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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR A"° PERCOLATION TESTS 1 P.°. BOX 7969 <br /> 115 <br /> H MAN RELATIONS � / MADISON,W153707 <br /> ov'� .Lui (I LHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> — /4 % 35 /T N/RIGE(or SWISS — c°4n v. 1-s2. , <br /> COUNTY: MAILING ADDRESS: <br /> URnISEN MAHLe I 1E 2ND -AV . SE. PLRItJVI N . 4 <br /> USE DATES OBSERVATIO S MADE <br /> NO.BEDRMS: COMM RCIAL DESCRIPTION: F NS: PERCOLATION TESTS: <br /> -]Residence � XNew ❑Replace q - 3 _ 92— 9 -3 - 42 <br /> RATING:S=Site suitable for system U-Site unsuitable for system <br /> ONVENTIONAL: MOUND IN-GIIRppO1U1NppD�RESSURE: SIYICCS�7TIEppM-IN-FILL (OL�DING�T7AIN K:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U ®J ❑U L7JS ❑U xS ❑U C7S IXIU COI`4VFN1110NIA <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> under s. ILHR 83. If an <br /> ��_ I y portion of the tested area is in the <br /> 0915)Ib),indicate: Floodplain, indicate Floodplain elevation: N� <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,IDEPTHNUMBER DEPfH IN, OBSERVED ES HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> (oo U NONE > wo- to8lms GD &1115 <br /> B Z � � NDN 0- I� BIn1s G- 5'1 SNn,s 57 - 11goni5w <br /> B- 3 k A7-0 /vONE > 6v o- S films 5- (00 .6'4rvls <br /> B- y NONE >12-- 0 - 7 $hwu -1- `22 {3tjms <br /> B 0 DrJE bb p - 6 151rn's b- Go Brims <br /> s- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME ", DROPTER LEVEL-IN HES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. ERIOD P PERINCH <br /> P2P- 2DP y 15i f 3 <br /> P- <br /> P. <br /> PLOT PLAN: Shaw 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 <br /> of land slope. surface elevation at all borings and the direction and percent <br /> rt <br /> SYSTEM ELEVATION 95. 3Scale I =Ho <br /> •3M IOD NAIL_ )N �2 roRK <br /> WWII �'6 &E3�`F7�arU $ -r <br /> __ <br /> LRIKE _. <br /> c LIS0({ v vfi3v W o �JRE-# <br /> I,the undersign , hereby certify that the soil ests reported on this form were made by me in accord with the procedures and meth ds spy ified in the Wisconsin <br /> Administrative C de,and that the data recorded and the location of the tests are torr t to t f my kn ledg nd belief. a —95.10 <br /> NAME (print : TE WERE COMPLETED ON: 7 <br /> IC 9 - 3 - 92 <br /> ADDRESS: <br /> CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> ro 0 w 35 W E8STs;rZ Wl. Sy893 31670 <br /> rs s66 Is <br /> �g <br /> CST SIGNATURE: <br /> ITR LZ a <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L7 <br /> DILHR-SBD-6395 (R, 10/83) —OVER — <br />