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HomeMy WebLinkAbout018-2011-83-000awn..oswnmaca..r.n.. PRIVATE SEWAGE SYSTEM $1 Croix INSPECTION REPORT uo sweet x" 81 $434 GENERAL INFORMATION (ATTACH TO PERMIT) siw ID Ns A Jason Grinnell n TOWN OF HAMMOND Tec M 1pi No 018-2011-83-000 eMei.. m.f7w� a n.eP" Dry etwT�""P'�M3029.1]1098 TANK INFORMATION ELEVATION DATA TYPE MnW CAPACITY STATION SitR ` ELEV Sect �!- marF O IOJ., y� 7.o i Its D -3fi- o r r G.tS .15 Set;se.e, 0.1Ant lNminle' 10.1 yen TANK SETBACK INFORMATION LD L�wli. Suw Owlel 0 1 VAILL I III ma.a g1b septic I y3, ibe' L Mnn 4. 89.75 n y > of I .,,Men a 7 l P« Al A. 7 ymg o, System PUMPISIPHONINFORMU ION kr wv%A/ Z7 PInn G,.ee TlsP.r Dem. Z �7 r ,IS 'f7. 95 �N�m„ ,40 97.7 R L�.95 P"TII�LoI. .,.5 5 I w�l •^ , mre�w. Pe o.w. .N.� e Z, 00 SE Svs:EM TO Ph SLOG W DISTRIBUTION SYSTEM B� n SS.O�IILL COVER unlpmie 0nry Onry J R` A ISor /111�0 a.MouLen��Z., IKLIt n _lx COMMENTS, pnauceconeenoepenw. pn a mn, in.paen Ax L� NAfi Covrr �-)E /Jet V kff 0.. •6A S"4, ,)AI, a"ixw. r 'a`{�aryx nol fan 4>'C�• n 2)!N ,IsWH-95 .mPNna 5gpOk�J wjsiokt ✓NL jvpi ewea,%A 4. .here. ,, nlnn.I�form Cie. oY o L/ a AT „n ss aM. N. s .m ee�.w om.w .�..1 201N WaNin01A 0Pn. nez sw�Pmvnxi 11 Nil aiwnM MM7-71e2 / » V�✓l l owni�..;:..z,.w-cw„x1,.---H+.»�-'-� I — ocnm ✓ emvlomPlot . n wvi.,. 1 J! n w.w�,�smw . r �mm�m...m..co�Dmr gem_ o�me .mm, St*®lwuoQ .z,... .>v.P mmmski .m s.m n,mmm.m o xmm.arx o axco,la�.�s ew ..me.-g Zs __ MR,, O�hFSa,emm,-lu,v n asv.m. B, nr+g��m� ssr,.m rem �Jkk 7 na �. �` {,, Z _ r"._x 1 1 zi S _ 3"o.r 'bso.�n 9 iar9 �..� LYCeN b.npwJ Itt+ System PLAT PLAN PROJECT Jaw entirely ADDRESS M DeM Ave Haiti W WME3 NN liil NA' ii4s 30 iT 29 N,R'-> TOWN HemmmO COUNTY ST CRj1X EYATEM ELEVATION 9]]' OATA911/19 BEDROOM 4 CONVENTIONAL AT -GRADE RXN CONVENTIONAL LOT HOLDING TANK MOUND _ SSPfiC TANK y1]2 1255 elLai TANK ME DOSE TANK sam 765 HOLDING TAKE 5¢E LOIN MTE 6 ARa0RE1'ION AREA IOW R or aEambertn00e kk BENCHMARK V.R P Top of P PC mad ASSUME ELEVATION IN FIIHl IIfWIlC Ishad ❑BORY.HOLE )WELL •H.RP same eS Benchmark ordinary Well u to meet all Al setteel NGi a to Bo Bone I Dee o owed run on Whey h MONnItt BlmM Tenn Wyslem \ 2 Al Lot (Belem. Scale = 1/41' = 10' 0' Ao Be' B 3 B-2 3%Sbpe BM Area 15 Delon "Stem is to Well is 10 meet all If setbacks If nmsturneE a DB >15' hom prcpany line \ B 1 fele0 property, Line lh V �uFS �pe�*Wad ONISION OF INOUSTRY 5RERRIASS I;N---\�.R GREEN NN Voke Pl oe lbmupeRemy UEalW ilarpmBnmeyeseryaem¢e vmw Memmingov toµ Dow ever; - mothrocir $epemher 11. 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES 1011F09-II Plan material PWA 091901069E SHAUN R HIRD 1432 C 1h St New Richmond W 154017 SITE Jason Grinnell 151F98(11 Arc Town of Hammond Saint Croix County Total Amount. $25000 Devn of.. 6000PD r1 ReLrvmr-VenCum ru dy,N Maimamnde Required Oil nIL !NAI LY t1YAN0 hRNIIT Y- � 11IRAG£S O SI510A GF I✓1FaN Y ZYALLCEe AI -Grade Compnnolt Manuel- all E C. SAO 10854 (NWmi Ula) kit re Dwart lln Compnnem Manual- Ver 20. Si 0ID0P No 01101, R IM1) The mbmmnl dmrnbLJ nbve he, on,, wedFly mnfalm lent. uppllcvbm NEGAmon Adem veCodes and Seasonally Congo The submlRalh s been CONDITIONALLY APPROVED This system is 0M1 cletl and Pavel m mwNmce with the melded sppmrvd plea and ,In as mmponem manoal(51 nefemend able, The oww'q v &Rwtlm cbl 10101(10), W ki Metals, l5 responsible ie mmphmrc ,,in all lode rtgmaeenu No Pomon may engage,, m work ad plumbing m the star eNma IIwaW to do 10 by the Deparmmt pert 14506. sids a' oll"Lle madame atoll be met Trans m .all otimeadaoon and pt0r0 oecupmcy am Panne 04penal area prior and during co ,moron to avoitl dinmhmcp mmpai and use of the site • With new vndN net to the pump to the days tank red lhn drib na pompld Forto hinerealler 001apalay • Montreal egm red from rselmm I nmg of Mmerae and Dols andsor left pmduulsehell mat be disehuOW Into the deans dnehalgmg to the prry sb vesNwvw nmlmt Lesson (POINTS) Wastegenerznd shall be properly disposed of on site 0t ofine • Any tall grosses, leave and shrubs shall be Lot soon Lord removed prior 0 idling the smlxc for lmmlladonto peel mntlme arnothedlspetmlerea All loose Grinnell material to be Gemnved from the POWTS Dtsp real • Prior 1, constreffeen of Cut dispersal AMR. slit it hem t Ithe sod To a &pill of all Cover Page Shaun Bid Bid Plumbing Inc -/ 1432 120th St, Now Richmond WI 54017 715-246-4516 Date:9/1119 OMIMJa4M Grinnell Location NW 114 NW1/4 S30 T29 14,1117W 151578th Ave Hammon Manuals Used AhGrade Component Manuel version 2 0 SBD Ill IN. 03MI) Pressure Distribution Manuel version 2 0 SBD 10]06-P(N. 01/01 R 10/12) Pages 1. Cover Page 2 At -Grade Plot Plan 3. At -Grade Cross Section 4 Pipe Cross Section ipe Layout 5. Pump Chamber Cross Section 6. Pump Curve ]. Flter Spea1[atwns 8-9 vessel and Cormngency Plan Attachments Sal Test n l Shaun Bill Signature ZK License number 00 Page 1 of System PLOT PLAN PROTECT Jason Odense ADDRESS Us DeM19 Aug RMerel 54023 NN Ilo NW TICS 30 I T 29 NIR O IN TOWN; Xemrmn0 VNTY ST CROIX SYSTEM ELEVATION BT T' 9IV19 BEDROOM C DATE — CONVEMTIONAL AT OµADE YEN CONVENTIONAL LIFT HOLDING TANK MOVND_ SF.FTIC TANK \TLC 1255 Palms IJkT TANK 412E DUKE TANK 566765 BUILDING TANK SIZE AD KATE 5 ADSORPTION AREA lOW k of thanes"none klu BENCHMARK V F. TOP Of I' peo pipe ASSUME ELEVATION W- fiber lifeOme FIFOUR❑BOREHOLE DWELL •HµF sameasbensim"M Property Line Well is a most all WDNR seMcb GreElrg AsSP be tlone w IHdrmm down run off Bwey Irom µNye HuKCWI Combo Tank pbm \ 2 Acre Lot \ Scale = 1/4" = 10' 0 0000' B3 B�2 � yL Slo BM Area 15' below system is 10 Well Is 10 meet all WDNR setbacks remaln undisturbed t0 be >15 from pmpeM line O \\5_1 97 ' Line .�2 0-`7 At -grade System Sloping Site Cross Section and Plan view E;.__________________________________ Y al I ,r,•'$ Y 14RS^3�t�'f�]{ktiSh(�({� 55S 5 4AA41 ` �231a t I. s;?:`jli4 ii'i2 F�kh,xuu• 7;`9,.2'.a .� .�,5f4'Sti.�, I W A 'l.{tyyiy 2Y)15]S]r)i] S?i(??2?i iyi^^>AT 15)�{2'xiiiyj .WdS]5.:•C:a f� S�:):S]:d��55a. •i•.:{iK:J 'Pr:S.Y`:`: f` ).iR4 1 ?ua �si49iri :iii'•:Frui•({}Y�"Ss�iiiiii�i�$]•,�ifri5i]it, ')^;ii � ).}i'%w)nf rTfS(SY.{i{(n(Slx�.iYt4 ��{Y`�i�}{.r. �•5(}(l�ijiSf t .S�,i],;x)r ,'l,•,(�{�,A,(,i<� ?x����S(�F2S�?iY�i ��.F�al(i���� i` 1 a. F3r3 I E ---- ae -----'-------e -• a_m %Slo 1-1 =Plowcd -Clean aggregate O —4 in sch Olive r basal area �.t©<; '— m 2 R m. dia. observation pipe Lateral wim 2" ToFaoil Cap aggmgare oj-QW; e Observation Pipe Gleanable ilc With cap Fabric ./J 9d PV Lateral Invert Topsoil Cep Slope Direction GENERAL INSTALLATION: The at pace area is staked out along she design contain Exismig vegemnon is mowed and raked ode me sue The basal area (Lx W) rs staked out end plowed vnth a moldboard or clusel plow Plowing may not proceed if ate sod is wet enough addle plow depth m form a''/. snob sod wile when a sample is rolled between the palms citing hands The A x B area is vend by clean agpegme deposited overhead by a backhoe Special care muss be used when placiogt nWa gawtom zewmpacnonoftleplowWs we After the wpsed cap is placed, the ®due at -grade is seeded and matched to promote vegetative gsawah, must erosion and protect from freezing. The observauou pipes are permeated in me town 6 inches and secures inPmce WIGS IgI page � o[ Pressure Lateral Layout One Lateral — End Manifold Forte