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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, � - DIVISION <br /> LABOR AND PERCOLATION TESTS (,,15) - MADISON WI 53;0; <br /> HUMAN RELATIONS p <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: NO.: SUBDIVISION NAME: <br /> NES/4OW �/a 2q /T�{0N/R14Elpr S 0 NibBLK.14 1 N <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:WI017 ,t5RUCE,WS 81 <br /> T)Merr IDAVID BAK <br /> USE NEW !S DATES OBSERVATIONS MADE <br /> NO.BEDRMB.: COMMER IAL DESCRIPTION PROFILE DESCRIPTIONS: ER OLATIONTESTS: <br /> Residence n �i. ❑New Replace I C_ to — 4Q �_ to —4p <br /> RATING:S=Site suitable for system U=Site unsuitable for system J 00 1 O O <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SVSTEMaoptional) <br /> ®S ❑U ®S DU ®S ❑11 I ❑S ®U I ❑S ®U I Coov. <br /> If Percolation Tests are NOT required DESIGN RATE: If any y portion of the tested area is in the <br /> under s. ILHR 83.091511b1,intlicate: �� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I l 0 '779 Nm,5 > 1110 <br /> o-s sl S - 14BOst IH-3 F'P_ 6-b2R s 62-110ym5 <br /> B- 2 100 97 2 NOIJE 0 91-100IM5 <br /> B-3 loo 17, Nov loo 0—S sIS-155as115-Z6Rc.26- 4W5y6-IOo Ms <br /> B- o BE C <br /> B- <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 PERIOD2 PrRIOD 3 PERINCH <br /> P- I 60 No 5 "z. I �S / <br /> P- 2 sr I No 5 3/ '/ '/ <br /> P- 0 j '/ VI c 5/ <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 <br /> nsurface elevation at all borings and the direction and percent <br /> of land slope. Su-/-Jw /"=SO, <br /> SYSTEM ELEVATION 92. <br /> I►M lOd Bo7f&q oFsi3O/,U6 <br /> Ll ��Rc <br /> BoR� OAK <br /> ` LAKE <br /> W:II �p- <br /> SLD6 <br /> 2 <br /> `��o �R►v�. �N <br /> I • <br /> 13 <br /> A <br /> All LOT L4NE5 7100 <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 /> NAME (print): ITESTS WERE COMPLETED ON: <br /> FSG f z OP41 - D -82 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> ZA495 /e OJl 5V9g5 36 76 s- 6 6- s <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. Lj <br /> D I LH R-SBD-6395 (R. 10/83) —OVER — <br />