Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> 7969 <br /> LABOR AND C P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON,WI 533707707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.5 <br /> NO.: SUBDIVISION NAME: <br /> E '/4NIL% 3 /T N/1115E (pr 5 NA IL <br /> COUNTY: MAILING ADDRESS: <br /> 5WOIT Jo ri2 1171 ML6 SL N HAPLE-WID0101 <br /> USE DATES OBSERVATIONS MADE <br /> 17 NO.BEDRMS.: COMMERCIAL DESCRIPTION: s��-yaI PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence h �� LXINew ❑Replace I /^ _ I I _� i7 � 1 I — � �7 <br /> RATING:S=Site suitable forsystemU=Site unsuitable for system / •7 L { 1 L� <br /> COIZSTI❑U . MNS. ❑� IN-GROUND ❑Q E: SYSTEM-I NO-FILL OL❑DINGNK: REC NN ENDE7SVPSTEMptional) <br /> IfPercolationTests are NOT required DESIGN RATE: ®S U If any portion of the tested yarea/is in the yI <br /> under s. ILHR 83.09(5)(b),indicate: �� Floodplain, indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- � 5 o No >7-5o -6131115 (9-1SBNMs <br /> B- z 1Z 9to p >'12 o-(p81pt5 (0-7zgNms <br /> B-3 '('L �L.� D�S� >?Z 0_113111_u 7 �Z�nlms <br /> B- 4 ' 2_ qS . DN� >72 6 -16tm5 '1- ?Z3Nm5 <br /> 13-5 '12 S.Z OtJ >?2 �31ru '7 -12_BNr1S <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIMEDROP IN WATER LEV L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PERIOD 3 PERINCH <br /> 1Ll <br /> P- I N 5 'yr. �z <br /> P- 2 3`t No 12n 3 <br /> P- 2_4 <br /> o y2 s/c <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 <br /> on the plot Ian. Show th surface elevation at all borings and he dir tion and percent <br /> of land slope. ORI-fi <br /> I GIOAL A <br /> SYSTEM ELEVATION 1q . o q3 <br /> P� K <br /> i�,f <br /> � cr <br /> .SCS I E 1''= <br /> ♦QIM 100 hOTfdM of S�0)r1G` , _ <br /> WPI roBr—, >-50 .Rom "MD <br /> TN <br /> 37 <br /> � I <br /> 3 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and Meth0 S pecified in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are corre tot a bes f my know dge nd belief. „$f; <br /> U If - 7_7_60 9d0 <br /> NAME (print): TEST WE E COMPLETED ON: <br /> Kj C M jq Rip o 5- 11 - <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 2�? w 35 �STEfz 1 S83 b o S b <br /> CST-SIGNATURE, <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-5395(R. 10/83) OVER — <br />