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HomeMy WebLinkAbout026-1077-50-100 a o 3 o I M a I E c ! � fV C b Z 0 c v � I d (r y rn I CD v I z° LL c d o 3 •v °o 0 nM I 3 N d N z y co W 0 O d d C,4 a m _O C z O Z d c w N V p ! OO O E m N C •N a 0 o O z c0o Z Z �1 d N V A I W J L .. n, t o c co C', �g m c H m N O bap z � > 3 �3l CL CIA co ca w a Z ov � 000 •N R oaaa y a I N J U I ai ai aNi I (D } o �V z w 'coo L m y O_I N Q v i L d O S � C r b N C 16 i P N C �. j N cM- N C C Q. p a O O N `p n oo c W c m c g HcD E !I co w y v z <b V O O O 2 2 E to m O .O o • N #k a • 'v a d d a i Form - STC - AS BUILT SANITARY SYSTEM REPORT OWNER S y�„ ,. TOWNSHIP ,, j yrtA711 SEC. c�& T-? N-R Z�9 W ADDRESS �� � ST. CROIX COUNTY, WISCONSIN 40 6�i SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM � �� the` ►ray 51 ►1`, M' rS,PwBl)� Len� INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ZJ`�� 4 c40.rC019,1!e✓� Elevation of vertical reference point: 1 0 D ` Proposed slope at site: 9"t SEPTIC TANK: Manufacturer: s Liquid Capacity: c9$' Number of rings used: D Tank manhole cover elevation: 1,95 -- Tank Inlet Elevation; /11 � Tank Outlet Elevation: /® jL Number pf feet from nearest Road: Front,®Side 10 Rear, �`' feet From nearest property line Front, Side, Rear, © o Q _ feet Number of feet from: well , building: L4 / / (Include this information of the bove plot plan)( 2 reference dimensions to septic tank) SEE RFVERSE STDF s , PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet Bottom of tank elevation: Pump off swit elevation: Gallons per cycle: Alarm Ma facturer:• Alarm Switch Type: Num r of feet from nearest property line: Front, OSide, O Rear, Ft Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: / Trench: Width: LZ Length: 5✓�� Number of Lines: Z. Area Built: Fill depth to top of pipe: a�3 E Number of feet from nearest property line: Front, Q Side, O Rear,O Ft .�° Number of feet from well: � Number of feet from building: / (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . 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: z2— Plumber on job License Number: Nl Paf—g) -32 T 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR 8;HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 CONVENTIONAL El ALTERNATIVE State Plan I.D.Number: , (If assigned) ❑Holding Tank ❑ In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ed Brown R. R. 1, New Richmond, WI 19—J3„J?j/ BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF,PT.ELEV.. SE SE, Section 26, T30N—R18W, Town of Richmond Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Gary Steel 3254 St. Croix 49478 SEPTIC TANK/HOLDING TANK: JI MANUFACTURER: L TANK INLET ELEV.. TANK OUTLET ELEV.. W NI LABEL LOCKING OVE PR ED: PROVIDE O 1 l 0 0 YES ❑NO ❑ 0.... BEDDING: VENT DIA.: VENT ATL.. HIGH WATE NUMBER CAP ROAD PROPER WELL /� JBUILDINIKVEN TO RESH ALARM. NU E 1 LINE:q / JAIR INLET ❑YES 0 ❑ NO NEAREST llY/ /O DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MA NUFACTURE WARNIN LABEL LOCKIDED, ER PROVI CI PROVIDED: ❑YES 1:1 NO "_❑NO I ❑YES ONO GALLONS PER CYCLE: 7ND CONTROLS OPERATIONAL. ..PH Q Y WELL. BUILDING:IVENTTO FRESH (DIFFERENCE BETWEEN FE ( LI AIR I"LET: PUMP ON AND OFF) ❑YES 1:1 NO N T SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LE&ITH D 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: LINGTH I NO,OF DISTR.PIPE SPACING: r��R INSI UE D A.. *PITS. LIQUID Fft?/IfIENCIi . 1 TREN`HES IAL: PIT DEPTH. OI!MtN�IONS �- GRAVEL DEPTH FILL DEPTH DISTR.PIP DISTR.PIPE DISTR.PIPE MATERIAL: NO. TR [NUMBER OF OPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE OV ER. LEV.INLET.EL,V EN r PIPE LINE: t t AIR INLET:FEET• ��� p / 2 2 NEAREST M YJ� l (� MOUND SYS EM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM 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: OBSERVATION WELLS ❑YES ❑NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER: EDGES: ❑YES ❑NO ❑YES ENO I0YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: `, N j+e'.,WIDTH JILENGTH TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER- �11ECsION ;.a MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. JNO.DISTR. JDISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING. ELEV. . ELEV.V.. DIA.. ELEV.: V.' PIPES: DIA.: » VATION i)~IT1I�3lITtN @ VERTICAL LIFT CORRESPONDS TO APPROVED HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL INFRMI ATION PLANS E:1 YES 0 N 1:1 YES E NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMISER®F- -PROPERTY WELL: BUILDING: 1FE5T-70 W,, OM LINE: ❑YES ❑NO ❑YES ❑NO 146A0ST � d—(o (P Z I Sketch System on R iq4n county file for audit. Reverse Side. gl � ITLE: DILHR SBD 6710(R.01/82) �� i EZ. consln APPLICATION FOR SANITARY PERMIT DILHR COUNTY (PLB 67) UNIFORM SANITARY PERMIT# USTRV,LRBOR 6 HUMRn.RELRT10nS 9h'78 —Attach complete plans in accord with s. H 63.05,Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size, —See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS J 1_ fZ421yali � ryz PROPERTY LOCATION C-t—Y- ,,�6E 114S��1/4, S 2- R 15 (010 W TOWN OF: jC 7 Av, 1 4 LOT NUMBER BLOCK NUkBERjSeBDJ,VISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): THIS PERMIT IS FOR A: .�New System ❑ Tank Replacement F-1 Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity 'D p /; Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: r IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Zo ;U 90,:�) , Private ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature- RAP/MPRSW No.: Phone Number: 0 oz'� ° 3 1-2 55--/ P �� )ZW, zGli Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved vy ❑ Owner Given Initial Yda4A'a d. 66 �/ Approved Adverse Determination Reason for Disapproval: Alternate course(s)of Action Available: DILHR-SBD-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner,Plumber 1 INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment,30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report,the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system,circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis.Adm. Code will be applicable. 10. A new permit will be needed if there is a change in,estimated wastewater flow, (number of bedrooms,etc.), location of the system, depth of the system,type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances,distances between beds if appropriate,tank locations,effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit.Private sewage systems must be properly maintained.Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years.If you have questions concerning your system,contact your local code administrator or the Bureau of Plumbing,DILHR,State of Wisconsin. L APPLICATION FOR SANITARY PERMIT S T C - 100 This 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 be intended for resale by owner/contractor, ("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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - /- - - - - - - - - - - - - - Owner of Property d 111Va,-t-�4 Location of Property S , Section (r , T N - R W Township C 14 Oil Mailing Address R b U �t (� gin, ► c/�� Subdivision Name Lot Number 4u I Previous Owner of Property Fe Total Size of Parcel S Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume S�L o and Page Number s 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 Map, the the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTy OWNER CERTIFICATION I (We) eeAti y that att bzatemenxis