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DEPARTM-ENTOF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (I LHR 83.091111 &Chapter 145) <br /> LOCr�AATION/: SE�CT7ION: �/fu e TOWNSHIP/MUNICIPALITY: LOTNO.:BLKNO.: SUBDIVISION NAME: <br /> uC '/ tie / / / 7 /If/b E ( )W o,sle-Cgna7 C' G ✓ l I (� �. <br /> COUNTY: WO NER•S BUYER'S NAME: MAILING ADDRESS: <br /> axr ^It ( I A k e 1 33 . aL q Dir rz 4vE C y1f,L1SSS <br /> DATES OBSERVATIONS MADE <br /> USE PROFI LE DES IPTIONS: E�ON NO.BEDRMS.: COMMERCIAL DESCRIPTION: ,,f eWI //�*esidence a �i P_- rL ❑Rlace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ON ENTIONAL: MO ND: 11'' IN_ -GRO ND-PRES''S'U1RE: SYSTEM-IN-FI LL HOLDIINcNG TANK: RECOMMENDED SYSTEM:(.opptioonnal) <br /> �� <br /> OU <br /> �Y MS �U �J U <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: �-�- Floodplain indicate Floodplain elevation: `I <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALD PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B 0 a C NOS 72 -7 <br /> B- /C�1�6 lolo" S 5L FY C-S_ <br /> SL t3L TS ry A'j i S . ✓ <br /> BRX <br /> - <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIODt PERIOD2 P RI PER INCH <br /> P .31 <br /> It <br /> P- 2 t <br /> P l — <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 yp�-ofints and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. x7,p- g ri ; !C <br /> SYSTEM ELEV ION r <br /> 16� _ 1 <br /> sf• APriv t — — <br /> �_7a <br /> Sy-p•l � � _ u�a.v�� — — <br /> I, the un rsigned, hereby certify that the soil tests reported on this form�r�r�.O by me in accord with the procedures and methods specified in the Wisconsin <br /> Adminis ative 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�M LETEp ON: <br /> ADDRESS. CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> f ✓acs 0 7 t <br /> 7� CST ATU �? <br /> ,4 E?I' �5ti� �O�u -5 7-� <br /> � f=64 mai ( <br /> pzw <br /> DISTRIBUTION: Original and one copy to Loca Au..'1thority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />