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HomeMy WebLinkAbout026-1168-36-000Pa PRNATE SEWAGE SYSTEM sN.rr•ae B.uaN or,w INSPECTION REPORT 9-125 GENERALINFORMATION NTTACHTOPERMITI 5315 No al,K�1 M- cn PTO PyworfTarCroix Ryan & Janelle Stephens OF RICMMOND 6000euLle, mnm 1342 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER �S GAPACnV STATION BS HOT IS ELEJ sepne ZOO aeNu,men 3. D d-S Im S.s 99I d �E. Bles sB.a � �. � r S1nn InI.I B .�j TANK SETBACK INFORMATION stun Dann TANK TOnP)LMLL@BLDG m YI sepae _mBnnm 8/4bDone dR�D meeaenM.n 3.0 A.NoNa^ Olt FrOr 3.a /do MIN Bo15ryMm 4.6 `i9 POMPISIPHON INFORMATION A MIM Z.a /6 M.r.,Iwallo, m iS/ Si T„ Mne.l Hame., '- iory L; ..a Fr011, ..3 srerem .a FI FI Fc,umNn Lend Div I'M" DIIIIENWINS aIn75 Lman34 m.ve TT - o \.. o� w.leomm � N20w ryw Lm i0 DISTRIBUTION SYSTEM 5.111.. mar/31.5Sm. Ze HUA,N,./ Ft "e"�. 97 —{ten N� SOIL COVER :Prel Syenms only ss Noun o, AtAtImsms eume only ..Ix�" Noz,rO,, Z ,.Nan Eap.. INm1 CA- . CN. nM COMMENTS, pneuee wee aso•uenoe• "�L° 1 mspeNuael �ISIl9 Inspetl"n Kz /pr _ Lanauen lea 12STH spl WV1eN Z� 1 -1 f—� 11MBM De•mpan. a.,f GoA.� 318 ,han. 35 are.e,- 71Ztl a � Plan Norman FW.rrM, ] Yes M no 7 g Use. sae, mae,a,.earlanel lnfa meta SODe,rarR,re,I D.N Q'fl pmJ &n I c adC D_ sAN aDre _/as __ �•q m 9emiv UP¢lo 24 2019 q 'Tin oa w�vidl:. if Cn" C - / ry crmLL Application zaxw+• 6:5vF ism.oae,�a, 1U eadvx.(FILTem, u-,.u.ompn ain� Prom<amwwn S11«erm e.s a o-.P.a rP,HI Ai H ik,d wURI)suiaCli Y Ed .m a Qlnllnl1 fn,m - ePon ell ioo mil _ _ o.FnN lamI Od b-Il ba- 3G-ooa �. u.m,r.IIN.m. a >)_ t - e� w� o<m W,.fiaoaa 30. 18. �3 .1 ��`P" l Alf F, dereaddenay Aw � --... __ 'Lx R R; *1 n rypeo/anneuR lw.ua...wM Ban f{�m/P.mIND s-N'.®bwmumm,__ _..' s inke. p.... /-, � - . ❑welie:emw.Rw-neaxu. 1=.=. ��1 — ❑u n or ❑ma rni-D�Peei,e�_r ❑Vrkn or NPm ., Ill It"i (CLetl:PWyuu ample¢ line e;finalk le) ^Q NrvSpin ❑ReplliSymord Tmunmu R Ircmui IX.l 3LVMA1sEfiuvoow Sv.mlapWnl ❑Pvmu Rmewl Orrin.w ❑�gMe.mm ❑Pmviirwb aVev Pam�Nmb�ml Welmtl/ eneiii g IVTadi P(PECTS_ m��, nnCIP, v ao ldwd,n. Rnn ❑w,m�<,.m ar.,we,mi �J oN.D,.n DOrd oulordidCann «.PWs ❑.�..�m,nd,d<=emm __— V.DI. ,.erne."BE_.. _ Rd.P�ni a.RB n Da y� 'vR'°fib.POP Fee III.oa.�.wRmmrwvn o17 W. Tank lulu ➢. b.n UWE Clim a If Mm,p anden Fill, vw.v �. L X n... a...,. vn dbrb.bmE te. •.m•o•7 ee..>P .... ftp. wn w.mp.e w..a�Re _ BE Mvun� a� one. Bw ' s n egym md t'oa in Pread FCCEd .. SZ? ae 1%<M fo.