Morn Ire .. `. L o o_ L. W r..A on New r4S eedieabous etcr 't_ In, eter In m ff�Un In e Ft Demeter In. Len R �—nae.dea Cleenopt Lateral Tum-ep —i Plug bong Sweep 90 Bend erm.are syaem c•nebnm+•b Istcrels arc wnsWc¢d of SchedW<40 PVC pipe Onfces ere dolled perpcndtcular to the pipe vnth a sharp doll brt and face down Lateral wm-aPa termitmm w�W a tMmdd clemoul Plug and ere enclosM m a 68 inch demercr lawn spw4lm vdve box accariNe from fwshW gratic. ••••• Grade 0 • •a•0H 0 •a a• bs lncIl Leone spnNdtt Valve Box 03/05lgj Page �, of, — Septic-DoseTBDk Cross Section And Pump Pet'fotmmm Specifications Tu,k Mmufua¢e 1'W Model N,mbm TOW TedtG ecity ]-Sti Mex.6ury Depth __ dlmFMawfp:Mv f F;x. Mead wmhe I . _.. Mltmvum Pump put Required OPM I>. Fr TDH OmW MmhOle Mb, 4" Abow Gletla WA Lw41n8Deeice InWM lst <b" Below D 9ednd Wetmdpht — -1 Fieiabed ('vatle Outtet FBtw West B ➢e xwitdhs am H.e,.e>�ry Tmk Vaiume- OPI ITrmmion Iabu Vol me Gd. (rmerve A ym, (Jam) B 1 2 ddee) C, 7 r la . deed) D TaW ,� 96t fecbvm Numbs Omubommr ZMll edd Nvmbm VE 1.,✓pe TOW Dyoemic Need CFOH) - Pep 2lewhma How J UW Ptww Nelwah l.a� Fmee Mom LaM D TOW I�b Mmhob Mx. d"AEwe O�Me 'y�(l Swm1YMd� Wlq laklog Wooffies,istroof1 luml- Bw w t Vast Miss. 11" Dmmscvmomt Abvn GrWe M® Web Vmt Gp GFJMBRAL dNRTALLAnl[)M ThO . pllddom bunk is bedded uW bawl, filled in a surd a with Me wnWxtura'e product apmovd epewdiopiom. Mmwnm dryth o bury m epedded by the mouflnneer mar not bmeetamelesIL M Nmu lb: �bdpdpand tluM1LisnOf Bapmpmre.oetl 5Mh0fl2L mwgnvrclenvbtivteo mills artOILmtMwith ' FtMh wme fwhd4ewnpd Ydun bsoilto Pve®t sNUB Of vpipThe fmrce mabu a4ad with 1- S,6 6IVC to Imndee t¢ un4 e»wuiwn W the elmelaeNed wtlwt�pbl. FJectlulwrvxe µmpllee MN NLC l00 ub Comm 161X. l Wits 1J Page 5 of� 280=SERIES 1/2 hp Submersible Effluent/Sump Pumps >n.ue.ryaioe.n..oma..�,.x�mamo- .Mrvm.maa.umw..,m..�-•n.,s, iwwe r.t..�..d�n.,.�W so�...,.wtVg a ul.B�„tla.. o.iv.tl.m..M unrM. wvw'� m-swy =+tea All Mo is Feature: . vo,W. .am WW%' •416a Nm.ptl, YUR •Pw,,WM IUEMI✓J uq,s ytlI~w ba moM1p • Ni ledenae - ewroebm,evie W il. W my naH •1'R OWivpe -a UmnuNtIsIs A.1- K mo ad. • MB4nnm Ilultl bmp,e4uB;1 ip F. f90M,hC UenM. MUM 10 HIM ssja so.( W ewe.a W 9, ewaw OI _ WA v e.ewm�amm�...w v~Wmu Bnp.n Motor MGMft xsowatlona •ro a%Mvan+m,mNwvm.cue p3vl v.nwssPMr+P.�sn. nvemv.Plsn .v.mnam.awl Poiftmanm Curve: 280Senes ......... SON - tots.... .ones...... Emmons Emmons no son Sam sonso ...oe....I.oesttMoo a sio is maL mM MMM M MMm USeioiu PvlMNe a a n�swIN wtxft No em Dimensiw Date: W. ssn, "OftI3' MNwvntlu.lo'n�e�l MlMmum Sump D/emebrs Musa 1.is .: a• f / d Y.W ANYMetoPos M.blaB1 MaWlm I M.nw, .mw snev.maM Mr MF.M. ro...m nm Wmm nm..mr� v.nmmm4 »imev .moon.. MOCONdM, vtIWwOM wMnMr mo sP c us l:eNneU uWePwM.•rMp NqN i.»a,.w.•e.nrv,, rwwvaF fONe•Pmmeosusxev F.. nam.t.lm .,.mtlw.meo-.nn.mm, .moo•. �. wm��„ 601 g POWTS OWNER'S MANUAL S MANAGEMENT PUN Pr._d_ FILE INFORMnON S �� CT .dice OImPWI.'ATIKUddS SSN.TW ((� CptlY j O.0 BWkTv! WUYapep OEEIGX PMAYERA9 ElM1rapy yeepyvy ONp a°`o18v1r^'s q OILS Eye NFftM o NA Numael e(pYYpFMYyVM )I NIP Tend CaPsyry am EnlmYed Am,(rwlgwl 406 ava pumpTEmlmseubafurs, 0ME DOYen blow teaN(EaO .Ts) G lava pumPmmufxlune e' oFyX Sml epPliwYonflW wavrowne PumPWb l „Zin OW. SIandaMlnflurnfflWMQWUUI MonMl/wa'pY prnamen MUNI F.M. au E Omar 1EW) egg MI 0samott [FN opM FIIW 91ON " OXryen Oomana(8004 a20 mi 0NR omev'nanlmllaraam 0W TolnsuawNeasol(I8s) :IEO hi oOIeInM1c4cn pOgr iTe EMuam OwFy MmNlyaWllse Ded,.1O ,,M GMT BVIrrq OSlWp (SNY Ogw.Sn ppni OlncrwM lymay) aIn(L,,,rFa dal cw rn 9 R5S1 Zp mqT .Orra OWvq EgIC^Nmn Nwmealomwl) sl?eJ10Onl oOnyYv 0Ofr Mwulwm Em,ml pw %M Ala, 0M,a ' cMA N am v.I...ImlwlaemwaaP..Y.aY..,a wpr Nnm..n ulna' am Mmbl ewer saMw Flaeuelcv un_ mpmm Of WXw At MOW mw awry 3Umnoth (msaanfmayganl oN4 pump oulmmenNdYrNU) NTm mmawa exdpe lane aoum OF WOW 9n IW(S) m bank vdlnlN am fwwadlawrgal wu(Y Al lMwl ow MOM ,j (° (Xvanumavgaw( aFA EthanollalnuNn When iAlNularomry y OMeantI GMA I negd more, MUM!, aAlaomi Al legal one awry 7 Un M(al OMA 91 N lebivNmwrun Wl pllrlmwawlY' > omowll9 ) OIU a Nod wlwgahr ommnl 0 n.Peoded" N w Ve mm.N Chat sTal lap Of by UP urchmal wrMina me Of un rolad, 11[Mnaoe or wnleulans mero, Emimm.WW gsgky gµr FO'MS lnspedor� MYOrs MMInYNn er', Shopi Sading Opnlin m k reporters MUM iw M Wae a NwY Aow Nate%M(a) h gmmy any mlaNnp or di a.amwan,I haffy YM Flotilla or May, mrwn the rolvmsN ...byM]eatlwable eom hat a M anyetlmorwnmroaemwmm ins mendding of al on ^Wrenn maleea IM p�nIng 01 b M C aw Yflmle g hoer uc cddrveao, PIPw and a tlnG k, any enema N WIMO on an ymuaa hoer. rYlnev � wM w Na gnu�d eMrfaw may melol a NIIInE mNlann sie rgwreo me Immaaltle roanWm N me IPUI moulhhn the mmaneav muleam NMorate am eammlam Ink weal.Pn.mly(to or mom of Me bank wlome, art Nln mmaM of In, art Nan be rum el by a sapbne Senndne Ownar, and doomed N m