Laserfiche WebLink
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> 7969 <br /> LABOR AND � P.O. BOX 3707 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: ECTIONOWNSHIPI�TP: O . BDL.NO.: SUB VISION N,A i �/ <br /> '/ e/4 7 IWN/ / �U(fi <br /> COMTV: MAILING ADDRESS: <br /> el Cr/r 11,91-1 -5 3 <br /> USE DA ES OBSERVATIONS MADE <br /> 10 NO.BEORMS.: COMMER I AL DESCR I PTION: A TS: <br /> Residence New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> O�STI❑U . M(1S. ❑U IN G�S El�RE: SVS❑TEM-IN-FILL OL❑DI r7f RE Q lqSYSTEM^� fional) <br /> (W�/�� DESIGN RATE: SS ®U ny U he test) he �t-c/ <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ib),indicate: 1 1 Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO TER-IN HES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- / / /C/O/� > �a„ - „ ; G/- <br /> -5 <br /> _ <br /> a- <br /> �� /�• / /4 > 5 <br /> B- 3 �" 9� 7 �C/cv?e > <br /> 0-7;8/5 /; 7"- �5"� .5, <br /> B q?i <br /> PERCOLATION TESTS <br /> FIESI DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHESRATE <br /> INCHES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RIO 1 p RI D2 P <br /> P- H O e- '�'p g7 <br /> P- 35" f <br /> P r <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate stale 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 /> SY T M ELEVATION. �U'eX�Pf <br /> r�ODCCt,ri/yICL 41 S/y f> / _ -1- - r r_ I� <br /> { <br /> v <br /> I i <br /> IIJ'/LY�•O.�erehmCl� , .1/Clr/ in G� _a�l ??� 4 f <br /> t — <br /> , <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 COMPLETED ON: <br /> ADDRESS' CERTIFICATION NUMBER: P NE UMBER optional): <br /> CST SIGNA//TURF: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. = <br /> DILHR-SBDb3951R. 10183) — OVER — <br />