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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND <br /> REL PERCOLATION TESTS (115) P.O. BOX 7969 <br /> 3707 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> �a t 4 (ILHR 83.09(1) & Chapter 145) LIB <br /> LOCA SE�ICTION: /� p�/- „ TOWNSHIP/Mk/AAG{ApteITV: LOT NO.:BLK_NO.: SUBDIVISION NAME: <br /> cSw '/4 SE '/ Or3 /�70N/Np [ (or)W o(/ •I? d/. 7v.TwI IV� /)V`!A� <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> BwurTr Ta *MISoA/ Sipen w /s . <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: M1M1�� PROFILEDESCRIPTIONS: R OZ LATI —TESTS: <br /> LXResidence 2 ISINew ❑Replace 6�a3lr6 6�d3 <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> OrVlInIS OU . MY�.❑� IN-G Sl� P❑�RE: SVOSTEM-I��LHOLDING�� . RECOMy ON �STEM:(oPtional) <br /> If Percolation Tests are NOT required DD ESIGN RATE: S lr <br /> g If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)161,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DE PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPiH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 13- 73- - P0FJt <br /> S"6 If <br /> B-3 7a P. y 7 7a " '�h L r ''R kr a� 6 " R •m ir <br /> / <br /> B- 7 �� 00 `I � 0� .r,Q, 4 � `� /�( � �Y dr <br /> B-S' 0 77, 5— It <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 PERIOD PERI D PER INCH <br /> P 33111 <br /> T AWE Nb Q -3 <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 _1f� <br /> Sd/t Parc <br /> r I -e f Cir r-e <br /> mar I <br /> c � • M S o .0 o <br /> Ill <br /> li'i7 1104) <br /> SP1 a� — >aoo1° F7-- fN <br /> o <br /> `8� <br /> O 1--r 4 <br /> F )'00 _r fli 8�t <br /> Wt= 7' SoV �. �4as � ,r-. <br /> 0 ex <br /> eNs4y RD <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 /> NA (prin 1: <br /> /j TESTS WERE COMPLETED ON: <br /> 6 Cl C h t G Cf n •$ (P �-3 a <br /> ADDRESS: CERTIFICAT ON NUM ER: PHONE N MBERIoptionall: <br /> C I N T RE 7 <br /> // <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. 4 <br /> DILHR-SBD-6395 (R, 10/83) -OVER - <br />