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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
<br /> 'INDUSTRY, DIVISION
<br /> LABOR AND • ' • PERCOLATION TESTS (115) MADISP.O. BOX 7969
<br /> ON WI 53707
<br /> HUMAN RELATIONS
<br /> (H63.09(1) & Chapter 145.045)
<br /> LOCATION: SECTION: TOWNSHIP/MUNiletPf4 tTY: `LOT NO.:BLK.NO.: SUBDIVISION NAME:
<br /> A'w t/,51Q1/ t, /T�',_,N/R.',./1 )W set) '- , ', Coa'. haf is 3
<br /> COUNTY: OWN-ER'S/D1WElt`S NAME: MAILING ADDRESS:
<br /> zna.ive \y i:)-,,,,e s '6 ,e- Ais -/ S'71-,09/z ✓2/. Spponrez/ c , -S-9/.9O/
<br /> USE DATES OBSERVATIONS MADE
<br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> Residence /, Si New `�
<br /> C- A/ El L- -la- kY 47'-(a
<br /> RATING:S=Site suitable for system U=Site unsuitable for system
<br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IIN--FFILLHOLDING TANK: RECOMMENDED SYSTEM:loptional)
<br /> Es U ES .__.-1 ESLJU ES LA ns 'xUJ Y/ostAt Rec./
<br /> If Percolation Tests are NOT required DESIGN RATE: If any
<br /> portion of the tested area is in the
<br /> under s.H63.09(5)(b),indicate: /
<br /> /y A, Floodplain, indicate Floodplain elevation: ,/V05".
<br /> PROFILE DESCRIPTIONS
<br /> BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
<br /> NUMBER DEPTH IN, OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
<br /> B- J ( () 99.6' Av'0A, r > 6.0
<br /> B- Z, Cp t"' - q9.-S 6.0 D-2"88/ s/Ts/ Z-36..$»S/ 3e-31.,"tar+vt.s/ 6,-4,o"ac30, p.feJS
<br /> B- .2 e- c 97,0 ' 6e,
<br /> B- q (v 4.. /0 0,.)--1 .N 6,4,
<br /> B- S co Co / 00,0' > 44.. o-Z "13/ S/Ts 2.-3tc".3h s 3e-- yL"Qr, n s
<br /> B- !, G,6, q9.0' >6.t
<br /> PERCOLATION TESTS
<br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
<br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. , PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
<br /> P- 7 . /? II/oA)e / Z / / /
<br /> P- I /2' ,/YO.v r / 2 //2- / i ' / %y /
<br /> P- 9 /P 1V'oAir / z%z- / /
<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 iz '
<br /> A/evie I, _,..4",o .4/F.,r_
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<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 /> /42 .4,v .! ,/,/e./7-.., 6/ -6 -'V
<br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
<br /> 2 Of BOX 7/ S,Poa .vrA, w/ sVerd/ 333,, _ 266-0/.17s
<br /> CST SIGNA E:
<br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
<br /> ‘ 7
<br /> DILHR-SBD-6395 (R.02/82) -OVER -
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