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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
<br /> INDUSTRY, DIVISION
<br /> LABOR AND ' . PERCOLATION TESTS (115) MADISON WI 53707
<br /> HUMAN RELATIONS
<br /> (H63.09(1) & Chapter 145.045)
<br /> LOCATION: SECTION: TOWNSH I P/M40.1404444,L-K-Y: LOT NO.:BLK.NO.: SUBDIVISION NAME:
<br /> Ncv //�;- 6 /T,.- N/R/ 1(...)W Se.Df,1- MI? C 1 f
<br /> COUNTY: OWNER'S/DUYCR'3 NAME: MAILING ADDRESS:
<br /> 13<--i2_ivC 747` /11'+,c' -) l) ie "'S f/ STf3l�' ./7 71, L�06/v -,?/ •4_.. , SAY?A/
<br /> USE DATES OBSERVATIONS MADE
<br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> Residence /) ®New ❑Replace
<br /> RATING:S=Site suitable for system U=Site unsuitable for system
<br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK::RECOMMENDED SYSTEM:(optional)
<br /> suu s u . snu ns . .0 s . u ,,.:, S, .AL _� ,/ '
<br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
<br /> under s.H63.09(5)(b),indicate: fy/7? Floodplain, indicate Floodplain elevation: ,/,./.09.
<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-
<br /> / l
<br /> / q 0 c) / `?.0 /V O Ai e > Co 0
<br /> / ,
<br /> B- G-n Gon /7,,-r -> l.'o L5 '2'L8/ s/iS/ Z. -?e-4'h5/ JO-34n"tVn yY- s'i J'L-!o0't3'r, s„,ds
<br /> B Y 4,4, /CEO, . �,G,
<br /> B- S! /^V / 00,0 i 4'�i d ? /�l S/TS -J
<br /> / 2. - (F."A7, t/ I-- UG.'/7/ % y�2 „,4-any,-fS
<br /> B- Co C,!v ci r r' l
<br /> > c,c-
<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- / /' /I/ONe / Z / l /
<br /> P- g /e fv'O,v r / 2//i / %Y / �, /
<br /> P- 9 /8' !\,'O,-'c / -%,- / / /
<br /> •
<br /> P-
<br /> P-
<br /> P-
<br /> -
<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 97 //c/ ).,6/Ail Cu/�>'
<br /> :5_sw'1
<br /> — s 1/o/e ; /Vc f;t'/04-
<br /> . If --� =414- /�c� . yc Q a' 1 mac, o '
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<br /> I irile t '. 1 /OU
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<br /> `S/ S 1 -T'
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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 /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
<br /> 1 , . . ;')� -2i A .-)e,cl .i'_ '2 "-', S--s' 0I . : - ' ?/ 2
<br /> 6 (., / SS
<br /> CST SIGNAT E:
<br /> .MV�7
<br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
<br /> DILHR-S6D-6395 (R.02i82) —OVER -- /�
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