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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & B DIVISI <br /> ILABOR ANDNDUSTRY, PERCOLATION TESTS P.O.(1143�01is-N-gx <br /> BOX 79% <br /> HUMAN RELATIONS 1 DISON W53707 <br /> (ILHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: S DIVISION NAME: <br /> �/ �/ 3(a /Tyl NIR E (p E PA 13 <br /> COUNTY: MAILI G ADDR SS: <br /> JRIJETT JoN DILAdG LO T• 2- Boy, 4o 1Ne- Kt <br /> ER A N. S O <br /> USE DATES OBSIONS MADE <br /> NO.BEDRMS,: COMMER A DESCRIPTION: 1s� TESTS: <br /> ❑Residence Z_ (�— IplNew ❑Replace I / / , ZQ _ 93 2p– 93 <br /> RATING:S=Site suitable for system U=Site unsuitable for system �jy J <br /> OZS EJ . M�S.❑u INGIMS ❑U E: SNnSYSTE1❑�L O�G TIN� :REcO��r.ENDED <br /> TIO :optional) <br /> If Percolation Tests are NOT required DESIGN RATE: III`Y�fCX�//'�7171s If any portion of thlettested area its fin the L y7 <br /> under s. ILHR 83.09(5)(b1,indicate: r Floodplain, indicate Floodplain elevation: Nrl <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUP DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I 6.5 dogE S5 o-G (ms G- 8S NM5 <br /> B- 2 C) 6.1 NOAIE >010 O_1 B lrhs 7-90 SNMS <br /> B- AlOdC > 8 0- 1 SIM &grn5 <br /> B- `I (Qb Z.0 NOA11C > (O0 o- 811n, - (ooBdp'U <br /> B-S 60 92.0 MONE ;> (0() 0- 81f+1s 7- o 13Nms <br /> B- (IP' ?Z—J J-5--I A1401VE > TZ I o-- (p 0►>ns <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERI D1 P RI D 2 PE IOD3 PERINCH <br /> P- 1 IJD 5 7g ` /'0 3 <br /> Is No 5 1 <br /> P. 0 I I. ft. / 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 the surface Elevation at all borings and the direction and percent <br /> of land slope. ALT_ SCALA III' (oc, <br /> SYSTEM ELEVATION 92.5 90.3 &gM job wAit- W Q IINo7;wxly <br /> 1 t 10 M 5 Ac c5 <br /> I <br /> I , _ 9 <br /> I <br /> % <br /> -� - - <br /> f PR o N <br /> I � <br /> ` - KE <br /> 4 I <br /> t � ► it ` � r i - ( -- <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and m [hodsz�Rec�i]{ied i the Wisconsin` <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of y kn w edge an bell f,p�ir yT"14,T1ef <br /> 07 <br /> Kf S€ gala' <br /> NAME (print), TESTS WERE UOMPLETED ON: <br /> ADDRESS: I `1 14 CERTIFIC TION NUMBER: P ONE NUMBER( ptional): <br /> 2 w .3.5 <br /> o E wl1 ;g893 3�l0 S - S <br /> CST SIGNATURE: <br /> iLl <br /> sI-tas–+ <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBDb395(R. 10/83) –OVER – <br />