Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, T_-- _d_. -- .. --� DIVISION <br /> LA43OR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> ((LHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/�;an: <br /> .crcliF": LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> ,5,_c_'/4 1/ /o /T2?N/R/ l )W ,duski <br /> COUNTY: OWN.Ia"IBUYERS NAME: MAI LING ADDRESS: <br /> btu z,PGf{ �iq/� S':wA.v /✓zf / �n u /215$ S bo Aee2 c,o <br /> USE DATES OBSERVATIONS MADE <br /> O.BEDRMS.: COMMERCIAL DESCRIPTION PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> �R evidence NZ /y9 - IfVew UReplace I /� -_ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-I WWI LLHOLD ING TANK: RECOMMENDED SYSTEM:(optional <br /> ❑X S ❑U ©S ❑II ©S ❑U ❑S ©U ❑S ©U 5/io sf wed <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. (LHR 83.09(5)(b),indicate: /V/q Floodplain, indicate Floodplain elevation: h/q <br /> PROFILE DESCRIPTIONS <br /> BORINGI TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER IDEPTH IN. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- / �� 9S0 ' /Vbrete, > �� O-✓"t4/.P/%r r/-26•'/.7 s 21-66"/3hS <br /> B- � G6 �`/•�' >L � b-Y"8/ s/T -zy"$n 2»cd3 Zf-66" f�nS <br /> B- 3 Y/ 96. 6-36" ,13n ,„,Ws, a� -moi sins <br /> 6-V 1,1131 s/ is -,761, n • et t/s 76-7S' Rn dy's <br /> B "l9na* 5r <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBERI INCHES I AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PER O3 PER INCH <br /> Va Nc-- <br /> P- N O <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 93. 3 ' %'«^ { v1•s` <br /> /V,, 4,e : ,4/o SC,/e <br /> 4 8 /-r C/r /oo o' <br /> cup/ <br /> c <br /> 4 � <br /> 1,k ' /� , TN <br /> D <br /> J 7/ <br /> b' S <br /> k <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): ITESTS WERE COMPLETED ON: <br /> 2%y r T lle Pto <br /> ADDRESS: nn CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> / G. po 7/ S� ao ✓sP cc S P0/ ,33 ?/ Gas-�r9S <br /> csr SIG T <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and So! Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />