Laserfiche WebLink
DEPARTMENT OF ''''''- REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS <br /> INDUSTRY, , DIVISION <br /> LABOR AND-. PERCOLATION TESTS (1151 P.O.BOX 7969 <br /> HUMAN RELATIONS, . \ / MADISON,WI 53707 <br /> • (1463.09(1)&Chapter 145.0 45) <br /> LOCATION: SECTION: TOWPSHIMUNICIPATY: <br /> LOT <br /> NOlBLK NO.:SUBDIVISION DIVISION NAME: <br /> y4 / / y/R( f lorw /GG��pn <br /> COUNTY: OWN A /BU Y R' `ME• MAILINGADDDRESS: <br /> J 20 C Oh l /7�a/ $a' Soq D/oS k v RI Akan, ' <br /> rS - <br /> • USE DATES OBSERVATIONS MADE <br /> NQ COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOII,,AATION,,,TTTESTS: <br /> esidence Jew ❑Replace ' /'8/f /O//9 I <br /> RATING:S-Site suitable for system U-Site unsuitable for system �l O O /' U <br /> CONVENTIONAL: MOUND: IN-GROLRJD•PRESSURE-SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:loptionall <br /> LS.LU DLDU OS DU DS ❑U OS CU ______I <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> eQ If any portion of the tested area is in the <br /> under s.H63.09(51(b1,indicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH <br /> NUMBER DWI1'l IN,ELEVATION OBSERVED ! EST.HIGHEST •TO BEDROCK IF OBSERVED(SEE ABBR ON BACK.) <br /> B- / 34 93,D iu. ,r > Alliov;Q0 81YSI I .,2"iei <br /> . B- a 34 9/. 7 ' - >3(s," a3" S„ 1„ <br /> B- 3 t.% 9'V.3 '. )36" 8„ R, $„ <br /> $-P1 a4 94/0 1. r3., sl <br /> ii-11,3 T 93 9' ,■ 4I a;l an %9 <br /> B-P-3 424 90/.7 i. i3rt 5 i„ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD�22 PERIO�Df-3 PER INCH r <br /> P- / a'I OW <br /> loo S O” Z /s- <br /> p. <br /> 3 a y 0 3 1/f lsb /air i�/.. ao <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 ye cal 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 /> SYSTE ELEVATION 9 <br /> as 111•1inii-- - - III _ _ <br /> I mo <br /> AVIIIIMIIIIII <br /> imp �' I <br /> El __ <br /> Ellinw���. T Q r cfsscr <br /> • OMN. , f3 13. <br /> 11 II G ,P I 1 I f �21111311 '4'4 <br /> ill — iii eft':.1411/1-1011.11' IMMMIll q111.1" <br /> .�I .....�Mvi IN iimull <br /> IM mime r ., ai - �� .. .. �u>ommum <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 CO PLETED ON: <br /> dG rilel rlb1Z /ol/y 5-A... _ <br /> ADDRESS• / ��AA'''' ERTIFICAJ lIl������tttttt������//////UMBER: PHONE NUMBERIoptiofpiell: <br /> R. I (j(/�C+ na k-A-`- J t-4/i s. SIGNATUR f✓C� Q3�.,'.���.G <br /> I <br /> 1 i1. •_- /-// �i�sir' <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. / /' , <br /> ,DILHR•SBD�395 IR.02/82) -OVER- - / <br />