Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY,. DIVISION <br /> LABOR AND P.O. BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITYLO NO. B�..l0SIJBD VISION NAME: <br /> 1/4SE '/4 rI /TtN/( IVT1orO <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> Duyz Ti fboc MO <br /> USE DATES OBSERVATIO SMADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: i� PROFILE DESCRIPTI NS: TS:R OLATION TES <br /> Residence 2 �� ANew ❑Replace LI_/Z—Q <br /> RATING:S=Site suitable for system U=Site unsuitable for system V <br /> C ENTI❑U . MQ _ S. ❑U IN-G®S ❑URE: SVS�T EM-INU HO❑L s TANK: RECCO-MijU DED SYSTEM (optional) <br /> OU <br /> If Percolation Tests are®NOT required DESIGN RATE: S U If any portion of the tested area is in the <br /> under s. ILHR 83.09151(bl,intlicate: �� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COL OR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B- $o qq_$ NorsE > 80 0-G7 61K ms 5- 86 8N Ms <br /> 13-�Z - 72- 99.1 0- 6614ms 6 _ 72-6UM5 <br /> B- 3 r12 qq5 ft o-5Bl4ms <br /> B- 2— SAME 45 8-3 <br /> B-5 r77 9$ tkt 61W 115 &3 <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 PERIOD PERIOD PERINCH <br /> P- 26 No 5 �Ib 3 Z <br /> P-2 110 <br /> P-s <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 Ian. Show the surface elevation at all boripigs and the direction and percent <br /> of land slope. = SG9L6 ("' YQ� <br /> SYSTEM ELEVATION A6A11CV0V1G B&,5dFaUMP 0�81QGf{ <br /> PRovosS£n � .�/ <br /> Z°Io pIDG P LE(( � <br /> p TN <br /> 1� <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and m thods 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 COMPLETE ON: <br /> oP olu5 /-f- /2-- 39 <br /> ADDRESS: CER;IFICrATION NUMBS ONE NUMBER(optional): <br /> CS SI�'i ATURE. /JS $6b S <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />