Laserfiche WebLink
DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR P.O. BOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) 10S1 — 3102 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: <br /> �/ 14 3 /T N/RISE (p )W W 155 EST PART N R NAo A eREs <br /> COUNTY: MAI ING ADDRESS: <br /> ZQRtl OM SRN LU KI51 Lu Ns �} DR.7AN IJTZ I. 5'f83o <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: Z- 1 -q1 <br /> A TESTS: <br /> Residence XNew ❑Replace L/ — I —n I / _ I _n <br /> RATING:S=Site suitable for system U=Site unsuitable for system (� ` "I �i l <br /> ONVENTI❑� . M jJ�. ❑� IN GROIJ� ❑� E, S❑ 1®�L ❑�G T . RCO M VENDED SYSTEM:Ioptional) <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: ! Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P H T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED H TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- ) "32 q00, NONE >'jZ ©-531ms 5 - '247 <br /> B- 2- 12 NONE >7Z 0-5'9IMS 5- 77Tsris <br /> B-3 '77- S APA16 -;;, 7z O- 31fns �k- ?Z3Nms <br /> B- `f Z NQN6 >-72- <br /> B-_5 <br /> 2 ©-fi81ms 5- 7zFNl(1S <br /> B 7•1S Q- `� 131nts �}-7S L3Nn1S <br /> B- <br /> PERCOLATION TESTS <br /> YTEST DEPTH I WATERIN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES- AFTERSWELLING INTERVAL-MIN. p RIOD1 PERIOD __PEH I VQ J PERINCH <br /> p- 1 140 5 Al— <br /> P. 2 3 n!0 5 % 3/r. ZP <br /> P- rAO9� S <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 %.Q <br /> a_ <br /> a , w <br /> J <br /> TN <br /> 5cfti`E C'__ `{o -uNLESs�IdfED _ <br /> AlM 10001L A B_"PoFFLE RiZ _ <br /> 1 Wit is flPRox �oo'_Nly�cttD1 Ti? l4cAL <br /> v 4 ?2DoTo +q�N �cl <br /> Ntu /5 91'Kox C i`,5ao of <br /> L t <br /> LC -500 <br /> I, the undersigned, hereby certify that the soil t sts reported on this form were made by me in accord with the procedures and methods 5pecif 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. ,�f,/a,.00 <br /> NAME print : TESTS WERE COMPLETED ON: <br /> IC 1 O�K�n1S <br /> ADDRESS CERTIFICATION NUMBER: PHONE UMBE (optional): <br /> T�2 , (0 0 1s' (off IS <br /> CST I NAT RE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R, 10/83) — — OVER — <br />