|
■
<br /> • DEPUSTRY NT OF ?C'R T ON SOIL BORINGS AND SAFETY & BUILDINGS
<br /> INT , DIVISION
<br /> LABOR AN-D 'PERCOLATION TESTS (1151 P.O. BOX 7969
<br /> HUMAN RELATIONS ' '�� \ / MADISON,WI 53707
<br /> (H63.09(1) & Chapter 145.045)
<br /> LOCATION: i 'SECTION: TOW NSHIP'1\,11:thftew*h-l±1': .LOT NO.:BLK.NO.: SUBDIVISION NAME:
<br /> to to %/awe/a /T J N/R:---E („tW ri\ E -, 1 I--) A '-'f-.R c E L c
<br /> COUNTY: 'OWNER'S/RDYER'S NAME: MAILING ADDRESS:
<br /> _r_.--v-A,,._)C ,- - - - __- _, i:,k-7-, /,',._ _ 1 i - -'; L-E-:_w E. L.L V 5! M 4-2 5 F-f q (--(- GN,/ S-3 s c Ci
<br /> USE DATES OBSERVATIONS R MADE
<br /> 5454 Residence PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> Residence ._- ___--___---------- L-7New ❑Replace _ST 70/2 ; /7 /Y3 6, 7-(y
<br /> RATING:S=Site suitable for system U=Site unsuitable for system
<br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:loptional)
<br /> ES HU S . Jul 2LS .0 —IS f •-qU L .S RU co ,),-, ---J7-70 ,--)
<br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
<br /> under s,H63.09151(b),indicate: &/ / ta'- Floodplain, indicate Floodplain elevation: ' /i�t
<br /> PROFILE DESCRIPTIONS ALL xyL (o '
<br /> c_672 S Aye (3„
<br /> BORING TOTAL f I DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH 1
<br /> NUMBER,DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
<br /> B- ! 7a I c f 1 v f_') ,v 3,r, I I /-7 5, �2 5 � Sri � `p L,-"r- 30-72.x /
<br /> B 2- 72- /pt(.3' h j v" !o Z 2(f Sc-C 7 72 5i cX�' r � , 3 �
<br /> o-
<br /> 7
<br /> B- S /o2.l ' 1, ;o '' /0_e -23 �,. 7v5iZd, ,,
<br /> 3o-7y
<br /> B- �� /ol 3 3'' 2`f 2� �i�i Sc� �C 5 ��-t�( " 3'3_L.0
<br /> B 7 F6 C63 /' i, 3a ' /ae 1 32 e 1 Y6ikl% L 32-J'6
<br /> B-
<br /> ,
<br /> ELEVATION PERCOLATION TESTS
<br /> • TEST DEPTH 1 WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
<br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH
<br /> P- 2.8 /0(.21 - d -)0 3 I(P 0-15-74 3 /O
<br /> P- "2- zi /owl' p 30 -/(G6 a //(l6 �t/C1- 7s—
<br /> P-
<br /> 3 2? (0/.2' I U 3� / '/Ie ..2- /'rlc
<br /> ii
<br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimension%of suita a 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 surface elevation at all borings and the direction and percent
<br /> of Ian. sloppy-eL� \\
<br /> S ,w Y VATION l'2- e IREPLACEMt'> I
<br /> r1 t% @ roe of 8"
<br /> 7S M�
<br /> L
<br /> T L iN, \cam 6.‘44-12-1(...e..0)
<br /> i r 0• \
<br /> z0 3 $
<br /> Ai\N, 9J
<br /> N YA-rz c F C. i3 c_ 4.«l..� <
<br /> t->
<br /> �c� r
<br /> 111=�O'
<br /> J 1
<br /> _ ._ –2 -- , - –11 t — ._ --1 x=nf��s
<br /> - 2oh - i i 60--- -
<br /> b=�'E,2GS
<br /> Afa�A C
<br /> I
<br /> —�L x
<br /> s m oo.P("t I S W L l '-
<br /> zs, I EIFt'A^fla S
<br /> 23-3 H--- ____ l o -- r----____4:725-
<br /> u£t-L MI lot-i r
<br /> f - L 442_ to3. N
<br /> 7-g%, � 2 3 azi3lof.(,'
<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):E FFREY L. HAM M ES TESTS WERE COMPLETED ON:
<br /> - 7 .---6 /
<br /> ADDRESS: (CERTIFICATION NUMBER: PHONE NUMBER(optional):
<br /> 3521 MARGARET ST. , MADISON , WI. 53714 2238 (6081222-8650
<br /> This soil test impart is the first step in securing a sanitary permit. The tasty or CST SIGNATURE-
<br /> the Department ray resaeet verification of this soil test in the field prior to permit
<br /> 10 THE 044ER isswnae. A complete set of plans for the private w age system and a permit application n _J G. - -
<br /> mist be sannitted to the appropriate local autlaity in or CO obtain a permit. The
<br /> sarutary r-i tt must be obtained and posted prior to the start of any oonsulstian.
<br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
<br /> DILHR-SBD-6395 (R.02.'82) -OVER --
<br />
|