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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - _ DIVISION <br /> P.O. BOX 7969 <br /> LABOR AND PERCOLATION TESTS (115) MADISON,WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHI /MW41W PAttTY: LOT O.:BLK.NO.: SUED VISIO NAME: <br /> NE'/SF—'14 3 / /Tq0 N/R/rt(or)W son .tl �/ <br /> COUNTY: O NER•S BUYER'S NAME: MAILING guRE, . <br /> r � � Q J71 oxer W 'Lo <br /> S �� r �� / • J'y1° 3 <br /> USE DATES OBSERVATIOP SMADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: ffqq PROFIL DESCRIPTI NS: ER OLATION TESTS: <br /> ;irResidence ❑New KXReplace �/ <br /> RATING:S=Site suitable for system U=Site unsuitable for system 0 P < r�• <br /> CONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FI LLHOLDING TANK: RECOMMENDED SYSTE :(optional) <br /> S ❑U ❑$ DU $ ❑U ❑$ ®U ❑$ Cau <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,CO OR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B- I q 77o I. 1 Po M-e > 9 9 bNB( *Arf/r <br /> B- O /O d. S- A) f3NY 7 f0 S`rQLm+edS <br /> B-a Ro 99. 5 Ajt5v -e > / 0 u� tM� JS aS� r, ek M IS <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 PE RI0D2 PERI PERINCH <br /> P- i Sb o / 9 / 8 ' i <br /> P- 9 10 a so//A37 3i 3 <br /> P- 3 7 <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 dislinces. 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 bor ngs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION PT It.C_ . <br /> S'Laz, <br /> y I S m r•e n <br /> uK Le rr NIf7-t <br /> likr< X00 ° Gr <br /> s4�l46t.0, <br /> .a _ 4'1J• t+t �7 tN <br /> r ti <br /> 41dlea (a M to 0 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and I iethods 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 LET ON: <br /> o T o to Y <br /> ADDRESS: CERTIF ION NUMB R: PHONE NUMBER(optional): <br /> l > � s �r iris . s 3 !s-B66 y/�f <br /> C GN T RE� <br /> V <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />