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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY; " DIVISION <br /> LABOR ANDPERCOLATION TESTS (115) MADISON WI 53707 <br /> HU <br /> S�A RE ATIONS S (ILHR 83.090) & Chapter 145) <br /> LOC TION: SECTION: TOWNSHIP/MUNICIPALITY: OTNO.:BLKNO.: SUBDIVISION NAME: <br /> *ZrYSZ-Y S /T3sN/Rp?9(pr Gra,hYs Aae <br /> COUNTY: i / MAILIN DRESS: r <br /> Rue,07 �✓` <br /> �ti` //i`e GQc TUUCrf /Qf /. .Box SSU UrCLhtr is <br /> USE of DATES OBSERVA061119 MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: <br /> Residence ' New ❑Replace TS: <br /> 0C t• dw/, /yYy/ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> COTNNVENTIONAL: MIIOOUpUIIND: IN-GROUNNDRRESSURE: SYSTEM-IN--FALL OLDINGTTANK:R ECOMMENDED SYSTEM:(optional) <br /> INS ❑U IDIS ❑U 54S ❑U ❑S JgU EIS ZU 1 <br /> c h VNh / jot( a <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the p <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: API-4 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED T TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B- .�Sl' ) 13"' b0A e ; ,r?ll 3"-S�" ty�i -S <br /> B- R ,/-S" IaO''3" on c <br /> B- 3 6 765 " <br /> B- �` 7/ U/ ' q'r P oh e > 7y'" 0 _a ., <br /> B- s Glu jO/ ' " /70ne >70" d - 3" 0�i �hJ <br /> 6- <br /> PERCOLATION TESTS <br /> tiTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RI of p RI D2 PERINCH <br /> P- 1 O n 3 /d 116 / 3 <br /> P- oZ Z 0 o e 3 /3 /ro45 <br /> P- 7 3i <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 q'7 ' 7 <br /> � I <br /> r I <br /> .!Y R_P.= �oi!iz,o?• y�/ C�� �'� -"* /���to , � . � � �._�-�--�- `� <br /> /�o , W e 7/ <br /> i l l j I I <br /> �i a /t a 6��rge�+t , firQler _ TN <br /> I <br /> -r- ti <br /> 10-0 <br /> I I a I I <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 specie d 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. Las N/j, 98',( y <br /> NAME (print) TESTS WERE COMPLETED ON: � Olt 6 <br /> �Ila-c- 0, Bnxsu Dc 7, .26 19ql ► I (' <br /> ADDRESS: CERTIFICATIO UMBER: PHONE NUMBER(optional): <br /> Sy�9-7 CS r 315 13 <br /> CSTSIG ATURE: <br /> Loll <br /> DISTRIBUTION Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD6395 (R. 10/83) —OVER — <br />