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J�'rY •�� <br /> •`'`�. Dane County <br /> 4•='= e- Community Support & Health Services Department <br /> Paul Meyer PUBLIC HEALTH DIVISION ;- <br /> Director <br /> ENVIRONMENTAL HEALTH 0.W.Hintz,R.S.,Director <br /> 1206 Northport Drive,Room 107 (608)241-4481 <br /> Madison,Wisconsin 5370 '2088' <br /> REPORT ON SITE EVALUATION AND NECESSITY FOR SOIL TESTING <br /> CA9 ►1/!ot'r,V Nys s I( MA-ocnl 537 <br /> Owner Owner Mailing Address <br /> u9 ( -0vt6t.,0 0--41. CA11 . <br /> property Address "CTS <br /> h <br /> q, Sec . it) , T C° N, R 12 E TN <br /> CSA1 or <br /> Lot Number , Block Number Subdivision <br /> Parcel Number <br /> An initial investigation has been made regarding compliance of the <br /> above-referenced private sewage system with Wisconsin Statutes and the <br /> Administrative Code. This investigation is authorized by Sec-1145. 20 (2) (g) <br /> and (2) (h) Wisconsin Statutes. <br /> --4aLA soil test report by Certified Soil Tester <br /> CST # 2 is on file in this office. An onsite verification <br /> inspection was conducted on <br /> /.1pc_I t_ ZS , 19 St5. The soil <br /> in the vicinity of the system absorption <br /> free <br /> in the absence of bedrock to a depth of <br /> bottom of the soil absorption area. <br /> The site evaluation which was conducted did not reveal conditions <br /> which require soil borings for further system analysis . <br /> The site evaluation which was conducted on , 19 , <br /> revealed conditions which are not in compliance with Wisconsin <br /> Administrative Code sILHR83 . Orders to correct the non complying <br /> conditions have been issued on , <br /> This inspection is limited in scope to soil suitability. If you <br /> have any question as to the age , size , or construction of the existing <br /> system, or any concerns about whether or not the system is properly <br /> functioning, this office urges you to contact a licensed master plumber. <br /> JUN 131988 <br /> dr.-4)RECEIVED (2. C, - <br /> ZONING DIV. County Authority <br /> This instrument drafted by Dane County Community Support & Health Services <br /> 10/87 <br />