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DEPARTMENT OF - REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUST.RY,_ - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.091) & Chapter 145) <br /> LOCATION: SECTIOY" u WTOWNSHIP f{ 1ND: SUBDIVISION <br /> SION NAME: <br /> ;-J/ L / � /e/ 7 // rVN//' <br /> CAUUNT ONER' BUYH'S NAME MAILING ADDRESS: LA)N % <br /> Li4r <br /> r <br /> USE DATE OBSERVATIONS MADE <br /> EO <br /> NO.BEDRMS: COMMERCIAL DESCRIPTI ROFI E DES ONS: PER OLATI IN TESTS: <br /> UGHesidence ❑Neweplace I ,;� oS— <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: LLHOLD ING TANK: RECOMMENDED SYSTEM:(optional) <br /> LAS ❑U ®S ❑U ®S ❑U I ❑S ®U I ❑S ®U C oAj <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ibl,indicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) 1 r <br /> 9' IlldUle 78 w 1� <br /> B- � A o � .. AICs S 11A (p .r Qotirsr t <br /> B-� 1?CO / tl > 8a � rrfI �,F i, �1 �. 5 V �' Ir Ir . r . , t <br /> B-3 d o . 4� /mss CZ 6 r'I3g5 il4s 7" R ( s &7 <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PERI H <br /> P- 3 - Nq to o f ID 7//'I9 <br /> P-a t0 3 911L3 <br /> P u <br /> lyP- <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 1wi ID <br /> �11�� � ,D`PrG • <br /> ❑ <br /> _ 1 <br /> TN <br /> o. <br /> v. 3 <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 /> NAM print)) TESTS WERE COMPLETED ON: <br /> oc�f r c 0 irtS — / 0 � �° S <br /> ADDRESS: ` t i r S CERTI FI TI1 NUMBER: PHIS-NUMIBERI I <br /> CSnal): <br /> I/s) W T T � /OfP <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. G <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />