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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> INDUSTRY, - <br /> LABOR ARD - P.O. BOX 7969 <br /> HUMAN piELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (I LHR 83.0911) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT N .:BLK.NO.: SUB IVISION NAME: <br /> Vel/ tie 1/ 3S / NIR! E ( r)W i s ,uA ,07`a`t3i6 <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> USE DATES OBSERVATIONS MADE <br /> NO.BED///���RMS.: COMMERCIAL DESCRIPTION: PROFILE9ES/RIPTIONS: ER OL TIONTESTS: <br /> esidence NP+- t54New ❑Replace I ;j�j k r 77 -7 � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONNVVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> [M ❑U CKS ❑U �S ❑U USOU ❑S M C�©.yuG�t yYc�i� <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: I Floodplain,indicate Floodplain elevation: <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 /> 1C <br /> Brt 7 H Sit, 7 rr T -R�fJGc5^_ <br /> B- 9� 7 " %'Sr /'7,/v " s� �G-/ .� `D' ' . g'. <br /> ` 6L_'w_rs- _)o ` '` $i'_[4701 S <br /> B- d 0 Cr lob ' ` ISL S)-r5 39' JZ.1=5 -)-4'` cM695 5 <br /> B u ,�. 3/0` R F<D 24, ww1> S . <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD ----PERIOD PER INCH <br /> P a3 a s <br /> P_ NG- 5 oz V'16 <br /> �- <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. Descri hat 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 andt direction an percent <br /> of land slope. T 0/AvW.4,W" QD <br /> SYSTEM ELEVATION ►� <br /> CRau&CW <br /> ca�F ate. <br /> 7a—, ov <br /> �\ <br /> c7+ <br /> SlA�1 of Comm Aj <br /> r_&AV-'LoG ASt awo- <br /> 140 <br /> o' <br /> G(,ouso4rs' N04 <br /> c, VL <br /> y <br /> 2v'-v" <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( nt): TESTS WERECOM LETED ON: <br /> fl �OY II ? 0 (3 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> r ��T y�D 1�A�1 5�F3� �s <br /> CST GNATU <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) OVER — <br />