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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> 3707 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) - 6 62 <br /> 1�� <br /> 3LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NONO.: SUBDIVISION NAME: <br /> '/4 'V4 (0 /T 0 E (p LFI fo " v'-L, X <br /> COUNTY: NMAILING ADDRESS: <br /> u li 0 3 IG PAuI MN. 5 10 <br /> USE DATESO SERVATI ONSMADE <br /> NO.BEDR11SCOMMER IAL DESCRIPTION: I NS: R ATION TESTS: <br /> �Aesidence ❑New Replace <br /> 17. 93 II. 17- 93 <br /> RATING:S=Site suitable for syst m U-Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSOR SYSTEM-1 N-FILL OLDING TANK:R ECOMMENDED SYSTEM:(optional) <br /> S E111E111 ®S U ®S ❑U : ®S ❑U ❑S VIQ I CONVE ANA 1- <br /> If <br /> If Percolation Tests are NOT requi red DESIGN RATE: <br /> 9 If any portion of the tested area is in the Q <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicate Floodplain elevation: tin <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATIO OBSERVED EST.HIGR—E—STTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 " ) NONE Z C ' C1 1511" - (44#314 16 9141S w KC-MR—or— <br /> B- Z <br /> c-m -oB- 2 Z ITT- N04E O-SBIIS 8- 69BNIs 4q- '►Z3f✓LwR�fn mo <br /> B-3 o- aBlts o <br /> gNls (oo - bz ,� s1a olvl mo <br /> 9(o•I oN 0 2 <br /> B- <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 AFTER SWELLING INTERVAL-MIN. PERIODi PERIOD 2 PERIOD PERINCH <br /> P- ) 11V__ _5 - 15/1 3l <br /> P- 2 3Z No PIS c /-% 3 <br /> P- 1y 9 yz <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 refere ce 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 ELEVATION4. 5 <br /> 1 - <br /> TRaPos�n ABM 10Q 961_ :is iWAM 919E_ <br /> AZO? -- <br /> I <br /> LAKE <br /> _ TN <br /> I <br /> 3 _ - <br /> I ' <br /> I,the un rsigned, 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 /> Adminis rative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (printl: TESTS WERE COMPLETED ON: <br /> XIcHARD P - 1,7 _ 93 <br /> ADDRESS: I .I CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 2�7(0o E85T . S 93 31070 l5 �6 IS <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />