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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON \N1 53707 <br /> n aT (I LHR 83.0917) & Chapter 145) <br /> L A ION: SECTION: TOWNSHIP/�Y: LOTNO.:BLK.NO.: SUBDIVISION NAME: <br /> '/ '/ /Tyo N/R/yk(or)W jr. 38 ,BARE n�� eNx'4 Belmq <br /> COUNTY: MAILING ADDRESS: <br /> u,p NETr 13oBERT ;C_c/H;o d3.1� G�[s°r sT .9c; e Wj :f3 S/03 <br /> USE DATES OBSERVATIONS MADE <br /> N0.BEDRMS.: COMMER IAL DESCRIPTION: I RSD R-()' NS: PERCOLATION TESTS: <br /> esidence [ ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system / <br /> ONVENTIONAL: MOUND: IN-GROUND4'RESSURE: SYSTEM-IN-FILL OLDI NG TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑S Ceti ❑S ❑SEN ❑S ait C�T5 ❑U Nao;,yc zewk <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)16),indicate: N/q Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUP DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 7.Z /oo.S Noll s TS o -3 ew-p `�'sT 3,— [3 Rlmo-s "�coeos; l3-S� <br /> N STS es- 81v Wc.8 - S? y-/y �p Mt4 S u/'Ca& /2/- <br /> B- 7// 99.Y 7A a6 m 8 a a .V/ Ze <br /> B-- 9�, ?- '�/� /y BN N <br /> STS o -3 d <br /> B-'/ <br /> 7/ ry8 <br /> &0 st f,-AA 0 - 1� /t s w-fir, 6y s-'< 3f-6� <br /> B- S4 F•<C o -Xyt Ip 5 a5� A9 cyP't <br /> El- <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 PERIOD2 P PERINCH <br /> P- <br /> P- <br /> P 711 /1 <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 "- ---hwa iZopO ��/�/�JGNE bx,0C <br /> ` ; I <br /> c I I . n- -BPRF T <br /> �a�iA . Gs1sT bF. <br /> ptR� IN <br /> IIf ' <br /> A3 <br /> I <br /> r 1°T o T° .. m;ooc l _ jWWY,�.A(.tjC 44KF <br /> AL, <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 COMPLETED ON: <br /> AD KESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> T,9t, &oA [ 0i 7 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R, 10/83) -OVER - A\J `JJ r-G/I 202 !> 4. <br />