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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, C DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON BOX 76 <br /> WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.090) & Chapter 145) 'JCL 60 Lff, 3 <br /> LOCATION: /4 <br /> SECTION: <br /> ON/R WJE (or w TOWNSHIP 0 NICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NA-A qOME: r r D0 O <br /> COUNTY: I,V/ MAILING ADDRESS: <br /> C� <br /> JRnIEREA LP -1 M S 0 <br /> USE - DATES OBSERVATIONS D <br /> IIr���yyy��� NO.BEDRMS: COMMER IAL[ ESCRIPTION: I R I S: PERCOLATION TESTS: <br /> L} Residence /7 ❑New Replace L L ¢O - (�7 / [ - 30 -� <br /> RATING:S=Site suitable forsystemU=Site unsuitable for system J _1 L-- —I LLL <br /> N ENTIONAL: MNIN-GE. SVI L GR ESYSTEM:)optional) <br /> S �uL'q QSEl0 NS � 0ONVFNM10NAL_ <br /> r <br /> If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Il Floodplain, indicate Floodplain elevation: N� <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.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- ' 7_ q'1, 6 NONE >77 b 581#15 5- '128Nm5 <br /> B- 2 ?2 4.5 NONE 0- !'31ms b-T28Nms <br /> B- 3 $0 19. 1 nloN�_ > `b0 0 � ms �'10131,io)5 <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES, RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. —PERIOD I PERIOD PERIOD PERINCH <br /> I I�0 I"L /y <br /> P- �7 3.s i1 3/S 15AL <br /> p- a A 112 1?-/11. <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. SCALE ►Ir^ Lt0' <br /> SYSTEM ELEVATION qS .io . BM IDO 36ROM 06 GRRflGE S�DIr10 <br /> �L <br /> ? k>57�nIG Sp WcP <br /> AQ 5°Io <br /> �ARR6E � � SL.D� TN <br /> to <br /> DRI gF L_1Kr <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and met ods specifi in the W,iscon,ji�J <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief <br /> Y / r- Fs 6 u � <br /> NAME(print): TESTS WERE COMPLETED ON: V C G <br /> Ric kApo NOPwIJs y - 3o - Iz <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional) <br /> Z-7-7(60 HWY 35 WEgST69 W1 . Sy$ � D S 6 / <br /> CS GN TUBE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD6395 (R, 10/83) —OVER — <br />