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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, G BO 76 <br /> DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> �ov't• LcfI (ILHR 83.09(1) &Chapter 145) 9 _ (e <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> 1/ y /T L.0 N/R is E Ip ) :5m KsorJ <br /> COUNTV: MAILING ADDR SS: <br /> err I C01PIR ETZ jLIS36 <br /> USE DATES OBSER ATIONS MADE <br /> NO.BEDR ,: COMMERCIAL DESCRIPTION: ��pIl PROFILE IP S: PERCOLATION TESTS: <br /> ❑Residence I ❑New WReplace / -ZZ ' (i 1 / _ zZ- 94 <br /> RATING: S=Site suitable for systemU=Site unsuitable for systemONVENF' _I to <br /> IN <br /> INS <br /> STElu . M®�.OU -GROUND EJU E: SVM S EAMS <br /> ❑SOLDING AQ :RECOMMENDED SYSTEM:(optional) <br /> If Percolation Tests are NOT requi ed DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indica /—I-- I Floodplain, indicate Floodplain elevation: 411 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, OR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHES—T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 �o� 93.9 NONE. <br /> o-SBI s S- 6b 8a s <br /> B- 7- <br /> 13- <br /> B- 3 /76 1 q.5.4kjogc 7$ <br /> o- 081f� 6- 8 <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSW LLING INTERVAL-MIN. PERIOD PERI002 PERIOD 3 PERINCH <br /> P_ 19 too 5 Is1i rl 3 <br /> p- 2- 27- Ntl 2v/)c I r L 3 <br /> P- 3 LJO <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 refere ce 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 /> Scqur_ I= '}0 <br /> SYSTEM ELEVATION q2 A,&A IDo NA)L- rJ IS""Ili <br /> E <br /> : I a <br /> E?cisn P G 79 W CP <br /> � I <br /> � i I <br /> LDO rJ <br /> L-P <br /> WEtI_ <br /> I,the undersigned, hereby certify hat 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 ata recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> 9— <br /> NAME (print): - --e TESTS WERE COMPLETED ON: <br /> TZIc Alzo OPKin%s (,- 22 `{ <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NMBER(optional): <br /> 27 35 6IEBs-fER W1 . 59813 3b70 cS $(U�b 4157 <br /> CST SIGNATURE. <br /> �f J�`: Ll IM�N.•tiPl <br /> DISTRIBUTION: ngma an Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-8395 (R. 10/83) —OVER — <br />