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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 7969 <br /> HUMAN�RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.0911) & Chapter 145) trj-zi _ Z <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SU DIVISION NAME: <br /> 1/ 1�T pN/RJE (or)W o4 n rkrn <br /> COUNTY: MAILING ADDR SS: <br /> 'P 8 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE T NS: PERCOLATION TESTS: <br /> ❑Residence ❑Neweplace <br /> �} - Zo - 13 4 - 2o- q3 <br /> RATING:S-Site suitable for system U=Site unsuitable for systtee7m( <br /> LJ-7.JTI❑U MWJ. ❑U ING52S ❑U E:sRS I❑ULH❑SG_ FTU .RE OMMENDED SYSTEM:^Of�VE1�lO pi�LoPtional) <br /> If Percolation Tests are NOT required DESI RATE: ® l- <br /> 9 If any portion of the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED I EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> > SS b- Awls �1 - �SgNrls <br /> B- Z 0 99 •d (JDWE > 100 o -rj [Ins S' IOo 0111Mu <br /> 13- 3 0 �� 8 140tJE 7 0 0- 501rns 5 So13wMs <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD ERIOD2 PERIOD3 PERINCH <br /> P- 3 No SI e `' 3 <br /> P. 2 No 1 /8 �iN ,0 3 <br /> P- -3 Z o Z Vs Z T/6 3 <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 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 /> SYSTEM ELEVATION l N 3 I <br /> �nn <br /> fl <br /> •$MIIOb B61tDr'1 � I <br /> OF 5)p11JG_ . iJ� <br /> F'vQJ ,10F 22-1 p$Z y <br /> tN <br /> - cul-�Tf4✓L_- <br /> 15T't�1b 5 �� <br /> �{�olPaSfD I <br /> 9,Do <br /> I <br /> I,the undersigned, hereby certify that the soil tests reporte 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 ocation of the tests are correct to the best of my knowledge and belief. <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> ADDRESS: CERTIFICA ION NUMBER: PHONE N MBER(optional): <br /> Z w 3 WI . $ 0 b S <br /> CST S JVATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-8395(R. 10/83) —OVER — <br />