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DEPARTMENTOF REPORTON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY,, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W1 7969 <br /> s/— <br /> HUMAN RELATIONS r <br /> (ILHR 83.09(1) & Chapter 145) �� M <br /> L 1/ SECTIO%T UN/R � lor)p TO SHIP MUACSPALITV: LO�NO.:BLK.NO.: SUBDIVISION NAME: <br /> WN R'S BUYER'S NAME: MAIVLIINwG ADDRESS: a?7 <br /> omp D. C ds {/S ro <br /> USE DATES OBSERVATIONS MA <br /> Na BEDRMS.: COMMER IAL DESCRIPTION: {� P/gOFI/L� DESC//R��IP IONS: Z LATION TUU: <br /> esidence Lp New ❑Replace /_ ^ -/ q— �� 6 i �q—. x / <br /> RATING:S=Site suitable for system U=Site unsuitable for system !� !� CCC/// <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-F I LLHOLDI NG TANK: R ECOMMEND ED SYSTEM:(optional) <br /> QS ❑U ❑S ®U EIS TKU ❑SKU EIS Su &A)ycNT/oN,4L- <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required I If any portion of the tested area is in the <br /> under s. ILHR 83.09151(bl,indicate: 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 /> B- I �0 99 ove � o d-7 / 17-30 Bf N cd o- <br /> B Z Z- 97-9 RNs > 16- 2 ,u - 7Z&-& U <br /> 3 Z 4' 3 d E - es <br /> B- N go q ,� go - <br /> -S 77— oxuE 77- - 6- <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 PERIOD P R PER INCH <br /> LP--r 3 Y / <br /> P- S v v S 3 '3 3 <br /> P- 0 3 /Y d <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. PirG O -BM foo PAIL 10 84,5<- of C/2L 4b k, <br /> SYSTEM ELEVATION Boer. • SCAlf I"-- YD' EX'Ler4 Whwi Noft# <br /> Lot Lin6 <br /> dOtt Fr-o V, Cac{ + LA�6 <br /> BM BIdS �`- <br /> • IN <br /> 0 <br /> � 7 ® ' � <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 /> N E Ip ntl: TESTS WERE OMPLET ON: <br /> DRESS: CERTIFIC ION NU ER: HONE NUMBER(optional): <br /> q e 3 t <br /> S T RE: { t <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />