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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INuUSTR?', DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/M1{HWFBfPAtifi : LOT NO.:BLK. NO.: SUBDIVISION NAME: <br /> Sw'/4Sw '/42y /TL/o N/R/ jwA sao tt /sem/ Nn Fees., 24AA= .qo%a <br /> COUNTY: OWNER'S/HHYE,R''S NAME: MAILING ADDRESS: <br /> QaC.ZP7G� /2/c./i 2� � BSc�'// 73659 9� r/•//c /Juc 2oS�r.,orU.! h SSob <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMIS.: COMMERCIAL DESCRIPTION1 PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence 3 YNew UReplace I � /4 <br /> RATING: S=Site suitable for system U-Site unsuitable for system <br /> CONVENTIONAL: MOUND: JIN-GROUND-PRESSURE: SVSTEM-IN-FILL HOLDING TANK: RECOMMENDED SVSTEM:(optional) <br /> ©S ❑U I HS ❑u I OS ❑U I ❑S DU ❑S DU ��s� �� ��d <br /> DESIGN RATE: <br /> If Percolation Tests are NOT re( red If any portion of the tested area is in the <br /> under s. ILHR 83 09(5)(6),indicate: /f//1 Floodplain, indicate Floodplain elevation: X1//3 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPlH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) <br /> B- / �o/p 9Z.L' /✓able to O-3G'"$r >,.��s .3�- g•' s a"l3�.s <br /> e.6-Cc6 <br /> B- 42.7- > G� <br /> 13-3 90 9S..7� > 96 0_7 6.` .4n JV.-'Jr"i7Adgs ,e-Lo-":darn 66- Yo"3x.a.R/S <br /> B 14, 93 B' > bf/ e-V!"' i+ d s --- 6/o"'en a> S <br /> B-c5— o 9S Z"` 90 6-��,,/r"e" r /1 yr- 4.0"8» Ess Go--Ven <br /> B- A/C le: A/ /e ro -3,95 mew/ /0-eN0✓I - <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 PERIOD2 PERIOD 3 PERINCH <br /> P- 7 A10 N C <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. <br /> SYSTEM ELEVATION 90.x A/��w � sy3 E/=�' 9Z.Z' <br /> ,.vole ; Al- SCF)le <br /> A /3 K erle r . /oe. o' <br /> /s`+{e-is�lE-isal .moo due // <br /> r <br /> �D (� So. <br /> T <br /> �i� /t2e/Geti� tc -�9/cC <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(p� - (TESTS WERE COMPLETED ON: <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> I . O, ao 7/ S Doti'en w S moo/ 333/ 7iS/-/<; <br /> CST SI TU <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />