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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUST AY; DIVISION <br /> LA$OR AN_D PERCOLATION TESTS (115) MADISON WI 7969 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATLQN: SECTION: S UNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> /z /Ta N R/4-E to 7as,, /u,�1 C5M v �z -7 <br /> COUNTY: OWNER' YER'S NA MAILING ADDRESS: <br /> B4)eil/eTT / 15fly e u7- BX 45'9 e i <br /> USE DATES OBSERVATIONS MADE <br /> Inesidence NO.SED3 RMS.: COMMERCIAL DESCRIPTION: (PROLE DESCRIPTIONS: ER OLATION TE TS: <br /> yu R /V4, ®New ❑Replace / /� <br /> RATING:S=Site suitable for system U=Site unsuitable for system ZS <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U S ❑U ZS ❑U ©S ❑U ❑S ©� /s'x 34., a dIb4j.+ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the N-4 <br /> 7 / ,(a( <br /> under s. ILHR 83.09(5)(b),indicate: A Floodplain, indicate Floodplain elevation: , / r <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> l 33 IT0,5' Oe)-0- 1 9 )�'18GAcL' lICApP aa1 7b 6r A56�s 3 StJT7 l4"su5 rm <br /> Z 4- It .j7 S" LSTs 32" NMIE ! I " 8N LS wQ+- M <br /> B- 3 -7 -2 9s.1 ° 7 7 2— CS v- 'c111 6M11 LS/ Ill $.v mEP 5, 3608v <br /> 5"Bt. <br /> B- 9�I- loo-4- s TS/ /4-" 491/ 4.5� 7S" S/V IT 5 r-L72 <br /> � 74 <br /> B- 5 `� �7.� „ �5 :S"Bi- STSG ! a" BN L- 5, -42-" BA, CS trj2 <br /> B- 6 1, 7 98. 0 7 3'lBL S -rS/ /%11gNLSj 4e-"&Iu0S ,2 <br /> S- 7 + <br /> 4" aLs � s/ zo" Bti �s� zc" 8ti es r 9�i <br /> Z ClS O S Q (2 11N s 2 w 6 n+ <br /> 13—S Sv 71,/ 11 7 g$ PERCOLATION TESTS 4"0"' ", 14"4ni<Sj7o" BN rC S r *,0t <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD P R PER INCH <br /> P- 31 No.v SZ7/ 2 / Z 3/lz <br /> P- 44 �/ al / 4/ Z <br /> P- 4 /r � Z4 2' <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 <br /> r ee TN <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 belief. <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> o 3e <br /> AD zDR SS: A � CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> rz;2 3 �� z2 /4 W e ox is GLl/J Z90 /, 7/S-Z3¢- 43'S <br /> S- CST SIGNATURE: <br /> [EUrSED 9 Z6/8� <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. f f r` Q F Z <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />