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HomeMy WebLinkAbout026-1004-60-001 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515251 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: Mattison, Shannon I Richmond, Town of 026- 1004 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: (,),e 0 01.30.18.16D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER i CAPACITY STATION BS HI FS ELEV. tiq S Septic / ' / S � l � � l � O Benchmark ?b 144- J Alt. BM Pa. ld& 50 Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet , �� 9(,• Z/ TANK TO N P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet o Septic $ 7 i ? J C 1 36 i Dt Bottom , Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM M el Number TD Lift Friction Loss System He TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO ` /L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION — CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 Bed/Trench Edges Topsoil Yes � No ®Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1498 Cty. Rd. GG New Richmond, WI 54017 (SE 1/4 SE 1/4 1 QT30/IN R18 �✓ W) NA Lot 1 // Parcel No: 01.30.1 .16D J 1.) Alt BM Description = 61 – a.� L a.S �tJ �{1 � �' rCMOv� 2.) Bldg sewer length / / - amount of cover = \ �' S i ti �a AJI� C s JJJ �a6� lfo,n Qd� aTr arv� tip r �a Plan revision Required? ❑ Yes ,NO L � _ LT L Use other side for additional information. _ l0 Date Insepc is Sign re Cert. No. SBD -6710 (R.3/97) i Safety and Buildings Division County 201 W. W �P� 7162 5� • � p � N VIsconsin 1 Sanitary Permit Number (to be filled in by Co.) 0826�6 -31 6 1: Z S Department of Commerce Sanitary Permit Application state Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide maybe used for secondary purposes Privacy Law, sIS.04(1xm) Project Address (if different than mailing address) I. Application Information - Please Print All Informatio l.C�� 8 G 01 Property Owner's Name Parcel # 0 / v Lot # Block # 4 i S f--, MAY 0 6 2010 ©4 - la c xo. -�&a'' � • Property Owner's Mailing Address ST. CROIX COUNTY Property Location f / f c PLANNING &ZONING OFFICE st � s - l e�X %, Y, Section City, State Zip Code Phone Number Cw �• Q� circle T�,3A m RE ore H. Type of Building (check all that pply) Subdivision Name CSM r 1 or 2 Family Dwelling -Number of Bedrooms �O (Z ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use ❑City_ ❑Village O'ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ` ❑ New System ❑ Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ! �� IV. Type of PO S stem: Check all that apply) H l 1SNon - Pressurized In- Ground ❑ Mound >24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel - less Pipe ❑ Other (explain) V. DispersaVrmatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation cwt VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks d �D Septic or Holding Tank DDD �OV eL Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assame responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum ignature M MPRS Number Business Phone Number umber's ddre (Street, City, State, Zip - d -- I zc) &k c;a 5 C3 S VIII. Coma /De rtment Use on Approved Sanitary Permit Fee (includes Groundwater Date ued Issuing Sign (N ) Surcharge Fee) G C tve � n Reason ill ✓ IX, Conditions of Approval/Reasons for Disapproval tYS1'EM OWN a d l 1. Septic tank, effluent filter and dispersal cell must all e s rvfce � maintained as per management plan provided by plumber, ` 5�6� • t � ` A-- G.0�521 � 3. AN salback requirements must be maintained v 48 Pd► • rand. lardira(toes, A p 6o Il` n r¢.�c�. . AM6 compiebe plans (to the county only) for dw system en papa' not tea duo Stn x t l inches in sin SBD -6398 (R. 01/03) Apr -20 -2010 02 25 PM St. Croix County Plan/Zoning 715 - 386 -4686 3/3 i v'd !7 . Y45CY, Sew•. I t30 a I(f . cp' o G�Q� Apr -20 -2010 02 25 PM St Croix County Plan /Zoning 715- 386 -4686 3/3 f a �• �l ��s -�-�� Tin s � � p s � • �`�°'� �` c if • 0 E l ra« ic (" W e e k - y ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer hQ f)-_e7 0 NQ 2�i Sd 'y Mailing Address �� �f� C fR 6 Property Address �-- (Verification required from Planning & Zoning Department for new construction.) City /State ��� /`Iij �� &jI Parcel Identification Number LEGAL DESCRIPTION Property Location' /4 ,Sec. � T _3�4-N RW, Town of f!l�jina Subdivision Plat: 0 A , Lot # 1 Certified Survey Map # �a � / , Volume , Page # Warranty Deed # S7'73 (before 2007)Volume Page # Spec house yes Xno Lot lines identifiable Ayes 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, signed 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 frill of sludge. 1 /we, 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. I /we 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. Number of bedrooms 712 704 2 =1__ SIGNATURE OF APPLICANT(S) DATE ** *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) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner A^0 Ma r d Septic Tank Capacity Aw gal ❑ NA Permit # 5) . 5 Z5 Septic Tank Manufacturer (� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model S ❑ NA Number of Public Facility Units ',RqA Pump Tank Capacity OA-- ga l ❑ NA Estimated flow (average) :366 gal /day Pump Tank Manufacturer J;rfdA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer OWA Soil Application Rate gal /day /W Pump Model WA Standard Influent /Effluent Quality &Ma age* Pretreatment Unit Fats, Oil & Grease (FOG) ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODO ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) VDAt-Grade ection ❑ Othe r: Pretreated Effluent Quality Monthly average l Cells ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ound (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :_30 mg /L [J NA ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: 4A Other: [I NA Other: 1"A * Values typical for domestic wastewater and septic tank effluent. Other: MAINTENANCE SCHEDULE Ser E Service Frequency Inspect condition of tank(s) At least once every: ❑ m nth(s) (Maximum 3 years) ❑ NA year(s) Pump out contents of tank(s) hen combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ onth(s) (Maximum 3 years) ❑ NA year(s) Clean effluent filter At least once every: ❑ month(s) ❑ year(s) ✓ ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ mo ❑ yeaarr((ss) ) ► Flush laterals and pressure test At least once every: ❑ mo ❑ year (s) ) ls) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) her ❑ NA e MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (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 S12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page of 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 cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs;. degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a 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. I ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone I SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name f✓r Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wi nsin A drAnistrative Code. START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed'by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs;, degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Gr+ , Phone I Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1 ), (2) & (3), Wi onsin AdrAn Code. / A r, n of com CERTIFIED SURVEY MAP o� SE 1/4-SE 1/4 SEC. I T 30 N, R 18 W N CO. MON. E 1/4 COR. SEC. I T30N,R 18W BEARING ARE ASSUMED AS N 00 ° - 25' -28"W ALONG 4 pNn5. ' E F THE I /4 OF SEC. � SE ON�p.��Efl - --. UNABLE TO SET PIPE, 281, 33' BECAUSE OF WATER S 89 184.87' J 96.46' 19 00 O 10 0• O 9� r� LOW 0 AREA CD Lp, N N 00 0] °T LOT -I N �p Np g . • �` 1.7 A. z 0 �p ajh N ' QD in lQ - IU m _ f 33, - PROVED S CIO 3 °9 J N 1 19 0 2 3S; 9�, C T s3•F el s ° , o, ST. ROIX V'.�:� )I �H ' OOJIURE IOW ppffy I�NW4 (, „ S , AM C&Kwkc- 0 = 1" X 24" IRON PIPE SET, WT. 1.68 LBS. / LIN. FT. 33. 0 50 75 too SCALE I "= 60' _.