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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - DIVISION <br /> 7969 <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX <br /> MADISON, <br /> HUMAN RELATIONS SON,WI 533707707 <br /> (1 LHR 83.0911) &Chapter 145) <br /> LOCATION: ISECTION: TOWNSHIPF <br /> PALITY: LOT NO.:BLK.NO.: UBDIVISION NAME: <br /> E (n CaFo CO NTY: OW 5 BUYER'S NAME:: G ADDRESS: <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE9C IIPT ONS: ER O ATION TESTS: <br /> Residence New ❑Replace ftp z aQ /qp�J <br /> RATING:S=Site suitable for system U=Site unsuitable for system Od <br /> CONVENTIONAL: MOUND: IN_ -GROUNDPRESSURE: SYSTEM-IN-FILL HOLDING TA K: RECOMMENDED S ST M:loptional) <br /> �$ ❑U M ❑U (BI$ ❑U ❑S U ❑S U ConueRfion .� <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in he <br /> under s. ILHR 83 09(5)(bl,indicate: Floodplain, indicate Floodplain eleva ion: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNE S,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION <br /> OBSERVED ES IGHEST TO BEDROCK IF OBSERVED (SEE ABBR .ON BACK.) <br /> B- 70 99. > 70 �✓17med. s. f�"-y7„� meds; ”-,5.5",e.3//.SS"-7o"/f <br /> -P'e/3/; <br /> B- 70 4/0ae > 7�„ erl.5 <br /> 0-7"B/S/; "-SG"Bn meds;S "-Sy'"l•s <br /> B_ 3 70)' 99.3 .t/ane > 74) ed. S <br /> B- 9q.�- 401)e- > 70 53Zne <br /> n u 0'!o"f/5/;!o"-S3"�nmc�•s; 3"-5l0",23/,•JL"-70' 154 <br /> B 5 �D qq.S 7clane > 70 ed. <br /> 13- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCHES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD P D <br /> P- <br /> l None � s <br /> PItlorlt <br /> - <br /> s 7 r� <br /> P- <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 97 7 �?z/e �G eYePo where �fe . <br /> F-- Cu/bP�f�scv> ,Prxz� <br /> �?�p/o�imafely' /O ^reS <br /> B�'9-/GY�.O Benc/vrarL, dlCxi/ in <br /> ba3e of 30' Oaf <br /> TN <br /> 0 0�� <br /> Bio $e, <br /> B 3 <br /> R <br /> c <br /> 0 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedu es and method 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. s <br /> NAME(printl: TESTS WERE COMPLETED ON: <br /> aye- 61.r/w/m 6 PP <br /> ADDRESS: LCl/S/Os—='( � <br /> FICATION N UMBER: P ONE NUMBER(optional), <br /> � Tra d ye.,5. °D. �X�?s �c%LL/er u/I . P9313583 /S �7v - <br /> ti <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. V' <br /> DILHR-SBD-6395 (8. 10/83) —OVER — <br />