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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 969 <br /> LABOR AND, P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> WLHR 83.0911) & Chapter 145) (,35- 29 2-e6fn J. 13 P.9ij <br /> LCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO,.: . <br /> � 1/4 �'/ 2D /T40N/R ly E for Sc N 4A I 6DV'- <br /> COUNTY: MAILING ADDRESS: <br /> -BuE1 29 CTt, -RDA WfE�5-r-F_F, , wi . 5L1S93 <br /> USE DATES OBSE VATIONS MADE <br /> NO.B DRMS: COMM R IAL DES RIPTION: PROF[LE DESCRIPTIONS: A ESTS: <br /> Residence /L—� xNew ❑Replace I <br /> RATING:S=Site suitable for system U=Site unsuitable for system 1 <br /> ONOVENTIOf�JAL: MOUND: ❑� IN-GOND-PRE RE: SVSOTEM-IN- ILL O❑LDING NK: R ECOM tIOUENDDED SYSTEM:(optional) <br /> If Percolation Tests are NOT required DESIIGN`{�RRAITE: S U If anSy portionn of the tested area is in the <br /> under s. (LHR 83.09151161,indicate: �i� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIONOBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.1 <br /> 0— 5 4, Z M5 <br /> B- 1 �q - 3q tl w cm No <br /> 42 OWE Z - Liz 1zr. w <br /> p_( I31 Ts (,,- 2-4 1,srilms -3b oti 15Vj wzma m <br /> g- 2 40 p tJE 2�{ - Rc W ploit <br /> B-3 1 L Li CAI NoIi,ic 30 ,7 - 4Li ms 12c-w o$5 30 3 ►� S IJ cM <br /> B 9 p R�0-S$IMs 5 o <br /> Ngl-s 3 - 46 N 5 W cM <br /> B-_5 <br /> p-(� Pj( tAM5 - NMsw cm mOft <br /> 50 101 .2 E - � w <br /> B_ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME -DROPIN WATER LEVEL-INCHES RATE MINUTES <br /> E <br /> RNUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERI D2 R PER INCH <br /> ) 0 2 D 12 2 1O �k //s <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable ., A ;tale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show :, at all borings and the direction and percent <br /> of land slope- <br /> SYSTEM ELEVATION CL <br /> ��0 <br /> 3 VORK <br /> R�JE <br /> awe _ <br /> TN <br /> LAKE <br /> L <br /> SC Pt E 1"= 50` - <br /> _ \n1E;Lt_ 76, _66 >50' 04 +3. t. ------- -- - - <br /> 1, 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 /> NAME print TESTS WERE COMPLETED ON: <br /> �) Nfl n It - <br /> gESS CERTIFICATION N MBER: PHONE NUMBER(optional): <br /> (JEB5T�i2 WI . 548 3(070 <br /> CST SI NAT RE: <br /> . Original and one copy to Local Authority,Property Owner and Soil Tester. u/ <br /> 395 (R. 10/83) — OVER — <br />