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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: / TOWNSHIP/ LOT N .:BLK.N .: SUBDIV SION NAME: <br /> ,VWv, VEll S /TytlN/R/A(or)W o g /T-La , N� A* AJ <br /> C NTY: OWNER'S/BUYER'S yAME: MAILING ADDRESS: P�� -� /� `G� , <br /> v+n� r4 ( �'rt d / e, tj-vaj Il Qat 4! ,(_ 5k�7��3 <br /> USE DATES OBSERVATIONS MADE <br /> NO.B^EDRMS.: COMMERCIAL DESCRIPTION: K PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence L [:]New I <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> DS ❑U ©S ❑U CSS ❑U <br /> CEIS 130 ES Ed Ce11tJ �l <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(511b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN.1/18. <br /> ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- � al N a oj--� ;> a 'S eAj r d S 7 S- /? v,,, <br /> B- -�, fa II9, 7 LI > o ,.8, 1111%*fs .2s ' ' P? pv. '. 1 f <br /> B-3 8� 18, H It �� f,�, 'Kdr S' " r? &wt.t li( S <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI D2 PERIOD PERINCH <br /> P- 2/ Olt- <br /> P <br /> P- 1 3a- <br /> P- d e /tb <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 <br /> � rrc • <br /> F11, - # p / 0 ReYkd laKIt- Ljore !� <br /> ScQ (C / 14 ' �,r►cll�w� sial Pei - STp <br /> —c)C<Ylis t w4rP. Q w-� (I 8 M ro a <br /> N 5T L • <br /> � eoa �T <br /> 4+' *4 C.v, T N <br /> 4/` t CL <br /> /SO'1 /ail• <br /> - 11111 L <br /> 3 <br /> I,the undersigned, hereby certify that the soil tests re orted on t 's rm were made by i accord with the procedures and methods specified in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of t e t s are correct t th est of my knowledge and belief, <br /> NAlpri tF. ` b TESTS WERE COMPLETED ON: <br /> Zev`IG O IlI4s 7 — 0pf J <br /> ADDRESS: CERTIFIC TION NUMBER: PHONE NU BER(o tional): <br /> � 6sT� rS/� �is''� �/� <br /> CST NA URE: <br /> � s <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LH R-SBD-6395 (R. 10/83) —OVER — <br />