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HomeMy WebLinkAbout020-1100-40-100 onsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix fety and Building Division INSPECTION REPORT Sanitary Permit No: 514806 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: Lutheran Social Services Hudson, Town of 020 - 1100 -40 -100 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No f CO lb M 1 GS 34.29.19.402i TANK INFORMATION , ELEVATION DATA TYPE MANUFACTURER " ✓ CAPACITY STATION BS HI FS ELEV. 1 Septic — r.....— I ■ O dQ Benchmark 03 , 16).63 /DID P ���,� Alt. Bilk , - c , G . S. b9 � y la k SZS "�' Aeration Bldg. Sewer Holding St/Ht Inlet I. 99.133 St /Ht Outlet TANK SETBACK INFORMATION G "5/4' 91 S7 TANK TO P/L WELL BLD Vent to Air Intake ROAD Dt Inlet 1 ``" , cc. _ BLDG. Dt Bottom ,, Septic , / L9 Z y Z7 Dosing Header /Man. /b 46g go, 95 Aeration ( Dist. Pipe / °'�`� 'a —■><''/ r/. t Y �3.a 1 7. (o Holding Bot. System �} er b c...) Final Grade l5 1 9 �/ " 33 PUMP /SIPHON INFORMATION (, 7 T Manufacturer Demand St Covel Ca �� ?, (01 9 , 7 � 31 / Model NWn er ---- / b J4-L. T, 11. SI $9. TDH 1 It if Friction Loss 'System He. • 1TD ` Ft )Z + '31 Z � Z \ .I Forcemain N,I.Bngth _ DJ Dist. to Well '00 0 r 3 ' . 4 ! 67 v4,, n SOIL ABSORPTION SYSTEM /W BED /TRENCH Width / Length i No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 I ' 3 4� cLA `' y �' SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: .., g. /1 rte, -, INFORMATION CHAMBER OR -i- Type Of System: ' i UNIT Model Number: (_ G D v� JG r 0 rM1G3C. /05 �D f Q 1 Gl� t-1/ DISTRIBUTION SYSTEM A 61 ZZ 4- zz-i-ZZ (eta `-04,k Header /Manifold , Distribution x Hole Size x Hole Spacing Vent to Air Intake , Pipe) ..---- _ A. � 4......_ 4......_ ? + '� V. Length 144 Dia 7 Length s Dia Spacing � •t> ,s►/'+ -- SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center g (,{. Bed /Trench Edges Topsoil ■ '`'..4,,,..- Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 698A Baker Road Hudson, WI 54016 (NE 1/4 NE 1/4 34 T29N R19W) NA Lot 3 h0 4 Parcel No: 34.29.19.402i ie 1.) Alt BM Description = 'Au 2.) Bldg sewer length = CNt& - � 1 Va►iu{ i ntall.e TYa le46 x 3 (42(1 a- - amount of cover = I Plan revision Required? I a Yes >eNo 17— L.{, 6 "I ' 1.100 G Use other side for additional information. i Date Insepctoq. Signat 1 SBD -6710 (R,3197) ,r: . 1?epiaLernerl+ commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 .37- C is co n s n Madison, WI 7 - Sanitary P ermit Numb ( / Eo be filled in by Co.) Department of Commerce d J � 5 J/ g y State Transaction umber /``�`//'' Sanitary Permit Applicatioo In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate gove unit is required prior to obtaining a sanitary permit. Note: Application forms for state - owned POWTS are Project Address (if different thanmailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. r o.pp � 1. Application Information - Please Print All Informs ' RECEIVED P n*ee � l .,,, S � , ""�� j Gdriiii/ Propeny Owner's Name # G1fo►r e0"" ••y 4 tars iel sscri'L. - r.5.edre.4 fs yy as oi' Property Owner's Mailing Address NUV 2 S 2007 Property Location 3 /2. 0 ' . e- idtvr -,A E✓1t!'!if? /lr ■ Govt. Lot — City, State Zip Code Pale Nth LOUNTY A , A _ y« //,, y,, Section $( — ZONING OFFICE (circle one 'f' RAN CL a.+.z 5- y 7 p/ 7 /S-- vs T 7 N R/7 E of z,1 If. Type of Buildin (check all that apply) Lot # 0 RI or Family Dwelling -- Number of Bedrooms 3 Subdivision Name • V404,12,, Block # . ❑ Public /Commercial - Describe Use ❑ City of CSM Number ❑ State Owned - Describe Use ❑ Village of sown of 6J it' 5) b;54-(; baf .` o,,` Cad Ill. Type of Permit: (Check only one box on line A. Complete line B if a p -" //a,)-'70-/o 44 licable) ®n • A. ❑ New System Lr1 R / an System ❑ Treatment/Holding Tank Replacement Only I Other Modification to Existing System (explain) . a 044. s.7: 9 1-3 ivywpCGS – of 9,11;6 r B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner /77J - „ - 1 -/.d.4J'j <usfJ l7 IV. Type of POWTS System /Component/Device: (Check all that apply) N�on- 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 (expl. - . ❑ Pretreatment Device (explain) V. Dispersal/treatment Area Information: t3o/ cf( / 4 Cam/ /s /.3 A / Ced 5E+ / = (44 aeAtTZE, ' ----, Design Flow (gpd) / Design Soil Application Rat _ • • - . - - . ' equired (st) Dispersal Area Proposed sf) System Elevatilrn C -1 = 92-- Q c - `r • 89.s c—.2.., 9 /• - , � Qj '� . r . 7 • . /r c--5 .y . P C- 3 a - 0. VI. Tank Info Capacity in ' Total # of - • ufacturer o o Gallons Gallons Units v .o V yy 7, �' .., v u ., New Tanks Existing Tanks / .- 'W.. %I c .3 8 (.77' 2 A L( Loa S'ZJ U in rn W A. Septic o°aldiog Tank r 000 / Food .OAP 3- male/ -- 4Ge t - ____7 J D � es: , CI.....L r /PR d1-0 - VII. Responsibility Statement- I, the undersigned, assume responsibility for installa n of tie POWTS shown on the attached plans. Plumber's Name (Print) Plum. • is Signature / MP /MPRS Number Business Phone Number ,./7ilv f 4 Ty i yt GP. /.6 ' 70a2 Plumber's Address (Street, City, Stfite, Zip Code) t ' - p D 7773 /Zd (L.z/v . t �✓ AY). S - 0oA) X, ,� '5o / c�tf 715 Y <6 VIII. County/Department Use Only / / A PP roved ❑ s' ppro Permit Fee Date kssued Issuing Ag ignature ❑ 0 � s yen Reason for Denial / � ( , IX. Conditi weasons for Disapproval 1. Septic tank, effluent fitter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained Attac r to corn ple p ar s o he system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD - 6398 (R. 01/07) Valid thru 01 /09 N 5 ZCAA4 4 / ra. ea II(W /09,0W D47 ( /4re . Celli ® /.° /, ,,' s /ire ir+!<ries 21.5-• 7 673 c4i hers /9./ S e Ads 6 s :g Gott . y 6'MnL • (. 2 c/rcr aims /9 67 -3 / . s� G� �' or 16 ®ose /e- �/ FOGERTY PLUMBING & PERK TESTING 2473 Rolling Green Rd. Spooner, WI 54801 1427 #3 (715) 468 -7000 Cell (715) 416 -0000 r0otto- / . ?tic. qt, /MP �/ 2 7 A = Aw- "or., 7 j/y ',vc r -/ 99 9-r =04, 4 ,40 s7 f / t) /r t9F0 fgt. we'd 5.T. = p r w,E'GL ( 3) 0 QZw,etx w o WIsLL `1 pt • i c s • 1111111111111111111111 � x tom I eg.ealvr vili, Ae r s A-( Y �crEll � I a -). t 0 / tyre AO' 1 ,6ST `,v/er 4 1 EAST LW" Lzwx\ f > Ate' J !omit N . . 1 FOGERTY PLUMBING & PERK TESTING 2473 Rolling Green Rd. Spooner, WI 54801 Ao j +e3 (715) 468 - 7000 Cell (715) 416 -0000 ' .Cefto, / v -= t ,zz / /fl f7 --;;:- C ' II- / = got. ®/ $' s/ fit /NO �� 207 , �' 4 - - = frLT Qom 7p of ly 2),4 Arms", 9y. 9 -r 0 D = B/g' /, 6k/ t oil. can .s T e ° -,....),,070,04.4,. &E s•T 0 = ppr wz'GL (3) O = Arligetarta W= wi4L 4. 3 pT . f 4-.5 I - . , c -�/ I i i c -3 I 1 I' c_.2. e_/ x . Jcvr 0 -. • _W- , #44tE (Vo11 0 Aereiza ` AfosO I c ,car /77syer 4 z —r r•/ - - - -- i Aire. . ( 5)/-47 — Lor 4,ric4e.\ > /Go Ers<3T .J AsvE,rr VAFLVE ii N L W ,S COSIn SOIL EVALUATION REPORT #2086 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service County Attach complete site plan on paper not less than 8 x 11 inches i.e. P n m St. Croix include, but not limited to: vertical and horizontal reference point ( dir ion d percent slope, scale or dimensions, north arrow, and location and ct r Parcel I.D. 020 - 1100 -40 -100 Please print all information. Reviewe y Date /,/ Personal information you provide may >e usecR telVEDs (Privacy Law, s. 15.04 (1) (m)). / /Ltii /a7 Property Owner r w Property Location Lutheran Social Services NOV 1 6 2007 Govt. Lot na NE1 /4, 1/4, S34, T29N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 3120 W Clairemont Rd Suite1.00 ST CROIX COUNTY 3 na CSM Vol.6 PG 1673 City St to Zip Code Phone Number 1 City Village J Town Nearest Road Eau Claire 1 WI 1 54701 i 715 796 - 7023 Hudson I Baker Rd i New Construction Use: Residential / Number of bedrooms 6 Code derived design flow rate 900 GPD 1_ Replacement Public or commercial - Describe: na Parent material outwash Flood plain elevation, if applicable na ft. General comments Conventional system, trnches spaced and depth to code. Sytsem elevation to be determined by designer and recommendations: or at the time allation. 1 Boring # Ground surface elev. 97.00 ft. Depth to limiting factor 1 i n. p 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -24 10yr4/4 none sl fill na na cs lc .0 .0 2 24 -41 10yr3/1 none sil 2msbk mfr cs na .6 .8 3 41 -48 10yr4/4 none sic' 2msbk mfr gw na .4 .6 4 48 -60 7.5yr4/4 none cos osg mfr gw na .7 1.6 1 5 68 -144 7.5yr4/6 none cos osg ml na na .7 1.6 There is 7.5yr5/6 staining of Iron in horizon 4. 2 Boring # Ground surface elev. 97.20 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -12 10yr4/4 none sl 2msbk mfr cs na .6 1.0 2 12 -32 10yr4/4 none sl 2msbk mfr cs na .6 1.0 3 32 -120 7.5yr4/6 none cos osg ml na na .7 1.6 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number David J. Steel __/1..---„_ 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 1699 150th St New Richmond, WI 54017 11/14/2007 715 - 760 - 0347 SBD -8330 (R.07 /00) Property Owner Lutheran Social Services Parcel ID # 020- 1100 -40 -100 Page 2 of 3 3 Boring # Ground surface elev. 88.30 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -12 10yr3/2 none sl fill na na cs if .0 .0 2 12 -41 10yr3/1 none sil 2msbk mfr cs na .6 .8 3 41 -69 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 69 -120 7.5yr4/4 none cos osg mfr gw na .7 1.6 Boring # I Ground surface elev. P limiting in ft. Depth to limitin factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD 5 < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R. 07/00) Steel's Soil Service L 3 of 3 : • STEEL'S SOIL SERVICE David J. Steel Lutheran Social Services 1699 150th St. CST-POWTSM NE1/4,NE1/4,S34,T329,R19W New Richmond, WI 54017 Lic. #248956 Town of Hudson, St. Croix Co. Direct 715-760-0347 CSM Lot 3 Fax 715-246-0318 N 1 = 40' , A = Benchmark Ele. 100.00 ft T PVC pipe , = Alt Benchmark El 99.95 ft 7 ________ 14 lF:- of 3/4" PVC pipe >- 57 kfr- = Borings Boring Elevations B1= 97.00 ft ok/ , -------- _ 97.20 ft bi 4 - e- /4-/e4--- B3 = 88.30 ft B4 = 0.00 ft pt )_____ -- - - - - -------------__ _ ,______ 't \ - 4 , ..- '1, cirf :;715111q & z 4 , q A oz ,c-.4_40mL■ii,....440....1 • V (*I C ler 0 0 , 7 1 ''' 1.. / ._‹. 9 70047._ "t 0 • 9,&-4 '‘'. -. 7 - 2.24z .QC 0 >c CeDe,r3 IP / A& 2-- L - ci, 4 . f 4314) IIP g-k 0 `-\-- c ii i °R) q - ---N- .- \:),,■.\-1/405 0 75 v .r..'XS 0 0 ,,4. 4, /--- I. ; fr-e- '---K- < 0' 100' 200' !.L I.- ` ' �� ) APPROVED 5 , flCTQ51983 .� , V P o06 1 Is' ST. CROIX COUNTY i. ' `\ 60 o '' COMP2EHENSIVE PARKS PLANNING n `1� AND ZONING COAAMITTEE h `` hOU Se (. � \ (4) LOT 1 _' �� 3.46 Acres± 150, 765 S.F.± \ ., \ ^ \ �' N 89 °58'W 577. 35' o • 1 1 351.25' 226.21' " I M 0 • 1 ?--,t. rte" IS r„ I c� N z 6 6 - cr; 1 "♦ �.. L OT 2 O1 • Q ps. 02 Acres+ , r:,, N VI I I. � 131,66E S.F. ±. Q I ^ J U. . �:; � w I • .� < E-- ¢I moo u m N 89 °58'W 571.00' • N d J1 M .E2 IL • J I Q I— W C1" N wl w - 'shed' ZD HI I 'E LOT 3 driveway I-1 ili 7.-. _ 3.58 Acres± < 1 W --rs C7 155,814 S.F.± J I Y ° N W I Q z = in Q. I m - C1 l L.. . ,, M — z I hh. ( (CZI ' 33' 33' N ` • N 87 °25' 30 "W 429.20' :4 °.21'10 "W n NORTHERLY RIGHT -OF -WAY LINE OF COUNT 14280' TRUNK HIGHWAY "N" Y This instrument drafted by James T. Swanson. Vo 1 txn P P /4.1 / Nov 15 07 10:28a FOGERTY PLUMBING 17156355286 p.3 cROH NORTHLAND MLAND PLUMBING. INC. FWC Imo. 715 643 - 2520 Sun. 04 2007 01= 56PM P2 • Northland Plumbing Inc. E 1 556 Stare Road 64 13oycevilJs, WI 54725 Office 715- 643 -2520 Fax 715 -643 -2131 May 24,2007 698 Balers Rd Hudson, WI 54016 Septic System Visual Inspection Type ofsyster : Conventional,.1 -1,000 allon septic to •1_ B p tank, . I ,U00 dry wells. This system was installed in 1979 as per WI Admin. Code, Comm B3 fora 3 bedroom home. At this time rho septic system is functioning properly. but is undersized far the home which Is now a 5 bedroom home. The 1,000 gallon septic tank manhole cover is St grade and does not have n paddle lock or chain to secuee the cover. The cover is ciao broken in One Gamer, this allows ground water to enter the tank. The 3 dry wells observed; 2 were tit/tetloning end the 3' was filled with sand at its Inspection pipe. The 1,000 gallon septic tank at this time was not pumped. Septic rank and dry wells are located proper distances from the house and well. Correctinna to be made: septic tank cover needs to have a now cover and be able to be locked. Well Inspection & Water Test Well is up to and located proper distances ITgtp the septic tank and drainfield. Water sample has been taken and test rosUlts are Included. Recommendations Septic system should be increased to accommodate the number of in this home_ Certification The anacnri cannot guarantee the continued acceptability of he private sewage disposal system due to unpredictable factors, which could later determine the lite or code compliance of the system. The undo i ed can reign not a,rantee the b'u continued aeeet>t+rbility of the private well and water system due to unpredictable factors, which could later determine the llfe or code compliance of the aystcm. Inspectors Sign 2- 67Q$,'r�.-._. 44 License H Type of License held 300V5 VUJ GI'n1 unn, /ri ii , Nov 15 07 10:28a FOGERTY PLUMBING 17156355286 p.2 EW1 .. FOGERTY PLUMBING & PERK TESTING 2473 Rolling Green Rd. Spooner, WI 54801 (715) 468 -7000 Cell (715) 416 -0000 (7 7 /. it rr r! jJ , f f b , , f LsT �3 t iG , , 49.49 6 Ser k- ,r►.tk e/ /'r as /OW' pal 7 ,A, e// J 1r7rileAa+n 0 J 4 irrn -1/te ;knee ' 6; 0 x -/ X r- frees✓ 6o r l itgt / .ff.e / " = yo (r;0r. thne rrwag' . x -3 M p vtr4j ! ivC F t— S'/ o L rr O — t f • � " — - ° .. x - - 1,YP_ ¢ 6 va l , f{a.r4/31: o z 0 pay wELLS 0 6:4, ‘.. of. 7. n, 7 a,z.) • 5.11 J ) !VI r.7. n+l�r1 /e �drl+ rl�.r/y. H 3b v.- nca�s' 7 1P / t crorAtf 4 r 3+. // ,./.14... , „p , :r► .r, 4aei4Lr I)-Scr.r .4 .tom/ 0 CGur. _ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of 2. FILE INFORMATION SYSTEM SPECIFICATIONS Owner L . Septic Tank Capacity - /t'<it� [apt/ e ;fee v� r�5' Sti Tk C p � ga l ❑ NA Permit Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer /fty ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 4 ). ❑ NA Number of Public Facility Units 13 NA Pump Tank Capacity - ga l ❑ NA Estimated flow (average) `pp gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated X 1.5) AV gal /day Pump Manufacturer ❑ NA Soil Application Rate gal/day/ftt Pump Model 13 NA Standard Influent /Effluent Quality Monthly average` Pretreatment Unit 0 NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg/L �n -Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510* cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y8 in dia. ❑ NA Other ❑ NA Other: DNA Other ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other ❑ NA MAINTENANCE SCHEDULE _ Service Event Service Frequency Inspect condition of tank(s) At least once every: El month(s) 3 X1 year(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At (east once every: ❑ month(s) 3 XS year(s) (Maximum 3 years) DNA ❑ month(s) Clean effluent filter At least once every: j fj year(s) ❑ NA ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) Flush laterals and pressure test / At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: r fe c t lit ❑ month(s) fu . At least once every: ❑ year(s) ❑ NA Oher: / i // uc ❑ NA _�tc 0.7 MAINTEN , NCE 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 (Y or more of the tank 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 51 2 months, shalt 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. Page 2 of 2 START UP AND OPERATION 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 cells) 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 Mamtamer 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 safety 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: 13 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 i Cr i • ter :dr at L.r lur Gritf 4fJ7t.r to/a r '" , POWTS INSTALLER . / POWTS MAINTAINER Name Name /Gj XA/LlbryS4X0 Phone ?/S y a ,_ Phone 7ls 79L" seiro SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S/"— cedar 7 pex- 49 x0a, Phone Phone 74 , This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. C CC 0 OS Eo - 2 in a N 0 0.�Y�c� a M ` - QS # m, 0 °° O o a B O OA N O r. 4) 4 so 1 w 'fi gg U 413 1 , 4 O : \ , � ` ` '-. � F` IA 2 ;-.1 5 4 4 _ 0 - ■ �i ' ■ -6 >i - -- -- ;_ - -_ --- v _ ` - Oc,' I .: - O In I 1 ♦ � . - i :__. - - --1 2 !CI 0 i -- '\ �• , ` 1 - Q+ ! � - X34 i s )- .. : . 1 m o - '...�1' t. b _ .. • N 0 ou - M Q ,ti .tom -- � %a ~ _ `' 41 o \ Z s m 0 i • • , . •\ i ''Ili . • - - 4 a 7‘litik 14\ 1 N, * I a 1 � \ = . - .... 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IV1A1N "1 LNAN C1r AtirKEEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 44irffer oN s G _SAAR' Are-a-5 Mailing Address 3470 Gv. zeh. .rkrz� �o� ,d":4e?i .ter s "YA,/ Property Address Zff /r s ,&2\ //c pso.r), cC.�- _ S y�rz (Verification required from p lanning & Zoning Department for new construction.) City /State Parcel Identification Number 010 - / /Po - Yo -/©o LEGAL DESCRIPTION Property Location ,#4 ' /4 , ,r/� ' /a , Sec. 2y , T ,?p N R /9 W, Town of Al -,si Subdivision , Lot # 3 . Certified Survey Map # , Volume , Page # **PO' Warranty Deed # 1f72 9f , Volume /%" ' , Page # /47„7 • Spec house 451011. Lot lines identifiable no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, s igned by the owner and by a master plumber, journeyman plumber, restricted plumber 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 necessary), the septic tank is less than 1/3 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 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 returned to the St Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /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. Numb r of bedrooms 6 (rite SIGNA F APPLICANT(S) - DAT yy' oir /irlr mom"' liarlsPe Att„.446 11 I ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) L 11/14/2007 19:47 7152460318 STEELS SOIL SERVICE PAGE 05/05 c 0' 100' 200' 4 cu W J 1 — (N 5:1.-5'.0°''',.: Vl �' tiy�\ y APPROVED 1 its 'OCT Q 51983 0 C. Q ' 6� ' 0 31 COM ►2EnEN IV PARKS N u�NNIN�i n \ (1‘) AND ZONING COMM11Th In 4 l',51)'4° N evi a l ■ .,�' \ N dr — (p LOT 3.46 Acres± 150, 765S.F.± \ I- N89 ° 58'W 577. 1 1 351.25' a � 6.21 j :):' 6 6 ^ A my -., ai ,� ^ Z I i v 4 t LOT 2 -1 1 a ♦ n - j i i,; r i r i0 � 3.02 Acres_* ° _ 131,6GE S.F.± IN D i Q 1 rl j r` O w �!- G: � ^ ^ w l \ 4 ° `=j • S N 89°58'W 571.00' ~ 0 j —II • + r LL t �O w C j 0 N z 4I j (X d� Z I w j w LJ I ~r i driveway LOT 3 ^ i--j ( ce To `� 3.58 Acres± Q � ( w ' — co 155,814 S.F. ± '" ° kJ.) `~ 0 z j m z ► �% ry Mz -4► I � Di 33` 33' `' N x • N87 429.20' +� NORTHERLY 1'1 "IN 1 TRUNK HIGHWAY This instrument drafted by James T. Swanson. V °1 Lit . 6 pae, /4.12 L - 1 11111111111111111111111111 11111111111111111111111 * 8 5 7 2 4 4 1* STATE BAR OF WISCONSIN FORM I - 2000 Document Number W ARRANTY DEED 857244 KATHLEEN H. WALSH This Deed, made between Michelle A. Sherley, a single person__ __ REGISTER OF DEEDS ST. CROIX CO., WI - -- - - -._- _._ - - -_ -_ - .___ -- RECEIVED FOR RECORD - _ -_ -- - _- _ __ .__ --- - __- _ ___. - - - ___ -." -_- 08/09/2007 10 :2OAM Grantor, and Lutheran Social Services of Wisconsin and Upper WARRANTY DEED Michigan, Inc., a Non -Stock Corporation EXEMPT 1 REC FEE: 11.00 — --_ _- ___ _ — TRANS FEE : 735.00 Grantee. - — _ - - - - - -- PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ _ _ __ County, State of Wisconsin (the "Property ") (if more space is needed, please attach addendum): Part of the NE 1/4 of NE 1/4 of Section 34, Township 29 North, Range 19 Recording Area 1/ West, St. Croix County, Wisconsin, described as follows: Lot 3 of Name and Return Addres, t'�'""' Certified Survey Map filed July 2, 1986 in Volume 6, Page 1673, as ed Hakala - T� Document No. 414046 EXCEPT part to St. Croix County in Vol. 1004, Lu ran S • Services of WI and Upper MI, tnc. page 459, as Document No. 497987. 1320 ont Avenue, Suite 200 Ea faire, WI 54701 -] ( 11LAn$ 020 - 1100 - 40-100 ` Parcel identification Number (PIN) This is not homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good. indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record, if any. Dated this 8th - day of August 2007 w / �� - -- - -- - - H Q- s &, * * Michelle A. Sherley ,_ �- _ - -�` * * AUTHENTICATION ACKNOWLEDGMENT Signatures) —_� STATE OF WISCONSIN ) )ss -- -- -- — St. Croix County ) authenticated this day of —_ _ _ _ , ___ ___ Personally came before me this 8th day of C'n August , 2007 the above named * �aG� �,,• 0 �, o �\G • 0 Michelle A. Sherley - . w on - - TITLE: MEMBER STATE BARt Itt NSIN - - - -- -- - -- -- (If not, 'ie O - :o ai, k . n o be f . r on who executed t. - foregoing authorized by § 706.06, V,�i3.Stats.) S �� a d • k . .j_e• t -e same. THIS INSTRUMENT WAS DRAFTED BY �,r ` i f William J. Radosevich, Attorney at Law — - 'otary Pub c, State of WISCONSIN 502 Second Street. Hudson, WI 54016 My Commi• ion is rmanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not nec;essary.) — _._.. —_— \ L. - '0\ •) * Names ofpetsons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN iptFO -PRO t ofl FORM No" 1 - 2000 ( 800 )655 -2021 www. inloproforms.corn Nov 25 07 09:51p Knudtson Plumbing 7157967023 p.1 ria 19 U'! 