Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (H63.090)& Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHI /MUNICIPALITY: LOT NO.:BILK.NO.: SUBDIVISION NAME: <br /> S(J 1 1/ 35 /T N/RW (o '_—r uo►J <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> 'aAu 5-�pp�ES -aR ��r-�. (.J� �,Z W 54893 <br /> USE DATES OBSERVATIO S MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: ER CATION TESTS: <br /> R esidencej New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system -VD G <br /> CONVEcNTIONAL: MOUN(D�: IN-GROUN(.D-PRESSURE: SYSTE(11�M-IN-FILCH 11L (:�1GTANK: RECOMMENDED SYSTEM:(optional) <br /> ©J ❑U ❑J ❑U ❑J ❑U ❑J ❑U ❑J ❑U <br /> If Percolation Tests are NOT required DESIGN RATE: e% If an <br /> y portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 0494.4 D&LsL 8+ F -16 AM S <br /> 11 <br /> B- <br /> B- 317n 09.6 st <br /> N <br /> B- S t�/� • y N N N <br /> B- 1. <br /> N <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. RATE MINUTES <br /> PE RIODt PERIOD2 P R D PER INCH <br /> P c ID 2., V7. 2., YL � <br /> P- 11. . '12- <br /> P- <br /> P- 24 " tos t s Z <br /> P- <br /> P- <br /> P- <br /> PLOT 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 /> 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 slope, <br /> SYSTEM ELEVATION 94.0 <br /> 13 .L7/ <br /> 407.484,W <br /> a�b <br /> OF p <br /> n <br /> $2. <br /> 40 tN <br /> s.ra <br /> 7S' <br /> 3 �. f�oPutTJ� if �ser.T Zo A. <br /> I, th 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 /> Adm, istrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> • <br /> (print): TESTS WERE COMPLETED ON: <br /> - <br /> RESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> A►� ALakk SIEAV'. CST 715-834 - <br /> N "Soo S. j3a2S-CotJ CST G ATURE: <br /> r-Av CLa►Re f (fit "lot Jf <br /> DIS RIBUTION: Ori_gi�l and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R.02/82) —OVER — <br />