Laserfiche WebLink
INDUSTRY, REPORT REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTR V, 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.: SUBD IV IS ION NAME: <br /> '/ <br /> Z3 /T�{oli/R 16 E (p O Fi b 5 — <br /> COUNTY: MAILIN NG ADDRESS: <br /> 83 +h 1_1J o MN . o <br /> USE DATES OBSERVA IONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: R�RIP NS: PERCOLATION TESTS: <br /> ❑Residence ��� New ❑Replace I S _ 10 _ <br /> _ IO _ p� Q - Io „q"/ <br /> RATING:S=Site suitable for system U=Site unsuitable for system O 1 v L- <br /> ��TI��. N��. ❑U IIV I <br /> N-G � ❑� E. SY�� I❑�LHOLDI❑�G�� . ^ONv� ED SYSTEM:(optional) <br /> NAL <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ibl,indicate: Floodplain, indicate Floodplain elevation: NR <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.HIGHffS—TTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 75 JO0.I NO N6 >75 O-b-Bkys 6- LTD3jm3 t{0– Coo Ras Lo-75'8rjru <br /> 13- 2- �0 9A-& NONE >(00 0-1,31rn3 6- 51B14ri 3`I- &UK.no <br /> B- 3 117- 99 .S 'q oNl� >'72 O-6 51fns 6- 473r­Atiy L{'L - 'IZRMs <br /> B- 7– 10NONE 572 U -C�31ms (� 1'C j3Nf+15 L}2-'7Z1<fsr5 <br /> BS (00 DD- G NOf46 »0 0-5-51eqs 0-94t.%s <br /> 13- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER L V L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PER1002003 PER INCH <br /> P- rL So t4 a TI/iS/ .� <br /> P- 3 ;v 9/� 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 pf_-(, ^_p`� <br /> SYSTEM ELEVATION -1 9$ .9 �,$MIDc�Ng14 �N �`f"I�oRw � <br /> I � <br /> DE <br /> TN <br /> r - <br /> Fr <br /> f��:. I..,�/ <br /> Alz <br /> I,the undersigned, e hereby certifyhattlhes "OpC. Nil tests reportedr on hio were madeby `n accord with the procedures and methods specified in the Wiscon <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 COMPLETED <br /> )CRRIZO NDPK/NJS `;- I0 - 9 2 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMB ER(optional): <br /> 2-7 -n o Hw '�100 '1(5- I5 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHRSBD-6395 (R. 10/83) -OVER - <br />