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EH115 Rev.9/78 <br /> REPORT ON SOIL BORINGS AND PERCOLATION TESTS <br /> WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES <br /> P.O. BOX 309,MADISON,WISCONSIN 53701 T <br /> LOCATION:''/<, _V✓Y<,SectionJZ-- ,T46N,RdV_X(or)W,Township or MnaicipaLlti' S 6-- <br /> Lot <br /> Lot No. / Block No. _, County 15 LL N <br /> �// /-Z" <br /> b rvlswn Name <br /> Owner's/Buyers Name: D 19 YJ �,/ 5 o ''/ <br /> Mailing Address: �T �'� J(,1e Z� a <br /> =L��y r �� <br /> TYPE OF OCCUPANCY: Residence ✓ No. of Bedrooms Zi COMMERCIAL <br /> EFFLUENT DISPOSAL SYSTEM: NEW ✓ REPLACEMENT ALTERNATE SYSTEM OTHER <br /> DATES OBSERVATIONS MADE: SOIL BORINGS y'.- z-s Al) PERCOLATION TESTS/6.. Z 3- A'12 <br /> SOIL MAP SHEET. O"YtL� _NAME OFSOIL MAP UNIT &cz 'r Ljs:TZ -4/✓, <br /> PERCOLATION TESTS <br /> TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE <br /> DEPTH CHARACTER OF SOIL <br /> NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN <br /> BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 <br /> P- ! Si-L / !lYL1Z ` -4-D 4,0 <br /> P- <br /> P- <br /> P- <br /> SOIL BORING TESTS <br /> TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, <br /> TEXTURE,MOTTLING AND DEPTH TO BEDROCK <br /> NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES <br /> B- / SD O TS <br /> B— 2 (7 0 ILS . <br /> B- 3 D 0 . <br /> " <br /> B— <br /> rw✓e 'd Gam. <br /> B- <br /> PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. <br /> Indicate number of square feet of absorption area needed for building type and occupancy 4-�'ffndicate scale or distances. <br /> Give horizontal and vertical reference points. Indicate slope. <br /> /Vdf fU JG'+Y/� / <br /> Q <br /> �I <br /> Y, YLe (.G/ke- bOOJ �N <br /> .35-1-4 0 <br /> / ZO / <br /> � o fps <br /> o � <br /> 1� <br /> coo( <br /> I,the undersigend,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods <br /> specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct to the best of my <br /> knowledge and belief. <br /> Name (print) ` �-14 Certification No. <br /> Address 2" <br /> Name of instal'?r if known <br /> �'--- CST Signat <br />