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DEPAIRTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, CC DIVISION <br /> HULA AN ANREDLATIONS PERCOLATION TESTS (11J) MADISON W 5370BOX 7 <br /> (H63.09(1) & Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/MU4444444LITY: 'LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> 4. '4 '/ , `/T y NCR/ I )W ,-+ 7+— <br /> COUNTY: OWN R'S/BtH(E11'S NAME: MAILING ADDRESS: N,�' <br /> I C l T M,/4. PO 7 E4' '2 6. "'> 5., /Gc IT 411e- p44:,, Roc. ,I'!L, Coo <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence / i LEA ❑New NiReplace //71-- 26 <br /> - V q_ 2C- ' <br /> RATING:S=Site suitable for system U=Site unsuitable for system S <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> 1S _U gS [JU L 'S ❑U ❑SNU ES NU ceff,, -2 ',• ' <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: 4/A Floodplain, indicate Floodplain elevation: AM <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 I EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- r7 33. r/ <br /> 1 2 <br /> B- .� 7 I ek i/- N°Li Alb -, - 6, ,& 5, C'y'',t ,. <br /> B- <br /> B- <br /> B- <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- "). a i► N6I /C 3 3 3 3 <br /> iLlPLAN: 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 ci2=ia"' <br /> H. _ ZiA /L At ts 5 17= go,;t <br /> res�r <br /> I I <br /> � � ' C hoc r T- <br /> ic > ' Z 13 o st <br /> , 1' I >,/ )[ _ _ �1 % t;Lyb�A roc -mnR(ER <br /> oi <br /> ' I <br /> )et t f,;f�P/I,2 is <br /> I�. h" it`� <br /> 0 " o! ) !1s$c°�'', [r rG�9 ter. <br /> , _ <br /> aii l �f`C S 'tt <br /> .'Lai. i 1 ilk API/2/E 1d xt <br /> �----.... PD, rv''r" /2D <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 /> ..? ti O, 8/C0 5;i?L?i /,.r.,,`, 5 S,g?Z e s i G S/ / .//] <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) -OVER - <br />