on this �olm ane tAue to the best o� my (ouA) know.bedge; that I (we) am (ane) the ownm(s) oA the pAopenty d"c i_bed in -thus inAmnat,%on AoAm, by v.vr-tue o4 a waivcanty deed Aeeonded in the O��ice oA the County RegizteA o4 DeeA ass Document No. 3 and that 1 (we) pAe/sentty own the pupozed site �oA the sewage poba .5y�s-tem (oA I (we) have obtained an eaaement, to tun with the above de.6cAibed ptopexty, �oA the condtAuct%on o4 said sybtem, and the same has been duty AecoAded in the 064ice o4 the County Regist" oA Deeda, ab Document No. )/ SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED 0"clal Z>CcuritY Number of Grantor 4Y t Name, F-��dr ess and Social Secur ty'�_-., r Revenge a•Cxiwtllld Je and Eleanor ge, Lrolz, - o G•antee -ontor refoted to grantee? id J• Eal'tt Z�aIIG2" i ge Brown / (Blood or Mor iioge) Yes Out F" 1 ess to which tax bills should be sent No �tiE'�lC13.'11C 54017 ra�ttee anty pf; PART 1 - PROPER Check Check proper box and enter name of municipality - --- ❑ Ci street address ess of - -- --- _ , pr is oP°" cnsf r Y er Croix ❑ Village OF:-- Town -s OhID�"Yf1--------- oal Description (Fill in legal description in spoce below or 0110th 2 copies of full l l d ego esCription Lot No:_- from instrumenT of co^YeYycei _ _ :.:----- -----Bkxk Mo._---__.Plot Nome_ i r Or metes and bounds ------------- ds description: y of S` . of Sectio ,t. � s? ip and 30 North, of Range 18 best; i of x:>i4 of Section Parcel Of land dezeribed�• zshi 3f P orth, of Ra a .. mQrthea t cc r sez. Of the s eO ei z^► r West EXCEPT 15fle6eet� 7320 .° st of the or � Y $h or~ `.:Test 115.6 Feet' thence East 115.6 fOet; thence North t©'thence and�_i Of SEA Of Section 2d�, }� y l` � North, od R-In e 18 11trest i i • 1 Kind of Property PART 11 - PHYSICAL DESCRIPTION AND INTENDED USE a. 2 Land Only 2• Principal Intended Use • New'Construction 0- ❑•Residential 3. Land Areo osd Type ' • Building Previously Used b. ❑ Commercial a. Lot Size-Estimated 0 6. Residential Units, if any C. ❑ Industrial X ❑ One Family d• W'Agriculturol b.--Total Acres-Estimated ❑ 2 thru 7 Units g ❑ Recreational I. -y Ti!lable Acres C1 8 or more Units f ❑ Other (Explain)-_ — W-T•L- Acres 3.— F.'C. Acres c.- -----Feet of Water-Frontage - Estimated ❑ Sale - TRANSFER 2. ❑GiFt ART III n,r, 3.❑Exchange 4. ❑Deed in satisfaction of L.C. doted_ ' ^ ' S.[ Other Ex ' plain r Total volue of rant";0te lronsferred (purrhose PART IV - COMPUTATION OF FEE ' Here t ^..'nwship interest tr ❑ Price. etc.), ansferred Full Other (Exploin) S n your opinion, was this sale or transfer mode of fair morket voluet ❑Yes No ?declare under penalty of law, that this return(including any accompanying ❑No Op,n,pn (if no or no opinion, Esploin edge and belief it a true, correct and complete. ®Here) _ _ nY ng schedule) has been exam;ned by me(us) and to the best of my(ter) Signature of Grant"- rantee ar Agent. Document No. Date V E Vol. (ROOD T 1 t Pope UmoQe) Dote Recorded I$ � • t Dire arw^"1K POrcrl Nurrit� EA -7,r /76- r NK -_A_. - 19- Ca •, code 'cr..-------- �� l t• Drdr,tr Code l C" 2 Fr1d T ----�_ 1 �-` 1 x to 3 Use 4 Refit T� COn-Watpn ' a H cn r r H • SEPTIC TANK MAINTENANCE AGREEMENT 0 St . Croix County z d 1 OWNER/BUYER ( H ROUTE/BOX NUMBER ��luf(' Fire Number .CITY/STATE N (' w it 172611C1 i-5 ° ZIP 5 6/ 7 PROPERTY LOCATION : Section T N , R W, Town of ��jl)�or7c� St . Croix County , Subdivision Lot number Improper use Snd 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 a licensed septic tank_ pumper . What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . 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 ( if 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 . H 0 E I/WE , the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein , as set by the Wisconsin Depart- Iry ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . S I G N E DATE St . Croix County Zoning Office P . O. Box 227 Hammond , WI 54015 715-796-2239 Sign, date and return to above address . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, . DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.090)& Chapter 145.045) LO ATIO� SE meiPAtt ,J [VISION NAME: Z,5e 6 or R'S BUYER'S NAME: AILING , RESS: ' l � may � . r G1 r _ DATES OBSERVATIdNS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence Z 1 /rj Ovew ❑Replace I "7/— RATING:S=Site suitable for system U=Site un su`iitable for system Y CONVEQQNTIONAL:MS ND: IN- PRESSURE:-PRESSURE: SYSTEQM-1(�-FILLHOLDIING TANK:RECOMMENDED SYSTEM:(optional) 3'v OU d �U J JCJU J _J If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: 0 1�c SrYV►tx� PROFILE DESCRIPTIONS `c 1�� p�qr C 2— BORINGI TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER D€�, ,r--'.N, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) Z 01 v.:3 - oo C 3 FB- Z7 JOJ so B-3 6 — dD d5 l)a '6 - �°��. B-� $3 �g 3d > 83 z� B- �ESimr�I PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER tNGIIES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PER PER INCH P- 3o f d P_ o!n �O/t1� D 3 �rz �/� 2-0 P- 3 2 5—° P-_ P- P- 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- zontal 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. SYSTEM ELEVATION ... - a - - j$7{Ii ��j [ r Y - > � - � r._ 0 f I _ ------ I 3 H C � 3 , m' 1,the undersigned, 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 the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): CST SIGN DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 i - To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section mast clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; b. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL DITHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred, A separate sheet may be used if desired; & Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 0. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolatioi test exemp- tion, if appropriate; 10. If the information (such as flood plain,elevation )does riot apply, place N.A.in the approl-riate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as recluired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIES? SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR Bedrock cob -- Cobble (3- 10") SS - Sandstone gr - Gravel (under 3") LS Limestone "s Sand HGW - Nigh Groundwater cs - Coarse Sand Perc - Percolation Rate med s - Medium Sand W - WeII fs Fine Sand Bldg - Building Is Loamy Sand > -_ Cheater Than sl - Sandy Loarn < - Less Than #1 Loam Bn --_ Brovyn sil --- Silt Loarn Bl Black Si - Silt fly - Cray cl - Clay Loam Y -_ Yellow scl - Sandy Clay Loam R - Red sicl Silty Clay Loam mot - Mettles sc - Sandy Clay w/ with sic - Silty Clay fff -- few,fine,faint X Clay ce common, coarse p1_ -- Peat nrdn -- Many, medium in - Muck d - distinct p - prorninent HWL - High water level, Six general soil textures surface water for liquid waste disposal BM Bench Mark VRP - Vertical Reference Point TO THE OWNER= This Soil test rrrfaor9 is the first step in securing a saniiwy permit. Thie county or the Department May request 0w' so€I test in the fic"Id Grier ry perrnit issumue. A Complete scat of plails (cr the private la. a'.,3 sySterra % rSr'' a pern-lit capphcat.ron i7Twil be stitsnutt`'d to tilt', zfpi)r€opriate local in i £�rd r to .?'a tai o p rn-J i e-ni!' ,11 p-,'IrE a ritusl be otstsa;€ed ar3t,p_,ste'd plot it) 'tali, 3t"'ir,of an",E c.¢;4!-M-1i"J i. f J 1 r C 10 06 i m j fi �JfiJ. /oo os 5 I