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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY; DIVISION <br /> LABOR AND PERCOLATIO TESTS (115) P.O. BOX 7969 <br /> 3707 <br /> HUMAN RELATIONS �- \ / MADISON,WI 53707 <br /> T� (ILHR 83.09(1{°& Chapter 145) <br /> L ATION- SECTION: OWNS Y: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> Y '/a �6 /TS%N/R/ ( in TT Mp nrp a' m <br /> COUNTY: - OWNER'S/BUYER'S NAME' MAI LING ADDRESS: <br /> -Ioto( iv' F012ld9RFr NE' .Se, ST, OEW4eZ <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: P�—LED SCRIPTIONS: OLATI ON TESTS: <br /> �R idence � Q'�w ❑Replace <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> ONVENTION(AIL: MOUNCD: l� IN-GROUNNED-PRESSURE: SYSTEM-IN-FI LL HOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> EI v 0S u v J Ht ❑H a Els L_TY CO/VUE�VTi an/iq L <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)(6),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 l oa /o/, 7 AloNr 68 K s #4`,WK <br /> lP,s o <br /> B- /og, 2 s-67 E s <br /> B-3 Fin o g 7 8o _46A a s dwn.s 3 es 28 le s-icoy / t <br /> Be 3 03.0 �� 41,W .0 Fp p <br /> B- 73 tea, o 73 <br /> D u,oya R s lP A-s-6sz 6 A�.nFa Y <br /> 13- <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 P PER INCH <br /> P- &0 <br /> P- 3(° N0 3 <br /> P- 3 <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 /> 13 <br /> 6c�s <br /> I \ Er i <br /> I <br /> V <br /> LA)p)tQ a 1 1 L Y i Are.-a � <br /> i <br /> --+ ' 9gsE ex ( `file <br /> - - 11 cU j ` GuooOs /2G4o �/W t14TfZ_ <br /> _ — <AQA/,/Aorlev> <br /> � 1igKe <br /> 53.x \ <br /> \ p f/ <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 (print): TESTS WERE COMPLETED ON: <br /> 6eci< 1 7 -^` 99 <br /> ADDRESS: CERTIFICATION NUMBER: IPHONE NUMBER(optional): <br /> f2T Ec< 410<1rW/'S 7 �Iaq /Sls3s >Ko <br /> CST IGNATU E: <br /> G4�1 r/ L <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LH R-SB D-6395 (R, 10/83) —OVER — <br />