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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> • (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDI VISION NAME: <br /> ill N/R14,1!f�,)W ,;U K <br /> COUNTY: MAILING ADDRESS: <br /> BUiN`' TT THO.� i G)' '�?N 1329 JUNO, ST PAUL, .,"iti 55116 <br /> USE DATES OBSERVATIONS MADE <br /> ��] NO.BEDRMS.: COMMERCIAL DESCRIPTION: A TS: <br /> c Residence P'_[.� ❑ <br /> N/A PNew Replace 4•/18/91 4-/18/91 <br /> RATING:S=Site suitable for system U-Site unsuitable for system ft <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURES STEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM;(optio <br /> ❑S ❑U EISElul ❑S EDU <br /> ❑S ❑U ❑S ❑U PRIVY P�,R„1T <br /> If Percolation Tests are NOT required DESIGN RATE: If any y portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: N/A Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTA DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> / „ �, cl 6�/'7.5Y3 1 �l ts ,6-24-"7.5YRw 6 med sr <br /> B- 1 71"', 100. : NON'' > 7 L_gLi,rr7.5Yx/,. 4 <br /> 2"7.5YR3/2 r'1 t,- 2-2?"7.5y_24/6 mod E; , <br /> B- 2 711" 100. 2 NOPd''' > 74 23- 4” YRLN 4- <br /> B. <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH . WATER IN HOLE TEST TIME D I WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERI D2 P PERINCH <br /> P_ 24 none 1 <br /> P- <br /> P- <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 <br /> NOT NJ CALL, ' <br /> {N , CORN_. 0t,' 00NC- Ty_' AR'ftGi- APRON) <br /> 1' Oy 'F&- T -501 JLU-1 1 <br /> s <br /> 5f- 'n'"Z5 u1FFu-, 3a" <br /> ZE nu marc <br /> _ TN <br /> 361 <br /> 1, the undersigned, hereby certify that the sail tests reported on this form were ode by me in accord with the procedures and methods specitied n the WJJJ'sco�99Jsin <br /> Administrative Code,and that the data recorded and the location of the tests are coect to the best of my knowledge and belief. � <br /> NAME (print): M & K ITESTS WERE COMPLETED ON: <br /> SEPTIC 8 Epx,c,AVAeTIION 4'/18/91 <br /> ADDRESS: , Box 478d CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> SpompirW1 5MI ;669 <br /> (715 ,sC 7Aex CST GNAT RE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHRSBD6395 (R. 10/83) —OVER — <br />