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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) d P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> 11463.090)& Chapter 145.045) <br /> LOCATION: SECTI N: TOWNS HIP/MW14WT IAln �Y: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> NAr '/a '/ 2Z /TgA/R/6")W PIFFI1 olv <br /> COUNTY: OWNER'S SME: MAILING ADDRESS: <br /> 1311R/yE VERsF <br /> . CAR l5 Xf 2 w4,F,c3STE A//.s. s 8 3 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFIL7F DESCRIPTIONS: PER OLATION TESTS: <br /> Residence � �R New ❑Replacey/ Z j_/O� ��� <br /> Q-7�CJ D <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL❑ U . MO�. IN-GROUND-PR RE: SYSTEM-I ILLHOLDINGTANK: RECOMM�DED SYSTEM:(optional) <br /> S WU <br /> S LIAIJU XS <br /> DESIGN RATE: nth <br /> If Percolation Tests are NOT required If any portion of the tested area is in the w� <br /> under s.H63.09(5)Ib),indicate: A Floodplain,indicate Floodplain elevation: /V <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH 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- / 70 /3�6 " <br /> B- 7V 100".5 '7Q" �Q�l /Qrr el, 54 '3q a'01 SL w <br /> B-5 412 16V 149'1 - <br /> 3 '' !c�" �D'`i�C 5� 32je4 5; 4 w <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 1 PERIOD PERIOD 3 PER INCH <br /> P- <br /> P_ 1110 P154204ATIO TEs W ,04 <br /> P- <br /> P_ To cc i-F <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. /_04,o/iU g 'T f}N k R k Q U 1R ED <br /> SYSTEM ELEVATION 00u.v7- RD. 0 M <br /> -la'- <br /> likpj <br /> �rNC�9RK � Cff�IN r=ENC� �. <br /> ,APP4oX. <br /> 'QV oFf 3 13EDRoo/►'! /eX$b 30�' I� <br /> ,SASE of andBt N4M <br /> ARFfI 1-Fi�F� <br /> v 3y <br /> aZ fi _4_. <br /> A0 INE <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 WER COMPL TED ON: <br /> U//!> S�il/so/U g 26 8.3 <br /> ADORES : CERTIFICATION UMBER: PHONE NUMBER(optional): <br /> - Z Gv��35T is 8•6� 7115--96,6 <br /> CST SIGN UR <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) —OVER — <br />