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Form - S T C - 104
r
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP #t_c<t1S jA SEC. / 7 T ZI� N-R / 7' W
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION , /Jiyzc) eio� �OT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
pGjaji
WCT1n'N
� rr-Bti Glu S ,j�C �JO l\
/U£ ?4` Carrt��/ '�C�
3 y3
o
--- — — —o
I INDICATE NORTH ARR%)
BENCHMARK: Describe the vertical reference point used /�J� Go c'v.�r�e•�
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings used: �/ ;,Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front (V Side 10Rear, O feet
From nearest property line Front 10 Side G Rear,0 f'% feet
Number of feet from: well 99, building: Z�
(Include this information of the above plot plan) ( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
1r T
PUMP CHAMBER
Manufacturer: /I/ Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear 0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Lengjth: Number of Lines: Area Built: .Svy
Fill depth to top of pipe:
Number of feet from nearest property line: Front, Side, O Rear,0 Ft . 26
Number of feet from well: 9
Number of feet from building: 53
(Include distances on plot plan).
SEEPAGE PIT
Size: v Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
a drop box or distribution box been used on an of the above soil
Has either y
P
O
absorbtion sytems. (Check one).
I
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: 9- ��- �� Plumber on job:
License Number: /�J/�' ,j' J-'-Z Z f
3/84:mj
'►DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O.BOX 7969 BUREAU OF PLUMBING
MADISON,WI 53707
SW4- SW!-4 S17 t29, M,R 19W K]CONVENTIONAL ❑ALTERNATIVE state Plan .Number:
Town Uj hud�san ❑Holding Tank ❑In-Ground Pressure El Mound III assigned)
Lot 99 Wittaw Ridge Easy
NAME OF PERMIT HOLDER. Ro ADDRESS OF PERMIT HOLDER: INSPECTION DA E:
Stephen Tute 5 Nudtsan, W1 54016 OI. —
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN REF.PT.ELEV.: 11-ST REF.PT.ELEV.
Name of Plumber MP/MPRSW No.: County: Sanitary Permit Number:
Ragetc Timm 3224 St. Ctiaix 112687
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.. IWARNINGLABEL LOCKING COVER
PROVIDED. PROVIDED
❑YES ONO [—]YES ONO
BEDDING: VENT DIA I VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. (VENT TO FRESH
ALARM FEET FROM LINE AIR INLET
OYES ONO ❑YES ❑NO NEAREST
DOSING CHAMBER:
MANUFACTURER BEDDING: LIQUID CAPACITY. PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED:
DYES ❑NO ❑YES ❑NO —]YES El NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING JVENTTOFR SH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) DYES ❑NO NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH JDIAMITEH MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING COVER INSIDE CIA SPITS LIQUID
BED/TRENCH TRENC s MATERIAL: PIT DEPTH
DIMENSIONS � S �"
GRAVEL DEPTH FILL DEPTH IDISTR PIPE DISTR PIPE DISTR.PIPE MATERIAL. NO.DISTR. NUMBER OF PROPE RTV WELL BUILDING VENT TO FRESH
BELOW PIPES ABOVE COVER. ELEV INLET ELEV.END' PIPES FEET FROM LINE AIR INLET
NEAREST
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
DYES ❑NO
SOIL COVER TEXTURE PERMANENT MARKERS OBSEHVATIONWELLS
❑YES ❑NO DYES ❑NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES.
❑YES ❑NO DYES ❑NO 1-1 YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE M NO DISTR DISTR PIPE DISTRIBUTION PIPE MATERIAL&MARKING
ELEVATION AND
ELEV.. ELEV. CIA.. ELEV.. PIPES DIA.:
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
DYES ONO 1:1 YES ❑NO
COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING-
Q FEET FROM LINE:
O.s DYES F-1 NO ❑YES 1:1 NO NEAREST
11•G(O IIt �d � i1,0V
J.o
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE TITLE 1
DILHR SBD 6710(R.01/82) Zoning AdminiztltatatL
Thom" C. Netz un
SANITARY PERMIT APPLICATION C M
DILHR In accord with ILHR 83.05,Wis.Adm.Code
•�^- STATE SANITARY PERMIT#
//0-4,97
/
-Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER
8%x 11 inches in size.
-See reverse side for instructions for completing this application. PETITION
1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES n NO
PROPERTY OWNER PROPERTY LOCATION
S11- ricc,K.� S '/4 0 %4, S -7 T7 N, R �� � (or
PROPE4ATY OWNER'S MAILING ADDRESS LOT NUMBER IBLOCKNUMBER SUBDIVISION NAME
CITY,STATE ZIP CODE PHONE NUMBE5 CITY NEAREST ROAD,LAKE LANDMARK
Z SS�O/ VILLAGE:
TOWN QF-
Ill. TYPE OF BUILDING OR USE SERVED: 441'' 0:90- //7c(- -X-000
Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify):
111. PURPOSE OF APPLICATION: (Check only one in##1. Check;!#2,3 or 4,if applicable)
1. a. X1 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2)
1. a. Conventional b. ❑Alternative c. ❑ Experimental
2. a. ❑System- b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. ❑ Seepage Bed b.X Seepage Trench c. ❑Seepage Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet):
1-.5 -.05CTD Feet WPrivate ❑Joint ❑ Public
CAPACITY
VI. TANK ##of Prefab. Site Fiber-
in gallons Total Manufacturer's Name structed Con- Steel Plastic Exper.
INFORMATION New Existing Gallons Tanks Concrete glass App.
Septic Tank or Holding Tanks Tanks Tank QdO ❑ ❑
Lift Pump Tank/Siphon Chamber ❑ I ❑ ❑
VII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's Signature:(No S mps) MP/MPRSW No.: Business Phone Number:
lznq�er mm 3� 71 772
PlumbeA Address(Street,City,State,Zip Code): Name of Desi r:
VIII. SOIL TEST INFORMATION
Certified oil Tester(CST)Name CST# 3�(�
CST's��A�DDDRESS treet ity,State,Zi Cbdde) / Phone Number:
7 7/5 3 E4 5/63J
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No St mps)
Approved ❑ Owner Given Initial � a u�? Groundwe er
Adverse Determination I QO'
X. COMMENTS/REASONS FOR DISAPPROVAL:
SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber
r �
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT
APPLICATION `
• _ s
TO THE APPLICANT:
1. This sanitary permit is valid for two (2) years;
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable;
3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed
if there is a change in your building plans, system location, estimated wastewater flow (number of bed-
rooms, etc.), depth of system, or type of system;
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD (3399) to be
submitted to the county prior to installation;
5. _Private sewage systems must be,properly maintained. The septic tank(s) should be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years;
6. If you have questions concerning your private sewage system, contact your local code administrator or the
State of Wisconsin, Bureau of Plumbing, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
I. Property owner's name and mailing address. Provide the legal description where the system is to be
installed;
11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
restaurant, etc.). Fill in number of bedrooms if'building is a one or two family dwelling;
III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or
repair;
IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project
is in conjunction with University of Wisconsin;
V. Absorption system information: Provide all information requested in #1-6;
VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons :o be installed,
number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
tanks received experimental product approval from EHLHR;
VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
applicable;
VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
IX. County/Department Use Only;
X. Comment area for use by county or resaon given when application is disapproved.
Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with comp3ete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement
system areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form.
GROUNDWATER SURCHARGE
On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more
commonly known as the groundwater protection law. This: change in statutes was the
result of over 2 years of steady negotiation and public debate. The groundwater bill Ground kwr
included the creation of surcharges (fees) for a number of regulated practices which disco in S
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried re8SUre
is used in your building is returned to the groundwater through your soil absorption u
system or the disposal site used by your holding tank purnper.
0
The monies collected through these surcharges are credited to the groundwater fund adminis-
tered by the Department of Natural Resources. These funds are used for monitoring ground- t
water, groundwater contamination investigations and establishment of standards. Groundwater,
it's worth protecting.
SBD-6398 IR.03186)
APPLICATION FOR SANITARY PERMIT
STC - 100
'Phis application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development b� intended for resale by owner/con.tractgz, ("spec
house") , then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - -11- - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property 5 k%��cJ• �l�/�
Location of Property ,i4 S� s4, Section /, T iA N - R W
Township O)c
Mailing Address � .�.� C� �a--J r-1 �J
P. 0- 704 0,J:5oj
Subdivision Name t'), L, ,.O,)
Lot. Number
Previous Owner of Property � � � �Ci (J F, t
Total Size of Parcel
Date Parcel was Created Poe. P•34 Do C•I"`'• 4 (o 7,,q 4o
T
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume f and Page Number as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
In addition, a certified survey, if available, would be helpful so as to avoid delays
of the reviewing process. If the deed description references to a Certified Survey
Mal), the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (We) eenti.6y that a t 6tatement6 on .th,i,a 6on.m aae -tAue to the but o6 my (oUn)
k.nowZedge; that I (we) am (are) the owner(a ) o6 the p11.opehty deacAibed in .this
,in6onmat%on 6onm, by viAtue o6 a waAAan-ty deed neeo11_ded in the 066.i.ee o6 the
County Reg ,SVn o6 DeeA as Document No. _43-74-13 ; and that I (we)
p11e.sentty own .the pnopo.tier' s4te 6011 the sewage. cApoaa�-ay,:; '^-1 (on. I (we) have.
obtained an eaaemeni, io Juan W-Uh :the above desULibed paope>cty, tiorL the
con,st .ucti,on o6 aa.id ays tem, a,nd the Game hays been duty 11.eco11.ded in the 066.ice
o6 the County Regiz teA o6 Deeds, as Document No. )
SIGNATUR OF OW ER SIGNATURE OF 0-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
a
{ DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-1382 THIS SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
43
This Deed, made between ------ -.-. REGISTER'S OFFICE
B .&. H. Development , Inc . ,, - - _ _ __
Rec ,;:" P'or.-rrr
p y Grantor, MAY 17 11tSa
-----Ste hen--J:-_-Terri-en arid--Sh rl-e_____J-:__Te'rrien,
and .-- -- - ---
husband- aril-wife- as- survivorship-inarit�al - --
_- _. at 3:45 Ph1
proper y
---- - --- ------ -------------------- --------- ----------------------------------- Grantee,
'B1tdc e,gSqV ,el6PItleeL said'Grantor, for a valuable consideration_- ___ Rogister of Deeds
- ---------- - -------------- _----------I----------------- -------------------------....
RETURN TO
conveys to Grantee the following described real estate in ---- ---------..____.-----------
County, State of Wisconsin:
'I
Lot 99 , Plat of Willow Ridge East in Tax Parcel No- -----------------------------------
the Town of Hudson, St. Croix County, Wisconsin.
MANSF
FEE e5-8,?0
This _-___-7 s___I)Ot_______ homestead property.
(is) (is not)
Together with all and .singular the hereditaments and appurte;,;inces thereunto belonging;;
And..... B-_& H__ Development -nc_. - -
_ .. - -
warrants that the title is good, indefeasible in fee simple and Crec and c1car of encumbrances except
easements , restrictions and rights-of-way of record,
if any.
and will warrant and defend the same.
Dated this _ _ _ _ _. day of _ May l9 88
(SEAL) _ .� !i ' r (SEAL)
___--_ g
------ ---- ----- ----------- ------------ -�- = - ; ...._.
y Donald_ E . B i or�nstad '
----. ----------- .--' - -- - ----- -----
-.(SEAL)
,. William C .. Harwell
AUTHENTICATION ACKNOWLEDGMENT
Dona Id E , ,.
Signature(s) _____-_- .Bj ornstad STATE OF WISCONSIN
William C . Harwell ss.
----------------- -------------------------- -----------------------------------
May 88 ------- ------------------- -----County.
authenticated this ........day of--------------------------, 19__.--- Personally came before me this ................day of
> - ------------------ 19-------- the above n:uual
------------- ----------------------••-- --------------------------------
*Kristina Ogland Lundeen --------_... --- ---------------------------------------------------------------
----------------------------------------------------------------------------- ------------------------------------------- -
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, -------- -- - -
authorized by § 706.06, Wis. Stats.) to me known to be the person __________ - who executed the
foreggoinl- instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristina Ogland Lundeen _ ____. _.-__ _------- - _--
-.Attorney_ at--Zaw--------------------------------------- ;K
----------•---------------------------- ------------- -------- --- Notary Public ---------------------- -------------County, Wis.
(Signatures may be authenticated or acknowledg;cd. Both MY Corrunissiou is permanent. (Tf not, state expiration
are not necessary.) date: -------------- ------------------ 19---------)
*Names of Persons signing in any caocu•.ity ,h(,u!ii Le printol their sip"l-l" rest.
�� WARRANTY DRET) ST.1'ri: HAR Ili% WISCON,''.(.^1 �'J i.:ri�rc�in TwVnl Blank Co. In.r,
10101 No. I —11183 �l it,,:u�kce. Wis.
. y
L ST C - 105 r
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H
SEPTIC TANK MAINTENANCE AGREEMENT ~o
St . Croix County
' v
1 H
O W N E R/B U Y l:R `jTj✓-�`�i�! �' >d s'�� Zt.. �' l rn
ROUTE/13OX NUMBER � Fire Number
C1'1'Y/STATIi � .._ LLJ'
PROPERTY LOCATION :So %a, L.� JT; , Section '� '1' Z�1_N , K W ,
Town of— /�✓ �� _.�^_ , St . Croix County ,
Subdivision _ !u'�' Lot number 71
Improper use and maintenance of your septic system could result in
its premature "failure to handle wastes . Proper maintenance con-
sists of pumping Out the septic tank every three years or sooner ,
if needed , by u licensed se tic tank pumper . What you p►it into
the system can affect the function of the septic Lank as a treat-
n►ent stage in the. waste disposal system .
St . - Croix County residents nlZy be eligible to receive a grarnt for
a maximum of 60% of the cost of replacement of a failing system,
which war. ln. operation prior to July 1 , 1078 . St . Croix County
accepted this program in August of 1980 , with the requirement that
owners of all new systems agree to keep their systems properly
maintained . ^�
The property owner agrees to submit to St . Croix County Zoning a
certification form, signed by the owner and by a master plumber ,
journeyman plumber , restricted plumber Or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2), after inspection and pumping (it nec-
essary) , the septic 'tank is less than 1/ 3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration . o
I/WE, the undersigned , have read tt!e above requirements and agree (,
to maintain the private sewage disposal system in accordance with H
the standards sot forth , hu'rei.n , as set by the Wisconsin Depart- b
ment of Natural Resources . Certification form must be completed
and returned 'to the St . Croix County Zoning Offkf-e within 30 days
of the three year expiration date .
V-'S ICNCll rL •
1)Al E _ �8
St . C,oix County , Zoning 'Office
P . O. ilox 96.
Uammo'pd ; WI 51,015
715-7 16-2231 or 715-425-8363
Sign , date and return to above address .
INAfl OF SAFETY
INDUSTRY, REPORT ON SOIL BORINGS AND DIVISION
LABOR AND PERCOLATION TESTS (115) MADISON WI 53907
HUMAN RELATIONS ` /
(H63.0911}b Chapter 145.045)
LOCATION: SECTION: N HI MUNICIPALITY: OT NO.: LK.NO.: SUBDIVISIO NAME:
S'4 '%w'/ I� / Rlgit(or So Q9 — fu.ow (�,��,� E.as.'
COUNTY: OWNER' BUY NAME: MAI LINu ADDRESS:
5.C�dlx S SNfA.4 _r kV 1.9
USE DATES 013SERVATIONS MADE
e NO.BE COMMERCIAL
I n/oy. i :�Redince UN� �New ❑Replace 3 /gs? foJ. 14, !° �7
'Solo. k A ,-( �
- �tkrJ taRt�T
RATING:S-Site suitable for system U-Site unsuitable for system
r,QNVENTIONAL:
S �U M S �U S DU S YSTIEM-IN-FILLIHOL
�SG U TANK:RECOMMENDED
yyw1/ria"A L(opti�aICNCNY Sw$pkLS
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b),indicate: - LgSS Floodplain,indicate Floodplain elevation: NA
PROFILE DESCRIPTIONS
BORING O T ATER INCHES HAR A TER O SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
NUMBER
ELEVATION OBSERVEP EST.HIGHEST TO BEDROCK IF OBSERVED MEE ABBRV.ON BACK.)
B- 9.75 q 4 .3p p4nuf >9. 16"gL rs A%"9R,4 L 6" S d ig S 3,"LT$afv MIS
i
B- 17,06 �SSS 3S` NoNE 7 7.00 / L STS $~ LT1 Qn1M.s
B- )I �� g3.4� > �I.3� 12.11 BLSLTS 7yLr6P4 S S'1hkR, 01%*6,k
i
B- 4 T'�;% .S > 7.ST �s�rs �" Q S�G,�7/ tr&tIMS
B- S % �3 4�5` N >$' 83 13"'Ls,ols 3 Rkfq Stt6>01 1%0Atr$Q41#1S
B- 6 9,6% /\/o Pq r > 9.0z Z1'QLS1.TS 0 `kcwt ,Si4 e 7? N (1iS
PERCOLATION TESTS
TEST QQ��PTH WATER IN HOLE TEST TIME S RA MINUTES
NUMBER ilV!✓A AFTER SWELLING INTERVAL-MIN. RERIQ 2 PRER1015 3 PER INCH
P- 1 S-Z0 e. 9 1.76 3 *z >2 <
P- Z S.60 . TZ.10 3 Z 12 <
P- ra o0 3 z- >Z <
P-
P _L-_ o-. - A L�` - _-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
ontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
I�Ty'TREN
SYSTEM ELEVATION' T�
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I,the undersigned hereby certify that the soil tests reported on this form were made by mein accord with the procedure and methods specified in the Wisconsin
Administrative C e,and that the data recorded and the location of the tests are correct to the best of my knowledge and ief.
N�AM,EJprint : TESTS WERE COMPLETED ON:
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MPCA 696 MN JOB 5 � � %er•'�c�n
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CALCULATED BY- �� '�" DATE 3a- Ire
Excavatin 9 Co. CHECKED BY
R I, Box 192, Wilson, WI 54027 SCALE
715.386-5443
ROGER TIMM 715-772.3214
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R I, Box 192, Wilson, WI 54027 SCALE
15-386-5443
ROGER TIMM 715-772-3214
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