Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.D. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 745) (ot2 _ SQ2�3�$ <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: L4BBTVf9fG1V"N>tiME< <br /> 'T%&-% 2`{ /T4kN/RI'1E ( r)W W15S wrST f<t NA Nfl 641 ACi2E.5 <br /> COUNTY: MAILING ADDRESS: <br /> v R CSS o f 2 R 0 <br /> USE DATES OBSE NATIONS MADE <br /> NO.BEDRW COMM R IALDESCRIPTION: _ A TESTS: <br /> Residence �] �'�_' XNew ❑Replace I _ 7S _ 91 <br /> _ z$— 91 <br /> RATING: S=Site suitable for system U=Site unsuitable for system O I <br /> O��TI❑� . NL �.QU ING�� ❑U E: SV❑� I QUL �eIG�U �ON UL COMMENDED <br /> 11►T-IAAIQISYSTEM: optional) <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHESf_ TO BEDROCK IF OBSERVED MEE ABBRV.ON BACK.) <br /> B- 1 S0 8,S Nor1E >,So D-_BBI s 9-000�rw lns <br /> 13-2 SO 14 NonAC >$o o-gDm 5- SO-6mms <br /> 13-3 72 •2 ADM- >?z 0 -531ms S-- ?2--13w <br /> B-S 72 qlq .� IL <br /> s- <br /> - PERCOLATION TESTS <br /> „yTEST DEPTH WATER IN HOLE TEST TIME DRO I WAT R LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. —PERIOD I PERIOD2 P PER INCH <br /> P. " 7xv tAo 3 <br /> P-2 A0 SY <br /> P- No �y <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 S •S <br /> r <br /> &BM 100 ARIL- iVJ `7" o AK <br /> All LPT urns <br /> VVr I 1036 >Sb 2 M T�rT�D A(Z&A r <br /> 9NIo N <br /> " s ViI <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 tyh'e.>W�y{sconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief, S' q!q <br /> ec <br /> NAME print : TESTS WERE COMPLETED ON: <br /> I Cil �D I�oPKI�IS _ <br /> ADDRESS: �� �� CERTIFICATTION NUMBER: P��E N MBER(optional): <br /> CST SI//VV AT 70 RE: / S <br /> 7 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) — OVER — <br />