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DEPARTMENTOF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
<br /> INDUSTRY, . 1 G DIVISION
<br /> LABOR AND PERCOLATION TESTS (115) MADIBOX SON WI 5379079
<br /> HUMAN RELATIONS
<br /> (H63.0911) & Chapter 145.045)
<br /> LOCATION:3[, SECT1 /TON/R/&r(or)W TOW`'o Irt a� 'LOT NO.:B�LKI fVO. SUBDIVISION NAME:
<br /> yTY: OWNER'S/BUYER'S NA E: MAILING ADDRESS: N/r1`Z R p�►'/ iR
<br /> n t° --�-'(I . �1.*es /)r L�0 l4 e 40'tt i1 h 11 r``X /.1 �"
<br /> USE r DATES OBSERVATIONS MADE
<br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> ❑Residence 3 1r��Sa r- teY❑New Replace / / L/ y—
<br /> ry
<br /> RATING:S=Site suitable for system U=Site unsuitable for system '
<br /> CONVENTIONAL:E U • ME S 1 U IN-GROUND-PRESSURE:E S 1U SYSTEM-IN-FILL HOLDING U STANK: RECOMMOENCZEtp,,, M:(o-n 1
<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: Floodplain,indicate Floodplain elevation:
<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- 1 3 s t 0 o. a- a 7 1 % �'q R s T 'eh Ls /.7 y ny,.e1 S
<br /> c r I� ,, l ii /B-a, 35- ey C/, a : - ' ri I I r c S yf�rl CS �l )'/' rYr►-P cf S
<br /> B-3 ,,5,- /�!~`�,3 0 a ) to I' iCS 1-i d h Ls i ' ,M,-ed. s
<br /> B- NYC Mod ki-- est 1lt1 X
<br /> B- 8 . c•
<br /> B-
<br /> PERCOLATION TESTS
<br /> TEST DEPTH WATER IN HOLE TEST E \ DROP IN WATER LEVEL-INCHES RATE MINUTES
<br /> NUrER INCHES AFTER SWELLING INT AL-MIN.I PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
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<br /> PLOT PLAN: Show locations of percola , soil borings and the dimensions of suitable soil areas. Indicate scale or distances.I5escn.e - - - _
<br /> zontal and vertical el reference of s ands heir location on the plan. Show a surface elevation at all borings irection and percent
<br /> of land 4K slope. ® Vt I t � m\
<br /> SYoTEM ELEVATION FFFF � �L a
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<br /> I,the undersigned, hereby certify that the soil tests reported on�t is form e r11'ac y me in latcnitehe procedures and methods specified in the Wisconsin
<br /> Administrative Code,and that the data recorded and the location c f the tests are correct to the best of my knowledge and belief.
<br /> NEE (print): . ^ TESTS WERE COMPLETED ON:
<br /> 0 d r v-t C TV 4:1_ or )---( 0 s
<br /> zif -
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<br /> RESS: �— ` CERTIFIC TION NUMBER: PHONE NUMBER(optional):
<br /> t�'�., Ls /�e �"' Lk It S C - c----V iQ.S 7/$-1'6 6"_ ///S'j
<br /> C N TU�k: ov*../0
<br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
<br /> DILHR-SBD-6395 (R.02/82) —OVER —
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