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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECT ON: TOW UNICIPALITY: LOT NO.:BILK.NO.: SUBDIVISION NAME: <br /> 1/ 1/ Sl /T0111/11/6E cG <br /> -F-- <br /> COUNTY: OWNER'S BUYS 'S NAME: MAIL <br /> birg,verl ar4 <br /> iso <br /> USE DATES OBSERVATJIONS MADE <br /> /f�I- NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE/gCRI/per ONS: PER OLATION TESTS: <br /> 'L[Iti esidencey /1 New ❑Replace I �jt/ // �� G'w..+n(�� <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CON�/ENTI O❑I L: MOUND: ❑� IN-GV�PR❑ESSURE: SVS- TQM-IN❑-FILL HO❑LDS rqQ : RECOMMENDED SYSTEM:6ptional) <br /> ARIA, n <br /> If Percolation Tests are NOT required DESIGN RATE: �L'�f'mac U If annyy portioofof the tested area is in the <br /> under s. ILHR 83.09(50),indicate: /� Floodplain,indicate Floodplain elevation: <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 BEDROrCKK IF /OBSERVED (SEE ABBRV.ON BACK.) <br /> B- f 7t , 7`5i <br /> r r` 6�/` JC.— , 7 Ag" 5 2k Ar "kP- <br /> 13- <br /> 13- -n+-LS cis <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 PERIOD PERIOD 3 PERI CH <br /> P- <br /> P- <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. t <br /> SYSTEM ELEVATION gg• l <br /> R�fc- <br /> �" S0 Zsr 1N <br /> NG-w <br /> Uo1'.1� <br /> l.LiA &ac*V_- <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 /> NAMF,,4"U: TESTS WERE COM LETFD 0 : <br /> ADDRE S. r CERTI FICATIO NUMBER: PHONE NUMB E R(optional <br /> T' g 0 r G GJ 1 - Sr '71 <br /> cs slGplexa e: n <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. o ,� <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />