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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W153707 <br /> HUMAN RELATIONS <br /> (I LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MHMff3MATTTV: LOT NO,:BLK.NO.: SUBDIVISION NAME: <br /> WYME1/4 3 /T3 N/R/6I(or)W M -Crtiu0 /+ .1 I i ' �adl e . aL Br <br /> COUNTY: OW R'S BUYER'S NAME: MAILING ADDHE:66: / <br /> 4�•1Y •.S '/1 G W D� EO/UQAllij A <br /> USE DATES OBSERVATIONS MADE <br /> Ig <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: II���� PROFILE DESCRIPTIONS: E CO ATION TESTS: <br /> IpResidence 7? 1 IG�New ❑Replace 19_/y- O� <br /> RATING:S=Site suitable for system U=Site unsuitable for system / <br /> CONVENTIONAL: MO❑U N D: � IN-GROUND®URE: SV❑ST EM-WILL HOLDINGTANK:RE OM�E ESYSTEM:(optional) <br /> S U — _ S U S U fL�Ci�S U <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),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. HI HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I �U p�•y / � D-8`BG�s g A0 " 4 v m. Ir W/nnt L <br /> /Zctif D <br /> B- 2 33 ! 6a coq 10%" D Pwr,Qur s _ Al," Bnm�. r ,a ': aYc9n. d s w 'IT- <br /> t/ o KC6 a? "- 3 " Na <br /> B 7 a IUJM1P O O-VdkIr b 's-1 nn . s 70 - n.c <br /> W 'M QT G" D <br /> B7. rJa os� 17 eccr 6 '= �� "R^^• s - �,t <br /> c C ilk. <br /> B_ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PER100 3 PERPERINCH <br /> P <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. o Q a h-, <br /> SYSTEM ELEVATION A Bgr� >�- �;,� sra„ IIA 770 <br /> r 3 k"fk <br /> 37 d view <br /> ,�� C� T N <br /> oly <br /> 1,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 (or/i/+t): L TESTS WERE COMPLETED ON: <br /> J O •e ht G A d /) c- . /Z/—(f 7 <br /> A RESS:67CERTIFICATION <br /> �TUR E:N <br /> UMBER: PHONE NUMBER(optio <br /> nal): <br /> G. e7/5*66Lf1T-7 <br /> � <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. �f <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />