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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.0911) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: <br /> LONOBKO � <br /> L '/ J '/ /T31N/R11E (p a CO�n <br /> "i Ac2Es <br /> COUNTY: MAILING ADDRESS: <br /> J nl c Zs to vW y 35 &k>jEJ <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence 7 � KNew ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system ! J <br /> OF7 I <br /> �TI❑� . M��. O� IN-G�� ❑�RE: SV � I❑�LH❑�G�� RECOMMCONVE�fI OIVpL NDED SYSTEM:(optional) <br /> DESIGN RATE:ES <br /> If Percolation Tests are NOT required DIf any portion of the tested area is in the yy�� <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: Nj'7 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATIGN OBSERVED ESHIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- � 7Z In, I MOIL SS o -to fil ms t; SB BNIfu S%-7Z$Nfns W?'CM m o{} <br /> B- '2- IZ 9• 2 W( _ W 0-11NMS r?- 603NM (PC) -7T34'jmSWIR't- &met+ <br /> B-3 '7'Z 3IMS tP- 6SSNMS (oS �Z►3NmSwR�mdmo�t <br /> B 4 `t2 qq 3 0r1� tO0 0 - - (PoBNms too- rirru w mo <br /> B 5 ?2 99 .9 000C 1m� 1 b3 3Nms (p3 -'Iz rrLswR�tnB o <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 PERIOD PERIOD 3 PER INCH <br /> p- 1 0 S 'L 3 //s <br /> P_ t4l) 1 .31t 431A. <br /> P.3f4D <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 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 ELEVATION <br /> U <br /> r s 9` lE Irl <br /> =6o <br /> LEM'100 01UN 7" ACK P1h(6 <br /> Y�ioPosEn _ yJE►1 "fb B� ��F2of^1 B� <br /> ���ER DKtJE,15 w�r�p AP�o?I 1�.S�N . <br /> of �k7�0_51 ' STN <br /> z <br /> DRIVE _ <br /> I,the undersigned, hereby certify that the s it tests reported on this for were made by me in accord with the procedures and met ods s ifjgn the �ifscons <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge a belief. J •oZ <br /> �� 1r <br /> NAME (print): TESTS WERE MPLETED <br /> K/CHHRO HOWOS 5- tt - Z <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Z??(oo HWY 3S W��s1�K w ► . 3'f8` 3b o S- <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD6395(R. 10/83) —OVER — <br />