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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, _ DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> (ILHR 83.09(1) & Chapter 145) S7- � � <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BILK.NO.: SUBDIVISION NAME: <br /> SW Y M 1/4 /T oN/R j& 0(or)W K 6AJA Perdu wee )#I <br /> COUNTY: O ER'S/BUYER'S NAME: MAILING ADDRESS: <br /> 01r o I Q <br /> USE DATES OBSERVATIONS MADE <br /> �IdNO.BEDRMS.: COMMERCIAL DESCRIPTION: LPROFIL DESCRIPTIONS. PER OLAT�I/ON TESTS: <br /> Residence New ❑Replace <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> CO®ENTI—A MO S ®UINGa�ROUIN P��RE: SYS❑TEM-I N5-FILL HO❑SG190 : RECp t4VeMTj8&)AL_MENDED SYSTEM: <br /> If Percolation Tests are NOT required DESIGN RATE: S U If any portion of the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: I Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DE <br /> PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATIONOBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) <br /> B- 1 72 1.y 7 72 0-9 Blk Meds 5- 7Z 8ou meds <br /> B-1 72- $rS Noir 7 7Z -SBI meds - 2 8,rij Meds <br /> B- 3 77- qq,l No�ve _-" 7z. 0-6 - TL <br /> B- %0 jq.3 riI go 15 B S - SO B <br /> B- 410&C > S o - L kc Mod s - 10 & imi <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERI002 PERIO PERINCH <br /> 7j S 3 '% 3 <br /> P- <br /> P t/ 33 yZ 3 <br /> P- z NO > .s 3� 3 <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 <br /> ,sthe surface elevation at all borings and the direction and percent <br /> of land slope. WGO 8M 100 (JAIL I►J ftlatI /Z- QED 04k <br /> SYSTEM ELEVATION 6oR• SCAII w=yo` apff Wkii coded <br /> ELLoW -P� i V 8 <br /> yRIVI <br /> fly <br /> TN, 2 <br /> 30 r 1 /a <br /> • <br /> y S <br /> 8M <br /> LUf IINE <br /> I, the undersigned, hereby certify that 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 data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NA rin ` TESTS WERE CO PLETEED ON: <br /> ` V <br /> / 0 1 �) <br /> AD RESS: ` CERTIFICATION NUMBER: PHONE NUMBER(optio nal): <br /> Y 3 <br /> is^ P it <br /> G IATUR E: <br /> 2 2q <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L/ <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />