Laserfiche WebLink
DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> �/ 23 /T N/R ISE io W ,(� 59r P I fl D AW. V V. <br /> COUNTY: y� MA LING AD�D7RESS: <br /> U 0 L L L �� ST. Nrlkr+[�ICLD oNhf. 2Z0,52 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: P IDESCRIPTIONS: R AG ON TESTS: <br /> ❑Residence "Z New [:]Replace I / _ Z�1 - / - 2 1 Q,ZS <br /> RATING:S=Site suitable for system U=Site unsuitable for system k7 L _l(� <br /> C N ENTIO❑NAL: ftQOVS I IN-G J ❑URE: 2S EM-I❑uLH❑SG, FyN� .RECOMMENDED C0NV9Nr10ALoPtional) <br /> S UU ny�(+I JS <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)(6),indicate: { v Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D P H T GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.( <br /> B- I 7Z- <br /> 13-2 'fL $ -Z 7Z 0-Gsits 21 $NIS V - '1Z $Nms <br /> B 6. E. s7S s B11, s-zy 3Nls 2y S Nh1S <br /> B-4 qy. I NION6 >77- <br /> B <br /> zBj. 0 X72 -6B1 6 FIs 1$ ZBN�,s <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBERINC ES AFTERSWELLING INTERVAL-MIN. P RIOD1 PERIOD 2 P PERINCH <br /> P- N o Yz <br /> P. 2 ND /4 e v 3 <br /> p- 3 0 4 t <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 loca ion on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. ��.� <br /> SYSTEM ELEVATION <br /> I <br /> Ss-�ttf: 1 140 <br /> A,SMiOO NAI4iu -$NDAWAJ - <br /> L <br /> WEU-To, Be > fKon1 SEED- 3- <br /> - t - <br /> r <br /> � N <br /> --� <br /> AWE2 �_ <br /> , <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 merh ds spified in thfl W,jsconsin <br /> sts <br /> Administrative Code,and that the data recorded and the location of the teare correM t the best of my knowledge and belief. IV <br /> s�� <br /> NAME (print): TESTS WERE COMFLE.ED O.Q. <br /> 0 ✓O (' - Z-61 - 2 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Z ?-7bo 9W 35 WFBS"fEK W► - Sy853 �,7o 6 IS <br /> CST 5IGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> 'I LHR-SBD-6395 (R. 10/83) -OVER - <br />