Laserfiche WebLink
YARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> ADUSTRY, DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN.R,EL.ATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (H63.090)& Chapter 145.045) .li,3 3 S- <br /> LOCATION:S SECTION: TOWNSHIP/Mb'Nte"RLYff1': LOTNO.:BLK.NO.: SUBDI ISION NAME: <br /> 51-o <br /> 1/4%V/4 <br /> 51-o /Y (or)W Q 4C A A''k <br /> COUNTY: OWWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> e4r CJI / 3 s 1i ti S 7, <br /> USE DATES OBSERVATION MADE <br /> NO.BED"' pgCOMMERCIAL DESCRIPTION: �IPROFILE DES RIPTIO S: OLATION TESTS: <br /> �esidence ❑New ICiReplace ,� v - a - ev - ,�. r., ` <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-(3ROUND0.PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM: optional) <br /> ❑S ®U MS ❑U ❑S2JU ❑S 1911 ❑S ©11 �e i 7 � rtad <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.1163.09(5)(b),indicate: I Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON B CK.) <br /> B- I � �' 98' 3 6,1 S, <br /> B- * qb' Y S " 0 -/0 Bsil 10 17 ins` 7 <br /> B-3 4j 9s7 I 6)S; L 7 -1- q eay ' g3 <br /> 4 t <br /> B- 4 b' I o t 6 -s-" B s I L 16 1%8 A,"i ( �� q if C <br /> B- Mod wr F s T 7'5 iC C A-4 ✓JJ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI 02 PERIOD3 PERINCH <br /> P- `/ / /� oL <br /> P- 3L 7/8 / S'// '7/5' <br /> P- I i ' <br /> P- <br /> P- <br /> P <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of\so itable soil areas. Sdista ces. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surfaceborin s and the direction and percent <br /> of land slope. <br /> b� <br /> SYSTEM ELEVATION /n c) • s ;t <br /> 7— <br /> Tel 4/c, <br /> C► <br /> feet <br /> b It <br /> r � <br /> N <br /> y �. ,ffIrl• �S <br /> t7 ji : N <br /> 'r c.,r to ,-`���•„�,t�•. <br /> 1,thf undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and ME thods 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 /> NAME(print): TESTS WERE COMPLETED ON: <br /> ,VOI •e r/ O r O '�L ._ V <br /> ADDRESS: ��, I CERTIFICATION NUMBER IPHONE NUMBER(optional): <br /> q /tee. P /S Y(vE is ` <br /> GNA U E <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester, <br /> DI LH R-SBD-6395 (R.02/82) —OVER — <br />