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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY,. DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> ULHR 83.09(1) & Chapter 145) , <br /> LOCATION: SECTION: TOWNSHIP/A6UW16#PRLTTY: LOT NO.:BLK.NO.: SUBDI ISION NAME' <br /> sw'/ AvF_Ya a8 /T O N/R/611,4 z q M a/ 6 Nft t� • 4UU . <br /> COUNTY: OWNER'S BUYER'S NAME: MAI LINU ADDRESS: <br /> rn yw- Y0 9 <br /> USE Cr DATES OBSERVATIONS MADE <br /> PRINO.BEDRMS : COMMERIAL DESCRIPTION: � DIP/ ONS: E /LApTIO�T�ESTS <br /> Residence h XNew ❑Replace ,G/ /0 : <br /> RATING: S=Site suitable for system U=Site unsuitable for system G 4m <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> ES ❑U ®S ❑U ©S ❑U I E ©U I El 21U I d0AlIJ, <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 ISEE ABBRV ON K.1 <br /> B- I o n w� > 90 �`ys B��l ' �.1 n <br /> 33 SD Bn �w. -� d S <br /> B- S- 80 R � 7 ff ;> Flo 8, Z/ .1. 49 r 1. • 3o h 61IyY <br /> p_y "/jL S- <br /> - n r h rtov <br /> B-� $ o I , S II ) 010 a " 4o <br /> D, r 12c <br /> " cr S— a4. ' BuGr a6 <br /> B-k/ 80 ��, � 1-7 �0 3 _ 8o ,. e , d s <br /> 8o q7. 7 <br /> If <br /> ��0 3a BBor r�. ay' g4`r� av h ra <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 PERIOD PER[ PERINCH <br /> P- ) s o a sof a liii <br /> P- su 3 J. V 7-- a F <br /> P-a .4 <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 S'C q e / "_ 40 ' <br /> p A I ��prc • ' <br /> 1106 1 2 IC` a F3oo <br /> Lill trrr � to 7'6 / 6o r-e C1 <br /> tI e� pyo <br /> P4-iL x:fv 'BPrray !3" Rrc/.°P.fi <br /> � "' ' D TN <br /> cx, r <br /> (I , o Stii /t <br /> V a n <br /> I, th 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 /> Adm istrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (pr TESTS/.,_. A-1 TESTS WER COMP EITTED ON: <br /> 0C7 � f )c � 1 0 MS /d 0 ,6 <br /> ADDRESS: CERTIFI ATIO NUMBER: PHONE NUMBER Ioptionall: <br /> r7 U3 7 X66 /r7 <br /> CSTSIG�A'T�UR E:Yn <br /> CTB"'�t/-t� <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R, 10/83) —OVER — <br />