Laserfiche WebLink
uL za--1011 <br /> EH 115 <br /> • Dane County EnvirortmlIWMONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICEOANE COUNTY <br /> • s`•' Hgalth DeparfW*lAIVISION OF HEALTH,BUREAU OF ENVIRONMENTAL HEALTI�NVIRONMENTAL HEALTH OW. <br /> ., , P.O.BOX 309 Room 313F, City-County Bldg. <br /> MADISON,WISCONSIN 63701 Madison, Wisconsin 53709 <br /> Ate Sw //��REPORT ON SOIL BORINGS AND PERCOLATION TESTS <br /> LOCATION:NwX,!E'/.,SectionGSt__,TIN,R£E(or)W,Township or Municipality eraO/7EAt 51 <br /> Lot No. / ,Block No. Subdivision Name County )4 r <br /> Owner's Name: ko-5 G..../6E <br /> Mailing Address: 1* / M'«fO/df £0 crCoJJ/C#/Nf _1-15-2f <br /> TYPE OF OCCUPANCY: Residence £ " No.of Bedrooms Other <br /> EFFLUENT DISPOSAL SYSTEM: NEW `/.- ADDITION REPLACEMENT <br /> DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS <br /> SOIL MAP SHEET SOIL TYPE SCI` « <br /> PERCOLATION TESTS <br /> TEST DEPfH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL,INCHES RATE <br /> NUM- INH.{EE THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN <br /> BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 <br /> . 6a" 56e Post/i✓GS 2 y .-!/U44- 3 D 2 k 2.' 2% 12 <br /> 2 a" <br /> P-3 394 3°, Z�i� 26�� <br /> P_V 3e" 2"/g 2% z.1- 12 <br /> SOIL BORING TESTS <br /> TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,INCHES <br /> NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) <br /> B_ / 92" ./ave 7 f2" -7-s 67/ rc 2 6'/ xi- eo ,/ <br /> 2 9Y„ 7 9y" /. 6" ci f" sc iv--s-e- ea„ <br /> 'y Tf” 77yr /I 6., r ?2" ...4-C/.. 5‘ii <br /> B <br /> .►3 9 9" 7 FY"' I., 6,. /, 7,, 5C To y. At ec " <br /> .- Sy" 7fYii ' 6" Sc tr., .0 c& 2f" £.t" <br /> B- e ....7 SU-T, <br /> 7 _ SIN .r/" 2 -1 7 69 _3"/LT c 1 S/f" /o.f', . <br /> PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) <br /> Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area <br /> needed for building type and occupancy. Indicate scale <br /> or distances. Give/ �horizontal and vertical reference points.Indicate slope. <br /> .�fa/#1 — Y° / .'Jl,lr�amrinri.um.■.■ , <br /> ■ EC IF1IN� _airiNEMIIIlIIiiiii►\r.1 <br /> 1121E.i if 111Ia...auii. ii ii.11iiiI1.. <br /> .N.. MiliiiELIMENIIIiiin11111RIMIME11111111 <br /> .Mlfil " E1i..111MIE IIII II sN.!II1..1II <br /> 111111111111 ..PIi..uauiii am'-�iiiir ii'im.1. <br /> III... __N1U..as11LIVA iii■iiTilln11 <br /> 11111•■ 11111111115111111WIEMEGIfiliiiiiihil i N <br /> MIME 1112M411111111 M11111112‘1 41a ii2wu <br /> MINIM 11F111211111111110/131NIIIAlt1111111111111 <br /> MINIM 111117111111111Ptioemorgefinimist <br /> 11.•11 1iu...uIuu1 INCIii1•i' <br /> 11.u� �A■...I.111.EPUI 411111411011 <br /> 11�■ ;���INIIIMIN• •N• Ii M1111 <br /> ;3. 8 ' <br /> I the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with t e proce+res <br /> a .. . ...r. . . . . •.. . , .oles are correct <br /> to the best of my knowledge and belief. Q <br /> Name(print) J Oce-ls/ A �E/.vAieL.-4.--. <br /> Certification No. �a/ <br /> Address /R I i!J6rrNJK <br /> Name of installer if known <br /> CST Signature�_�3 � <br /> COPY A—LOCAL AUTHORITY <br />