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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, ... DIVISION . <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 5397079 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) 3—F-3--7— <br /> LOLC­AT ION: 1S�EECCTION: 1� p TO NSR P/MUNICIPALITY: LOT N BLK.NNO.: SUBDIVISION NAME: <br /> � '/SG I/ d7 /� W /11KE (or rk iii <br /> /� A) 14 <br /> COUNTY: _,,L OW ER'S/BUYER'S NAME: MAILING ADDRESS. <br /> uy l tt Y C 70 Bo t.v' '1 <br /> USE DATES OBSERVATIONS MADE <br /> Na BEDRMS.: COMMERCIAL DESCRIPTION'. r PROF LE DES RIPTIONS: ER /LfAATI PESTS: <br /> RATING: <br /> ESTS: <br /> I/e,Resideneee J New LJReplace I ��i�la &-7 s�ya �7C <br /> � v � <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI LLHOLDING_TANK:R ECOMMEND ED SYSTEM:(optional) <br /> ®S ❑u .©S ❑U ,®S ❑U ❑SA I ❑S JKU I CoNue16cNA1 rer,3,ill <br /> It Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> unde <br /> rr s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D 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 /> EP <br /> B- I OS q7 I Nove ';;;, 95- ()-g1161 $I, 1- q, ' am M&d It y! - $S"gNCS <br /> B-Z qS q,,2 It t` 'f 0-3' 461,51, S'HO ' /JIMCds , 1/0 , BN('S <br /> B-3 83 9d. y it y 8' o-s er sI, S- yy BNMcds, 1q-�3 eNcs <br /> B_' go 9 't. 1 �? gZI 0- 6'r 8i5116-0" BN Mess) `l3 , g0 8/JCS <br /> B-s gi qq<3 I 415-"AjMars, tis W&CS <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 PERIOD2 PERIOD3 PERINCH <br /> P- 2 _ 0 _ 31 & /5 -7 <br /> P- 2 NO 3 1 Via 13 i6 <br /> P-3 Ar& 3 �/ 3 <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 qy• y P.'. It, C <br /> Scg1� I� 40` 4 o7' Gil- <br /> uuicu <br /> 0 <br /> 8M a"'Red onk ` T i <br /> wi.i} ko Iu 646, syS BS <br /> 'if <br /> 150' <br /> 61111 lob &00'To <br /> R <br /> i <br /> W <br /> 3 <br /> fi <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 (prntl: TESTS WERE COMPLETEp ON: <br /> ADDRESS: CERTI FICA ON NUMBER: PHONE NUMBER(o tional): <br /> e S 7�r' w r i. Y- eF f o <br /> GN TURE: <br /> c <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester <br /> - <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />