Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> P.O. BOX 796 <br /> H AN RELATIONS <br /> p ,t _ (ILHR 83.09(1) & Chapter 145) <br /> LOCAliIiiTION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: SUBDIVISION NAME: <br /> 1/ 1/ /T ONAIS E 4 JRC y CSm I/, 1-/ <br /> COUNTY: MAILING ADDRESS: <br /> PPI RI C I R AER EZ- 7- 11 0. Q�gf g (Z I. SqB`L3 <br /> USE DA ES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS:p / A I r EST <br /> Residence Q ❑New Replace y v7 - Q I -(2 - I <br /> RATING:S=Site suitable for system U=Site unsuitable for system O L <br /> O �TI❑� . JMOVN IN S ❑� E: SVOEM-FILL OLODIN TANK:R�O• ,/ T/O�nLOMMENDED SYSTEM: oPtional) <br /> DESIGN RATE: S U S U !VV / f"7 <br /> If Percolation Tests are NOT required If any Dortion of the tested area is in the <br /> under s. ILHR 83.0915)(b),indicate: Floodplain, indicate Floodplain elevation: A/0 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALP H TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED I EST. HIGHEST—TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 13- 1 15' 101 . 5 NoNE :�'Sic, o S Slms S- SSS BNms <br /> B-Z 7S . S 7S o-S31rns 5'- 75 BNrns <br /> IB_ Z 100-2 NON _>72- o S31m_s S- 7Z BMms <br /> E- <br /> B- <br /> JB- <br /> PERCOLATION TESTS <br /> FTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 p RIOD2 PERIOD PERINCH <br /> P. No S I-Z / <br /> P-2 3 N 0 5 "Al- '414 <br /> P <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate stale 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 q7. 'l pL <br /> TXoMPsoNBAy <br /> sys 3 r s =ti-°'-� <br /> e <br />-a-,— lif r�X Z'(o To, _ 'BL D6 TN <br /> N; ANp AKE` wul• <br /> �M Pty .SCALL ttr= 'far <br /> Gg2F E. _ _ A,5Mloo?Ot of_��JAG <br /> :. <br /> ---- --- - - - <br /> 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods spec; gfm 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. ` s E 97 sj1 <br /> NAME (print). ITESTS WERE COMPLETED ON: d//j 9/ <br /> IG+Ifl {dol 1n15 � 12- fJ <br /> ADDRESS: r(� C ERTIFICAA!^TtION NUMBER: PHONE NUMBERIoptionall: <br /> - IS� <br /> CST IG ATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) -OVER - <br />