HomeMy WebLinkAbout006-1003-10-040 (2)
Jr6aors ~c~a dr)e-t ar PRIVATE SEWAGE SYSTEM St. Croix
alcf: sad fiu omy lir, i. .m
INSPECTION REPORT San tar Perre't
GENERAL INFORMATION iATTACl1 TO PERVIT) 615428
Pe,,nn., f.,nrct nn rr- ~ p: _e -ay be "see for ^dar; por . jl rn,,: , L- _ 'A i in n
odor; ;e TOWN OF CYLON Par el I_. r. 006-1003-10-040
Daniel & Karen Schwerdtfe9er
7T EA! E e:. I^sc Hb1 Elev I BK oipbn.. Sect .an: I:1.n : Rance `der.
02.31r.16.17A-30
TANK INFORMATION ELEVATION DATA
_YPE tAANUrAC-URCR CAPACI IY STA`ION BS HI I-S LLEV
Sep(IC BwuFmlatk
Dmrg All Brill
A(:Iatl:lrl Bldg. Sewer
•-old rg Stall Irlet
S::~•I Outlc!
TANK SETBACK INFORMATION
lAvK 10 wL ?4I I HI DG col to All lolaie ROAC Ul VT O
Sept c Ct Bottom
Dos rp Headerl1.1an.
Aeratioi CIs1. Pipe
H(I d111U Bol. System
rlllal VradV
PUMP/SIPHON INFORMATION
(olanulaelwar I)r.'Im'Id SI Cove,
rdCdel NLn'he'
I-)ll LB ~rc:.cr Loss 3rslem-vac TRH ct
Eun:ct-ra1lt _crtglh Uli. C s:. toi
SOIL ABSORPTION SYSTEM
BED!rRENCH :'via'.h Le--t' No. 'enehes PITDIMENSIONS aside Ca. I,.:: :)rani
DIMENSIONS
SETBACK "YSIFMT{ r'tI PL CE 's1'rlI IAWSIREA`.1 LEACHING btun..'aa'n,ir
INFORMATION CHAMBER OR
ly::e ;)I S:ra°r UNH tt:rde Vu-nt:e'
DISTRIBUTION SYSTEM
leade' V:r Ar..:: Jul'ibemin [HeleSize. x..nle e [to Pir lr'a.o
Lena- Cio .^nplh Cia
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Dept- ;cr Cept- Cac' n Gcpt^ e' rK Sec:lce:;:~_dep 'aLOChed
EcdrTco ah Cro'nr EndrTTcmh Edq=.= Top::;+il
- rL:, ves I, No
COMMENTS: I n(' I..^.r ca!e ;tiscrepencies. per,'.rns preserl, etc I nspectlon z1 Inspection 82.
Location: 2S6I: 250Ti I S I
I j Alt B'.1 Descridf or -
2 } Bldg sewer viI =
- amocri of cover =
Plan (evls:or) Required? I I Yes I I No
Use other side for additional informat'on. _
SBC-6710 {R 9:571 Catc Insepew, N S 3nafure Cent No
ST. CROIX COUNTY ZONING OFFICE.
CERTIFICATION STATEMENT
['OR UTILIZA'T'ION OF EXISTING SEPTIC TANK(S)
This is to certifv that I have inspected the existing septic and/or dose tank
presently serving the fitllowing residence.
(Street address) located
at: %J, Section Town N. Range W,
Town of St. Croix County Wisconsin.
l;pon inspection, 1 certify that I have Iound the tank(s), to the best of my
knowledge, will conform to the reyuircments of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes No
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
'l'ank Capacity:
Construction: prefab Concrele Steel Other
Manufacturer (if known):
Age of Tank (i f'known): -
permit number (if known)
(Licensed plumber Signature) (Print Name)
(Title) (License NUmhcr) hIP/MPRS
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
unty
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2nl,W LVashingtnn Ave., P.O. Box 7T E2 Sanitary 1'u-n':I Num•`cr (lo he lilled it 1+}' (
tpt DSp.. rl V 09 2~ I h~HdiSCnVr ll '37U7-7167. L17Z'9
'~q n, - _ ' r-"T•I~ - - ~ Sln'r.Tmn.arlia N n x
e 7) lox Adm Ce Je .brdx rnr tl t_ fore t the appr ,n 1 g,vc n:nentnl tMl _ -11LI1
In a cc mJ PS xP
sl , 1I..!It l abl tininga'~tiloy PCrmt t 'AP :Ii~d tt t tor. talc nn dIU+' l' ra. wl;n•trrJ to Pmjnt Td•hcs.iil'i'. f. r. rl then ntc"R4 nddross)
- . l crs ual [t i 1:11 :r r •.ric'cay 1. r.' d for sccoulary 7,3q6 Z 5644%
roc l )cp t .'ten -N, fcly arc? Ptofa.+ oral S nt n
)ux, do ewilb lLel r.ci.a_v, 't, 1(I l!m) ltxl _ - -
1 \pp7 _lien lnl)rncttinnYrinf :\III rt11ntinn arccl 0
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~fr~ ~ Tot - - - - - - - --l
1[ 'r) pe of Nuthlut•;e•r(check nll thnl npplV) SuLdusmu Nanm
Lil Ni-*). fa rutllu ;inv,-Vuu:bcrof NCdrnom`'~/-^ -
t bhrlCo n n rnl Ur+rnt.~ Csc - -
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t ltal IQn:nh ; (f CAN
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lit. ,'}ate of I'crmiC (Chin - - - 'o)line 1 Co nplcic Iwr it if applicable) I Lrr Mb~d Sr-t rzn u 1 w:br~ isrfm (rxp,^ic)
I- ❑ L. trv. r,r rl I. tl.:i.'r plxe,. n. t).I)•
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Il. I ~ P..tm Itc':ctc',I I I Pv. r: Rc, a.nn ) U.
Rcfow [.xpnliot 1.. -
treat Compote nl Drvlee (Check all Ih'tf apply) _ - - rl t1 and cl sat~blr mts n.~
f] rota'+t d 24;n . ol'suta I s+ t t
Von Ptt4 tnz..c1 h: Cir. and l ~l t son cd In C a .n l f l Ci, dr 1 ~ Prrh to .l Davtcc (rxp 3i') "Y -
to^, vt t tlhs s,l (.:np,t tt lrx{LW)- _ -
S.~n AppGr ,,I Aarnlnlmn R -U. cts.l ,tee RcGuired (.+'Y/ I Dt<ncnnle Proposed . yc3 Glew~~~:1i~ 7 z-ii--
\ DrsptrSnL'Trralm~enl 1l
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?nf ( -A+mtGctur::r7 `Y I q,~ I p o
lJl ae Ix m o 'C
i \ f. Tank JnfO Units -
I :1 aTanA. I
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I
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x..J.L~•v H. IId
It fLS'i t - - t I - -
Urs n<ss Phnnr N'nnher 1
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FIN 1P:Td RS lsmnbe
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I. Sept: tark eYlLl.n: alto- tM
(A%Per ' cell u+l all be ='S
ss per mar3remen' plan p, o -.cr^. by Ju-nae.. 4) - f f-'7 y~tG7r'.
2. AN eeR»rAt fT[LN!1C-Mts M1.0 ua ce.,r.6 h e : _
as pYf Yppcnb1+a15: i :M:rnrct_- CL7~ V_
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I:. •sirir!ntial api dic:aliun
INDt X ANI) TITI I PAGI_
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ne:
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I'~_T-? Y tnm ling & r,lo Aclinn
Owner s
r 1~e } l , , r , 'j Name'- OC-/1 Sr X,,vy,.lJT (C1 y'r+
l'~i~er' r nn!cn.~ncr. Infaln illcn I~ - -
Ownel
~.l„ c~ r 1 ,r Igemc nt I hn - . Address: 3 e1 J Z! 7/ S
I i9~' i r tic Tr 11 CI nr'en uu r I iirin -'S
- -
I l.-le t, <..,L1 orl'L~? - ,'il LO f'Y/ Y6✓ l~ !N
A'fai:hmcn' Soil Tr a S'9 7 -
Loyal Duscription: Ni=-Mt: S z T'.3 ! IV le✓ 4 La1
Subdivision: - - - I of # Z
Town: ~ y Al n - -
Counly: e ✓ a! - -
DesignerlPlumbur: I icense /1 7 Z 1. 7 /
`=rlrmh_Irc' - p
Connnrnlr:
n.•ar ucii hui,n:uit to Ihr In r,roruul Sell Absorption Component Ivlanuol fur I'UL1~15
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P04NTS OWNER'S MANUAL & MANAGEMENT PLAN _
FILE INFORP,IA7IUiJ
Owner SYS ttrJ1 SPECIFICATIONS
3fmIC ;F _Uuv T-v_I: C.,p:unty 176 6 pal ❑ NA
rpbc I auk rlonnracturor- L../,f-fX.J l i NA
11-SIGN PARAMF I ER, I f n. nt fdtm R nutartur.=r / t'
G
~cie 1`1~r~v~tij
(hare of -fr 7 II(JAI IifluirFill rfecir; y-
- - f1 /d0
sake r Ct I , bl! I u_I C thl,ls -
_ d. J. t. P u np Tam, f i u I,y
p•d
I .-.tin 4rtrd t
flare (a"ra•1cl --p , - I'unil, 7o.Ik t .l''!r'.•.irCr _ ..in
r . gn .4, lf. ) iLslint• I. II L:a le l ' jf!
I•~lannl-!c;u~rr -
- t7 NA
Apphr,aticn (tale I
❑ N'A
nd:,rrl Inlluerl l.'L:Ilu~~nl i r:,lity Mowiuy -r! rr..a!nW:rll I_!oil
1 n hiA
Fats, (ill R f'u a. - Or;) -c01 lq!L I I :,old .2,a -'I Filer
i Il Pear Filt:r
Liochemical Osygclt U,,mand IGOIJ^) 220 mq;L ❑ N..( Ll Aola!i,m LI Wutl.
n, l
I, tAI tl nrl _,i - dr/ (Tti I :I r,': nt1 I . 1 tf r.. r. t LI test r:
7.:I n: I u I rf(lunnt Lu-Ib} f ulllliy a,<aIpC In pr .al C.I!I 1 r J P!A.
It-aem! al tl y itn 1loul_r _ I,I GD.I ! .O ~;I-Vl i In wu•I,l , l vi -!t-4 f1 In C, numi fprr. .urran~ll
I oral Su~.ponlled Sr.iids I r:;S) ¢30 rng'I. 1 1 F'IA I I Al .u.'e I I Meunrl
Fecal Ccl!form (georimuic mean) S70` cfullOCmI I I I_aip-Lh)C I I Other:
lalaxinnlm Effluent Particle Sizes y, in dies. ❑ (JA Glhnr. I'I NA
TINA ❑NA-
Values tyrvcal far d,,:cestir. v,•as:r-•,vdul and neprir, I=ak olllur.nt. Other-: - LI NA
'A{NTF:NANCL= SCHEDULE
Service Event V Service Frr•,gnency
'napuct condili,_n of tanf:(!:l - At ast eI
:ce ni:ry: `7 ❑ mnrdh(sl (Maximum 3 years) CJ NA
f<ttyearf)
Pump out content:; of ta:,kls) n combined sludge and scam equals one-third I of tank volume.f1 NA
luspoet dispersal r:ell(s) ast nnce rvc:ry: yearls) (Maxfnu!m 3 years) ❑ NA
(lew, effluent filter ast once oveay: O montlik;) NA
W,I .r l pump, 1)[1111F) contents R alantt Al least ucce rutty: ❑ ntonlh(s) 11 NA
- - - IJy,,v(sl
Push laterals and pressure test At least once wary: l ! month(::) U tJA
- - - - - - Il y, al (sl
Llher:
At Inast nnce every: f] monthl=:) -
L I yearls) ❑ NA
I_I NA
v4AIN I FNANCE INS "I RUr'I IONS
luspections of tanks and rlir:J;ersal rolls shall be n+ade by :!n irdivi iuz! carrying o,u: of th.:: following licenses or ccirtl(lrOflnlls:
Msster Plumber; Master Plumber Hesliirted Se%yra; POWI•`; Ltsprclrr, PU61+TS Mihilainer; Septagn Fmvicinq Operator. tank
inspections must include a visual in sper,lion of the tankfs) to ider.t)ty any mis sing or brr.ken hmdware, idowify any cracks or leaks,
measure the volrn.;e of rontb4v:!d sludge and scum and fn check far any hark up or pending of effluem on the ground Surface.
The dispersal (:ellls) shall bn visually insporn,d to check liw effiurul I+:vels in the obswvation Pipes anal m eheck for any pondinq
of r••fflucnt en the. ground s!.ufarc. The ponding of effluent on the ground surfa,:n may indil:-le a Inning ccndi;irnl and require; the
immediate notification of Ihn local rr,Gulatory authorily.
When the combined incumulabon of sludge and scum in a!:y tank equals one-third f!;1 or more of tho tank vnlnntr, the entiro
contents of IIm tank shalt he removed by a Septagc Servicing Operator and disposed of in arcoidanrr. with citsptrr NR 113,
Wisconsin Administrative Code.
/',It other services, inetudinq hot riot limited to the sorvicinq at ellluunt fillers, wochanical or pressurized comPonents, pretreatment
units, and any servicing al intervals of 512 months, shall Fe Pnrfnuned by a :erlili"d POW IS Mainlainer.
A servico report shall be providod to the loner IepuLanly amholity 10 play'; of c,:nlpictien of coy sulvice r. •,r.nt.
G'dY4 ;,t+~~ 11
gaga of _
3I'ART 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 sePtago servicing operator prior in use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface- j
'_lurng power outages pump tanks may fill above normal highwaler levels. When power is restated the excess wastewater will be
L!;,!harged to the dispersal relifsl in nee large dose, overloading the cellis)'and may result in the backup or surface discharge of
fl' ,;eat. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
-cv✓er to the effluent pump or contact a Plumber or POINTS Maintainer to assist in manually operating the pump controls In
i,!srore normal levels within the pump tank.
Dj not drive or park vehicles over tanks and dispersal cells. no not drive or park over, or otherwise disturb or compact, the air-a
=thin 15 feet down slope, of any mound or at-grade soil absorption area.
R:-.duction or elimination of ilia following from the, wastewater stream may improve the performance and prolong the life of the
!1oWTS: antibiotics; baby wipe.,; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; far;
foundation drain fsump pumpl water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
[!aiming products; pesticides; sanitary napkins; tampons; and water softener brine.
'.B.4NDONMEN 1'
l+Jl.tar the PONTS fails and/or is pernanently taken out of service the following steps shall be taken to insure, that the system is
„rnprrly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
0 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.
,'ONI-INGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
: eplacement system;
El 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 front existing and proposed structure, lot lines and wells. Failure to protect the replacement area wit.
result in the need for a now soil arid site evaluation to establish a suitable replacement area. Replacement systems must
1.:01TtPly with the rules in effect at that time.
Fl A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in PONTS
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. Upun failure of the PUWTS 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 POW I S.
11 Mound and at grade soil absorption systems rnay be wronstructed 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
FNTER A SEPTIC, PUMP OR OTHER TREATMENT TANK LINDER ANY CIRCUMSTANCES. DEATH MAY RESULT- RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
!DDITIONAL COMMENTS
10WTS INSTALLER POWTS MAINTAINER
tJame b~iJ ✓J j-j :
Nance
Phone t71 S - 21. 1' L .3~ Phone
;EPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name
z lift `
Namr, ST. ci e+l C~7y _2C4
Phone I - -
Phone 7r.r- I r4 - UG
his docmnerri was drafted in compliance with chapter Comm 83.22(21(b1(1)ldj F((I and 83.5411). (2) & (3), Wisconsin Admiuisnalive Coda.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer__ S. 11LCIi'r- -4 C cnr-
Mailing Address T H C f f~ " r
Propem Address a1 r
( Verification required irtnn Planning R Zoning Dcpaament fin- Ile%% constivetion.)
CityrStale
- _ / Parcel identification Number Ono V
LEGAL. DESCRIPTION
~G
Property Location N r:: • Ii . Sec. _ v , T N R _ W, Town of
Subdivision Plat:_ Ct 5 /'yi rw ur}E, l
Lot 4 t-
Certified Survey pia - -
P # Volume ( _Z,Page# 7~iVrLr_.
-
Warranty Deed # ) Zy(O`T, Page k_ ~Q
- _Z~ 153 (before 300' Volume
Spec house ❑pes[Ili' Lot line ulcnidinhlc Q\cs0no
S1'STEilI 11iA1NTENANCE .4ND O«'NER CERTIFICATION
impioper Ilse- and nnialtenuner of pwr sapnc sxsienI could restdt in its pn•nlonne IS:l ore io h:uuhr wastes Pn>pet
alaitilcnnnee enasisls of pumping uul Ilse septic tank Ivory three nears or sooner, if needed, by a licen,cd pumper. \\'hai tug pat gnu
file system can atlcct [Ile funeltun of (be septie lank a, a uraunant serge in the waste disposal wsivirt. (teener ntaintenaii
I C,ponsl hilt lies are sperdi,d in §SPS- ,815-111) and in Cliapier 12 - St. Croix County Sanitary IAdinance.
I he propene owner agrees to submit to St. Croix Count}' Plmuling x Lanin_ Mpartmem a certification throe-. vgned by the
owner and by a master plumber, luumecmmn plumber, restricted p:untber or a licensed pumper verifying that I I ) the on-site
waslcwater disposal svstem is in ploperopcmtun, condition and of uli,r inspection and pooping lifticcessary'), the septie lank i,
less (ban F3 full ofslud2c. the
we, die undersigned have read the above rcquiremerns and a,_ ee it) maintain (he pricale sewage disposal sysleni with Ilse
sl:uulm'tls xel firth, herein, as set by life Departnlenl of Safely- A\iul Ploiis,ioma Sen'iee, and the Department of Natural Resources,
Slate of ll'izconsia C'e;'tifieation Stalin, that your wmic syslem ltas bo,n mgiiaained Aunt he compleled and ieuaved it) die St. Oois
C'oum)' Planning & lolling Deparuneut '[Inn 311 ruts ot•Ihc three y'e:u rxltiration dale.
6Wc ccniti' item all st:neglcnts ou IhiS f m arc Inrr to the ilea of nn''uur know Icdgc. I w', :nu;uc the osnerlS) ni li:c
pn,perly' described above, be vintn ofa tvarr• hdecd «rorded in licgister ol'Uectk t ttiicc
Number of bedrooms
11G1411-JR-E-OF APPLICANT(S) DATE
--="Aav itaRnmation that is mislepresenled inav result in the sanitary pemlil being revoked by the Planning l Aoning Depatti not.
Include with this application a recorded w'ananiv decd Item the Rcgi,ler of Deeds ( tllice and a cupv of the certified Survey ntap it
tel renee is made in the tvarmntr decd
(RLV.04112)
Wawnsln Depamoerd of Commerce count'.
.Safety and BWkang omsion PRIVATE SEWAGE SYSTEM St. Croix
INSPECTION REPORT Sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) 430419 0
Stale Plan ID No'
Personal infor ton you 1lrowoo may ee used fa sewndery purposes (Privacy Law. a.15,04 (1)(m)I.
Pemhx Holders Name.- City Village Township Parcel Tax N . ?J9 N
inke Mike C Ion Townshi 0 -1003 ow 41 A2 j CST BM Elev: BM Descxipdow SectlorVrowMta
f W , 0 ' A•a k. 4e 4 b ' fr o20TANK INFORMATION ELEVATION DATA prtw 3Q
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
~-L ~ ~~D o 7n OD•D
Dosing AIL SM
7, U
Aeration SrN~ 814:19" Saw
Holding Stmt Inlet
7s.o
TANK SETBACK INFORMATION SVHI Outlet -7. el o
TANK TO P/L WELL BLDG. Vent 10 Air Intake ROAD Dt Inlet
Septic > I Ob / / 17 -1 p Dt Bottom
1
Dosing Header/Man. - 1 _
9,3
Aeration Dist. Pipe U.19"t
Holding _ o
Bot System wet
~sr • (do t~
PUMP/SIPHON INFORMATION Final Grade 53U 9 7,yp c~-
Manufacturer Demand St Cover
GPM y.SC 1a
Model Numb
~I
TDH Lift F 'on Loss ISystem He TD) Ft
Force n Length Oia. rowel.
1- 7i
SOIL ABSORPTION SYSTEM
SEW MENCH W 6h Length No. OfTrenUgs Ct PR DIMENSIONS No. q Pile Inside Dla L'qub Daph
DIMENSIONS 3 ' $1 q / c h ~re~n
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Marwlactwol a
INFORMATION type of Syelem: CHAMBER OR r/10x.
~
rC>`•1 Vv {+ot% M UNIT Model Number.
DISTRIBUTION SYSTEM
IHeaderNandoid thctnbutron 1 1 x Hole Size X We Speong Vent 1o Air IrHace
lergdh Dia_`? _ La gMi~l A Dla '7 " Spaana._l(L. N4
Ma
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems only
Depth Over Deptn Dver xx Depth of xx Seeded/Soddad m Mulched
Bed/Tronch Came Bod/Trerich Edges { No 0
COMMENTS: (inciude code discrepancies, persons present. 9t Inspection #1:) b /L3' r 03EL
Looaton: 2390 250th Street Deer Park, WI 54007 (NE 1/4¢6 ((1`//14 2 T31 N R16W 40 acres Lot 2 Parcel No: 02.31 16 1
1.)a1 BM Description= Tt, Gv+,d afICA NW Y~ Well ',n~, t _ tac, ~r
2.> Bldg sewer longnh = 3N ' L orh¢ T WIZ00~( ,Sri Q ► GOQ 1 - eC IJI~//U~
• amount of cover = `I .T IW/ U
bl / rYlP.A-64 1" r 5~✓j -
Use r ision Required? in Yes I - No i I'I ~~ll ~ - J ~ 1 ill /ql S'
Use othet r si side for additional information. ~ ~_~~✓)!y VX/vl
SBD-6710 (R.3/a7) Dote Ineopcoes Signature No.
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