1:7: - is rLV P e r rLurioinu i }.lv J., aJ r_vv ~ 11 - 1 - nu 14:61 rAA tlz C 6040 a • • ST. CR.OIX. COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING- SEPTIC TANK This is to certify that 1 have inspected the septic tank presently serving the _ ,, :. • ,G residence located at: N ' %, Section jy _._ Town N, Range /_? - -- W, Town. of _fjtu ge r� _ St. Croix. County Wisconsin. Upon inspection, I certify that I have found tine rank(s), to the lest of :ray knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes NoC (if no, skip next line.) Approximate volume or length of time _ gallons minutes Capacity_ / a Construction; Prefab Concrete _, __ Steel Other _ Manufacturer (if known): _ . Age of Tar+k (if knn n): G'l „4,& i c enstd Pl igtatg (Print Nam) .1x.2 /2‘.c y<, V /3 (Title) (License Number) MVINIPRS • / 1 .�Il /ems (Date / Form to he completed by licensed plumber ;s. 145.06, Wisconsin Statutes) or licensed disposer (IvR 113 Wisconsin At ninistrative Code) Si ► sin SOIL EVALUATION REPORT #2086 - Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service County Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 020- 1100 -40 -100 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Lutheran Social Services Govt. Lot na NE1 /4, NE1 /4, S34, T29N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 3120 W Clairemont Rd Suite 200 3 na CSM Vol.6 PG 1673 City State Zip Code Phone Number I City Village _ Town Nearest Road Eau Claire I WI 54701 I 715 - 796 - 7023 Hudson I Baker Rd New Construction Use: Residential / Number of bedrooms 6 Code derived design flow rate 900 GPD _I Replacement L I Public or commercial - Describe: na Parent material outwash Flood plain elevation, if applicable na ft. General comments Conventional system, trnches spaced and depth to code. Sytsem elevation to be determined by designer and recommendations: or at the time of installation. 1 Boring # 1 - _ LI Ground surface elev. 97.00 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -24 10yr4/4 none sl fill na na cs lc .0 .0 2 24 -41 10yr3/1 none sil 2msbk mfr cs na .6 .8 3 41 -48 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 48 -60 7.5yr4/4 none cos osg mfr gw na .7 1.6 5 68 -1'/ 7.5yr4/6 none cos osg ml na na .7 1.6 There is 7.5yr5/6 staining of Iron in horizon 4. 2 Boring # L Ground surface elev. 97.20 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff #1 *Eff #2 1 0 -12 10yr4/4 none sl 2msbk mfr cs na .6 1.0 2 12 -32 10yr4/4 none sl 2msbk mfr cs na .6 1.0 - 3 32 -120 7.5yr4/6 none cos osg ml na na .7 1.6 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) 0 ),,,,,, Signature: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 1699 150th St New Richmond, WI 54017 11/14/2007 715 760 - 0347 SBD -8330 (R. 07/00) Property Owner Lutheran Social Services Parcel ID # 020 - 1100 -40 -100 Page 2 of 3 3 Boring # Ground surface elev. 88 ft Depth to limiting factor 1 2 0 i n. - -� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -12 10yr3/2 none sl fill na na cs 1f .0 .0 2 12 -41 10yr3/1 none sil 2msbk mfr cs na .6 .8 3 41 -69 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 69 -120 7.5yr4/4 none cos osg mfr gw na .7 1.6 1 Boring # ] Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 "4„-rt, 9 &<- /I-- ,, le `Z `.. 3y „.7'” ,tox, S a nt � , �` -�� _ �. O 9x./1-7,5-ye. s o f vvti .