Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFEF•f& BUILDIN N <br /> INDUSTRY, DIVISION <br /> LABQR AND P.O. BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 5379079 53707 <br /> (H63.090)& Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUB DIVISION NAME: <br /> x' 0Y '/ g /T3g N/R/ fir)W <br /> C UNTV:y/ OWN ER'S�UYER'S NAME/:t MAI NG ADDRESS: <br /> % t JCS C SS�Q✓OI <br /> USE ATES OBSERVATIONS(MADE <br /> NO.BEDRMS.: COMMER ADESCRIPTION: IPR DESCRIPTIONS: PERCOL TONTESTS: <br /> $Residence —� ❑New [$Replace � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUNpD: IN-GROUN(�6PRESSURE: SYSTE(�M-IN-FILL HOLDI(N�G TANK: RECOMMENDED SV TEM:loptionall / <br /> ❑ S � �S ❑U ❑S �U ❑S U ❑S U / � :� Gk4�+ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.H63.091511 b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORINGTOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COL R, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHE TO BEDROCK IF OBSERVED (SEE AB V.ON CK.) <br /> r If a <br /> B / a6 9c. s �n 30 �s � orx ' AR <br /> Ir <br /> * <br /> B- `'� f 97, P NON A' 3`z " $z' Cz <br /> B 3 561/ 97 o S 3 11 <br /> ell ",o� �, , �..� <br /> D 1z If .L 4 rr /P . t.// <br /> n �I 6" dG 7 S 5 j /S ✓G .�v� <br /> B- 75,v he'iU,E p'z / G t 6 5,4- A13- 14, Alewea <br /> if <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. p RIDD1 PERIOD pER PERINCH <br /> P- 1A of U O 6 el� IGam. <br /> P- / Ir 0 ! l l <br /> P- oZ <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 boring/6 and the direction and percent <br /> of land slope. % A,4 4r P jd • <br /> SYSTEM ELEVATION. <br /> rI <br /> 1 E <br /> i <br /> I I <br /> I j i n tt <br /> -- -i iit <br /> k TN <br /> I <br /> 1 <br /> I ! � ! `t" ii l if <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures anfQ I e Isconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belie��s V " + <br /> NAME ,i t / TESTS W RE COMP ETED ON: <br /> �Y�l ZZ <br /> ADDRESS: CE TI ICATI(�N NUMBER: PHONE NUMBER(optional): <br /> 7� ,?ON A /s SSS -7 0 5" -/ S %S1461 <br /> CST SIGNAJURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SOD-6395 (R.02/82) —OVER — <br /> r <br />