Laserfiche WebLink
DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, �, DIVISION <br /> LABOR ANDP.O. BOX 769 <br /> PERCOLATION TESTS (115) MADISON WI 537 <br /> HUMAN RELATIONS 07 <br /> (I LHR 83.0911) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> -- '/ 23 n W/T 40N/RISEI3ACK50t4 Wt NA DV a Add, b VV <br /> COUNTY: MAILING ADDRESS: <br /> LORr41211 TAVID RArJ I S M L 5� <br /> USE DATES ISSERVATIONS MADE <br /> NO.BEDRMS.: COMMER ALDESCRIPTION: �,�II P FI D NS: ER ATION TESTS: <br /> ❑Residence �_ XNew ❑Replace <br /> -IS 9z (, - IS q2 <br /> RATING:S=Site suitable for system U=Site unsuitable for system Q �rc7�T� <br /> O®STI❑6 ONAL. N SLVIN . ❑u IN-G S OU E: SNS 1❑�L OEIJLDI Gv"U TANK:RECOMMENDED tVt&Ef4110rJALMaoPtional) <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> q If any portion of the tested area is in the 1� <br /> under s. ILHR 83.09(5)(W,indicate: �_ Floodplain, indicate Floodplain elevation: 1.7I <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. GHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B o > $5 (P31ms (xi- 33 B'Jim g3 -59 brvloi w,j - <br /> N r� <br /> B- Z �Z q� > 2 b- BlryLz (o t{Z prJms 14z ZBNms rvr�, <br /> q - 51) BNPIS 30 - (Dq BNms wr <br /> 5 <br /> /n� Qn- (oBlr�s (o- 301, $N(V0 3'\- IOL. BN ms 11 y <br /> B- _I V ' Z oro- 6 6- TS N <br /> B-S 7t <br /> (o-3 E >?2 -,5-13 M) S J'Z5uyns 42- '7-L8NMs w y <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD 2 P 3 PERINCH <br /> P- I o 5 Y <br /> P-Z <br /> P- S IR N 0 1 yip <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 ELEVA ION <br /> SCALE I`� (no 0-UL of .*c <br /> 'L'Ohl LOO, OAL M �tf 4ORW A <br /> 1cJE4.._70 3l. -?SD- AZW <br /> ✓G <br /> 974, E-- <br /> 2 _ <br /> I,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods sp ifie 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 /> trm..Q ellen a $h1 . <br /> NAME (print): TESTS ERE COMPLETED ON: <br /> KIcHi9ev <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional) <br /> Q-116o Hwy 35 LJF_85FE12 wi . 5 8 3L o = h S <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one Copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD6395(R. 10/63) —OVER — <br />