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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> HLABOR P.O. BOX 76 <br /> UMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP///MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> 11'Ii y14 20 j`f)N/R Id-E (pr) J(LCrC SU!1 5`oa rr. Ns 41- /Vk- � a <br /> COUNTY: O,WNNER'S BUYER'SSNNAME: MAILING ADDRESS: <br /> VPfhu�e CexA1;/'/G l t,7jS-, . �el� . �✓c�✓��v ✓N. ,��I6'9J <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMMERCIAL DESCRIPTION: Ti—RnTTET_DnCRIPTIONS: A - ON TESTS: <br /> Residence NINew ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND�PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> 0S ❑U ZS ❑U WS ❑U I ❑S MU I ❑S M I co/1 /intn z / <br /> If Percolation TestsDESIGN RATE: <br /> are NOT required If any portion of the tested area is in the <br /> 11b1 <br /> under s. ILHR 83.09(5 ,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALD PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION 'OBSERVED EST.HIGHEST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 3 60 94 '// " A' p 10 - " 1a z ` 60 " /?A <br /> B- 70 16'O '//" A, One 7 7t' -112 /1 � ' 7 �" 174j <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. PERIDDI PERIOD2 P R PER INCH <br /> P /J A< 3 " 6 " '�;_" 3 <br /> P- 3 <br /> p_ 0 n j i, ✓, ii G 3? <br /> P- 2 3 <br /> P — ---L-------- <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 /> f I -1 <br /> II o� 3 'to <br /> ah'Aa a7�. P;y '��l tvt /ioeltl tr /a ,Ja✓�6/< ' <br /> p'✓ aru7 v I a/ems p`4 kt�a i7s✓ <br /> .Ft/) and %lmt — — — _ _ _ . —•� _4-.•,f T/.P. .te�a a��t ha"of 0 <br /> 1 1 <br /> &&peak ba/! M./14 r,d' X f� i /fhuJr fo peafi-yek- VAd<� <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 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 <br /> 1 WERE COMPLETED ON: <br /> Wo- a c < J . Bn Jo- / ! ct f �Q `1O <br /> ADDRESS: (� CERTIFI ATION MBAR: PHONE NUMBER(optional): <br /> /'i/2r /3 e,1 / / d. b'r� fcr 47i� . Srry 3 CS 'Y 39/ -3 7/d" EGG - / <br /> CST SIGNATURE: <br /> / Qaa /r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L=/ <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />