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DEPARTMENT OF REPORT ON SOIL BORINGS AND JArCIT & IS IIVIS <br /> I 11NiL <br /> 0 <br /> INDUSTRY, BOX 79E <br /> LABOR AND PERCOLATION TESTS (115) MADISON,WI 537( <br /> HUMAN RELATIONS <br /> (I LHR 83.09(1)&Chapter 145) <br /> LOCATION: SECTION: - TOWNSHIP/MbWtetPAtTrY: OT N0.• LK.NO.: SUBDIVISIO NAME: <br /> '/4//ud/ ) /T_9A/RAA (p -� — C 17 dv� <br /> CO TY: MAILIN : <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMM R IAL DES RIPTION' I�F.SF���TS <br /> Residence 'J _ XNew ❑Replace I /O/ �j <br /> RATING:S-Site suitable for system U-Site unsuitable for System VVV <br /> p❑�T NAU, MEl S MU IN GO S ZU E: S❑EM-IN-F LL OLDSG❑U f n'ir:C3 SYSTEM: <br /> To-17i, all <br /> ® LESIGN RATE: S U <br /> If Percolation Tests are NOT requiretl If 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 TOTALPTH 7 N <br /> GR UDWATER-INCHES CHARA TER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTI <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST,ATURESTO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> ,.,, -cf'iL�,[ ,fY�s • "-�?O"i(`i'�%ax./.��t i ;�'_y5i <br /> B- ,3" //9� / //Ori 17" <br /> e <br /> B- '�/ <br /> B. w 77 Y /�IG�C� /j'/ Q-5/1"M b2/-111 5/'=i/� �n/sw/E <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIMEDROP IN WATERV H RATE MINUTES <br /> F <br /> NUMBER INCHES I AFTERSWELLING INTERVAL-MI RIO t v PER INCH <br /> P. / <br /> P- <br /> P <br /> P- <br /> P- ) '1 <br /> P. <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sale or distances. Describe what aro the he <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 perm <br /> of land slope. <br /> SYSTEM ELEVATIONS/e <br /> r Q6� I <br /> } <br /> I <br /> - <br /> i ��Tl <br /> -7- -r T-—t <br /> -- __ �/`/Cr'.Li ,L�•rx/,vn��c, �f/c+'n _GT.S/�(//-+� r— T _l <br /> J 4 <br /> }--64/ <br /> I, the undersig ed, hereby certify that the soil tests reported on this form were made by me in accord with the pro and methods specified in the Wisconsi <br /> Administrati ode,and that the data recorded and the location of the tests are correct to the best of my kn ledge and belief. <br /> NAME (printl, �------------- - � dE' �TESTER COMPLETED ON: <br /> c /9 I <br /> ADDR - CERTIFICATION NUMBER: PHONE y MBERIo tional <br /> Q. X7573 7L <br /> CST SIGNA UR <br /> l� <br /> DISTRIBUTION:Original and one copy to Local Authonty.Property Owner and Soil Tester. <br /> DILHR-SBDE395(R. 10/83) -OVER - <br />