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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, - <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (ILHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIPILOT N O.:BLK.NO.: SUBDIVISION NATE: <br /> S '/ISw'/ /T N/R/6U )W 0!? <br /> l � 4�c o4k�rkd S' �o� <br /> COUNTY: O��WI1NER'S BUYER'S NAMIE: MAILING APD ES <br /> IQ h 7r I lot V r d K V W-B G <br /> USE DATES OBSERVATIONS MADE <br /> rr��f NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILED DESCRIPTIO PER LATI ON TESTS: <br /> VJ Residence . New ❑Replace I S� a —f S p—a <br /> RATING: S=Site suitable for system U=Site unsuitable for system o O <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U ®S ❑U ®S ❑U 10S ®U I ❑S ®U cU N J <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83 091511b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH 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- / to /o o ,(1 40T -,>I d 6 "09., i s /J" C t 6.1 iP &n ,,,-d/J <br /> B- 1 ua <br /> alto^ . t' V ",d, ( t /,L`' 4 s 16 �p " k .mt c� S <br /> B- Owl /UC�t 11 ��'� ll�H � f /J-`' CS OCr tel/ J <br /> B- 9v /CQ-7 ' 1 > `Z0 b'CgaCS lo" ( s 7y " . gid S <br /> B- S 40 / o/. l ' 7 0 6``Bq s 9 S 7S R rh1.i <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 PERIOD P R D PERINCH <br /> P- 30 <br /> P-.)- <br /> P_ <br /> P_ <br /> PLOT <br /> -P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicat( 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-sarface ilevat n at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION <br /> S9'e-RC = 1 "� yo t �BvrrQ <br /> --e X o �o f w A �•� `e y zD o' rt <br /> IlJc1�-�-� l�a ape I /SOd /C T' <br /> 13 4a Io �/ If 174-L 4�r2 <br /> 1�d1 F'— E�F3c 6 �I )Feb <br /> o4k � lCro 1N <br /> loo ' <br /> F<nr.,,$ Q L% 'c <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pro edures 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 (P <br /> ): TESTS WERE COMPLETI Q 0�: <br /> r r` t� a �t st f 8 - ^Yil <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBE R(optional): <br /> CS NAT�IR E: s <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LH R-SBD-6395 (R. 10/83) —OVER — <br />