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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX <br /> 969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> (ILHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/IM_14161 ..-11 `: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> � '/b1k1'/4 :3c. /Ty/ N/R/SE(or)W u�,'ss L"16, <br /> � e4mt, -e4 SDI <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> p �\\ Q <br /> UvAnr vrv. (� (G A' �' . C crit- <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: �I PROFjLE DESCRIPTIO <br /> NS: PER LAT .1V TESTS: <br /> y�Residence I yVReplace I �/� p7 ap rir/ /7 <br /> RATING:S=Site suitable for system U=Site unsuitablii yttlint O <br /> CONVENTIONAL: MOUND: IN-GROUND-PR : S TEM-IN-FI LLHOLDI NG TANK: RECOMMENDED SYSTEM:(optional) <br /> YS ❑QNS EA � ` (! S ®U ❑S [HU <br /> DESIGN R E: <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO G U WATER IN CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION +p RV EST"... IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I '7J 77S'` 0 . 3 r`f311 owtc S 7st. /M1„ r / S <br /> B- a- X 119 a " s �h�w1 1a $.,. i4„ -r J S <br /> B-.� a-- 7 /. 1 V� j110 n •'Mt Y�Q S 6U` 7a <br /> 4/1- <br /> 13- <br /> B_ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFT ER SWE LLING INTERVAL-MIN. PERIOD PERIOD2 PER1003 PER INCH <br /> P- 1 1 3 e 01 s S( `/ <br /> P- 3- t s /3 / a > a _ <br /> P-2 A C I N C s01 <br /> 77/& 6L y <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 ELEI ATION �' s r^c .. <br /> at <br /> Iteel �6C� air <br /> I Stn �� -� <br /> putt°� tN <br /> 0 � <br /> till" <br /> � t <br /> IN <br /> �b u <br /> I,the undersigned, hereb certify that the so [ests reporte on this form were made by me in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Co, and hat the data recordedlae4tAeJeeelon of the sts are correct to the best of my knowledge and belief. <br /> O <br /> NAME(print): TESTS WERE PL 7,� <br /> 0 J• T•1 C r K- (I/r <br /> ADDRESS: CERTIFICTION NUMBER: P ONE N B R(o tion 1: <br /> 7 is � `r <br /> C N TUR E: r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) OVER — <br />