rQ

PROJECT:

N,

CLIENT:

,<

SC

.1

PROJECTNO.: ( )-_/ L/

LoCAloN:

l?f,uZsr,_y
'

SCOPE:

al UV
/

PRoPOSED: (Borings, No., Depths, type driUils (HSA/mud rotary/corins/other?)

'

/ *- ,^,

A.,r'

l"

.t

t:il
f

, ilr,*"rif ,:/ {- anp

tro Q,pfoptfe-

of,tsL__l
t?C\+ L+I tD rrn,-,1-e

ACTUAL (EXp LAt N DEV!I

Qt
;cA ,n 32' tas
\J
'ro

Drilling Co

Rig Model(Mobile 8-65 et. at./CME 45 et. at.,

Acker...)

Ct-

7S

1,uCV UrtUn+eC(

Excavation Contractor:

Backhoe/excavator model: (John

SITE DESCRIPTION:
ANTICI PATED GEOLOGY: (BEDROCK?, cLAC|ATED?, DEpTHS?,)

Altg,rfn

DEVELOPMENT:
SURFACE COVER: (Asphatt, Buildings, Grass, Vegetated, pavement

Condition?, Depressions?)

CtW

EXISTINc BUILDINGS: (Yes/No, SF?,

distress?, No. of floors/sublevels?)

re pu(

ANECDOTAL

IN

FORMATION?:

IWZWehd@@6m

Existing Cracks or
'J't(Jyt

.t2,t^C)(

clitru e

tr,,

TOPOGRAPHY: (N/S/EJW?, High point?, Radial?, Saddte?, Variable?)

DRAINAGE: (Bodies of open water?, flow directions?, ponded water on

Pavement?, Catchbasins?, Catchbasins maintained or full of debris?)

UTILITIES: (ON SITE UTILITES? OVERHEAD/UNDERGROUND?

storm sewer, sanitary sewer, septic system, electric, Natural gas, telecom/phone,
cable, potable water, fire.water, Petroleum product lines/vent lines, general ocation?)

SITE VICINITY DESCRIPTION:

BOUNDARY: (N/S/EA/V?, General Description, Buitdings?, Street Names?,

No. Floors/sublevels, Vacant?, Wooded?, ...)

UTI LlTl ES: (VlS I BLE OBSERVATTON,

Overhead/Underground?, SS, San,

Electric, Natural Gas, Telecom/Phone, Fiberoptic, potable water,

Fire water,

'^?l

ROCK CUTS tN AREA? (YES/NO, D|STANCE, TypE, DESCR|pTtON)

Fkldd

odN1[JzWeh

*s @

foh

PHOTOGRAPHS

ANECDOTAL INFORMATION?:

OTHER

l,urs )
Ztt Strrest

cl

il

'i* S
r:
'*= V
1"*)

u5.
L/

- -l---- _.

4<,r

u.ittjtl',f,

fllMwQnt IUr*,
Lon^ T l\ lv

itc'l(tV('

\l

bY *Ivezt
SITE SKETCH WITH BORING

LOCATIONSNffi

(sHow NoRTH ARROW)

R1l,ffit RdGdehFd

d R@ FmMspgd

tl1#

re tumsso se prs ad s hddWdh

* re(run