Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, C DIVISION <br /> LABOR ANBOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 5379079 53707 <br /> LOCATIONSECTION: TOWN SH I P/MW41V P#tL7TY: LOT NO.:BLK.NO.: S DIVISION NAME: <br /> 3 / /T `/©N/WSDIp11W Juc so / a /� r "0 q <br /> C UNTY: OWNER'SBUYER'SNA E: MAILLIINGADDRESS <br /> : <br /> rt1`p C i�en q r /�3 C 'Sc y 0 hf'� I SS7S <br /> USE DATES OBSERVATIONS MADE <br /> NO.BERRMS.: COMMERCIAL DESCRIPTION: NN��""'� TESTS <br /> RIG�J, <br /> : <br /> esidence , / New ❑Replace <br /> LLL ' 'SS` 4;) .� <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CQNV S 1:]-N-NAL: MOUND:❑ IN-GROUNDICI �URE: SYS❑TEM-I®I LL HOLD I NG®NK: RECOM MENo pSYSTEM:,1 optional) <br /> LIf r'Percolation Tests are NOU I TIS required LLD�DEESI��IGGN RATTE:S T MSEL U If any portion of the lot isinin the <br /> s.H63.091511b1,Tndicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO ROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED E GHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B <br /> B a- 9 0 6 „ S do <br /> B- 7 v 6" n s ice 4 s s <br /> B- 7— 6" B t / ? "45 y '7 `` c S .:K <br /> B-5" 7 7 73— 61, .6, 4 2- 4 S- ` & C S <br /> PERCOLATION TESTS e <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTER VA/pL-MIN. P RIO PERIOD p PERINCH <br /> P- 'A Ll V <br /> P_ <br /> PLANVIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> 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 <br /> of land slop. <br /> SYSTEM ELEVATION 97 r <br /> Lt'T 3 0 <br /> 4r � cl, <br /> TN <br /> ay Pig k11 f �v -v � w1 /[� Ftp ce fld:. <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin <br /> Admimistrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NA (prin .. TESTS WERE COMPLETED ON: <br /> C �QrIC � 4 5 — .s— S' ..'�— <br /> ADDRESS: �_ CERT FICATION NUMBER: PHONE NUMBER optional): <br /> w� �sx/ 00 Y3 is 866 yls- <br /> C I�T flEr <br /> DISTRIBUTION: Original-Local Authority,2nd page-Bureau of Plumbing,3rd page-Property Owner,4th page-Soil Tester. <br /> DILHR-SBD-6395(N.03/81) <br />