aworaenw win mwW MR na, W Wn wdmmmraaw code NI CAMW wrvkw. Including dN mod omMa OF the ven'mna of nomem Nan. mafWIwI or gwwmea mmenems. palmN man am? M Imarrala of rag dollar Nll OFPW.Im awfirr by a 000I PTS M.n.r NnseMwnyll al MImal ame 1=1 a'lMv hdarny Mmm IPlam N win Mb gam AterenL 90� Poll STARTUPANOOPERATION _ trgMent tg F tha rynlmpeae Cu treat paceaet�Mb Femme NalepwY (PAID) a) If high onGMNe am dodamooa nave IM1ermtlenY of the knkk) mmaM W a aepipa aeMdrp opener, nor OF we System den UP snot no asor Mon sou nMmcm are Gwen at No bM Emma eubaw ItloodRe�tl mutatilFF too oomPUPUnl^meIa ILrps owe. omallNormoing ne, ardaw and MY nv���m. MCeup or0u,leGne�ryaMfe�HIW2 To avow ml. MUNon five the connote of the pomp Ynk removed w a Bepwe servklrO Opened, Door to morins Waver to HB Water MOM or mN+d a PmMy ne PCWfS Mowawy to most In =m W WmNnO a'e Pomp stow b mbn nc^ntl Navels tern Napumpimx Do not drum or Dark nnMP ever bey aM NepelNl Wlle On For dive or Peru cvW Or onegreiee dumb ar men Na sere wNeln tE wet down dope W my TOM OF elyMe mR ebwrptlon area RedrSm m hearmabn of to Nut"n0 ma UPmww we'sr Naem mev Imp,we Nro "Demand, erA DroknO Pe oft of W POWMan fS W Wotlq harry wMBIR clgyMk bNY, condoms, mlloa Mama. doommw, her flee: NaPem dkNktlenlo,1, fo unMbn IWM team WgNemore) want. PLO Brom rom eN dom wdMngs, garrine NwaF; nmdtlaes, meal eaeW, nave'Icellme, dl� pin0n0 gouge: way ABANDONMENT Wmamng M"to emeMoned In Barryman to PLATE hals left wM cneporm Contra ID Sl WoottonALm�ea inle"brivs CodablwaNNRB epkmkPeCWW Far • NJ gping b Forks and MIN and bedumnnedetl and" aidnduned DlIO opeI sealed • iM mettle dell Yny entl plY YUll beremwMentl prcpedytllepord rf rye 9eplpe 5ervain00pa'ekr After pumpin0, all Anne and we snot me m svabd and mews] or Ndr coven nmwed and No yob apex fiIIM rum e011, Btml or srpNar men cold makdd CONTINGENCY PLAN It the POWl6 Ste aN apron be mparred rM IOI1wdn0 mtnurea now, coon' or mud M Won. b poach a ode amp q rW mmenrayalen 0 A wit be redeamMl one ye own Neumd and try rem USIDed for to ICa6on of aN ndw Oa l Met _ worn n eye fed e omD,Damm ew snob be proYtlM ktto &nomad and amWNon an for son ow Fell dIOvalea�keed ll�loh a ssuG 16m Oe mtomeaa Repl MM eydrow ME wMg wor ells Sea In dlevmal V.mtlme. 0 holdup Saw MY W ha w eF etleat mFomt b mplem a" Now POWs Pon a or In and MEN lloaye l ee aWn hm OF been MdwRd b WOMW a callable mpwametono Uworgoompon lelWm al Me POVJf6awA entl eery evalue{en d Mentltto d emb, sup f6Wsmmaniw I(no npecemenlemele wetlWke MldlnOYrk,noY ra lnaWb]u NO fimer'! Mmina and dyreae Bar a deTten ayYme m y be roommaea m Me, rotwnM woman of nM Nwnel el N. kmlMtlre tea. RxoroWilme d BONN"amm mod amply wM be mks In eFea M then MOM 10MARNING" SEPTIC, PUMP AND OTHER TREATMENT PAIRS MAY CONTAIN WTHALO " ANDOR INSUFFICIENT OX(F W1407 ENTER MOM AIC, PLIMP INE R TT HER TREATMENT TANK K UNDER ANY RIMCPOOUNIS ACES. DEATN MAY RESULT. RESCUE OF PERNPOIN POMSI ALEN POWTB MAINTNNER N e Now, Pnme ,f more SEPTAGI INSINOOPERATO UMPER LOCAL REOUTATORY AVT WRNY NonName f Phone �� a Put,...IJ A D TmFtlmsevewd. sn o,o, pa Oregon, epsYgkr, north end MI W) ma Ot Moore, M"k,L'u°q^ CI°e 9D-�� rvisrMwrrr.r,qa„r.rr.yrypp�y�q{ySOIL EVALUATION REPORT 5 O,.Mg9�,,'wowaw.wMM1WMe.Y.brYa µr�lorvuu er.,p0erq� 6 w.x�. � s*churn ncs b mr ua��r..aSU`2q xr,lle� Bw.wn ..@n�rrrrxwa.gm..n2`L wr.+'.xwYrn.rr_� su2 aILa-- �a„area p�...w o-.r.g..4w0..m rw NM m w4mr n M _ �4YC �— �— OM gi .. 97Lb. P z 10 t I tSTN T xeeN P,w.Mo.. __ Owewkv w N„q-1.i��. we„ g _ ci c ra.xu•co0.'nsmwr.•�aiunu S'a'^w'v uv.xu.ou .5rvmriwiuvmq M Lpmrvemal W,mrcve bm ryul nyluvmmi IMagna.l,br Iryil ..w uI.... S.. nll ry Icon mJ wlerla mrn.lam¢(w,nq Pb .mvn Nuarymmila W1.144. I n..t3_r,l 3 Nn61l.�t ntg3 re,anl..r un unu ,�.6u�u na ly ls9 t:n./}q..� SCALC 1-- 4� rrt u Bml CLGVAtION orvn uesaurllnn �p o.[_I`p+a P,ae -®+ EM3ELCVn WInec3Q.- Emzocsawnnl14 e�4j .p✓` P-P+ I I _. . SYS I W CLLVAIY t1 UG eveury rs of M-/e.a8. yr mwd SIONAIUMn or uAll NME-60 f1 wr6e em&u and soe fotdntnweuetnent Dmwte arro We demeeed POWTS site nn lN' l 134 W <Itm / I yN zx ypZ n. CROM coom T SEMC TANK MAWCE CE AGRFDAENi T AND d� 0WNERSH@CEItT CATION FORM Owvc/Buyer �lU UJ�m �(� P �� Mmtng naaea� �dY D, 11 d k1„P /�7 Property Aam��.I7 f 7 R� Qr �'. (VmdtaOmnqupetl Soar Pla®mvg&Zupmg Oga4 awc®Mtchm) COIStete ParcelldmtficanonNmuba Ol/ �d372;7) LEGAL DESCRIPTION // Pmparty L 0atim9l &-1/,11/�Y„Sa. �C�TZof NR�W,Townot'�A Subaiu m'F� �li / /s/ W, LW# 8'3 CertlDed Survey Map k Vo)tmte Page#' wat tyDeedk /0 30� Valetne — Pagep Spctuxam( w LotLmn,dmu6ebk �'�m SYSTEM MAINTENANCE AND OWNER CERTIFICATION fmpmp«a«ata armvaa.are wWmm«poe ayeemcowet®wtm mPuves,memmem=w«m. Ftopm iem o[pumlm6aut We aePac dvk wmv Ym«>em or.oma.ti«etled M.Luuea P^am«. Whmtwpm arm me eyeb lmu are) twci to§ o(the V52mvkuatr®tmeut2- Stiv Oiemsa dupoeelmye�. 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