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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, REPORT v �a DIVISION <br /> LABOR AND P.O. BOX 769 <br /> HUMAN RELATIONS PERCOLATION TESTS 115) i MADISON WI 53707 <br /> (ILHR 83.0917) & Chapter 145) <br /> LOCATION: SECTION: / l TOWWW��UNICIPALITV: 1 BLK.NO.: �d OVIS ucl OT 0Z0� <br /> 11E'/ nE'/, IS /T4oN R ) #�r)W oVi�� .. (TT[-,n1 r <br /> COUNTY: MAILING ADDRESS: <br /> 1 txSLvt¢# -1✓A I4e'L� YE u)eST deL_ LZA•,r —j 10$? <br /> USE DATES OBSERV ATIONS MADE <br /> ll�tyyll NO.BEDRMS.: COMMERCIAL DESCRIPTION: S: PERCOLATION TESTS: <br /> Zell r4 <br /> 1LcJ Residence ❑New ®Replace it 5 92. 61 IGN <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> O�N,VIENTIONAL: MOUND: IN-GROUNN PRESSURE: SVSTEpM-IN-F I LLHOLDIINNG TANK:R ECO MENDEDSYSTEM:(optional) <br /> 1 <br /> RS ❑U ❑S ©U ®S ❑U ❑S ®U ❑S X❑U ).-;4 fo � otz o 7 Ht_ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in he <br /> under s. ILHR 83.09(5)(b),indicate: , ly2 Floodplain, indicate Floodplain eleva ion: n A <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNE S,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPfH IN, ELEVATION OBSERVED I EST7TIrCH_EST TO BEDROCK IF OBSERVED (SEE ABBR .ON BACK.) <br /> El- 1 1�" 5Io.8' rl O*nc >?�" 4" SYR Ali <br /> 4"5 R F �J-74 <br /> r, <br /> B- L -7e -74" z"`Sy" "5YP- • b- 14-74 5M SI <br /> B- 3 74" 98.4' ovte 7?�" 4"5Y¢ �- " SYIZ4 3 74"5yz <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI D2 P PERINCH <br /> P- µ I ell <br /> n e 1 L <br /> P- O" none <br /> P- <br /> P_ <br /> p- <br /> PLOT <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 It borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION <br /> IF 4A <br /> wh` _ fIN` LI�RII- ku�4XS�l�� <br /> I <br /> 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 bE lief. <br /> NAME�(print : TESTS WERE COMP ETED ON: <br /> w it 1.51 tiZ <br /> ADDRES : CERTIFI ATION N MBER: PHONE NUMBER(optional): <br /> 400 55 4-I&L vier Ltd'. st+Vol VNATUI <br /> - 3S-7 81- <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-8395 (R. 10/83) —OVER — <br />