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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR1 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 5379079 53707 <br /> (1­163.090)& Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/ teWisr: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> N& 1/NuV4 23 /T38 N/R i?1-t,,o W v,e N lkcs 1 NAAJ-41 IV4 <br /> COUNTY: OWNER'S BH*ER'S NAME: MAILING ADDRESS: <br /> &,q IV E rr 1l)6 N 15 M, 5/ o s R T/ S //lc i�sf 22 <br /> U E DATES OBSERVATIONS MADE <br /> ®Residence NO.BEDRNS. COMMER IAL DESCRIPTION: New PROFILESSSTS: <br /> ? A/A .5 — to _ 9a it F3 <br /> RATING:S-Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURES STEM-IN-FILLHOLDINGTANK:RECOMMENDED SYSTEM:(optional) <br /> ©S ❑u ZS ❑u QS ❑u ❑S DU ❑S ©u �a,�d i84 3s/ <br /> If Percolation Tests are NOT required DESIGN RATE: If an <br /> / ,,tt y portion of the tested area is in the <br /> under s,H63.09(5)1b1,indicate: /�'/'r Floodplain, indicate Floodplain elevation: Al <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPiH IN, ELEVATION OBSERVED ES I HE T TO BEDROCK IF OBSERVED (SEE ABBR V.ON BACK.) <br /> B 1 72 ice'_ Z.r nr _ ' 72 q,161 S l g- ­ / s <br /> B7�2 ro a - c I f v" / / 3 / <br /> B- ! 2 ct —lo' f , t I It S 5 '' S ��'"!�j / <br /> B 72 9 — lv / s is 5 <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. RI o I PERIOD2 PERIOD PERINCH <br /> P- 1 / 0L 9 3 3 <br /> P- 3'1 N d <br /> P. 3 s 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 ere 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 `17- -2 <br /> WALDORA Aof a or/RE W 3-2y <br /> A= 4012F BEY fr yo RcrPS (YR)✓ WAy. — � <br /> _ r <br /> l sof FLae/Z NW C60NIU y1by�(yK- <br /> oP a� " K <br /> ,asst aorof,_ em Cw�9Atof, <br /> TN <br /> bZ RQ, QI81-1 M -1/0a.. <br /> - Ong *• Y,� ,/. _ U / / <br /> �C c S 6' � a�l° Pkr.SEtii <br /> Q/i15 <br /> Ale hl/EL,L Td Br 50' i=R'0A'I ZW41,0III �57 <br /> Soo t � _ <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 /> ADDRESS: CERTIFICATION NUMBER: I PHONE NUMBER(optional): <br /> AT 2 4 d x S/p SiRcN Lu rS _5 %4r�Z C r oY>i 'q <br /> CST SIGNATURE: <br /> 44— j lis <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6195 M.02/82) <br />