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...n llY II '.p' . ,,l I I, .NV [,IJUIN CJI:it V I ULb 1 <br /> DIVISION OF HEALTH BUREAU OF ENV 110NMTMTAL HEALTH .. <br /> P.o. Rnx 3oe <br /> - MAOISONf WISCONSINRi3701 <br /> REPORT ON SOI1. Bo;x',i:G3 4rJD I`ERCOLATION TESTS } <br /> LOCATION:S!'_G. SG_'/..Section/f i�lc'J. R /¢$fmIF1 T.+v:.,alp� •.,i:.w:«a.rhty.._.._..].�U.L__.�_:._..... ' - �' <br /> :Lot No. 1 _, Block No_- <br /> Cot 1/ ._-.:a tL LL 1 <br /> Mailing Address: lhl�� cl !Lhnv_. u: Lily '.,.yr..L'.:r . 0 <br /> TYPE OF OCCUPANCY: Re idents, .. . .._ No.: I M!'Hoop" <br /> ...... GIY. <br /> L .-. .. ,....._� . <br /> EFFLUENT DISPOSAL SYSTEM: NEW AOnl IIUIJ -„REPLACEMENT .. . .... <br /> DATES O BSERVATIONS MADE' SOILBORINGS._ //.`._ . <br /> .PFPI ULATION TESTS <br /> SOIL MAP SHEET _ T7 SOIL TYPE <br /> PERCOLATION TESTS <br /> `TEST DEPTH � - . HOURS WArER IN . TEST-TIME , DROP IN WATER LEVE L.INCH RATE ' <br /> CH nq ACTER OF SOIL 1 <br /> NUM- plO1E5 THICKNESS IN INCHES, 51NCE HOLE HOLE AFTER INTERVAL <br /> 8EH _ _ - <br /> L1rWETTEO SWELLING IrJ L1INUTESPEO IOP! PEgIOD T PERIOD 3 nIV/INH <br /> i <br /> rte f / o: ./C <br /> R,3 <br /> SOIL BORING TESTS <br /> TEST '7: 'TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHAR ACTER OF}SOI L WITH THICKNESS, INCHES <br /> .'NUMBER, , INCHES OBSERVED ESTIMATED RICHES ii (DEPTH TO BEDROCK IF OBSERVED) ' <br /> B _ �'�•'/ r 3' 67T �/�O+� Fyyvy M< 3 :L PF nr ra i <br /> -',' I � ' 1 / .G, 3G I`.Ij rL i.;.. r4 7F .'_ b cds 1 . SL7ry'.J_c.Q r✓L 1 . <br /> , ., 7 <br /> %vy <br /> yid:. �Q S.an Zfi :S•LCrGr L• y <br /> i 7� <br /> . !" AN VIEW iLorate percolation testssdil bore holes and swtablc idil'areas l'` x W-;4' <br /> Indicate on the plan the IOCabon and square feet of!suwtahle areas Indicate number of square feet of absorption area <br /> needild for building type and occupancy. ' /' W^'- '-Indicate scale <br /> or"distances. Give reference point. Indicate slope <br /> _ I <br /> �— <br /> / `' <br /> S <br /> �I f <br /> � I <br /> rr• <br /> k L <br /> i <br /> t _ <br /> I <br /> T71' <br /> ` f I,the unBersigned, hen y crrtify that the so tests reported nn Ihls form were made 6y me, in accvrd wrthihe procedures <br /> and methods specified of the W',sconsin Adoupt,tranwo Code.,, That :ho data recorded and los bort of lest holes are correct <br /> to the best of my kkn'owle/dg ,, d brl d /�� /l Id t }\ <br /> Name (Print) F./ r L/-�n Iq, _ -�%'�j-}/�`vary. '---'-'-a_ <br /> Certifira[nn No <br /> Na,nr of installer if <br /> Cc.; A - Propol Pf <br />