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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - DIVISION <br /> C P.O. BOX 7969 <br /> LABOR AND <br /> HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON,WI 53707 <br /> (1 LHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWN /MUNICIPALITY: LOT NO.:BILK.NO.: SUBDIVISION NAME: <br /> 5je-1/4 suA/4 3 /T ;UV N/RNE (p — rJ v n_ eve <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> d,,<A/F4T 6=AtzTL-to rAPsorb 1s40o cr RD 47 /x`/ dNiN /yb✓, ss�4fo <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILDESCRIPTIONS: OLATION TESTS: <br /> Residence � /• ,t__ New ❑Replace I /7_ / ,g <br /> f <br /> RATING:S=Site suitable for system U=Site unsuitable for system / 1 <br /> CO ENTIO❑NAL: MOUND: IN-GF_ND-REE.SSURE:JE: I❑�LHQ�G®� . R ECO EN�IJ✓ENT/O HionoI1) <br /> SS UU LAN(` LD�LESNIpGN RATUE: <br /> If Percolation Tests are NOT required I If any portion of the tested area is in the <br /> under s. ILHR 83.0915e NO indicate: (j" Il Floodplain,indicate Floodplain elevation: N jN1E- <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 ABSRV.ON BACK.) <br /> B- I ClCl-0" Nom � ? B4 SLTs 40 " CS 5&15 �3" km /o`e--r <br /> B- 7�/' 9G 6" Ndr�� 7 " 7 �� 9` 1 Sir c s 0 gMS 1.2", <br /> B 3 �7.r !� fl �� +�L SLV7, 38 cs e a2 0" RrhS IS" PM <br /> B- 7y 160, 0" N ?7 4` 6LSL'T q2_' 0-5 6r5 19`" ewls 12" t)PS <br /> B- 5 �' " Too'- a , u ? 77" 4- 6Ls1_T5,, 4d` cs, aNs, ?0' R>"s t3K-S <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 I PERIOD2 PER PERINCH <br /> P 3a„ OVL <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 /> SY TEM ELEVATION l7'D" <br /> i yoC Fl cizE �vnc FAi?z>/ eXIST/G'w Go[✓�R. TWrn/ <br /> 4,9 8"V <br /> g25Q <br /> r <br /> a•m� <br /> �21TN <br /> Bp1, BnsEZd <br /> ersse, <br /> p�wi <br /> '_"� <br /> 23' <br /> In-_JK44 <br /> ego? Waf.0 <br /> Ta 7/101+1P`bl/�oAD Z �� <br /> I,the ndersigned, 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 (pri ,7TESTS WERE COMPLETED ON: <br /> � [� l�l{ CI'f1 � - / t -- S7 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> �6� x /? D - z of H/R ND e 71 O <br /> CST GNA RE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. " <br /> DI LHR-SBD-6395 (R. 10/83) —OVER — <br />