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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> '/ '1 3(�/TyON/RISEfp �( NW Np <br /> COUNTY: MAILING ADDRESS <br /> N O 00 O PCrloloif <br /> USE DATES 013SERVATIONS MADE <br /> NO.BEDRMS,: COMM R IAL DESCRIPTION: <br /> Residence ❑New ,,Replacef S - 2O ' qO 12 /� TESTS: <br /> RATING: S=Site suitable for system U=Site unsuitable for system L L "I l 1 <br /> a� � <br /> CO�ENTI . MOUND�. ❑� IN-GROUND�RESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> 1��((�JJJJS <br /> EN �S ❑u D Mu ❑S 'Zu <br /> If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br /> under s. ILHR 83.0915)(b),indicate: (N_� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION P HT R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST. HIGH T TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.1 <br /> B- 72 9� •� 0 7 O - films 3O 3Nmg 30 - 1'Z'Kms <br /> B- 2 12 O9 D- 5BIm5 5- 2(0 $Nms <br /> B_ IZ J7. NOXE O- (ow rA5 Its, - 'Ll 5N mi 'L-1- 7Z�h1S <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> lTEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES- AFTERSWELLING INTERVAL-MIN. P RI D1 P RI D2 P FI1003 PERINCH <br /> P- 32— S/ z <br /> p- 17-A NO 43/ s <br /> p- 3 % y� <br /> P- <br /> P- <br /> P. <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION —95.4 <br /> l <br /> A' Wh 160 NAIL_ IN 17-"RED ©AK SANG <br /> I <br /> t _ <br /> N <br /> I <br /> + rt <br /> E�D- <br /> 1. <br /> the undersigned, hereby certify that the soil tests reported on this form were made by <br /> me in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (print : TESTS WERE COMPLETED ON <br /> 1 }IOI�KI ISS _ _ `$ - 2-0 - 9c) <br /> ADDRESS. CERTIFICATION NUMBER PHONE NUMBERfoptional): <br /> C wl s`t8 3�7n s- �a�� <br /> CE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. !7Y <br /> DI LHR-SBD8395(R. 10/83) -OVER - LJ� <br />