(or Dii....I lib.tTe.�.d//yy'��i LJ djA 9B6639TR BRIEF) i - I sfc4 l s d _owo - V ,Wolir rWPA r i rH*r$ 4 i i tT'1/i✓a1S nirrvr � lwF'y y.ae,W. DIVISION GrirvpmrcSERVICES goalus as ip GREEHMY 'nont T0Ya9m5itt ough Foram Rp.IMarc N 9n+IpRramM1tluD urvvea � nz nyE .G mm May 21, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES. 2021-05-21 Ph, genera PWTSA51900654-0 KIM A OCONNI .ti %/....V- Us. * SITE: RYAN STEPHENS 1494 125" Street Town ofRtchmond Saint Croix County TOYI Amount: $25000 Pressure Dislnbubon Compnneni Manuel Ver 20, SRO-1V06-P (N 01Pl, R 10/12) AILMe Compared Manuel -Va 20, SRO-10854 (114O3N9,R 1112) Mmn¢nance RegmeM The submnW described above has been «vrtwedfor confatmnnce with applicable Wisconsin Admmis ,ve Code, and Wiuun,m Sol,[,, The mbmlml has rune CONDITIONALLY APPROVED This system is an be wnsnuttld and lmoul m m,mr hi ce Won We erimeJ nppmved plans and with any romponeat manutl(s) II.cad above The as defined in chapter 10101(10), Wisconsin ,p in SmI I, mo...We 6co mpliance with all code nationals;m No person may engage n orwmk at plumbingm the efit, ,I... licensed to do m by the Depnnmem per s 145 gQ sun The full ... union, shall be and during contraction or insuallannn and prior or cupancy or use Preurve dispersal am poor and dmmg mma mi ma nod dietmbmu, romp^cuon and use of me rite With new ended not to arhot, the pump in Me arm, conk until the Ynks me pumped Prior to homeowner oaupancy We mwrter genera led from rontri dh,mg of equipment and tools andsor left over mnsdmcbon pndwashall our M dnchumdmb the dimes dmchmgmg to the privatewae¢wader treatment sysrt (PORTS) WIntcommmilmVibepmpmlydnpoeed ofmntmmfl,otmile "Still grasses, leanod di shall belt short and removed pr,,rm thing th mildeefor installation prevent mOnng under the dispersal arc,. All homeostatic matenel m be removW fmm the PORTS Dispersal Prior to wmtmeWn of the domain rim, thank the moisture contem oft the so,I to a depth of0 mclat Smearing ad compacting of we can will result m red ..ng a, hiltraturn captain of Le smI Proper soil tin be daatnt� by mllurg I dl Wrap], howeet de huts l f n ron[i aI*mcbw IM sRi towq m if n cwmles, to Pmimmm an promol lfdw. 111e¢m WPterim. do War fineN until s dries • awn surface ware. sort NwlT Area. • All Oman hall mmfm, to SPS Table 38430-3 Who SPS Table 39430-5 • Imubu bulW1o11 ewer beyond 30 feet per SPS 392 10 (11 As) • ink ImmUefioo In