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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 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP MUNICIPALITY OT NO.:BLK,NO.: SUBpIVISION NAME: <br /> '/ '/ 20 /TgoN/R 16E (or O Z S N <br /> COUNTY:` MAILING ADDRESS: Qu <br /> SO <br /> 30 <br /> USE E DATES OftERVATIONSMADE <br /> Residence NO.BEDRM : COMMERCIAL DES RIPTION: PERCOLATION <br /> O A _ C�hE <br /> TSu 'New ❑Replace5 - I4 — go <br /> RATING:S=Site suitable for system U=Site unsuitable for system : <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL OLDI NG TANK: R ECOMMENDED SYSTEM!(optional) <br /> S OU T'S ❑U ®S ❑U OS NU OS UyVr_NTjj" <br /> If Percolation Tests are NOT required DE IGN RATE: If an <br /> y 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 TOTALELEVATION P H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. OBSERVED S TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- NoNr > 72 _53- 7ZB)Jn <br /> B- 2 12 . 2 0 > 72 56-�7,&6 <br /> B-3 92 91.5 AnNe 7 0- - RM N <br /> B- Ll 12, 6 > 72_ - N ✓ q' M <br /> Node 77Z -7 u <br /> B- <br /> PERCOLATION TESTS <br /> DEPTH WATER IN HOLE TEST TIME DROP IN WATER LV L-IN HES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD tp RI D2 p R PERINCH <br /> P- ) "% 1131y( <br /> P- 2 9/8 //( <br /> P- <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 9-5 0 <br /> Ftp <br /> . a <br /> r T . oda SCRLC-J'', `ta" �-0URS <br /> 806- ,�.BMiooklAll._ItJ29��14'tLE <br /> y _ ' /Y =_11IORJK W 51 of <br /> r <br /> s YELLOW! M—W <br /> Is <br /> S D, <br /> 1, 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 : TESTS WERE COMPLETED ON: <br /> ADDRESS. O CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 7 � / X66 S <br /> CS IG ATURE: <br /> " <br /> DISTRIBUTION: Ongmal and one copy to Local Authority, Properly Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />