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UTMENTOF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 5370697 <br /> HUMAN RELATIONS <br /> (H63.09(1) & Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/MFlfal@Tf'RtYYY: LOT N0.:BLK.NO: S <br /> . UBDIVISION NAME: <br /> S '/w'/ /Tvo N/R�44w)W 5 .r.r / I A41 I NA <br /> COUNTY: OWNER'S MAILING ADDRESS: <br /> 6f/ AlETT 6/1-1- !36oBAc /0 2 APPLE V aE /iVAIA. 5.5 2 <br /> USE DATES OBSERVATIONS MADE <br /> ��{{ NO.BEDRMS: COMMERCIAL DESCRIPTION: PROFILE DPERCOLATION TESTS: <br /> W1Residence 2 ^/A New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ®$ ❑u ®$ ❑Q ®$ ❑� ❑$ ❑$ XQ 00414E T/DAM L <br /> If Percolation Tests are NOT required DESIGN RATE: If any y portion of the tested area is in the <br /> under s,H63.09(5)(b),indicate: /v 4 Floodplain,indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH 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 ABBRV.ON BACK.) <br /> B- l d 6 /00",7 NDNE 6 Z/ if y''a 62`i13 s w!✓i07 AT IICIrI - <br /> B-3 viv, / " 11 > 6y" y;, bo"eil Aces <br /> B-41 60 /ol ''-/ > h0 „4T [. IF 56'/ <br /> B-5 �7 /D2'oo �� > Y"&4c 63 o, r s <br /> 13-(; 5� l0/' 3'' 11 5 511 y"13 . 5'/ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERI D2 P RO PER INCH <br /> P_ /q NO- 2Xvr / � 3 <br /> P- 2 <br /> P- r / <br /> P- Z <br /> P- 2 /r S <br /> 2 'L 2 <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. ,(�/Q F/S H <br /> SYSTEM ELEVATION 99`00 fCEQa�RcO «KE 4/FT pump <br /> i LIUE I E <br /> IF <br /> 40 <br /> I t R LA E T TN <br /> 57 <br /> -- v c k ER / s O r j^ <br /> L-/` -. <br /> S sTt BQ <br /> OFgo c Ivbf. SuRC Ey "r <br /> accord with th <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in acce pro du sand 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 COMP ETED ON: <br /> C11`1-010t�ENsoN y 7 s <br /> ADDRESS: CERTIFICATION UMBER: PHONE NUMBER(optional): <br /> Rt.Z iNE(35TER W 15. 5 89 /s"&6 7�5-b�66-� 6 <br /> CSTSI NAT RE:� <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R.02/82) —OVER — <br />