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DEPARTMENT OF REPORT ON SOIL BORINGS_ AND SAFETY& BUILDINGS <br /> INDUSTRY, - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53769 <br /> 07 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT N 0.:BLK.NO.: SUBDIVISION NAME: <br /> �/ �4 -'� /T3 N/R 1Y (p W <br /> COUNTY: <br /> OWNER'S BUVE 'S NAME: ICI G ADDRESS:In, NO. (.G7Y <br /> tCkUElfL444q0QA1 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BED ( <br /> RMS.: COMMERCIAL DESCRIPTION: <br /> 14 <br /> PROFILE DES RZ, IPTIONS <br /> µl : PER CATION TESTS: <br /> Residence /—,A New ❑ e <br /> IReplacs/a' <br /> RATING:S=Site suitable for system U=Site unINsuitable for system L✓ /0 <br /> CONVENTIONAL: MOUND: -GROUND-PRESSURE: SYSTEM-IN-FI LLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> �$ ❑U ❑S ®U ❑� S ❑U 17S EA I OS DU I C'au 1 - 6Sos5 u <br /> If Percolation Tests are NOT required DESIGN RATE: y� If any portion of the tested area is in the <br /> C(.,.� <br /> under s. ILHR 83.09151(b),indicate: SS y_ I Floodplain, indicate Floodplain elevation: <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. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 9j".(3 NO �72u G-j-yybry & lied /tS;e-92 Y-9n MS GndSr. <br /> C�85y�� ,� lfS;8b5lydvMSw,dgr. O r�nl <br /> B- 6A4' C/6.7 1 4>o ¢t bo'. <br /> 3 (,$0 c ' e-?Sj bN b'wed ItS,k-&4r o mS andjr. 6 FF '1 <br /> O. mar A f 6 <br /> B_ i7,S 6� <br /> o-f/ y b^) ed /tS •P-a 4 IZAI -3v y&S,1;3ra�� ms <br /> tillr <br /> B- `I �Ll 4�i'.l DIY" I'R wee c.FQ®mor q+ vY'- 4b & Ir15 and r. <br /> B_ Q�./ rG <br /> H o-fr �y bN d,red 1&r.. y.2o &4m 1 'Ao a y&S,1 a9-1/o txn <br /> ' .aa.�l S cktvf¢+•.1Mtn • y6- +/ V& MS <br /> B- <br /> '0_L- aetw e..,};/e, fps PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD ( PERIOD2 PER PER INCH <br /> P- e56` _ 8 io i,.�. G( ' L" e-trvrr,a is <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 <br /> I +'S�4e _�ort)�Chlo drive,. <br /> 34 �Bz <br /> B3h jute_ sstr ai?G29 <br /> I �Ae�rCciJO w 5urioSs tN <br /> 1 .Pli .PSI _4 &-l< hole5 <br /> Sy M q� / � tv • <br /> I, 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 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 (print): TESTS WERE COMPLETED ON: <br /> ,o F �a� � <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> .£F.C,Qot r/s Vdir .S11o3y 00.3S� g -4'/ 8 <br /> CST GN,ATTU}lE- <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. 4/66 <br /> DILHR-SBD-6395 (R. 10/83) —OVER — /// <br />