fellow At mm,moums mmmmenddlom Pump 4lnala la be aer and ven(etl per aPP•^veJ Phn. Any chengmm,y Wendy in Pump resrrii meet I III I aml (A•M SPeolimprOD& • Verify property limits) prior to installation • Well mthac6 b mrd chs NR 911&912 • Am, that oWuprM mNrak fragments, trn seats. slump[ and boulders reduce tl¢ m... I f,od '.treble for POM, tournmentties adrtt Sir, is available, n the m alma of the O-gtadomust be III at ground level AlargerIII l and is naessury as any of the above mndieum arc mommued, b pmw@ m?tie mhhra • SPSM1.541 net The anagement plan his POWTS WallspaIhmlly All the servtung mahamcso(an m mba or mmmbm mmnmt uY m a holding Imo when, eitM of from milam rag mMmom eson 1 TIZ MIom of the lands locamed more that l5 (M Mbu the ale alumn where by venue pal is focused 2 Ibe honors of the tank Is local more than 150 feet fammrmally fmm wheri smtnng peal is bcnetl Owner Responsibilities The ,,,at omiutl cash recall mm, lall nave a ropy Orion Inter Including m+tmctme minting to pri Wdm nµn eofthesystem OpaNllm ecopyoftheappmmy . pnLmpend manualmammance hab or mour's manual far the POWTS desutbed in this approval SPS 38YW 1)n In theevent this,itabsorption system wy ul it tman nem par malfunctionsahealth I.'mrd, Me pmemy owner most b11ow the wnummicir phi as d.... bid in Nc improved pones Acopy of the approved plays, specifications and this Inter s'M1all be onanc during commission =4 Pend, m[pev'tmn Fy voNonzetl mprteenmrtves oMe Oepanmanl wM1tµ may mdutle Inml mvpeclors All pemmh required by the late noc local mmopaub shall be obutmtl queen mmm,"mm of mn[wtlmNmstallau nior,mtl O In panting this approval Oe 0.nsmn of treasury Services msrves the net Whom ohmgu Ot WdNov should mMmm.s now mhmg them necessary fore de mmpuvae As pas sure 5Ws 101 I2(21, mining In toil review "I cruise the desymer of the respom ulat for deigning a ssfc budding, unchn. or mmpomm In9uin mmg now mrmpommee may he made m me at me nupMrc number lived how, or A for Wdreu on tin lmmamd The abve tell Wrovee fitl1 pmwtle a over of this letter and the PUWTS management plan o tie owm and my b nch who are mmonsble for We Inmllvmn, operation Or met minimum of the pi maturely. '%ems seAssrd Tim Venda but Pnvte Sewage Plea Rw Division of Industry Wma"s 1920g92-2214 Mon -Fry dd0 am 330 pm um vandul.v. lcOw, rev =INDUSTRYSERVIICES ofg RESIDENTIAL AT -GRADE DESIG— P ss,rme -Sloping SIN INDEX AND TITLE SHEET Pmiscl sleveom _-.. Omer Ron 6 James slegwne MCreu 13"21M Aw New R4npnd Wl W17 Lewd Dea*Akan NW E-w22-TY IM Tovn l Po nxmad cony SIGdx SuWNMon Name NMV Mea]owelll Ldfb 36 Pere& ID NMnW 02 11683BLCO Plan 7mnswdbn Number IMex sbM Page 1 catrvlamns Page2 Atgretle draavnw paw Lalaals and dose lank Pa" a s�nlf .elbns Pages Managbnanl d oantingonry lien Page Pump cars 6 awwca os Page] Me Man Pages Ad sd Evaluatlon Pepalo er pmpm AOci�, Nun'Oa 22R263 3pnalurw-- Soma Marine Rvn Nunba 716901-]g17 Dew M Wlg Ma w]TS SBUb AIMgrade Cwm�aMemel geDV> a For pwgaw ,grid a9-P INaW- Se 01)eMnd SSpwa,e Deddon880ealg�dee edae Ver ea SNJd (BT-Sl.K IR12) Pafan C4eidnM [.u�wx+N Maiwl vw 2A BBP10]OBA (H. O1N1. R tdl]I vaawi 7 Dlsrnzl Pywl a 9 PRESSURIZED AT -GRADE DESIGN Mynas Dxlgn wnrkeM1.M-Shaken SMN Flelks an88M Eere Erihy (ror c) 110.W RxMwpMnwmmew(g allmalW weelewebrIlow(Wel Oxen weeuxnter flow (pW) %Site polus Depart Mm tw.lnwladerade ow(in) (fl) Oepm to d apthn atop (In) Inalw wd epplrsllan mm Ispd'fl!) Ub4W Wen I Mlnmepon (Iwz) �Inlnwlwesl awabr yuaGty A50 Lmem ImJlnprate= 7.W ERxlrva eLwrylun xMN(ft) i.M Mes.emeclixwkltM1permifletl (fl) 134 p0 Pgpeegeb bnplM1 (II) Frx I (c or e) �I oeeipr�er xbl W bl8rel chemetn RECEIVED NAY 7 2919 INDUSTRY SERVICES Center or end lateral connot Feel of lMaers 00I diameter (n) a 025 Estimated mllm spereng (fl) Fonrurr am dmmeld' (n) 7 nlanp:(o.gm) nrex) yam - n) vo<n weaormneln dree lrav Frump WkebvNpn Oft) Yan Mlelxala elflgM1a p9nfl Syebm M1m](fl) a 1.3 Np Va&aIM dr) 3Y8 Forcenuln draiffial(pM1 Friction ass (it) 10i.5 u LNeral vptl volume ("If In -line Filter Loss(it) 140.1 Minimum dose Muted, ) Total dynamic head (If MO Srybm demand(ypn) mail Month I'lliter M Won limerick IFIlteramenufal PL us Fllbrnwdelrlumber (iYbnNnM CFlculetar fcPnonyl M120 Total Tank Cap Jry (raj)3e Tnlal Working Lqutl D (n) 333 GaVn (enter hawk in 1048) Tnahnem Tank inflammation 1200 Su Iw Iwk cahmme (pe) WLv ManRactrm Oox Tank Information M 8.0 Ooae Wk wp (pit1 23.2 Dose Wme kvcLme (gelrkl) WWn ManRecNn Project, Shipman Transaction Numkn. Pqa 2 d 9 RECEIVED MAY 7 2019 INDUSI RY SERVICES AT -GRADE PLAN VIEW oT mft � yea oa�x+x+:pr�PMyO A ]WR 009 B 100A0 ft 1.8B ?Me W + .. �c C 500fl D 600fl E 0011 L WWII W19.0 IN AxB 10W00W0D M1 �L =TU91 eg] ]ele mllRxB T1%*wImm,P� � sklnne, e O=FbxMam LxW mah, edW' T AT�GRADE CROSS SECTION Rom,.. ii '. In, ""gate aelow AI and 2 In steove am Plalan BNpM1ene Timmxllm Nwntew Pq3 N 9 PRESSURE DISTRIBUTION AND DOSE TANK L Clyrn- Eml conmNon P I e,.mdu.11rr .o,y, an"� • *..�.v+uen..w.wnrnwdue Itleral speclnu4nm 0.1L5 QRNatlWlabf (In) 5tl 9 lelerel mnnmlbn lnl .� 1.9] Onfm apediq (X) 1 NumCaklaaLs 6B Onf�elel P 131N Lalemi WNlti(A) iB0 Lai Gsl'9e nb 19Nn) 2.00 Lelorel Ewmmen(in) 2.00 For®rnandmmeler(m) 28.0 Sya disa rue(gyin) 200.00 Forrammn LBrgN(9) VM TDH(11) Typbl Pump ChamBer Layout •quuau mnafemerwm drr.ww. n �— mwNNmwPdananm meammew a< Indw Dalbe 9.7 Z729 2.0 44 7A 83 1401 8.0 fl]8 no MID F a.mm �ePmi:w MNom —� rAw I— 88008 Co111Aa PurymaWaduer 9JE R8pmMr Nmn mae4amer PEN PurymcBalmmBar 1NMW Piro motiYmeMs Pmloct supordm Transaction Num mn Pi 4 N 9 RECEIVED MAY 7 7(l19 INDUS RR______y SERV�CES, illlj�rade Shrill Mallindivenal and Oitteral Sitentlfflipartion Savlm RmMefs Nmre KmgOminlol Rvn ]15381-]91] P S Rgrylalcfa Noma toT Crcd ZaFI F1vn 715:1BBA893 8Mn ibw aM LwE PMarnelwa Deelgn Flow Peak B00 pact Maalmum Innue PrtWY Stria 19 N Euroeans Flow - Average q00 pPd M m b_`OS Y10 myL all Tank Gateway 1A0 pM all TSS 150 myl adl gLwryuon Comparison Sire 10W.o V Mss4num FOG 3o mp4 Taro W commensal Ocmmk Meslmum Fall Whom >10E0 dW100 mL Sepgc and Pump Tank Effluent Finn Pump and Commb Abml P.e.aee ayarri Mauer Omer Servke Faisal Ilu c1arlNa mMu aura eve 3 In alct cbendbnlOme 9c Teri on® 3 SMUM Wlmon IaMW enpaM se nawdara WW 1.s lainnoi eM 3 MWMe "S Construction eM MN Sleldads 1.LM elm pope are sWa] aq malls conform W Tede SPS W,1, Mro a avowalll W. and are secure] In as 9exn In the at -Wade uanPonml manual. ] Dandiacal ceX epdrejale comares to SPS 3M 30 (BNI), WIs Met Case 3 PI gaNN arN eweuc ltlp'alg malenalsconlamlo ere rpulcmeNln SP538l, Wb. PAm Code a TMente of Om Eeeal dead is economical wlln a mdd Word or chisel plow s The at 0rede awcNre and oNa aiswbed arm Mil the seeded and mulched her pleoam" erosion end reap will fmdl pandra lm B. Areas wMb 15 feel of IM downabpe M will M prolxled Irn... .:..adman ]. All alMr mm mnalkn colons am as pa the alyrode camp nr...m nixnual SM-1 all (N. 0l Lateral Tom'uo Detail FMMW ......mt� ......... GSMe v Sr Dl thesev..r—a1,rMkI. v.Neerer>ti,garaaveNe gII.BO fl —� ep 80aSo"eBendor Two Daryb lalwal Protect alegnns Transeobm Nummr. RECEIVED sae AlAY 7 2919 INDUS I RY SERVICES ALgade System Management Plan Punrplrtlo9pa 989.eiWY.RIm cUs e OenaN meruYe 19061[fl56PN �W,fl 01/19 W�w6 Pem CWi,aNaNAmaFuuuelnzmYiManual VpMMll4 rmymW IN 01pt.P lMRflaMbAlu WbNnpaWmemeyaWnmeliNne r+e uumwilwrm eMo 209961WOn No OW SWUM mrertra eyei orpnp lmh Arm Nnpawa peso, may IS Faunal Nfl wl uwe doom. Septice YYuaunbaranleMXWndmtlao Mai SPS ]SS.]A, Wle Mm CWawnn MbnbwrobgaruWa 9a� neerMne�endenixidW ue� MarM1OntnNatlno+rKFllonrlwuim�l4MaeuxE mvLLreaz fau¢WMnW nYy]WfBnemnluregdat FyMMxedgaOgaeae�a NeneFW¢FEYn�eMhe:wMtyennMevtirelwWp AeWub FdeMMenMf winautlMW sAy Moe W�XndmpnreM LWkiaM M sgticlenhalrypa mYNeveJLYan VW IrWNeuAr,e mderameeµa Wkeivba iBl N, 6We TxmiYrYgye vyEn dea'N°drme ...r9 �'.evmRpomo;'war elm cam maewmYaroae�Aoaae..PaauY.nemmaY..we. �n�IaW.nauNaY.,.e.a r+deead,Ym MmampaP®npmalm maBwnrevieanwmne mm>me nmademAAd ummmmnapnmlmaYa.n.,�nmmnr,omre.vrlrem. xm. ma,mmppm.m.a.am�. u`. n re,nmiru: a.mi.mYmadnro.de.n. Ym.n mmNndmamn.wm.nn.9ea.nm,ndareem+mare eegY rrx Amu Na.IY axnu Imw,m.na, Ina aeMma m nam..M son m am urN ww w ue XtlAe an,. m Xm m iurwai eNna nma ar a Iea'rpel.uerarery. rr W mmame gravvel aN1 aM®Pe arm, N see: "axti: pYvo,,.m m m.ml. n I..a uaa maxslwo wm.ae ak,epa.m.nwpe,., m. rerx .i:`aeeiuo�aem®marm.alral.emu�mnmm�. awuawRpamm.are i. w.relbrolrea:.a nae..r.n.�a�P�mm. aadnuer Amle.MPmamW„reuW,xad FvrN pap.mn.nlw�,r�,.®. m.pm�oadaare�mmwlwmwar.'ueM wa,laaremmlatual empann nMUem Fear Ylnrmmd Wmn ma box a aeXm eposee eM aM�ee MHnkary celWlu YAnmwerypgr Hne �numnaneuYMgenbem lFn eYprnea Plntirp �bertmg �0motammepo mm.sp xeapWa wkea Infla" .aBNedae ,relm w.re.ee n a,reloaanm.e we Xma Baum eleirnd�h mmmpeui[nmuauntr Mlpmmou4wrpeneuaumr� mkW anew.loalmnwr Fwn.YldkwanW weld mmrmauwnpaemm �vL8OD5lyWinabtloal9nea eylnrmmnmide¢rJSAnpL9CM 150rry1i .m13 my�FOG lmaeepR WNeMuvnvSo mySpauendo,the IF SO, Sro�a'itaWn rw nwrmmkmrnypbnmeMmrem. d,I as ar® m..mn,emFe, m. .ad& rtin spend la Needed Wu. nlWnp pAal mUSA end N dam Indent, Sea XYramrrneNetlSet dean Need me vray lBmmW Wlma elan YpsMmaaaaaMen rcmpnnebtlo YYNIYP �mdebmmre fn ygyrylvomnrp�W ne I1MA®tlnNgplaAUYed pmambFepW eln Watlon xAnn Mdlmd�uWainmeei.p.mAoaeenAdderlad Yreaaen� PwgdateWa nlNhnne Wwnar,anuy rowYemaeq NAYawnaeameasenlmnitlYml.AiYitralunm�YrvpamlbnM, molenepwnlmor:mdrq It um®NYWo- many FISS, mpe,.n F®re eaanalO YAnk Orr daresenall She be mpAnd or ra+•m OF Nrn had PNro,BAde apbOur mla�de nl Yaris rymp wardeKMadden Ad e nerenal Founded dWeFFA nd dAMOSAF apYn�elFen to lnreWYv npm'l v Mp oar tls den Or aN9eurwniarix If IM mgrmg un ld MIN an raN rw an pure an nrfagaxeaYvnia an Ne pwd AAAFF xMthe Fel OF lauds, ad Ifts prowntMama,by,wrevp F.x.aavand WASSOF nand OF IS no,wre Bn Flalap®rramad4aamn>. MM WAFFIFUM mdeM Wells mm paoand 'd rMpwW stands n6 an dandum m®ssarY an NN San Papa 5 IF I'M"I rp W r®ma aM Wg marp"r a pr lvel PIXYl9 mpUYFa Add dues pmnr ",pact Stephens To, '' RECEIVED "Mande a MAY 7 2019 INDUSIRRVICES [QGOULDS PUMPS - RWEIVED MAY 7 ER � INOUSIRV SERVICES M1,G1M6 Spaal,�trtle •Mo.d Symle • g10e5.b¢ •8»aaooY+9 Mtlnnr iPb.. • gpbk mxlA� li.1d a nr . Mnd nWA.. .�fl hk • pplomaive9 utur.ue. 1f31 Pmp: • YULam4�Y 501A1 • w,n.m n.rt ismx rss, �a wrn®�.ur Mr w;, rtrn • sms.as�mww • rrrs.a.w�n,ox of Submersible Effluent Pump PE am.t • QmBY.Ntri • wj9wH0uEs4d Ilw: • 33 w.3DPWL • f]D WYnasp PG, Yti.rP�� • mw.smwss • rs ss.,a��w • vsc h9go Bs ssr. • saw. wowr • ustra.aa.� • rsce.q� r-: a i F } s b 5 ]a 01L ., kap .a n.ne+ra+a.ft ®II(ba .Mb4 libeltr rAe! .MeeaYmY.ou �mr.raryn sw,sb,au smsan wass-isr.aa c p ns�yo bhn % d �u s���. . sre.+d�e.ia.s m.¢uxsaea+n�. .'Yi®aJlemm SAS, T Wmma asa�,oe..lr n.r ar�nms.,sm.. GJIVSRR TA. �. . . U So i may// i �+/•,vas. ii � �� � i�, i i � � � ' �`r� - d t9 F� CnN+r.GJF-f1i98.3 4R"fae:/b.�. .gym• � _ _ Al 1 WEST URE Of THE NN A OF TT# NEI/1, 'E 1323.82 --- Y- a x a DUBUC STREET--- noa,a'sr s sfla.aa' `- �r ' I i -- - ' -LMM --a---e -- W --- -- -- -- uo NL. roN COUNTY TRUNK HIGHWAY II_G" p w _ TowN 8 $ N o$ O IPICK, If AN0 NOULFE 2CONSIN i AND TO WN OF EPPICK, nnwcnnD SEN GJ �I �I 7. M89.40'47 W 366 00' •Fi0( 4410W__ __ _ __ _ _ IMll_ 90 38 39 '3rF ES (7704180EFF) noe6AN as �n3� } / ,eeo so Ftl �. N W.00WE35 r m I ) 36 ACRES ae SO Fri Iazs9 e W W33 I F 'aiffffff $_ss ga4 gl 3C N V � siw n IB9 WEFT) I 6 I c SS,— M89BB <�W 400 00' _\ Y o,TM i UJs MIMI OWNERSFU CERnFTCATTON FORM I. L ., TZGAT r 1/i. � DAM c51--a015-0-73 III W. 1111f Slf� i� � .� �. IJIIII swam., .�,� IM W..Vi:,,llm �.°mdI W ��� IZI °.aLa 3 Mg W= IY� �II�w W � F ©®®� ® .. _ . ©©® W"�l��I.:PAt>•!I�lAI lI�IL01 �IlS>• �1lA�f 17A�.7A1 �l'RJ1I R�llll�R!>•lL�R�If �esr Ir�!�a �r Nwmseom s�O�e a .. � m ❑BeMptl ❑qa ng GmnE aunen tlev _n ❑ GapinlolmXlnplMd _In ❑9onroa ❑B^Ang ❑ Gw,d ,Iwn eln o.ptmuXmXlnprpd_in. EMumta1-500,>30&MlghaMl99> W n 1%lglL ElAumd3=BO0>b<yO mgLL aMT55>p0a�50 myL MAY 19 I- SIR OB®Iir.+ OG1 �sr�mrhrra� ����aniw[��rraw��r-a ■ :: CC�CCC��� ✓3 '�g/%o. �k i ,VQ�-Nc aEa.�;.7-T=Tv/1��u71 I i ��2�� I _ irfiYl4 cfg 1� cwL.�1JE-.E.0 9g3 - �s \ laf 36