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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 745) S <br /> SECTION: /} pp/� TOWNSHII P/gkHNV6WALLZY: LOT NO.'.BLK.NO.: SUBDIVISION NAME: <br /> of 1/ �� 4- c� ITV4 N/N� ( r) J4C1t6C21 <br /> COUNTY: OWNER' `EFMSNAME: MAILIN%ADDRE�S: <br /> HAYM <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRM : COMMS TION: PROF( DE RIPTIONS: PER OjATI NTESTS: <br /> ❑Residence S. <br /> ❑New XReplace ? / � "j/l.I�•f j <br /> RATING:S=Site suitable for system U=Site un u*e for s <br /> ONVENTIONAL MOUND: IN- PRESSUR STS -IN-FFILLHOLDIpNG TANK: RECOMMENDED SYSTEM:(optional) <br /> MJ QQZUANO S D� XU ❑J ®U <br /> If Percolation Tests are NOT required - SIG TE/ If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: n: <br /> ,:" Floodplain, indicate Floodplain elevatio . <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- YF `77ol7� /�' ! a 2wl 3E" s� a w erd /a'' / �a~e simwelt .T <br /> i <br /> B — -6- /UT 3 eRI1 sia a" s c!" si�c�lR01.r <br /> 6n s <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PE IOD 2 P 3 PERINCH <br /> P ^� / <br /> P- r 17 J P- <br /> P_ <br /> - <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 G7� rx'Sr1,,VC- :5�friYl rtrPAtieN 951417) <br /> SCALE /(Block:10" <br /> QCS <br /> BPs I BM- 807MAI OF S;WV6 <br /> t� C85 1 <br /> ttF BAR <br /> EL - /00` <br /> TN <br /> `� BM 13 .sa1,c BaRi�°r S <br /> C$ACk NcE� <br /> a pct 44P A PE,1llf rEsrS <br /> jifT C,ROt+NOWA'�R A'a6'/te r,� <br /> rale' At M/ ie.. P3 ;/����7 <br /> 0-rH A <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): TESTS WERE COMP TED ON: <br /> hkl �Zo � <br /> ADDRESS: CERTIFI ATION NUMBER: PHONE NUMBER(optional): <br /> CST SIGN T E. <br /> A <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHRSBD6395 (R. 10/83) —OVER — <br />