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;a <br /> INDUS <br /> TRY, <br /> DEPARTMENTOF <br /> INDUS REPORT ON SOIL BORINGS AN SAFETY & BU LDINGS <br /> / <br /> LABOR AND DIVISIONPERCOLATION TESTS (115) C� P.O. BOX 7969 <br /> HUMAN RELATIONS / MADISON,�l 53707 <br /> (H63.09(1) & Chapter 145.045) <br /> LOCATION: SEC�T2 ? N <br /> TOWNSHIP/bFf1fdtetF*L_ /: - LOT NOt.:BL' NO.: SUBDIVISION NAME <br /> sw 1/4sw/a /R�y B 1 W R "s,4- 1 <br /> COUNTY: OWNER'S Bd I Ef S NAME: MAILING ADDRESS: ----- --- <br /> �j 3 <br /> �ttf��i�� ��.l'Re /'r. /�.��CpS�IA_Q ��1 •�iow v/f! .f aC.VG2 te,i3 S7�cf e / <br /> USE _ <br /> NO.BEDRMS : COMMER AL DESCRIPTION: DATES OB ERVATIONS MADE <br /> Residence 34.cv�tNew ❑Replace PROFI E CRIPTIONS: ER O A IOMTESTS: <br /> �/� <br /> RATING: I Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMEN D SYSTEM:(optional) <br /> ©s au ©s ❑u ©s ❑u o s du [:IS <br /> ©u s � ;d 1 <br /> If Percolation Tests are NOT required DESIGN RATE: If any <br /> portion of the tested are` is in the <br /> under s.H63.09(5)(b1,indicate: Floodplain, indicate Floodplain,elevation: ✓/? i <br /> — -- <br /> PROFILE DESCRIPTIONS <br /> BORINGI TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THIC NESS, COLOR, TEXTURE, AN DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE BBRV.ON BACK.) <br /> B- 2 78 99 s' <br /> -- <br /> 8� S Zz" n McP S <br /> B- S< 78 98•s' <br /> B- <br /> E <br /> B <br /> _T <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHE RATE MIN TES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 p R PER IN H <br /> I�A,ales <br /> P- 7 3 A/e�e 2- (� t C1,�dc,e <br /> P- to N Z Co to �d <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate cafe or distances. Describe what aInd <br /> e the hori- <br /> !ontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevati at all borings and the direction percent <br /> of land slope. <br /> SYSTEM ELEVATION 9�,0 ' ?'; J ` ` A , �. xC Y <br /> 4,0 <br /> .1117 <br /> � So•1 /9f�e•y <br /> s :Zz <br /> fin•!. /9 AC���' <br /> 3 5 <br /> lo+lo <br /> the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with theIpro dures and methods specified in theLisconsin <br /> kdministrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge nd belief. <br /> VAME (print): TESTS WERE OMPLETED ON -- '- <br /> 4DDRESS: CERTIFICATI N NUMBER: PHONE NUMBER(nptio-ri-i 1 <br /> CST SIGN U / <br /> )ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Testes, f <br />