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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LA&OR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS ` , DISO, 1 537 <br /> (ILHR 83.09(1) & Chapter 145 �/ rib <br /> LOCATION: SECTION: TOWNSHIP�MUNICIPALIT LOT NO.:BLK.NO.: SUBDI I ION AME: <br /> .%-7 l3 /Tt/UN/R EIp <br /> COUNTY: OWNER'S BUYER'S NAME: G ADDRESS! <br /> 7✓�NElr RtC9lA(Lb RD OD LnTERA)ATrouA6 OA �5u/TE Bas /+IPS 6U/. s'3S2D <br /> USE DATES OBSERVATI ON MAD <br /> NO.BLDMM. COMMERUI AIL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence1 A. N vt_ Vew ❑Replace �_. ! J ` sJ �_ �� �'� <br /> RATING:S=Site suitable for system U=Site unsuita-bile for system / <br /> ONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM (optional) <br /> ®S ❑U LCIS ❑U S ❑U S ❑U ❑S U e©AhJ6U7101IJ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.091511 b),indicate: Id A- Floodplain, indicate Floodplain elevation: �J <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COL R, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGRS8T TO BEDROCK IF OBSERVED (SEE ABBRV. ON ACK.) <br /> B- 7X' q_,f D IJpIli E > 72` 6 S L �3L /S' 36 dN/5 /�"/ ms / "t3,vi3 <br /> > <br /> B- a 7� CICS!6r. IJD�� / �, S sL, l3l_,75 3cr,i a,, Fs, /6 ?n75, .3S dNFS , <br /> B- 3 8�" loo'o" ,Nc �p¢r, s s� '1'51I, is. nn. r3 s, is � s 2v" 6uF5, <br /> B- A 8y" /vofD" > g4,. S' s� sc , 7s 34' aNr=s r, /:?Pls 3s" 6AJFS, <br /> B- 78° WC' M�L 7 V 5' 5L P,k, TS. 36 BNf-S lo ' 12MS ,27 " SaFS, <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PERIOD PER INCH <br /> P I '� )Vo-c- s 5/ ., —PERIOD <br /> 4 1 , <br /> p_ a o 0,- <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 dista ces. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on t plan. Show the surface elevation at all borin s and the direction and percent <br /> of land slope. _ ___------ --- - -- <br /> SYSTEM ELEVATION !° <br /> p(gNuen <br /> -9` 9.+utAgq"rb �I taT� r 10611-pv <br /> T <br /> i <br /> i <br /> !uT<4 <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures an m thodsspeci�ed i#44tikisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and beli f. <br /> NAME(printL. TESTS WERE COM LETED ON: �0 <br /> � .41- �/- <br /> ADDRESS: CERTIFIC TION NUMBERk PHONE NUM ER(optional): <br /> �T dox 5i R� c.�� • SLf 8 �-zy 9 <br /> CST NAT E {f^, <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. N <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />