Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUM N RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION. TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> W '/ '/ Z /T p N/RI E (o W UP4100 £Fl T PFlRT 3 I — VOL- <br /> OUNTY: MA LING ADDRE <br /> BEV u_?,tsm 12.9S20 yauw L-K. RD. WEBSTEK WI, 5`f8g3 <br /> USE DATES OBSERVATIONS MADE <br /> t� <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: F7T6FTLE A I TESTS: <br /> %Residence ^, ONew ❑Replace I /O - '/ - �O 10 - Ib - 50 <br /> RATING:S=Site suitable for system U=Site unsuitable for system ID <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑S ®u NS ❑u ❑SOU ❑S U [IS M <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> 9 �_ If any portion is the tested area is in the <br /> under s. ILHR 83.09151(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL j2EPTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED H ST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B 0 `1 I�bNE 2 0-5 BI 0 5- 2-9BN s <br /> - 2 3 s w tnd M <br /> B- 2 3'8 1-3 .9 XMIC 27 0-5'5115 5-2-7 13015 7-1 - 3%&15wXtmd,rA <br /> B- 3 36 100.0 AID MF 27 0 - y811s 4-2-TUS 21- 3 6015wKc04PI <br /> 3� O 58�1s 5 2`I aN s 2 1 3 t .+ sw LM <br /> 98 <br /> B- • NONE Z`1 I 56 B ICA <br /> B- <br /> JB- <br /> ON TESTS <br /> l EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-IN HES RATE MINUTES <br /> F NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI 02 P R PERINCH <br /> P- I If <br /> 0 10 3 Y <br /> P- 2 IZ o 10 Y b be <br /> P- 7 j <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 <br /> t 3 <br /> E WI <br /> yR t�+ER <br /> FIAu9�F <br /> Wr14Q�Q'L C •r��v <br /> � C^4 r <br /> tN <br /> Abmft-To PCF 5►-H3 ELDG RIDE Q <br /> WE1L• SNCP 6HRA6> <br /> I, the undersigned, hereby certify thathe soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Code,and that the data ecorde I and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME print): ITESTS WERE COMPLETED ON: <br /> a <br /> ADDRESS: CERT(FI ATION NUMBER'. PHONE�N,t�MBER(optional): <br /> Lot 5�{ .3G70 -X106- IS <br /> CST SIG ATURE: <br /> IES+. <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />