Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> 69 <br /> LABOR AND PERCOLATION TESTS 115) MADISON,WI 3707 <br /> HUMAN RELATIONS <br /> ((LHR 83.0911) & Chapter 145) <br /> SECTION: TOWNSHIPIMUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> OW %S W % 9 /P10 NIR R E(n K LANs ' Nfl INR I nl <br /> COUNTY: MAILING AODR SS: <br /> vRN LUOV 1WX I BoX 15 L5FM LAKC <br /> E DATES OBSERVATIONS MADE <br /> Iv .B : COMMERCIAL I41PROFILE DESCRIPTIONS:1PERCOLATION TESTS: <br /> tpRasidence ❑New (�RePlace <br /> RATING:S-Site suitable for system U-Site unsuitable for system 1 <br /> : MOUND: IN-GROUND-PRESSURE: E -IN-FILL OLDING TANK: R ECOMM ENDED SYSTEM:(optional) <br /> ®s ❑u sou ®sau as u os ®u Cow. <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.I LHR 83.09Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUINDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> i <br /> ER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> j B- 1 72 7. f 6131 m5 6 -72 Ams <br /> i <br /> B•2 72 �6•� p >?2 o-581 M5 S- 72Rms <br /> B• 3 72- i6 NONE 772- 5HME A5 B—Z <br /> B- <br /> B- <br /> B <br /> PERCOLATION TESTS <br /> 1TEST. DEPTH .1 WATER IN HOLE TEST TIME D I WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RI D1 P R10132 PERINCH <br /> P. 3o Ab //c 3 <br /> P. 2-S NO5 3 <br /> P. 3 NO <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 aro 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 9 4.5 <br /> 1 ABM 100 NA)L 10 1 <br /> y oPo55�p' 7RAILG2 T �ACEy" eL := <br /> I <br /> I I ' <br /> 7 A <br /> OujHouse. � ; - I WE �'f '>SbI�R r-- <br /> 11r0U, 7 �5 <br /> F t sH�� A�1oT �1s ? y{ <br /> — —I Willa N <br /> iI I I <br /> I <br /> t <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 specified 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 bcllef. <br /> NA (print): TESTS WERE COMPLETED ON: <br /> RX-HAR-0 HOP/00 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUM13ER(optional): <br /> WE135-peA W1 Sof893 3670 - 866 - 7 <br /> CST SIGNATURE: <br /> i <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHRSBO6395(R.10183) — OVER — <br />