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DPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> I DUSTRY, DIVISION <br /> iTABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> UMAN RELATIONS MADISON,WI 53707 <br /> (1 LHR 83.09(1)& Chapter 145) - Z 32 <br /> LOCA;I N: ' T SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLiEidO': <br /> /4 5t O n/R 15 E (or C *2 16L..5#41 CSM -4 213y <br /> COUNTY: MAILING ADDRESS: <br /> DouG STRna IV? O NT14S-19 <br /> USE DATES OBS RVA IONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: K 19 - 4- 93 <br /> L DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence t[y New ❑Replace 19 - 4- 9 2 9 _ il - 33 <br /> RATING:S=Site suitable for system U=Site unsuitable for system I J -1 <br /> ONVENTIONAL: OU D: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING T NK:RECOMMENDED SYSTEM: optional) <br /> s ❑u s ❑u MSF-111 9 s ❑u ❑s u Lw - <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)(b),indicati Floodplain, indicate Floodplain elevation: N p <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHE T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 �6 96. N0460-181015 '1 100 BP1M4 (01D - (PL BrJM3 W R crn mot <br /> B- Z '12 97,2 NotjE <br /> ) ?2 b- blew 8- '1 2 BNma <br /> B- 3 (ad <br /> 6`1311n>> 8 _s-S(vBO 5� (oo$,�nlsNiR��ndnmTt <br /> 0 E 56 <br /> B- 4 60 AW S O- b)as 9-5q 130pts S4 (O BNms WRcrAiI.Molt <br /> B- 5 72- 96.7 Aide 69 o•I Nks IASAMS 0- '("#*W W RcmaoiOt <br /> D 95.1 NoNe Lno-t131vw 4- 4at80m y9- too SNr>isw(Z�r•,d rt otr <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERI D1 PERI D2 P R PER INCH <br /> P- I /4 3 <br /> P_ 2 No Z 171S fzi <br /> P-3 19 hn !7/3 f'yk, <br /> kP_ <br /> .J !1r +V1�/Z Y '3/' b I 6 <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 9q•y 9y.OS TMJ-GICOUND PWSSUAC OLT• <br /> i <br /> _ - - � -- <br /> r <br /> y.. ,._.. a ..._ y. .......... _..._. i— .i—_.._f <br /> I <br /> L TT <br /> , <br /> , <br /> _ N <br /> i ,. <br /> I <br /> {.. ! J. <br /> i <br /> �-- <br /> I__ I I <br /> I I , <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 /> RIUS 9 -H - 93 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 2 L.1 � <br /> CSIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) —OVER — <br />