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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRYLABOR , C DIVISION <br /> BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON INI 53707 <br /> (ILHR 83.09(1) & Chapter 145) N # - 30-74 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: 9F6M-NiIQ(�: <br /> �'/SW Y4 3 /T39 N/Rl'}E Ip W nfA <br /> COUNTY: MAILING ADDRESS: <br /> $URgE[C WwToN C1iR15Tn1£K 2S4 0, 13ENO lJ • 8 <br /> USE DATES OBSERVATIONS MADE <br /> ��pp1( NO.BEDRMS.: COMMER IAL DESCRIPTION: CF1TP A TESTS: <br /> ytxR esidence it ('�� ❑New Replace I - r- - olf /^ _ _qt <br /> RATING:S=Site suitable for system U=Site unsuitable for system L -7 <br /> CONVENTIONAL: MOUND: IN-GROUND-PRE—IE: S STEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:loptional) <br /> ❑S ZU N$ ❑U $ ❑� ❑$ ❑$ U - 6 0 <br /> It Percolation Tests are NOT required DESIGN RAIf any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL EPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED H S TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> D.6 els b- 2- MS War 2- NMs <br /> B- I DAI E �� <br /> B-2— G-5 Q �r o-(oBlrns 1n-3zRmswc�r 32^ 5 13wrv15 <br /> IrO ,I 0 S`f 54- (MS $roms w R Uyl& <br /> 0--7-510%5 7- ri W 9Y 0- SS N n1s <br /> B- <br /> 13- <br /> 13- <br /> B. <br /> PERCOLATION <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> tiTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LVEL-IN H S RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I P RIOD2 P R PERINCH <br /> P- 3 N 5 7i 3/ <br /> P- 2 !g �h 3 <br /> P 0 ?� 6 <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 96 .7 <br /> a � r <br /> I , <br /> Is =SO, <br /> All 07144E2 LCIF UAlb <br /> weu T_ <br /> K ? I <br /> co'. <br /> TN <br /> DRI 0E _ - <br /> 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 ethods specifiey 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 ITESTS WERE COMPLETED ON'. / <br /> ADDRESS: CERTI KATION NUMBER: PHONE NUMBERIo tionall: <br /> (o D <br /> CS= , <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) - OVER - <br />