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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCO TION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> W6'13.090) & Chapter 145.045) <br /> LOCATION: SECTION: TOWNS FI IP/Mbl"t&RAU-FW LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> Gad y '/a 1/a -) 7 /T*37N/R /lft�)W T JAL LIFE 3 ►✓ tF A/ <br /> C UNTY: OWNER'S DLIYE,R'S NAME: MAILING ADDRESS: <br /> 611 SNL 1 L/j ON R-1 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTI:)N:1 PROFILE DESCRIPTIONS! PERCOLATION TESTS: <br /> ®Residence a r4 A ENew ❑Replace I G>97�� q^ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ( / <br /> CONY STO� . N] �. ❑� IN-G�S F_] URE: SY TEM-INI EILDING®NK: RECOMMENDED SYSTEM:(optio(optional) <br /> IfT�PVeSrllcolation Tests are NOT required DESIGN RATE: S U If any portion of the tested area is in the <br /> under s.H63.09(5)Ib),indicate: Floodplain, indicate Floodplain elevation: N�^ <br /> P 3OFILE DESCRIPTIONS <br /> BORING TOTALD PTH TO GROUNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HI HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- r 78 9s <br /> B- <br /> 7? 95-G" 1 , 7 r 7" ,f SL 2 22" eztctl <br /> B- 3 2 9 '1a' r' Z 'r s ! z c i "3„ s <br /> B- 72 $ 51zY"i3!2 !5/_, 24" /S . S <br /> B- 12- ?7-'� • f ? 2- G"/3 L /4/" 222 C 5Sul <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING I INTERVAL-MIN. PERI Dt PERIOD 2 PER10o PERINCH <br /> P. t - 3$ ra 3 � <br /> P- / 3 3 z <br /> P- 3 36 <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 92 - ` " <br /> 1 _- P <br /> 4 , 18o-Rr Trrs� f D I �0 <br /> I <br /> P DW <br /> �^ <br /> h-55 U07 +�5_ .__ 1_. <br /> , IQ <br /> 1 <br /> . 8Bct AIL � I � <br /> 57b T q,"841 4R,FAl Y Ig�l�(�B8 �LdPk 65` <br /> _ 1_ <br /> r � , <br /> x <br /> } d T I Nt- <br /> f — � F/ <br /> l� 4l4[1.tTd S <br /> � d' F$ch1 ,�A�ti <br /> t")f Or <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 WERE COMPLETED ON: <br /> jl 6JMV t"Deg y -- '27 - 9 3 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMB ER(optional): <br /> 1 T 2 13 I 6 S( &IV c57Cg2i s�.7 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LH R-SBD-6395 (R.02/82) —OVER — (� <br />