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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> ;NDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS 115 P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (H63.09(1) &Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/,..e...v�,.�,-rT LOT NO.13L NO.: SURDI VISION NAME: <br /> _ Y,,�Y4 /3 /TyoN/RIAlia IW T c , > v 92 Ns� bee/z CodIF <br /> COUNTY: OWN--FRYY'S NAME: MAILING ADDRESS: <br /> 2v e>>f 'E �J E eoofe.,Z 4 �, 80/ <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: R IPROFILEDESCRI TIONS: ER O ATIONTESTS: <br /> ®Residence rT New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system / <br /> CONVENTIONAL: MOUND: IN-GROUNDPRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:M ❑u 9s ❑u �s au I 19u ❑s ©u s� <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: IK9 1 1 Floodplain, indicate Floodplain elevation: /i 9 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH 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- J (o lP o' Na NC_ > 6� <br /> B- m_Lyes/ 1;d—e"v'�3s s/ <br /> B- 32- 9 1,57' > 72 <br /> B- 3- 7 z /19-0.6 > 72 <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 PERIOD PERIOD PERINCH <br /> P- 2 /VQ At / Z �Y / %L 2_ / <br /> P- 'UD/Nc' l L� <br /> P- <br /> P_ <br /> P_ <br /> P_ <br /> PLOT <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 9 7, a ' <br /> tj <br /> .z 31--��J.S� V`Z� - MO <br /> V r /",Pay, %Z /?C of <br /> 0 <br /> Q /ee' N <br /> V. <br /> in <br /> { <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified 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): TESTS WERE COMPLETED ON: <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBERIoptionall: <br /> 71S &6,vc/z w' moo/ 333/ 76�-2/ss <br /> CST SIGNA RE <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) —OVER -- <br />