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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> 1ILHR 83.0911)&Chapter 145) <br /> LOCATION: SECTION: TO NSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> 1/4 NO V423 /T N/Rlb E for W ISS <br /> COUNTY: MAI LINU ADDRESS: <br /> AARdOT— REI fJ BUORF -36q9) qWY <br /> USE I P4NSYBtERV17IONS MADE <br /> NO.BEDR .: COMMER IAL DES RIPTION: QIP1 -3 - 31 <br /> T STS: <br /> ❑ <br /> Residence 2 �_ New OAeplace I 3 . 3I 1-1 3 - 31 - 9q - <br /> RATING:S-Site suitable for system U-Site unsuitable for system <br /> ONVf"NTIO� . M_fV�.❑� IN-GROUNDD�ESSURE: S ST M-I N❑-FILL O❑LOING TANK:REA OMMENDED SYSTEM:(optional) <br /> JE] <br /> IIILPer SS IILLMMYY DESIGN RATE: <br /> S U S U lf/ <br /> If Percolation Tests are NOT requi ed If any portion of the tested area is in the yI <br /> under s. ILHR 83.09(5)(b),indicate; �— Floodplain, indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED ISE ABBRV.ON BACK.) <br /> B- I 0 100• r1 NONE qo ° 9b $ <br /> B- 2 _ 9•`f Node <br /> B- 31 $ -6 NONE <br /> B- <br /> B- <br /> B_ <br /> PERCOLATION <br /> •B- <br /> B- <br /> PERCOLATION TESTS <br /> RNUMBER <br /> DEPTH WATER IN HOLE TESTTIME DRO 1 WATER LEVEL-INCHES RATE MINUTES <br /> INCHES AFTERSW LLING INTERVAL-MIN. IOD PER INCH <br /> 0 5 13 0 I _ <br /> P- <br /> PLOT PLAN: Show locations ofrcolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation refereeice points and show their location on the plot plan. Shaw the surface elevation at all borings and the direction and percent <br /> of land slope. I <br /> SYSTEM ELE"TI N30 1 5 Rs <br /> ��3M IoO�Bp-�a 5_►�►N� I 1 � � I <br /> I { © I � 1� Ryll <br /> 1 r { _ <br /> I I I <br /> I,the undersigned, hereby certifythat the soil tests reported on this form were made by me in accord with the procedures and methods s cified in the Wisconsin <br /> Administrative Code,and that the ata recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (print): n TESTS WERE COMPLETED ON: <br /> ADDRESS: ) rKIN CERTIFICATION NUMBER: PHONE NUMB R(optional): <br /> 2,1766 <br /> E 93 IS- 6 S <br /> CST SIGN URE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Taster. Igo(.J� �� <br /> DILHR-SBD.6395(R. 10/83) �I -OVER- <br />