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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 /> (ILHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> y �/ 35 /Tyb N/R ISE (now C G.t . V0 L. <br /> l <br /> COUNTY: MAILING ADDR SS: <br /> EL-PON 'k oN o D <br /> USE DATES OBSERVATI NS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: TESTS: <br /> ❑Residence Z 1 <br /> ❑New oReplace �1- "'Ji - J3 .qr AI/( <br /> RATING:S=Site suitable for system U=Site unsuitable for system ` / 3 f V IT <br /> ON❑VENTIO ?L: MO❑UND.�U ING❑S _NURE: SVGS I�UL Q. -SG❑U .RE 0L0/,/G SYSTEM: CJ(optional) <br /> SS U SS rL�dl _rrf jT IV 1 <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)(b1,indicate: --� Floodplain, indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- Nc� y 0 o- - 2/0Zo- Z'? W R molt' <br /> O- 'iBlfi �- I�B 16- z� dmr%gF Ino�l <br /> B- Z '�D q •`� �� '] - 32— q ,r s w R stn 9- o <br /> B- <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 PERI D2 Ra PERINCH <br /> P- <br /> P- <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 N <br /> _.- �. f TI M1Z�T,I HAS (`I(�U IIW1 y _ <br /> � <br /> r <br /> L <br /> i <br /> T_ <br /> �xlsTluG ; F1eD I n � ��- <br /> DIECK <br /> J i 1 , L <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods 16 i d 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 /> )c+1 AR iPPk S - 2-6 - 1�3 <br /> ADDRESS: CERTIFICATION NUMBER: P ONE NBE (optional): <br /> Z7 �D w 3 068sirfZ !. Lqs 3G O15-!Rum <br /> CST NATURE: _ <br /> M/J <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-8395(R. 10/83) -OVER - <br />