1983/09/23 - SANITARY - SAN - New HT - 11037

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• r t INSTRUCTIONS FOR COMPLETING FORM 11 - SBD - 6395 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must 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; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER 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; S. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test:exemp- tion, if appropriate; 10. If the information (such as flood plain,elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures lather Syn-)bols st -- Stone {over 10") BR Bedrock col? -- Cobble Q- 10") SS Sandstone gr - Gravel (under 3") LS - Limestone `s - Sand HGW - High Groundwater cs Coarse Sand Perc Percolation Rate med s - Medium Sand W - Well fs Fine San(] Bldg -- Building Is - Loamy Sand > - Greater Than "sl Sandy Loarn < - Less Than 'l - Loam Bn - Brown *si - Silt Loam BI Black si - Silt Gy Gray �cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Fled sicl - Silty Clay Loam mot - Mottles sc Sandy Clay wl - with sic Silty Clay fff few, fine,faint Ac - Clay cc - common,coarse pt _. Peat rnm - Many, medium rn 'Muck d - distinct p prominent 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 report is the first step in securing a sanitary permit.The county or the Department may request verification of this soil test in the field prior to permit: issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must: be obtained and posted prior to the start of any construction.