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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, � - - - - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W153707 <br /> HUMAN RELATIONS ppn //__6�//)� <br /> (ILHR 83.0911) & Chapter 145) S�D /_l�V <br /> LOCATION: SECTION: TOWNSHIP/MJ4444*000" Y: LOT NO.:BILK NO: SUBD VISION NAME: <br /> Sia /0E�/ a /T` ON/R/gV(or)W AJ !l VA k <br /> COUNTY: O R'S BUYER'S NA E: MAILING ADDRESS <br /> B4Pnt7fi �/ 4 I-to /pm rn s o / 4AaS' l�tf L ssy/ <br /> USE DATES OBSE VATIO S MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTI NS: PERCOLATION TESTS: <br /> �Residonce 3- l f.Vaw L�Replaca �� D� !^ p <br /> RATING:S=Site suitable for system U=Site unsuitable for system VV U !! <br /> CONVENTIONAL IMOUND: IN-GROUNDPRESSURE: SYSTEM-IN-FILLHOLDING TAN kvSVSTE :(optional <br /> CSS ❑U 19SOUl OS ljM 10S ®U <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required any Portion of Q��1d a ip the <br /> under s. ILHR 83.09(5)(b),indicate: add e PTOOdplai bion: <br /> PROFILE DESCR TIO S <br /> BORINGS TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTEREOQF IL WITH Sii1C NESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST.HIGHEST TO BRE3'C IF OBS (SEE ABBRV. N ACK.) <br /> �y 4IM, .377'16 <br /> B- �- Ai -e- 7U/ wrntttiTR�� 0 7�F'=P� w •,.a7 <br /> �D � B-bnsl.ts b =6s` r.»-� r r . 7c gy <br /> 7 m.. <br /> B- 3— t W ii t e T P cap G w �+wo 7- <br /> B4 <br /> - `7J� 9 it / p O-6" 44 C, Co ` fin $" ur !0�`= 74r, &MV .S' <br /> (L/j� C &110, w <br /> } p4as/_Ir b " Ue1" gti ..w S Y = S0 'G <br /> B- 4( 0 6 t 1 Ilk O- ir 10 <br /> ey 7C <br /> B-Cl S 0�. `t wb!�eCT ^ y� "4rtwxr r S <br /> w <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 __P_E_RT=3 PERINCH <br /> P- IU-o / S F �+ <br /> P- a- ri c TW-Y— "//(p <br /> 5— <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 had igs and the direction and percent <br /> of land slope. v rt �,C <br /> SYSTEM LE"TION RtpLecc,. i:.f ,07.3 1 �G <br /> e <br /> t <br /> Sc it ! '. yo ' <br /> 0 <br /> R4 b rtU-e a I a o tN <br /> otr <br /> I, the undersigned, hereby certify that the soil tes reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Cod ,and that the data and the location of the tests are correct to the best of my knowledge and belief. <br /> NA (per rin j: 1 TESTS WERE COM PLET ON: <br /> tr h c KR <br /> CERTIFIPAITION NUMB&I, PH%i E NUMB�ER(dp .na1): <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />