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EH 115 Rev.9/78 _— <br /> r REPORT ON SOIL BORINGS AND PERCOLATION TESTS <br /> WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES <br /> P.O. BOX 309,MADISON,WISCONSIN 53701 <br /> C c"4'/ 3 <br /> LOCATION: '/<, %,Section -Z`� ,TAN,13li-6•br)W Township <br /> oridlvntctpafrty,— i.:. C'[ jo. <br /> Lot No. , Block No. <br /> u Ivlslon ame County K 7r <br /> Owner's/Buyers Name: <br /> Mailing Address: & <br /> TYPE OF OCCUPANCY: Residence ' <br /> No.of Bedrooms COMMERCIAL <br /> EFFLUENT DISPOSAL SYSTEM: NEW Y REPLACEMENT <br /> DATES OBSERVATIONS MADE: SOIL BORINGS .�- / _ 7 cr ALTERNATE SYSTEM_____OTHER___._� <br /> PERCOLATION TESTS- <br /> SOIL MAP SHEET JM � Z <br /> NAME OF SOIL MAP UNIT <br /> TEST <br /> PERCOLATION TESTS <br /> NUM- DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME <br /> BER INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL DROP IN WATER LEVEL, INCHES <br /> RATE <br /> P- <br /> 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN <br /> -F 1 <br /> P--2 C1 Ir lr <br /> r► 27 I 7 <br /> P_ <br /> '• ,I <br /> ,r 2z <br /> P— SC' rr 1 rl -4 <br /> r/ a Z rl <br /> ,r Ir 22- 11 <br /> P-4 <br /> 21_ <br /> rr <br /> SOIL BORING TESTS <br /> TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, <br /> NUMBER INCHES OBSERVED ESTIMATED HIGHEST TEXTURE,MOTTLING AND DEPTH TO BEDROCK <br /> 3_ � 7L IF OBSERVED IN INCHES <br /> 3_ A .t � f S.� •r <br /> .r <br /> ;— -7.2 ,1 YL <br /> LAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. <br /> ldicate number of square feet of absorption area needed for building type and occupancy <br /> ive horizontal and vertical reference points. Indicate slope. p y�C �Indicate scale or distances. <br /> A I;C A <br /> c fTrr <br /> r- <br /> 92 sy <br /> �C��V�•iVIJ At7 <br /> JUgU , N <br /> 983 <br /> 1i <br /> 0" <br /> r'r c' <br /> 17 <br /> �a� F <br /> Sidi �1%V�lei A <br /> 1,the undersigend,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods <br /> specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct to the best of my <br /> knowledge and belief. <br /> Name (print) L�a�°�9f217 61, <br /> Address_ ", �/2 y..� _Certification No. <br /> Name of installer if known, <br /> — ----------- -- <br /> COPY A— Local Authority <br />