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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> Y, DIVISION <br /> INDUSTR <br /> LAC P.O. BOX 7969 <br /> LABOR AND MAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (1 LHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: OWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> W 1/44) '�T3 N/W E ( )w o, N� �a ti <br /> COUNTY: MA ING ADDRESS: <br /> 9-v4!;' <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.:fl:OMMERCIAL DESCRIPTION: �/ PROF E D RIP NS: ER A I TESTS: <br /> Residence o Al OCJ New ❑Replace I <br /> RATING:S Site suitable for <br /> �system U=Site unsuitable for system •I`` <br /> NVESN , M"S,❑A IN-GS ❑Q E: SY�EM-I NJ <br /> -FILL O�G TANK:RE Colu ED SYST <br /> D <br /> EM:(optional) <br /> DESIGN RATE: SJ <br /> U <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b 1,indicate: Floodplain indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEP TH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, <br /> ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE A68RV.ON BACK.) <br /> B- l 80' S cl^-D ob0M6:_ 8Q u 4„ . 75 f V-" ICAS, 32- n'10tj s <br /> B p 8 gqU ` BL SL rS SS. F$S. 2-1'- I)'1 <br /> e- 3 77,y9 q5�� , ��11 $t—S�f� �3 FaS 2L' Irl b�S <br /> B O(/• �l�/�1 DFV 87 LSA t5 Wtr <br /> B- K �$ �i 4 <br /> 13- <br /> PERCOLATION TESTS <br /> EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCHES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PERIOD <br /> ) <br /> P- <br /> P- <br /> a f 5 h <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 /> : <br /> Y - <br /> IN <br /> SAE; ►�14tf i� <br /> v + <br /> i <br /> 1 � <br /> I,the undersigned, h reby certify that the soil tests reported on this form were made by me in accord with the procedures and methods spcifled 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 (prin TESTS WERE CO LETED ON: <br /> ADDRESS: CERTIFICATI N NUMBER: PHONE NUMBER(optional): <br /> rlv 3 _2 �'6 <br /> CST SI <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />