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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, c DIVISION <br /> LABO9 AND PERCOLATION TESTS (115) MADISON BOX WI 53707 <br /> " HUMAN RELATIONS <br /> (H63.09(1) & Chapter 145.045) <br /> LOCATION:NW SECTION: TOWNSHIP/ • 'LOT NO.:BLK.NO.: SUBDIVIS ON NAME: <br /> NE 1/ 1/4 35- /T�/o N/R IbFor)Y-11e u ) c, K Ar)A ,v , <br /> CO NTY: T- OWNER'S/BUYER'S NAME: y- / -MAILING ADDRESS: <br /> S4rn TIT Po 13 L G Z-EVwI'S t �r / Rey ail �,�� �. I k7;r r s 6' <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS,: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TEST <br /> Residence 3 New ❑Replace - 3 -- e of 7-- 3 - 8,9 <br /> RATING:S=Site suitable for system U=Site unsuitable for system 7 <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> XSfU JS ❑U XS ❑U ❑S XU fSZUJ c0iv0 _ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED I EST. HIGHEST TO BEDROCK IF OBSERVED (SEE/A�BBRV.ON BACK.) <br /> B I 67 0 6/62 A,,0 �''� 7 `' Jr ""e n L s" i s- "` ic is 5-7 `" e P'1 �d s <br /> B- ,� qt , `� ? 6' Ds ' Cr / �, �, ;Us 5- 1 "I i' w'1 YJ S <br /> B- o vy t, > 1 ° S- !Ji74f / ! 1/ R4J Vo " M.,-ECS J <br /> B- IS O 9 '°l, a- ,\ > f 0 S".eh L f a 0 " R 4 r 6-s-" oc tJ S' <br /> B- 6 f o 7 9 j "19/4 L s i R LS.. s7 " e i►., -5— <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH <br /> P- 1 30 _ t `o J / a i/ Q '��0 . /4. �/ <br /> P- 1 & iLV'10 f tZ a / a Mo gi. "Mk. a Ve "/ <br /> P-3 3 h nI 0 t c . a. 1//e I /1/0 A 1/p 5^ <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 pn the direction and pert t <br /> of land slope. ,p vt' i L. luft-e II <br /> SYSTEM ELEVATION f r. tr 4/0 4c, r rs A , <br /> o <br /> r v <br /> is la E <br /> la <br /> 0riu •.< <br /> .----------,N\ tN <br /> 't IN 1.7) ......3 t- illus <br /> V <br /> itvet, & <br /> tT'ta <br /> i4 ic re i 4 -t, <br /> arT4. <br /> I,th 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 /> NA E (p int): TESTS WERE COMPLETED ON: <br /> h1e & <br /> ADDRESS: z CERT( (CATION NUMBER: PHONE NUMBER(optional): <br /> .W '•e. b S. r Wt s c . .s"'9dr . 3 7 -v.3- 66- �/ 7 <br /> C GNAT RE: JN <br /> 0-c.` 1 <br /> !,/ <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) —OVER — <br />