o6 pits GtaveX around pits yes no
Outside. diameters At Depth beXow inlet At
TotaX absorption area bt
AnLea tequiked 6t
,vSPECTED BV TITLE
1'PROVED DATE 19 8
t JECTED DATE 1 8
iASON FOR REJECTION
State and County State Permit # 7
P-LB 67 Permit Application County Permit
for Private Domestic Sewage Systems County ,,ezc
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
J41 /A/ A "0% A "Z/z5ZZ
B. LOCATION: '/°_SIZI Section , T N, (or) 6L Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family _ Duplex No. of Bedrooms No. of Persons
D.
SEPTIC TANK CAPACITY WOO Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber./OTotal gallons Prefab concrete .I_Poured-in-Place -Other (Specify)
E. EFFLUEN DISPOSAL SYSTEM: Percolation Rate ~ Total Absorb Area sq. ft.
Nev, Replacement Alternate (Specify). .4, Sul.'' 0/.5r ~zx!!'r d ~5,w ~/V~,►l~Cc+~v4,)
Seepage Trench: -No. No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Length -s-3 Width -Depth 0, Tile depth (top) e No. of Lines
Seepage Pit: Inside dia,m~o Liquid Depth No. of Seepage Pits
Percent slope of land I . Distance from critical slope `
WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Cert ed Soil T ter,
NAME (rlitirvc'S C.S.T. # and other information
obtained from (owner/builder).
X
Plumber's Signature MP/MPRSW# Phone # ,SJ
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
-
F
F
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application o~
Fees Paid: State ~ , County C~ D~je ' ~ ~v
Permit Issued/Rejected (date) g 'c;1?o? r 10 Issuing Agent Name .CJ
_.A_No State Valid# Date Recd
Inspection Yes
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. Plumber (canary copy) Revised Date 7/1/78
.111111111h- A
Plb. t-A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES
Division of Health
Section of Plumbing & Fire Protection Systems
ON-SITE WASTE DISPOSAL INSPECTION REPORT
Name of Premises
Street City County
Master Plumber Address
Owner Address
❑ County Permits ❑ Appropriate State Permits
Type of Building: ❑ Public ❑ Single Family or Duplex
CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM
❑ Building Sewer ❑ Conventional Soil Absorption System
❑ Septic Tank ❑ Conventional System-in-fill
❑ Holding Tank ❑ Alternate Mound System
❑ Seepage Bed ❑ Holding Tank
❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System
BRIEF, FACTUAL COMMENTS AND SKETCH:
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❑SEE ATTACHED
DISCUSSED WITH PLUMBER 1 ► Yes ( ► No SIGNATURE (Voluntary)
DATE OF INSPECTION
Signature of Inspector
White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party
EH 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:,/YL '/4, L? '/4, Section ,T.; LN,RA 0 (or) W, Township or Municipality ~T 3X. /?s
Lot No. , Block No. _ County ( )
kl V
' ub ivision Name
Owner's/Buyers Name:
Mailing Address: 1
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW_REPLACEMENT ALTERNATE SYSTEM U - ~ OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS~5~ PERCOLATION TESTS -~l 32
SOIL MAP SHEET -{f%I NAME OF SOIL MAP UNIT /4,22~ _C,4A1-0(_j y2' `l
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
RATE
NUM- SINCE HOLE HOLE AFTE INTERVAL
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
jJ
P- 1 0
P- 1~ t >
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- - S
B-
- - S
B- T 7,2
B-
B- -
B- - 5
PLAN V IEW7 (Locate percolate n tests, soil bor holes and suitJ~le
areas.) Indic
ate on the plan4the~ locali9n and square feet of suitable areas.
Indicate number of square feetiof absorp~a needed for bype and occupancy -aGs~ .Indica scale or stances.
Give horizon land vertical refrerence points. Ir icate slope.
17
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I, the undersigend, hereby certify that th soil tests reported on this form were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my /
knowledge and belief.
Name %print) /el Certification No.
Address
Name of installer if known ih
Copy A -Local Authority CST Signature - _
State of Wisconsin ` Department of Industry, Labor and Human Relations
SAFETI` I SION
Bur lu y 4ting a Protection
P.O 79
T0: NI n, w 4
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Plan Identification No.
Gentlemen:
Re:
The Bureau of Plumbing, Platting and Fire Protection has reviewed plans,
site survey information and installation details for the construction of
an alternative private sewage system to be installed at the above-mentioned
location. The plans and specifications were prepared by
and received for approval on
The soil and site evaluation was conducted by
. The site meets the soil
an site requirements sped ied in c H 3, Wis. Adm. Code, for the use
of
The proposed system is for a
. Wastes from the building will discharge to a
gallon capacity septic tank which will discharge to a gallon capacity
pump chamber from which a pump having a capacity of gallons per minute
against a total dynamic head of feet will disc-~ arge through a inch
diameter pipe to the soil absorption system.
It is of utmost importance that the system be installed in complete accord
with the plans and installation details and the conditions of approval con-
tained in this letter. The licensed plumber responsible for the installation
shall notify the county inspector when the installation of the system will
commence so that the county inspector shall be able to inspect this instal-
lation. The installer shall not deviate from this approval and shall follow
the directions or orders issued by the appropriate local or state authorities.
DILRH-SBD-6159 (N.7/80)
1
In accord with ch. 145, tats., and ch. H 63, Wis. Adm. Cone, the plans and
specifications are approved contingent upon compliance with the stipulations
Indicated on the plans. Please review your cede for the requirements of
each code section noted.
The architect, professional engineer, registered designer, owner or plumbing
contractor shall keep one set of plans bearing the stamp of approval of this
department at the construction site.
If the installation of this system has not commenced within two years from
the date of this letter, this approval shall become void and new application
shall be made for approval of these plans before work may commence.
in granting this approval, the Division of Safety and Buildings does not
ld itself liable for any defects in plans or specifications, plan omissions,
examination oversight, construction or any damage that may result in or after
installation and reserves the right to order changes or additions should con-
ditions arise making this necessary.
This approval is based on ch. H 63, this. Adm. Code, requirements. It shall
be necessary to obtain and fulfill the permit requirements of the county in
rich this installation is to be constructed. Failure to obtain county
permits will automatically void this acceptance.
Sincerely,
Ja s Sargent
Bureau Director
JS:JP: s
enc.. c,cures
tee.: JWS
1b. 106
r' Plan Identification No. V S
Construction Inspection of Alternate Design Sewage Disposal Systems
Wisconsin Department of Health b Social Services
Section of Plumbing b Fire Protection Systems
Owner's Name
Mailing Address
A. Site Investigation at onset of construction
1. Name of Installer
2. County 5-~- Croix Inspector ML, Date
3. Package`
4. Preliminary onsite made by Date
5• Depth to limiting factor (50% unconsolidated rock or estimated ground
water level)
6. Percolation rate
County installation permit number
8. Are percolation and soil boring holes evident? Yes No
9. Is system located in area of soil tests? Yes No
10. Is system located in area shown on state approved plans? Yes No
H. Ground slope in area of system
12. Site data is correct as presented by C.S.T. and system desiqner? Yes
K K
No
B. Inspection of Construction
1: Disposal site plowed and properly prepared? Yes No
2. Disposal site conditions wet or damp? Wet Damp Dry
3• Type of fill material
4. Depth of fill (I' Minimum)
5. Is a crawler type tractor used? Yes No
a. Blade Bucket
6. Has site been driven on by any vehicles? Yes No
If yes, explain
7. Trench width as indicated on approved plans? Yes No
8. Trench spacing as indicated on approved plans? Yes 1Jo
9. Have trench bottoms been properly leveled? Yes No
10, Trench length and number as shown on approved plans? Yes No
11. Distribution piping proper diameter? Yes No
12. Holes in distribution piping properly sized? Yes No
13. Holes in distribution piping properly spaced? Yes No
14. Holes in distribution piping in a straight line? Yes No
15. Distribution holes drilled straight into piping? Yes No
16. Depth of gravel below distribution piping
17. Depth of gravel above distribution piping
18. Thickness of marsh hay covering
19. Permanent marker at end of each trench
20. Depth of fill over center of system
21. Depth of fill over outer trenches
22. Side slopes
23. Type of fill used above trenches
24. Depth of top soil
p
25. Seeded? Yes No If no, has mulch been placed over mound?
Yes No
C. Pumping Chamber i`
1. Diameter of inlet
2. Diameter of outlet
3. Head
4. Size of pump tank gallons
5. Draw down or oallons pumped per cycle
6. Manufacturer and type of pump same as that indicated on approved
plans? Yes No If no, indicate Mfg. and. Model f of pump used.
4r
7. Quick disconnect provided? Yes No
2
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8. Diameter of manhole
9. Height of manhole above finished grade
10. Diameter of vent
11. Height of vent above finished grade
12. Pump tank located as shown on approved plans? Yes No
D. Septic Tank
1. Properly installed? Yes No
COMMENTS
1, the undersigned, hereby certify that the questions were answered
on the basis of my personal inspection or knowledge of the construction
of this alternate system and further that all data and answers recorded
on this form are correct and to the best of my knowledge and belief.
Name: Signaturr-:
Title:
WE HAVE INCLUDED TWO COPIES OF THIS FORM FOR COMPLETION BY YOUR OFFICE.
WHEN INSPECTION OF CONSTRUCTION IS COMPLETE, ONE COMPLETED FORM SHALL
BE RETURNED TO THIS OFFICE WITHIN TEN (10) DAYS AFTER YOUR FINAL INSPECTION
OF THIS ALTERNATE SYSTEM.
Date received by Section of Plumbing & Fire Protection Systems
3
b 100a 12/78
Detach And Return Upper State of Wisconsin
DIVISON OF HEALTH
Portion Of This Form With SECTION OF PLUMBING
Any Return Correspondence " AND FIRE PROTECTION SYSTEMS
~ MAIL ADDRESS: P, O. BOX 309
MADISON, WISCONSIN 53701
608-266-3815
DATE:
PROJECT:
PLAN ID. #
DETACH HERE
PROJECT NAME PLAN ID. #
This is to acknowledge receipt of your plans and specifications for the above-indicated project.
Preliminary review indicates the plan review fee required is $
❑ Plan accepted for review. Fee received is $
Fee is being returned because of ❑ Overpayment ❑ Underpayment.
Providing one of the two catagories above is checked, remit correct fee in one payment.
❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance.
❑ Plans being returned.
❑ Additional information required. SEE BELOW.
1. Plan Submission
❑ Additional information shall be submitted in triplicate unless specifically noted.
❑ Plans not clear, legible or permanent.
❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2) (a) Wisconsin Administrative Code.
❑ Affidavit enclosed.
11. Alternate sewage Disposal Systems (Mound Systems)
❑ PLB 108 (Application for use of an alternate system).
❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution
❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate.
III. Private Sewage Disposal Systems
❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides.
❑ Elevation of permanent reference point (benchmark).
❑ Location of area suitable for replacement system - provide soil test data.
❑ Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc.
❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast.
❑ Construction detail and cross-section of soil absorption system.
❑ Soil boring and percolation test on EH 115 completed by certified soil tester (1 copy).
❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed.
❑Deed restriction required (1 copy).
IV. Holding Tanks
❑ Profile of holding tank
❑ Holding tank agreement signed uy owner and local unit of government (sample: enclosed).
❑ Reason for installing holding tank soil test or statement from county (1 copy).
V. Lift Pump
'ECaICUlz:t"on- '0 utai 10 r ,::.!mp di ,th& !!':c'ad oallom pumped G ~ .ycl;3.
__J Size, 4.-ngth & depth of force main.
E-1
❑ Detail & model of pump or automatic siphons including size, t utnp cl, v and averoge flo rate GPM,
( Cross section of lift pump tank showing hump(s) or siphr'n
VI, Systems in Fill (Fill must be placed prior to plan submission)
t--j otai area filled ?fill to extend 20' beyond edge of trench heir s,(<e ;in
-1 rep`h and type of fill.
;__i Copy of o h.ite repoft by county or el, r3
l._ Length of ;:r.e ?`i1i has beE n in place.
REPORT ON INSPECTION OF SANITARY PERMIT # .;29*V 1
(1) Name and A dress of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
Name, ress, 1cense o. o ns a ing Plumber
i
3 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
(4)BENCHMARK:(Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity:
Tank Inlet Elevation: Tank Outlet Elev:
# ft to lot or property line: # ft to well:
(7)DOSING TANK: Manufacturer: # of gallons:
# of gallon pump set for a cycle gallons; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑ YES ❑ NO Wired? ❑YES ❑ NO
;
8 HOLDING TANK: Manufacturer o gallons
construction depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: ft width; ft length; tile depth.;
lineal feet tile; ft to residence; ft to well; ft to lot or
property line; ft to ordinary high water mark of lake or stream; ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ft.
11 SEEPAGE TREN H: Total length of seepage trench ft; width ft;
tile depth ft; ft to well; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
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LINDSAY BROS. CO. '60044 5 4
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2 highly efficient models-SV25A (1/4 hp) and SV33A (1/3 hp) pro-
SV SERIES vide maximum drainage at lowest operating cost in effluent, septic
tank and sump service.
• Low initial cost.
• Unique Mercury Displacement Switch (Pat. Pend.) is designed for
S U B IM E R S I B L E over 1,000,000 cycles of trouble-free service.
• Non-clog vortex impeller, with back pump-out vanes, handles 3/4
SUMP PUMPS inch solids, lint, sand and gravel.
• No screens to plug.
• Heavy-duty, oil-filled motor, with thermal overload protection, pro-
vides superior cooling and bearing lubrication.
• Rugged cast iron or bronze motor housing.
• Heavy-duty, long life lower ball bearing absorbs thrust load and
minimizes friction.
- • Sintered top sleeve bearing assures alignment of rotor and stator.
- • Spring-loaded mechanical seal for long, leakproof life. Durable
- carbon and ceramic faces.
• Bottom suction prevents build-up of debris in sump.
• Easy to install. Automatic pumps are shipped ready for operation
after attaching discharge pipe and plugging in the cord.
Strain-relieved power cord seal prevents power cord from being.
14 pulled out of housing.
• Completely field serviceable. Stainless steel fasteners facilitate
I field repair after years of service.
• Choice of automatic or manual units in cast iron or bronze. Also
f.- available with Mercury Displacement Satellite Switch.
t
28
Electrode
s t- 24
Displacement w S~/33
Core LL 20
z
Mercury p 16
a 3V 5
Permanent Z 12
Magnet
0 8
~ 4
OFF ON
0 5 10 15 20 25 30 35 40 45
MDS Switch Is Simple and Reliable U.S. GALLONS PER MINUTE
The sump float raises the permanent magnet into Head-Capacity: SV25 and SV33 Submersible Sump Pumps
the proximity of the displacement core which is float- Max. Solids 3/e" Sphere; 4 Pole, 60 Hz.
ing on mercury. Magnetic force pulls the displace-
ment core down and forces the mercury up to com-
plete the electrical circuit with the electrode. As the Capacities Heads Solids NPT Motor
water level is drawn down by the pump, the action is Model to to Handling Discharge hp
reversed, breaking the circuit.
SV25A 34 gpm 23 feet inch 11/4 inch 1/4
SV33A 44 gpm 25 feet 3/4 inch 1112 inch 1/3
`Specify automatic or manual, cast iron or bronze.
Lindsay
Product Model
Number Number Description
582336 SV25AI 1/4 HP 115V Automatic Pump
582301 SV25MI 1/4 HP 115V Manual Pump
582344 SV33AI 1/3 HP 115V Automatic Pump
582352 SV33MI 1/3 HP 115V Manual Pump
189