---. , 7 /.6 Boring # ` Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 O — ( ' 1 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS <30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. SBD - 8330 (R.07 /00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 1 David J. Steel Lutheran Social Services 1699 150th St. CST- POWTSM NE1/4,NE1/4,S34,T329,R19W New Richmond, WI 54017 Lic. #248956 Town of Hudson, St. Croix Co. Direct 715- 760 -0347 CSM Lot 3 Fax 715- 246 -0318 Legend N 1 " = 40' r _ ♦ = Benchmark Ele. 100.00 ft CK ...:---__Y ' Top of 3/4" PVC pipe • = Alt Benchmark El 99.95 ft j/- / Li- 7 - 77 6 c Top of 3/4" PVC pipc i ...1., 57/ left) 1 "'1''-4-- ❑ = Borings Boring Elevations B1= 97.00 ft 2 _= 97.20 ft L )l s? e__ 4/C B3 = 88 .30 ft CC. _- B4 = 0.00 ft c 4 < `r / . crz. r c- / E S S e 4, e°j . Sai- (413' b -------__ 7" <:, *13 --5-4 Th r 16e(n"'l 0 7 a -r- X L. H .) C,, 9/, 411 ' 1 4. is iN 3 C 75 0 r 0 — a r . . , FORM NO. 985-A n It f I1.'Cmpy® n 1Q 7 Stock No. 26273 F I L E D 414046 ta JUL 2- 1986 i JAMS a CONNI L bolster of Duds A, CERTIFIED SURVEY MAP c9 SA Gobi � �� S LOCATED IN THE NE1 /4 OF THE NE1/4 OF SECTION 34, T29N, R19W, S fi TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN ■ NE CORNER SECTION 34 T29N, R19W o 0 of o SCALE IN EET POINT OF M N 3 BEGINNING t.--. 0' 100' 200' LU w \ l_ c), (K ijr Ce I- P `' o ' ti APPROVED *0 �� '1 , �%' OCT 051983 1 Q %, Pi � 00c0 1 ST. CROIX COUNTY i. `\ 6 0 0 3 COMP2EHENSIVE PARKS PUNNING N \C3-1/4' AND ZONING COMMITTEE N rou se N w 0 c '� '� \ \ dC,J e (4) LOT 1 � \ 3.46 Acres± 150, 765S.F.± \ \\ • ` 1, N89°58'W 577. 35' 1 1 351.25' 226.21' i N I Co -... Q LOT 2 °' c.n.. d"`— ms � o • Q 0 3. 02 Acres± N 0 1 oC 131,668 S.F.± ' c7 '.. I °O ' LL ,. , N. o w l 0 1 c 0W o no I-I V ) ZI ~ N89 °58'W 571.00' ..,_) v) 1- ¢1 =t 0 vm ^ o ¢I r 1 M IJ. w I 0 0 i I Q I—w CL 01 W Q Z Z ! wI w -I ishedi x I �--..e....... ' LOT 3 1•-1 driveway 1 --1 - 3.58 Acres± � -- 155, 814 S.F. ± Q 2 o dl CQ o Ck' M N 33' 33' N s. • N 87 °25' 30 "W 429.20' ..() c4 °21'10 "W NORTHERLY RIGHT -OF -WAY LINE OF COUNTY 142.80' ' TRUNK HIGHWAY "N" This instrument drafted by James T. Swanson. Vo 1 LIT' r, ! Paa,. J 1,1'9 '2 , e‘c 'BM ...., / 7) -2 )_ Name: * --- 1 99( 9 5 f_...5 ALT BM ? Address: 1 71' 9 7 o'D B1 6, ---- v , (., (k (2" 9) ,,,.-y Phone: 6 9 P7 B2 tz,,, (, Lot # B3 /cc B4 -/-- 7 r■--- ; / 4) CL -t)-4 -( .44--$41>1. ( /I 6 ,., A „.-- ,---- g° __-- 95 5t, ,......,„ ,......._ ..-. -,......,_-___. , -....., , , i , 1 / / hC mit / .2.2.... ____----_ //3 5 : (9------------7('' /03 -; _ -- 1.4 „_..._._.__________.__, 6,7 im. ___________,P 5 _ -----.___ 1 :SMIEWel In 4 , _MEI GUMMI o) tilde° • ' 14 . 'mils . . , - punojo • 04? k I i 1;0 ■ s 0 # 6upog :sx.reweld _ JaPel EMI NM 1111111111111 6Upplif ol Woo — , Mill ;• 110111.111M IIIIIIIIIIIIIIIIIIIIR • 14 'Map IIIIIMIIIIIEII ) 1 1111111111.01 t ..'" t - 1V Ell Pijn°j _ A Mg i XYA mum k zl,,,,, .tct15,s,4 c'' ' Q IiiMiMMENUMMinnifilganii #6upo ,pue.a. peg - Lis - zs - .0 lobo - woo - zs - no iiesum 1.1 szaaid Ampullae ermaisisuoo z44/GdO am10 semaitm Jo in° lueuitnoo wisp uozooH :SAJBWO8 • - ui - -- , .... __. _ ___ _ , ___________ _ lapel 6uilkuil of Indeo 14 A puncuo 5a ,) - 1 .s.'42 Aii, y i • .,, :...., I '''' * 1 4 / 1 4, ; ' ' -li•,) .1.tUk‘qr . • , 1 # 6upos :SAJPW08 _ • __________ - ui .tolae; . fitipiwil immi wrimacifilm ,^.; i IIIIMIE111111 111111111111111“11111111 ol uldea "Th WiliffilaltagAll -4- 11111E IMEIMIIMMINIE 'flap / 9/ rei punc„ 11111211111111111•111W11 i ..., OM= e --/ Mill Immi.cm71" J "7' 4 iPee- Pee • '4S -2 S 'Jo _Imo woo - zs no liasum • 1.1i =, 4 ' 0§e, sioau fuepunoo aauaistsuno eingxei • ampngs seinoyy Joioo ILIBIMUJOO Ludaa uozu0H # 6U1.108 **al 1391:11fd jo - a6Ed ESNMO AlindOtid 180d31:1 N01-14180S30 110S i