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EH X15 B <br /> • REPORT ON SOIL BORINGS AND PERCOLATION TESTS <br /> WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES <br /> - P.O. BOX 309,MADISON,WISCONSIN 53701 <br /> LOCATION:1kg'L," Y.,Section/� ,TOCLN,Rjff-@ (or)W,Townshipor Municipality `SDe l <br /> I Lot No. , Block No. County ri 4 fl <br /> d ry slon ame <br /> Owner's/Buyers Name: JQswx tl ! '� f <br /> -?G-Mailing Address: -?G-Op 3 k' I.�T J /y L I /Y CG p 'r"7e <br /> TYPE OF OCCUPANCY: Residence X No.of Bedrooms COMMERCIAL <br /> EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER <br /> DATES OBSERVATIONS MADE' SOILBORINGS / [� PERCOLATION TESTS V-- <br /> i <br /> SOIL MAP SHEET NAME OF SOIL MAP UNIT <br /> ' PERCOLATION TESTS <br /> TEST DEPTH CHARACTER OF BOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL,INCHES dRATENUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL <br /> BER ISTWETTED SWELLING INMINUTES PES19DI PERIOD2 PERIODS <br /> �' <br /> P- <br /> P- <br /> P- <br /> SOIL BORING TESTS <br /> TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR_ <br /> TEXTURE,MOTTLING AND DEPTH TO BEDROCK <br /> NUMBER INCHES <br /> OBSERVED ESTIMATED HIGHESTIF OBSERVED IN INCHES <br /> it <br /> B- "I- 73 2 " E3- T <br /> B- " 6nr /S S'< < s <br /> PLAN VIEW (Lorme percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locatiZand square feet of suitable areas. I <br /> Indicate number of square feet of absorption area needed for building type and occupancy /I Indicate scale or distances. I <br /> Give horizontal and vertical reference points. Indicate slope. <br /> q0j �-IT <br /> /f <br /> tj <br /> At I <br /> 1 <br /> I <br /> iter �• �`$e 6 r o-`.w�. <br /> cir/, �t� 4��rr <br /> I,the undersigend,hereby certify that the soil tau reported on this form Were made by me in accord with the procedures and methods <br /> specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct to the fest of my-'7 <br /> knowledge and belief. L <br /> Name (print) ° ! P r) .0 I S Certification No. <br /> Address LA J LIN S 9 3 �� <br /> ,Name of installer if known <br /> Copy A—Local Authority - (ST Signature <br />