Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, ` DIVISION <br /> LABOR ANBOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (H63.09(1) & Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/ULLWC42, 64-y; LOT NO]I3 NO.: SUBDIVISION NAME: <br /> sw '1W14 'I'DR'/Tvo N/Ri ®4')W ..vg sv/v �� d cod R`i <br /> COUNTY: OWNES NAME: MAI LING ADDRESS: <br /> �/e f o Lu <br /> S`O � NeS G <br /> USE DATES OBSERVATIONS MADE <br /> Fr� NO.BEDRMS.: COMMER IAL DESCRIPTION: ��jj�� PROFILE DES RIP IONS: ER OLA ION TESTS: <br /> Residence Z NI9 ❑New c,p+tePlace I '/Zo 86 �_ z0 -86 <br /> RATING:S=Site suitable for system U=Site unsuitable for system T <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:Ioptional) <br /> ESE111 ©S ❑U ®S ❑U EISE111 ❑S ©U <br /> If Percolation Tests are NOT required DESIGN RATE: If any Portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: �!1/j5p, Floodplain, indicate Floodplain elevation: Nzq <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B 7Z_ /oo. - trNe 7Z <br /> -v yc/ —7Z eJ <br /> B- 2- oz. \\ 09 � e- ' T 3-60" s. 6o-6 z'" z- 96" 4322 LS' <br /> B- 3 $ ! a o io"vd/r/�3- io-z s. z6-78'` s,'• - aY- e"a3>: <br /> B 60-B5� Sir, 'a++ccl S <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD P R PERINCH <br /> F 3 o0 c < 3 <br /> P- S c % < <br /> P- <br /> P_ <br /> P_ <br /> PLOT <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 177 s" <br /> . . . . _ . . . .. .. . . . <br /> ,/✓ate No scA/� _ <br /> Ay_ _E'/e✓ ' /o'a. v ' <br /> v <br /> a `1 <br /> \t \ n°�e- <br /> n <br /> � P <br /> z !� TN <br /> S r <br /> 41 <br /> �.� <br /> T . <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 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 belief. <br /> NAME(Print): �/ TESTS WERE COMPLETED ON: <br /> / � �- 'x e� 2,0- yea <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Rnx / sla oaN« �,` s 8Q 3331 7/S-63S—�J 9 i <br /> CST SIG UR r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> )ILHR-SBD-6395 (R.02/82) —OVER — <br />