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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY,. DIVISION <br /> LABOR PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RE <br /> RELATIONS MADISON,WI 53707707 <br /> .5 '!�V -Z8 (H63.090) & Chapter 145.045) <br /> LOCATIO • SECTION: TOWNSHIP/*HidtCTP=TY: LOT NO.:BILK.NO.: SUBDIVISION NAME: <br /> '/ 1/ /Tyu N/R/ E (or)W c- U % '0 A1 A <br /> C UNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER OLATION TESTS: <br /> Residence New ❑Re lace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IIV-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> S ❑U ©$ ❑ J X S ❑� ❑S ZU [:Is ©U <br /> If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- a- 8 8 It <br /> is 8 n A V to" f 4S sv " c5. <br /> B �� it <br /> r /l,6 5S " Id Ir /1 L .4r �C U 7 k CS <br /> B-(� 8� �, '_�7 y`' J «r''/'c /a is 'rl „ 11 cs <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH <br /> P- I Aj 0 1 t, / // /�- `? / 7 <br /> P /v % i <br /> P %V a Q %r <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 /> r. lov I- <br /> +r <br /> C <br /> iy �� P � . <br /> 4 � <br /> ac <br /> I,the undersigneoer erti hat the soil tests reported on this form were made by me in accord wit a 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 nowledge and belief. <br /> NA +E(pr. t):P ` ` TESTS WERE COMPLETED ON: <br /> r1C h V 7 '9- 9.:. <br /> DRESS: CERTIFICATION NUMBER: JPHONE NUMBER(optional): <br /> C IG URE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LHR-SBD-6395 (R.02/82) —OVER — <br />