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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> ' II LHR 83.0911)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: 9tlB9Wi9f9PHNAME: <br /> 1/ 1/ Ito /T N/R ISE (o W yAcK50n1 D cRE <br /> COUNTY: MAILING ADDRESS: <br /> BUR 8 • R - C I- S O <br /> USE DATES OBS ATIONS MADE <br /> NUBEDR .: COMMERCIAL DESCRIPTION: Ipr P6f•IL�_ �/ TONS: A TESTS: <br /> esidence 2 ��� ❑New /c]LReplace I �_ .�/ -q l �•�i/ _ 9 <br /> RATING:S=Site suitable for syste m U=Site unsuitable for system Lv 1 Lb <br /> ONVENTIONAL: IMOUND: IN-GRC)UND-PRESSURE: SYSTEM-IN-FILLOLDI NG TANK:R ECOMMENDED SYSTEM:(optional) <br /> KS DU I ZS Eul ZS ❑U I ®S ❑U r E EU <br /> DESIGN RATE: <br /> If Percolation Tests are NOT requ red If any portion of the tested area is in the �� <br /> under s. ILHR 83.09(5)(b),indica e: rte— 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, ELEVATIONOBSERVED ES HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 7Z IOb.3 NONE �1 0 -sBhns - 'l� 8ants `il �23ur»swRCmQmalf <br /> 0-08�^1s 8- 18 BNms <br /> B- 2 01.3 oNE > <br /> o- Ulm -1- 61614rns Io-7- ` 7-6NMsu Rt "fek <br /> B- 3 Z 10c).0 NDNE. �7 <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 AFTERSW LLING INTERVAL-MIN. PERIOD PERIOD P PERINCH <br /> p- Z $ <br /> P- 9 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 <br /> A ' <br /> RIS ISM 1a o f�' of a;aaZa Ap <br /> MIDDLE GAKer>E FIRE3 - '- <br /> LQ0�1 <br /> LF{KE <br /> IN <br /> ..O-- E>5lmfav sys , <br /> . Z r <br /> _ S�9EFni Q7T _ <br /> PORCH - <br /> 1 <br /> I,the undersign , 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 C de,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 /> Ic AR0 11CPPKjrJJ 4- 2-4,- 9 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optionall: <br /> Z7 35 WEmToz 1. S 993 3(0 ! 66 l5� <br /> CST IGNATURE: <br /> DISTRIBUTION: Original and do copy to Local Authority,Property Owner and Soil Tester. � � <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />