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/���+a-/��Su /Uy-� <br /> DEPARTMENT OF REPORT ON SOIL BORINGS MND SAFETY& BUILDINGS <br /> INDUSTRY; DIVISION <br /> HUMAN AND PERCOLATION TESTS (115) MADISON WI 53;0; <br /> HUMAN RELATIONS <br /> ((LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LONO.:BLK.NO.: SUBDIVISION NAME: <br /> y - y /T3 N/R SE (p W000 RNE.K NS ?•S <br /> Hc2E-S <br /> COUNTY: MAILING ADDRESS: <br /> 130KOE71T f ERA( O IN62, 12-11660 H\-IyOol GRRWFS&KG Wj r <br /> 73\4'RL40 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: 'P—ROFILES: PERCOLATION TESTS: <br /> or <br /> Residence /) /__� KNew ❑Replace I 5•- 1 I - 92 5 - iq - !Z <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-INFILL OLDI NG TANK:R ECOMMENDED SYSTEM:(optional) <br /> �$ ❑� �$ ❑U $ ❑u ®$ ❑u ❑$ U rJJErJToNWL <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the �p <br /> under s. ILHR 83.09(5)(b),indicate: I /-- � Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH N. ELEVATION OBSERVED ES GHE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B ` �-�2 q NoNE (0(1 (0 ai mS 6- (v !jIjras "- '1 ZBNmS W kcmknoft <br /> B-Z 'J2- qb. 8 NoN� >'I7 o 'l Gins - I-Z BNM5 <br /> 0- Irns Nms - z fvnsw amd <br /> B-3 ?� qb N (�13 <br /> �OLA 0 6- IMS 6 (a { 8r11�5 (04 - ZBNetsw cm m NON('. <br /> 0-'0 BImS - 60 SNA-6 $- 1Z 1511 1s WRC'M&fkev� <br /> B-5 '12 6 . `f rloaE (off <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD etHluuj PER INCH <br /> P- I210 No 5 31 /G 3 <br /> P- 2- 31 No 5 %z // <br /> P- 0 0 0/4 <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 K2. PL <br /> 5 Q <br /> y 3 A�Rnx <br /> GRA � : �K�o Ply• , <br /> a ScA� )"= bo UN4ESS 1JoTEq <br /> s J13t1 10013NIoM_CIF GOW $(DING <br /> ?fJ t 10 3( >5 D FRof-1 13CD <br /> 6tH£R Lur 14A <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and me)hods specified in th Wi consin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. X&u-Ze.7-SF- 9 01 <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> )cNARP }IDPKlas 5- 1q-9Z <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Z 60 w Cg5TE2 ' WI. Sy 9S 3Dj( i5 <br /> CSTSIGNATUREE: <br /> R rl <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD$395 (R. 10/83) -OVER - <br />