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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> WJ C P.O. BOX 7969 <br /> LABOR AfPERCOLATION TESTS (11rJ) MADISON,W1 533707707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/ LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> pw1/ sE�/ jo /T16N/RJ61(oHW p fIrl, #A A h <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING AD DRESS: <br /> rn 0d �e C JI h S'0 Jl9' / v e.4 die /Il W iel <br /> - <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: PROFILED DESCRIPTIONS: ERGO LATI ON TESTS: <br /> Residence �1 New Replace I -,- �0 , 9-iQ -fr <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM-(optional) <br /> NS ❑U XIS ❑U RS ❑U ❑S ICo tyc/ <br /> If Percolation Tests are NOT requiretl DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),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- 8o 99, l �> g, e"eAts a0 "e't kr Sy r"Aw f s <br /> B � so qq. Y ,voN - > Ofd s lftr ,6or4 S6tr rm,@ s <br /> B3 Qa /V O N`e > 80 6`9444- /Frr & 4S S(o t' 2 ',il,. r d s <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 AFTERSWELLING INTERVAL-MIN. PERIOD ( PERIOD2 PER PER INCH <br /> P- •t� 3 'V010 9 //a- <br /> P- r1' o o a -3 8 a '7/41 <br /> s <br /> P- 3 u 1 0 <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 9� ' o R <br /> if <br /> Uroa <br /> jkr,el�In� •b /O7o 6r CCL <br /> TN <br /> .0 <br /> SCoP� ��AY <br /> lye{{ <br /> Sc � L� <br /> -max«/r \bt Lt v-e N oTe 1 <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(pri t): % TESTS WERE COMPLETED ON: <br /> o- eh[G IFS 9- (f -Qr <br /> ADDRESS: CERT( CA ION NUMBER: PHONE NUMBER(optional): <br /> k—k-) S f� v rt's C_ S Y P 0: 7 3-7 <br /> CS GN TUBE: <br /> RIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> SED6395 (R. 10/83) —OVER — <br />