�1i�i�► \ THIS INSTRUMENT DRAFTED N BY A.C.N. JOB NO. 80 -13 ALLEN C. &1407 - m HUSSOK WiS..�� �►p VOL. 4 PAGE 9511 �'�A1 �� • �� CO. MON, CERTIFIED SURVEY MAPS I1 • 41% e SE COR- SEC. 1 M ST. CROIX COUNTY, WI. I T 30N, R 18 W Volume 4 Page 954 i !Hill 11111101111111 p1l 1111111il 111111 »11 1111 STATE BAR OF WISCONSIN FORM 3- 1998 V t j I V b KATHLEEN H. WALSH REGISTER OF DEEDS a L awrence Ma tiso ms toShannon ST. CROIX CO., WI Lawrence W. Mattison, a/k/ L en e t rrl uit- clai M. Mattison, the following described real estate in St. Croix County, State RECEIVED FOR RECORD of Wisconsin: 04/30/2008 11:55AM QUIT CLAIM DEED Lot 1 of Certified Survey Map filed in Volume 4, Page 954, being in the EXEMPT 0 8M Southeast Quarter of the Southeast Quarter (SE 1/4 of the SE 1/4) of REC FEE: 11.00 Section 1, Township 30 North, Range 18 West, Town of Richmond, St. PAGES: 1 Croix County, Wisconsin. Recordinq Area Name and Return Address Kristine E. O'Boyle VAN DYK, O'BOYLE & SILER. S.C. 201 South Knowles Avenue New Richmond, WI 54017 026- 1004 -60 -000 Parcel Identification Number (PIN) This is not homestead property. This conveyance is given pursuant to divorce judgment granted in St. Croix County, Wisconsin, Case No. 07 FA 86, on April 7, 2008. Dated this day of 2008. rence W. Mattison ' AUTHENTICATION ACKNOWLEDGMENT Signature(s) �A'WiOCV_ &:5;6 j STATE OF WISCONSIN ) )Ss. ) authenticated this day of /, , 2008. County Personally came before me this day of 2008 the above named to me known to be the person(s) who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN instrument and acknowledge the same. (If not, authorized by § 706.06, Wis. Slats.) , THIS INSTRUMENT WAS DRAFTED BY Notary Public . State of Wisconsin Kristina E. O'Boyle My Commission is permanent. (If not, state expiration VAN DYK, O'BOYLE 81 SILER, S.C. date: , 20 ) 201 S. Knowles Avenue New Richmond, WI 54017 (Signatures may be authenticated or acknowledge. Both are not necessary.) .Names of persons signing in any capacity should be typed or printed below their signatures 1 of 1 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3 • 1995 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI AMl- RFS­­ Apr -20 -2010 02 25 PM St. Croix County Plan /Zoning 715- 386 -4686 2/3 EH 115 111 0/78 A 1 �.Q, REPORT ON SOIL BORINGS AND PERCOLATION TESTS RrC�T WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES J /v t o IM Box 309, MADISON, WISCONSIN 53701 1 j�N /NB 9 0 �;� LOCATIONt V 'k„7_ Section T -QN,R, 2 (or) W, Township or AAl+rAdMA t ! Lot No. , Block No. Coin Owner's/Buyers Name: Iv s ! $,t amg� � � —`— Mailing Address: A A/ 1 !1!,70 �`! `7L _ TYPE OF OCCUPANCY: Residence r No. of Bedrooms & COMMERCIA EFFLUENT DISPOSAL SYSTEM: NEW k---- REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIh BORINGS PERCOLATION TESTS SOIL MAP SHEET a51 NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST I DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHE NUM• INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL RATE Si INCHES SWELLING INMINUTES PERIOD? PERIOD? PERIOD MIN /IN v p- 0 , P- P_ P_ SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH HICKNESS, COLOR, NUMBER INCHES OBSERVED ESTIMATED HIGHEST TEXTURE, MOTTLING AND DEPTH TO BEDROCK IF OBSERVED IN INCHES M 92 % N 4 17 4 // b PLAN VIEW (Locate percolation tests, soil bore holes and Suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number Of square feet of absorption area needed for building type and occup M ite Pe LY IM to scale or distances. Give horizontal and vertical reference points. Indicate slope. /a 0 N A it � I. I T _ - 1, the undenil"nd, hereby certify that the soil test, reported on this form were made by me In accord With the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of tat holes are correct to the beat Of my knowledge and belief. Name (ii 14 k 6 � L Certifi ion N . Z z fS Address 91Z ace r �7 a �� .Name of Irinallar If known Cc" A -- Local Authority CST Sig-W Apr -20 -2010 02 26 PM St. Croix County Plan /Zoning 715- 386 -4686 1 REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Penm.it � State Septic 4#,C SAME ��� Tawnah.ip �. -.1 St CAOix County ;jcat.jon Sec•.tian�Lo.t N Subd.iv4a,.ion PTIC TANK Size. as ga.tlona Number. 06 eompa4tmen.ta , tatance 00m: Wetx Bu.itding 41 0 12$ s l o pe Hdghwa.teA 'LIMPING CHAMBER S.Lze� Falb r(„ 4ctuheK Model Numb en oLDING TANK (�// r Size gattona Nu n 6' a � Pumpe.h r .. Sy em '(6 tanee 640 MI Wgtt 8 •L.tdiAs �12$ 'slope_ ...— HiohwateA 8 SORPTION SITE Bed TAena'• ., (stance 6Aom: We t —Atn, Bui$ding _►2$ elope __ HighwateA 8SORPTION SITE DIMENSIONS Width a6 .thench /2 it R e qudned area Length o each line 4 1 4 it Depth 06 Koek below ,til Number 06 l.Lnea Z Depth u6 hack uve tilt, in Total length u6 Linea `1'� it Depth u6 tile below ghade��i Diotanee between 4inee it Slope 06 .trench .cry. pen 100 At z 104µ1 Uboukptiun area .t Ty pe ype o6 covets apex on a.trtaw ni IT DIMENSIONS - Number u6 p.L,te GAavel around p.i46 yeb__,�rtu -0f ide d.iame•teA it Depth below inlet - -6t Total abaoAp.t.ion aA it •A)Lea tequ•i%ed„ 6,t ' NSPECTED• TITLE i'P LIED DATE 19 B iJECTED DATE 1y� (ASON FOR REJECTION Apr -20 -2010 02 25 PM St. Croix County Plan /Zoning 715 - 386 -4686 1/3 q .13855 REPORT ON INSPECTION OF SANITARY PERMIT # 4'9� 1 Name and Address of permit Holder Person /persons at Site Date of Inspection �"Z ame, ress, cense o. o ns a fig Plumb Time of Inspection d INST L : ❑ Septic Tank (� Seepage Trench ❑ Dosing chamber ❑ Seepage Pit Q Seepage Bed ❑ Holding Tank ❑ Fill System ermanen re Terence in scr e: 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 # of gallons ; construction depth to the cover ft; If septic tank is being used are baffles remove ? YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is tFe device insu C3 YES ❑ NO; Wired? OYES El M5 Lacking device on cover? ❑ YES Q 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 wel1; ft to property line; ft to ordinary hig 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; the depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of Take 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) SWAULIKLNL` : Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary hig 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? OYES []NO (13) Has system been installed in floodway? ❑ YES [3 NO Floodplain? []YES (] NO DIIHR- Signature of Inspector -° M `tea *• CA rip. _ 0 0 '6 N x° r? 3 m n ��� CD � 0 CL Q c w CO N CL a . a a y P r 0) 0 cr ic ID i '00 N �p I'Il CD b a N 1 y N 'P "I O r Gj• 7 r d G f 1 og ° ko �... { cs O ns r� i r o w bi ._ u� s o ° , O ° h? • ;r i fV o r & s O og ° I ---- --- --------'—'- # s ri C o m (� If O x to � tl m�'d i n o C C as r, CO) ° CD *�, 0 d� @ JD cfi o tt CD ° N i t r 4 try CD ga . 4 r 2 M i h � j sk r , r r'7 w n L E ``w Q t` CERTIFIED SURVEY MAP o� S E 1/4 - S E 1/4 SEC. I T 30 N, R 18 W CO. MON. N E 1/4 COR. SEC. I T3ON,R 18W BEARING ARE ASSUMED AS N 00 -25 -28 W ALONG 1.P E I/4 OF LI OF THE �Np�P11- ev SE EC, 1 33 UNABLE TO SET PIPE, 281, BECAUSE OF WATER S 89'-34 19 00 1 84.87' � 9 6.4 6 0 0 `OO 0 0, / 90w rn LOW A NO w o AREA co N N � C OD / O LOT -I 1.70 A. o os OD N t(1 -4 CD A 1 y 33, PROVED \ S sso 3 s0.9 J N 1 "8 1999 Q S3„ S ST. CROIX / 01 COMPRE ifMOYE ,P,dtPXy I".44NNINdi AND 60#408E O = 1" X 24" IRON PIPE SET, WT. 1.68 LBS. / LIN, FT. 33, 0 50 75 100 SCALE I"= 60' - ����� ►''b LR THIS INSTRUMENT DRAFTED ��!' %q ' p w BY A.C.N. JOB NO. 80 -13 ` ALLEN C• - s N $� NYHAGE.4 �_ L_ 84407 m_ fr os m, �{ VOL. 4 PAGE 954 Np 3u ♦i�,�a' Co MON. CERTIFIED SURVEY MAPS `'�6 •� �'' e s E coR. SEC. 1 ST. CROIX COUNTY, WI T3ON, R 18 W Volume 4 Page 954 r Parcel #: 026- 1004 -60 -000 06/26/2006 01:14 PM PAGE 1 OF 1 Alt. Parcel #: 1.30.18.16D 026 - TOWN OF RICHMOND Current I 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 LAWRENCE &SHANNON MATTISON O - MATTISON, LAWRENCE & SHANNON 1498 CTY RD GG NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1498 CTY RD GG SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.700 Plat: N/A -NOT AVAILABLE SEC 1 T30N R18W 17A IN SE SE LOT 1 OF Block/Condo Bldg: CSM IN VOL 4/954 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 01- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.700 36,500 79,200 115,700 NO Totals for 2006: General Property 1.700 36,500 79,200 115,700 Woodland 0.000 0 0 Totals for 2005: General Property 1.700 36,500 79,200 115,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 114 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 OWNER _. / iS u9iL .__. _4.. _,> TOWNSHIP i SEC ADDRESS ,1�. cJ , i /►.G�n k� s T. CROI:X WISCONSIN. SUBDIVISION �_, LOT LOT SIZE PLAN VIEW Distances & aimensions to meet requirements of H62.20 SHON EVERYTHING WITHIN 00 FEET OF SYSTEM - i tw I di atte o th Arrow SCAL ' I SEPTIC TANK(S) GR. , 1221, . CONCRETE STEEL N0. of rings on cover Depth � PUMPING CHAMBER SIZE PUMP MFGR. � M ODEL NO. 'r GALLONS Per Cycle TRENCHES NO. of width length area BED N0, of lines width I;L - length ,� ? area 2- depth to top of pip 14 NUMBER OF SEEPAGE P /ITS Outside diameter total pit area AGGREGATE ) ,�' �2p 3� - t� PERK RATE AREA REQUIRED / ti AREA AS BUILT Disclaimer: The inspection of this system by St. Croix'Cbunty does not imply complete compliance with State Administrative Codes, There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THI INSP DATED /► � � a �// ._ ���; Zf °4 (-) PLUMBER ON JO n LICENSE NUMBE� s/ _ .113 8 REPORT ON INSPECTION OF SANITARY PERMIT # !2 ?c;V (1 ) Name and Address of Permit Holder Person /Persons at Site (2 )Date of Inspection � Time of Inspection ame, Aaaress, License N o. OT instahing Plumber i6 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench [:]Dosing Chamber ❑ Seepa a Pit ❑ Seepa a Bed ❑ Holding Tank ❑ Fill System ermanen reference in 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: M 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 of 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 TRENCH: 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.0 /80 Signature of Inspector REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM San.itany Permit State Septic. TAME Towne hip 0 j" j jX /.— St. Choix County ocation Sec N Subd.ivte. ion I PTIC. TANK Size ZOOO ga.t.tone Numbers o6 eompantmen,te �(e.tance Anom: Wet.t fj� , 8uitd.ing 4� 12% e,tope H.ighwaten 'LIMPIN CHAMBER S i z e eat.to na Pu a �ac�ltwte& Mo dex Numbers , O LDING TANK , Size gatton4 N o a Pumpe-h em "ietance 6n0m: Wett B itd.ing 12% etope_ HighwateK 8 SORPTION SITE Bed ( 6nom: We.t,.t 7L Bu.i.tding � 12% e.tope H.ighwaten. 8SO RPTION SITE DIMENSIONS Width o6 tneneh /Z At Requ.ined anea Ax Length o6 each tine — At Depth o6 hock bekow tike_. -��_ -- to Numb vi o6 fineb Z Depth u6 hock oven -tile To ta. ke ngth o 6 tine.6 At Depth u 6 t.i.te bexow gnade____� in 0i6tanee between .t.inee 6t Stope o6 .trench 4.n. pen 100 At 1 u 4 u.t abo oa t iun aneu „ rJ 6t Type o6 Coven: apen an et naw � IT DIMENSIONS - Numben o6 Pit-6 Gnave.E around p4i.te yee nu Oute.ide. d.iameten 6t Depth betow .in.tet At Totat abeohption an 6t ,A)Lea requit . .................. . . ............ . ^. NSPECTED. '�+� TITLE IIP " D DATE �� �(/ i � 198 c JECTED DATE 19 8 IASON FOR REJECTION PLB �� State and County State Permit # °� Permit Application County Permit # for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: a, . i4- �So� "mil l [�✓! B. 'LOCATION: _ ' / / <, Section T N, R � (o0 W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township i C. TYPE OF OCCUPANCY: * Commercial *Industrial *Other (specify) Variance Single family 4 / Duplex No. of Bedrooms 3 No. of Persons D. SEPTIC TANK CAPACITY /000 Total gallons No. of tanks / HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured -in -Place Steel Fiberglass Other (specify) New Installation Lw_�_ Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1 Total Absorb Area sq. ft. New 4 `' -- Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top of Trenches Seepage Bed: � Length -S'Z ' Width 12 - Depth 3 C- "' Tile depth (top 24 a No. of Line �- Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑ Owners name as Iisted on EH 115 if other than p owner: 1, 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 Certified Soil Tester, NAME O 'f C.S # 7— Z. r 16 and other information obtained from ow /builder). Plumber's Signature Mp PRSW# ,� Phone Plumber's Address i ;, 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. g { i F i 1 c € 9 x 3 E r E t I P a w ' J i 3 a i 3 3 a a a E Do Not Write in Space elow FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fes Paid: State /L/, � County ' Date f Permit Issued /Rajected ( ate) UZI Issuing Agent Name Inspection Yes No State Valid# Date Recd 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 T �l 9 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 j 19 8 °NiNG 0 r - �fF /CF !� LOCATION' /4„ ' / <, Section l_ jvkN,R�f (or) W, Township or MunickbWAv o Lot No. ,Block No. County S � 1 ivlslo ame Owner's /Buyers Name: u ZO # l I J ` Mailing Address: TYPE OF OCCUPANCY: Residence t of Bedrooms COMMERCIA EFFLUENT DISPOSAL SYSTEM: NEW 41_� REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTEF INTERVAL MIN /IN / BER — 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P— P— P— SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B — G — v 1I 7 7Z �� r' d i J0 S ~ Y Z Fi 772 ho , fe 77 "' h // PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy ✓� In d" to scale or distances. Give horizontal and vertical reference points. Indicate slope. C/ 30,0 Jlgbj &� F S • Eo 1a'6 _ �� w � F • i � �N r I. . ; �M s s , E 4 00f I — ��w.�. .•:.,.«.� d. ®m.. ..y... ,ten»,. m.....«...�_ ,d ..— _..i._.. _. .�. _ >�,. E 1 v I 4 i + 3 ` t 4 4 3 � I, the undersigend, hereby certify that the 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) �'�' Certifica ion No. Z Z Address 1 .Name of installer if known Copy A —Local Authority CST Signatur Y4, 5C Yc�, Aso. , I f 3 OA) 1 ,s ^^ w uo ws�' • Parcel #: 026- 1004 -60 -000 12/01/20PAGE : M 1 OF Alt. Parcel #: 1.30.18.16D 026 - TOWN OF RICHMOND Current 1 , 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 LAWRENCE &SHANNON MATTISON O - MATTISON, LAWRENCE & SHANNON 1498 CTY RD GG NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1498 CTY RD GG SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.700 Plat: N/A -NOT AVAILABLE SEC 1 T30N R18W 17A IN SE SE LOT 1 OF Block/Condo Bldg: CSM IN VOL 4/954 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 01- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.700 36,500 79,200 115,700 NO Totals for 2005: General Property 1.700 36,500 79,200 115,700 Woodland 0.000 0 0 Totals for 2004: General Property 1.700 36,500 79,200 115,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 114 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total p 0.00 p 0 00 q 0.00 I� ♦ C. n a l comt& 364864 b CERTIFIED SURVEY MAP OT SE 1/4-SE 1/4 SEC. I T30N, R 18W N CO. MON. N E 1/4 COR. SEC. I T30N,R 18W BEARING ARE ASSUMED q g AS N 00 °- 25' -28"W ALONG `.AN THE EAST LINE OF THE SE 1/4 OF SEC. I uN UNABLE TO SET PIPE, 281.33' BECAUSE OF. WATER S 89 ° - 34 - 32 "W 184.87' 96.46' oa 9 O a00 o- / 9 0 , Oo rn L AREA w o c - / N u) oO Obi 0- LOT -I 1.70 A. o q5 o (p tijy OD N N - o' R 33, PROVED \ S 309 J N 1*8 1989 6Sp Q 33 , e _ C 1, S3 F s s ST. CR0i.1C j y 01 COMPRE E1141Yi ;P {+, y Kvf'i` mkdi •, GC �'S% MW 60#&WECE O = 1" X 24" IRON PIPE SET, WT. 1.68 LBS. / LIN* FT. 33, 0 50 75 100 \\ SCALE 1 "= 60' THIS INSTRUMENT DRAFTED 'd ��� C. AA Apo BY A.C.N. JOB N0. 80 -13 .r ro t4y J - S-1467 m w;s. 4 VOL. 4 PAGE 954 No sti ig 'J ��. Co MON. CERTIFIED SURVEY MAPS `�� e• SE COR. SEC I ST. CROIX COUNTY, WI T30N, R 18 W Volume 4 Page 954 4r 98-9T PaPO 3 a3vQ 98 - i7z - T 3u MaOd LTW75 IM P uouiuoTg man puOmp t2l 36 _umos_ HONRaff'I `NOSIllvw