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DEPARTMENT OF REPORT ON SOIL BORINGS AND SArt 1 Y St t/VILUIIV(i5
<br /> INDUSTRY, DIVISION
<br /> LABOR AND PERCOLATION TESTS (115) MADISON BOX
<br /> s390
<br /> HUMAN RELATIONS
<br /> era w./ v 6 i . SECTION: rl TOWN H NII LITY: FO . NO.: !VISION NAME:�/�j�
<br /> 1
<br /> COUNTY: OWNER'S/BER'S NAME: MAILING ADDRESS:
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<br /> &AN'ETr Jo tirV WAG/ 01 5 , r/ C/al S 7 ,1�7 ? !
<br /> USE DATES OBSERVATIONS MADE
<br /> 'NO.BEDRMS_-COMMERCIAL DESCRIPTION:' ' PROFILE DESCRI ''f1ONS: PERCOLATION TESTS:
<br /> FEIResidence Z _ Iii0iNew ❑Replace /0 r /3-- 8►1 /O — / 3 "'e/
<br /> RATING:S=Site suitable for system U=Site unsuitable for system
<br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEMJN-EILLklOLDING TANK:RECOMMENDED SYSTEM:loptionse
<br /> aS ❑u nS ❑V OSLU DSEN DSau
<br /> If Percolation Tests are NIT required DESIGN RATE:SYSTEM E If any portion of the lot is in the
<br /> under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation:
<br /> iPROFILE DESCRIPTIONS
<br /> BORING TOTALNUMBER DEPTH IN, ELEVATION/D IS'i".SE OBSll ERVED EST.
<br /> HIGH '` TO BEDROCK IF OBSERVED: FIARACTER OF SOIL H(S E ABBRV..,ON BACK.)TEXTURE,AND DEPTH
<br /> B- 1 72 99= 9' ,vows > 72 „s/ r 96,'� s f Ia "Is /V„�,S
<br /> B- 2 72 gr_oi, If ,71'd/ r5, Y8"r3,, S, G "Is, Ito " , s
<br /> B- 3 72 /0e-- V" a a "61 n, Gbr' &. S, .2 " o.'`' c $
<br /> B- 4 72 io t ya iI .r ,r '' rl
<br /> B- 7 72 160!- a.si '' ,r .I rr
<br /> '
<br /> B- 4 72 lal - a" y a
<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. Perkt001 PERIOD 2 I PERIOD 3 PER INCH
<br /> P- I _ '24' Alt/ la 544, 3 3
<br /> P- 2 30 A/a t U d 4 3 '74 1 3 3 I
<br /> P- 3 ,3 /UU /o " �,r I 3 '_- 3
<br /> P-
<br /> P-
<br /> PLAN VIEW: 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 slop.
<br /> SYSTEM ELEVATION R'7 - v"
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<br /> t 4,32= 00`1),sr 1 ,ae- =
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<br /> ay 75 p.IT' z0X37 26C 3 eih':1 'Oh" N st tN
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<br /> i 17 i,
<br /> ii)014.444R01.141r5: . !• _ _._.
<br /> the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin
<br /> Admimistrative 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 /> a &du1Ak,,D k? 45cHfC 604'R
<br /> `ADDRESS: _ CERTIFICATION NUMBER: PHONE NUMBER(optionall:j
<br /> CST SIGNATURE:
<br /> e' ' ) !
<br /> DISTRIBUTION: Original-Local Authority,2nd page-Bureau of Plumbing,3rd page-Property Owner,4th page-Soo Tester.
<br /> DILHR-SBD-6395(N.03/811
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