Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> P.O. BOX 7969 <br /> MADISON,WI 53707 <br /> LABOR AND PERCOLATION TESTS (115) <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/M 0iI+etRA-IYTY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> uEy Wy /8 IMN/Rh I(or)W v 9 /1-4 p d 7 14 P '4. , a"iI"9dJ <br /> COUNTY: ^Y� OWNER'S o vc�o••c ni�..E: MAILING AUUH1,SS: ? <br /> 411 ie /I d IIS .1 C2-rdn S �� YJ 0 y <br /> USE DATES OBSERVATIOV ADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: rq PROFI DES R PTI NS: ER DILATION TESTS: <br /> [Residence '1 IX New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTE :(optional) <br /> $ ❑U ©S ❑U �S ❑U [IS ©U EIS OU o kvo <br /> If Percolation Testsare NeeESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83 0915)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, CC LOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIONOBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) <br /> B- y6. > 8 Q o•s'Bll r•_ ibe ani,<�ls ry "-sD^ Rr, Y Jr <br /> B1 � � I ` 1 > �n e -6.'B �� = rvo ,,.,,,. 1s 1y= p0 ' r4✓1 CJs <br /> B-3 go 96. g 1 7 � a sir, '{s 1 <br /> B-V $ 0 9S. t 1 > 8 � c P4 � 1 <br /> B-S tO Iflp ..3 k1 -7N6n [r 7 - I6" gn,.. Jr t6 r-Po rRh,cJr <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIODI PERIOD2 PER PER INCH <br /> P- 3-7 a ryf, a 9/ <br /> P- y q PI) <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 scale or di tances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface eles the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION g . D " '0 -e. <br /> A BM Gel <br /> at 7— ITf,ra <br /> � I Bores A <br /> I <br /> _7 TN <br /> i <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and me e,,ris specified in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the bat or my knowledge and belief. <br /> NAME rint): TESTS WERE COMPILE DON: <br /> D <br /> •errc r <br /> % 3 -1 <br /> AD RESS CERTIFICATION NUMBER: PHONE NUMBERIoptional): <br /> W�e �sTr 3 is ire �s <br /> CST A,T•URE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R, 10/83) —OVER — <br />