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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTR Y,� DIVISION <br /> LABOR,ANP.O. BOX 7969 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> ULHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTNO.:BLK-NO.: SUBDI VISION NAME: <br /> y %4. 23/T4pN/R15EInr W JAcKSo (off — ovE2LgNn <br /> COUNTY: MAILING ADDRESS: <br /> IZt4 ON t✓ 13000 LI[I co L T- BLAINE , M4. `'I3`f <br /> USE DATES OBSERVATI NS MADE <br /> NO.BEDRM&: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: AION TESTS: <br /> ❑Residence -'7 �� New ❑Replace - / 93 <br /> RATING:S=Site suitable forsystemU=Site unsuitable for system l' 10 <br /> O��TI❑� . IMOVN—D--.-----❑P IN G®SROUN ❑�RE: SV,ST <br /> I❑jO❑j <br /> L G®UTANK:R torivEimot4ALCOMMENDED <br /> (optional) <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)Ibl,indicate: �-� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D P HTO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED EST. HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I '12 991 NONE >?7 0 - 10 1M 6- '12 ms <br /> B_ Z 7Z 99. 0 N D rq f > -17 b'')81rns - 2tiZrns <br /> B- 3 Z 99.q ►Jolie > ?Z <br /> B- `I 7Z 99,9 <br /> 1 140 E o (0 inns 6- z rlwts <br /> d- H� <e- '1'i &I s <br /> B- 5 IZ q9. 2 GONE >"iZ <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. PERIODI PERIOD2 R PER INCH <br /> P- I 32 140 5 1 /y 8 II. 3 <br /> P- 2 72{ No 5 1a 17r 9/g <br /> P- <br /> P_ <br /> - 3 2q s I 6 <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 17- 0 <br /> - 1 <br /> r I ' <br /> l <br /> A- <br /> N <br /> 3' <br /> y _ S <br /> Q' <br /> SCALE Irl- 40' o <br /> rr _ <br /> �M tPo_ �111{� ItJ 1`1- SZEn QA k; <br /> Ell ?D 3� a59 `2ofw $ED_ <br /> PL. <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and met ods specified nsin <br /> cified in the Wis <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and elief. f* - sle:_ �-q0 1 <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> ICHARo 000 5 'Ll - (V - 13 <br /> ADDRESS: � 0 ` ' �� G�ST�-lam �' ����� CERTIFICATION ICA nON NUMBER: PHONE NUMB ER Ioj tional): <br /> W G CSTSII)GONATVURE: St/O 1-115 <br /> DISTRIBUTION: Original-arMcnrtrlpy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />