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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABORAND.. PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS 1 MADISON,WI 53707 <br /> 1C1-53 (H63.090) & Chapter 145.045) <br /> LOCATION: SECTION: OWNSHIP MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> �rb-r 1/01/4 at- /T ql N/R t�E (or S�►iss ! 2� �►4 csm Bloc . p ��-?� <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> i51.,., ^Err <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: �/ (PROFILE DESCRIPTIONS:1PERCOLATION TESTS: <br /> Residence �1 /4 L,\New El Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM-(optional) <br /> ®,S ❑U W S ❑U ES ❑U ❑S ®U ❑S MU <br /> If Pe�rs. <br /> lation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br /> If <br /> H63.09(51(b),indicate: /V� 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 ; (�� ���„ �lc�c/E ? �0 / "84 5�C T.S41 "2 .5 Z " cuv2cL �n <br /> B- C' �,,�� (� 5,,�� sL i 5 �2 FS <br /> B- ; A/L BL 5L r-5 '/Z" I2 FS C S <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD2 PERIOD 3 PER INCH <br /> P- I 2 01JE10 <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 �°TC�� �T ,�-y EC�N�/v .�jLTU2tif-)7C S;YL" !S <br /> �'SCT) PKov�n�. le" 7�72q- Ce�uLT7L <br /> ! -_r" j <br /> £� <br /> i9=1 � S✓Rv MAr <br /> �� 85` dM <br /> Sv�to�� �t�xl ���•�� <br /> - <br /> � <br /> o)U i JT 4t sC. A% A9at4=0 <br /> 3z' IOKvf' (ydr <br /> STRKL-?)dd7' <br /> 1,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 /> NAMr., Z44 <br /> : TESTS WERE COMPLETED ON: <br /> Q Rd71-ti--sc 7 41�:' //J 3 <br /> ADDRESS: CERTIFICATION NUMBER: Der- <br /> ONE NUMBER(optional): <br /> �'T �3 go Y q7C 21w4e Z41 601', s"y83o , S 29-5 o <br /> C7DoTURE:� <br /> ISTRIBUTION:Original and one copy to Local Authority,Property Owner acid Soil Tester. <br /> ulL:;-?-5BU-6.i°5 (R.02!L;LI -C•,FR — <br />