Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDPERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/I111:1NY@fPAtTFY: LOT NO.:IiLT.700.: SUBDIVISION NAME: <br /> !Vw'Y,NE Y4 3.2 /T-ION/R16 E Ip /v PNO Brs w i-AKF- Esta <br /> COUNTY: OWNER'S �: MAI LING ADDRESS: 0- 4Z-2-,2yay Al 47,L-,20.10 <br /> &o)erT 40, E reNgav &x lgl /-PC&" . S <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: J� IPROFIL DESCRIPTIONS: PER OLATION TESTS: <br /> Residence 7 44, <br /> /r 'I"`NlNew ❑Replace S�S�p� <br /> RATING`:S=Site suitable for <br /> rrrssystem U=Site unsuitable for system � <br /> CONVENTIONAL: Mv, J.❑� IN-GR IBJ P❑�RE: SVS❑TEM-I®ULHOLDING�� RECOMMENDED <br /> BEU ST�SXp.3SJ <br /> If Percolation Tests are NOT required DESIGN RATE: S If any portion of the tested area is in the <br /> -11 <br /> under s. ILHR 83.09(5)(b),indicate: Im Floodplain,indicate Floodplain elevation: /V/4 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPT TO GROUNDWATER-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- 67 99 9a` 6 3 1163 /o' /s ,z75 eaAmr <br /> B- �, 99.83 ;2 6 10'W 51 a" 5 11"AISx 'yeT <br /> B- 3 ff3 /0/,7/a' o E 79, ss S" n-5 <br /> B �3 /V 33' 78 /S/ 'rep _S . ,.e4 s 6Aer Rm <br /> B- <br /> /o/. iIal moAle77 S s k <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. PERIOD ( PERIO 2 PERIOD PERINCH <br /> P- J a3 a tE 3 <br /> P- 3 / / ` '711f <br /> 3 <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 /> J <br /> SYSTEM ELEVATION 9� <br /> SCALE - / 84o e& /o' <br /> EAs'FiyEA�/,TrWOO 4oT i 04��Fy�_ I b <br /> Iga d By T TEMel ES 0 em - ?OP of %"RdD <br /> PAP,2 P:j4R3 I <br /> _j ROAD A)14) COAN04 <br /> To 3s Q 504 &,P/N6S <br /> � TN <br /> Q PEec ZeTr.5 <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 OMP ETED ON: <br /> &FA) .BEL Ir s <br /> ADDRESS: CERTIFI ATI NUMBER: PHONE NUMBER(optional): <br /> a WE S� L✓ , - 3 C-s"r- 33a z 35/ -aq? <br /> CST SIG ATUR E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. 5 LTl� <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />