Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, � � DIVISION <br /> LABORAND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> HUMAN <br /> (I LHR 83.0911) &Chapter 145) 1Z, '�'� , 7- <br /> LOCATION: SECTION: TOWNSHIP/M UNICIPALITV: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> 32 /T'}oN/R II�E (or W OAKLAND S 1 JFFFR1ES <br /> COUNTY: MAILING ADDRESS: <br /> IYA MEYER 3303 K L AV. LAKE ELMO <br /> USE _ DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMMERCIAL DESCRIPTION: I DESCRIPTIONS: ATION TESTS: <br /> ❑Residence - �_ KNew ❑Replace I /O- ��- q2 /V -��_ pq <br /> RATING:S=Site suitable for system U=Site unsuitable for system I V /L <br /> IL�ISTIDU Ml�.]JS ❑U IN-Gg]S ❑URE. �S I❑UL ❑SOLDI G TANK:RECOMMENDED VI-NTOAWL (optiona) <br /> -(((jJJJ t1/1 C, <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> Q r___. <br /> � If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ib),indicate: { AM <br /> 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 ES HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I 2- 3. NONE >12 O -l�Bifs 6- 12,8frf5 <br /> B- 2- qb.0 n1oNr= ;' S 6- 8S5A <br /> B-3 2- V60 <br /> o �2 S <br /> � IJ-5 Bl$ -IZ_a , & <br /> B- `1 oNE >17- 6-513ifs S- '7 o-Fs <br /> B-5 $5 N()N6 > g5 0- 1r81ms b-V$Nfs <br /> B_ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-IN HES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN, PERIOD I PERIOD2 ERIOD 3 PERINCH <br /> P- i <br /> 11O11 E 5 1 3 <br /> P-2- Noric 5t, 3 <br /> P- 140NE v 131, 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. SCiPIILrZ 1 r1= L{0� rf <br /> SYSTEM ELEVATION 92- • Z- ABrM 100 N#1It_111,1 q tJORvJfl <br /> 1 \(JEIl 16,612-,i 1.$0'fP\DJM <br /> Fj 21 <br /> 11 <br /> k� <br /> TN <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and met o s spec fied in the Wisconv <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. Sf- 9� . <br /> NAME (print : TESTS WERE COMPLETED ON: 7 <br /> 1CHH1Zr> HdPKlz 16 - 12. - 92- <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 2'7 0 w ' 35 W 68STER W1 , 54893 3670 'J/S- 66 L1157 <br /> CSTSIGNATURE <br /> —ISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> LHR-SBD-6395 (R. 10/83) —OVER — <br />