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1984/09/12 - SANITARY - NPP - Valut Privy
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5344
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1984/09/12 - SANITARY - NPP - Valut Privy
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Last modified
11/18/2024 3:08:57 PM
Creation date
9/28/2017 10:51:36 AM
Metadata
Fields
Template:
Property Files v2
Document Date
9/12/1984
Document Type 1
SANITARY
Document Type 2
NPP
Document Type 3
Vault Privy
County Permit Number
11620
Tax ID
5344
Pin Number
07-012-2-40-15-17-1 01-000-013000
Legacy Pin
012421701400
Municipality
TOWN OF JACKSON
Owner Name
CHANDRA A HOFFMAN LIVING TRUST DTD AUG 19 2013 DANIEL J & PAMELA S GIRTZ
Property Address
5005 COUNTY RD C
City
DANBURY
State
WI
Zip
54830
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)EPARREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSDUSTRY, - DIVISION <br /> LABOR AN-lUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> G.L. 1 (H63.09(1)III Chapter 145.045) <br /> LOCATION: 1 17 T40 1 TOWNdacksonICIPALITY: 1 L%NO.: SLI D Vi 10 1N 9M . 170 <br /> " / ' N/R 5[ (or)W N C3di / 1 <br /> COUNTY: OWN A <br /> Burnett Guy Buddemeyer 3126`FLnns Avs., Cincinnati, Ohio 45211 <br /> JSE DATES OBSERVATIONS MADE <br /> CottageNO.B : COM ION: PROFILE DESCRIPTIONSfERCULATIONTE <br /> ❑Raldence NA EC New ❑Replace I Sept. 11, 19 NA <br /> RATING:S-Site suitable for system U-Sita unsuitable for system <br /> CONY NAL: MOUND: IN-GROUN -I -F LL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> Privy <br /> It Percolation Tests are NOT requiredDESIGN RATE: Ii any portion of the tested area is in the Not qualified to <br /> under s.H63.0915)(b),indicate: Floodplain, indicate Floodplain elevation: detbrmine <br /> PROFILE DESCRIPTIONS <br /> BORINGTOTAL P H T GROUNDWATER-INCHES CHARACTER L WITH COLOR, TEXTURE, AND DEPTH <br /> NUMBER IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED iSEE ABBRV.ON BACK.) <br /> B- 1 70 20.7 None 7 70 70" fs to os. clay layer•at- 56" and slightly <br /> cemented sand st 64" lar a stone at 70" <br /> B- <br /> B- <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS NA <br /> TEST DEPTH WATER IN HOLE TESTTIME RATE MINUTESNUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERINCH <br /> ' P- <br /> I P- <br /> P- <br /> P- <br /> P- <br /> P- <br /> 'LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> 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 <br /> if lard No". <br /> SYSTEM ELEVATION 17.9' <br /> I <br /> say <br /> � <br /> �►" � -_�_ j <br /> + fi <br /> l , <br /> 10 <br /> ; r ; <br /> _ <br /> IN <br /> , I <br /> _j.. <br /> T_j <br /> C 1_ I <br /> I,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 <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NA (print): TISTSWERE COMPLETEj�pp ON: <br /> Thomas E. Swenson Sopt'. 11, 1964 <br /> AD CERTIFI ATION NUMBER: HONE B o tionall: <br /> Route 3. Box 185, Webster, WI 54893 1153 715- <br /> CST SIGNATURE: <br /> a0' <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBO8395 (R.02/821 -OVER - <br />
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