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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOW NSHIPIMUNICIPALITV: DIVISION NAME: <br /> �/ W �/ /T�{0 N/R15E (pr W J ON 31 �1P HAWI`S N�sT <br /> COUNTY: MAILING ADDRESS: <br /> Vo W - NSU A0 (, 05 c a Ew 218 6b0C N 1 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IALDESCR____: (�/� PERCOLATION TESTS: <br /> ❑Residence ��/ �JJew ❑Replace - -I V - 1Q - O <br /> RATING:S=Site suitable for system U=Site unsuitable for system V o0 <br /> �p �71❑� , MOUND��. ❑� IN-GROUND-PRESSURE:❑� E. SVS❑TEM-TILL OL❑DINGTANK-JR ECOMMENDED SYSTEM:(optional) <br /> ® DESIGN RATE: S U S U <br /> LZ <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALP H TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGP—EST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 17 - t 72 O - 5 guns S -7z 131v�1s <br /> B-7- -12- 91. 10ME ;>?z O -SBlrns 5-3a �ms 3o-�zf3Nfhs <br /> B- 12 �Tt Na c > 72- 6 - '31 Rrhii ;L1 -?11PftS <br /> B-L '11 `j$ ,1 »2- 5- ?7- 13ti is <br /> B- $ 1Z 1 .2, 6NE 712 511 fps 8 - Z <br /> B- <br /> PERCOLATION TESTS <br /> tiTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI Dt P RI D2 PER1003 PERPER INCH <br /> P- ! 3 fOb 3 11% <br /> IV,L <br /> '7/t 3/ 3 <br /> P- <br /> P- <br /> LP- <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 <br /> Scwl. I"--4b/ _ ._ l 1 <br /> akl,p k w�A1LR111`or4 well <br /> n lY ` <br /> Vb�E �t d• peLa� <br /> - - o <br /> tN <br /> 5 <br /> >a <br /> 1, 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 Wis onsin <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 /> JCN�R� NaPK��S _ <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 6013 <br /> CST <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. f+�" <br /> DILHR-SBD.6395 (R. 10/831 -OVER - <br />