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DEPARTMENT OF REPORT ON SOIL _BORINGS AND SAFETY & BUILDINGS DIVISION <br /> INDUSTRY, _.._ <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BILK.NO: SSBDIVISI 70`0 1/4 Nu/'/a /B /T O N/R/&E (o le/OnCI� %OW/�3/� %� 8 fU�dun afKl i vct� Pines <br /> COUNTY: OWNER'S B YER'S NAME: ,�niC MAI LINQ ADDRESS �3-�q7 <br /> G�irnc Foy. ewe/ly'�//3O� /vinc l , mil e.r/.E./77/ n i3,/nc/ 557//P <br /> USE ____ DATES OBSERVATIONS MADE <br /> NO.BEDR : COMM ER IAL DESCRIPTION: n� PROFILE DNS: E ATION TESTS: <br /> Residence �' - yS.1 New ❑Replace I /7��tr.,G 7 /9QSJ /-.,L �i /t?.PF <br /> RATING:S=Site suitable for syst m U=Site unsuitable for system d <br /> O®ENT111.1 : MOUND: IN-GR S I S P❑uESSURE: SYS❑TEM-®ULH❑sGN�TANK: R��VCn /6� /IoPtionall <br /> If Percolation Tests are NOT req DESIGN RATE: <br /> I I If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indic te: IL 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 N.JELEVATIOI OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED <br /> "(SEE <br /> ABBRV.'ON/BACK.) <br /> B- / /Z,?" 9( 7 vQ/G < 7, " /; S ; <br /> B- -7 r eW. 7 .t/rne < <br /> 3 ?'BnmM; 41a _ 7a" / arra <br /> B- 7a" 99•j /1/on e < 7a7" <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER I HOLE TEST TIME DROP IN WATER LEVEL-1 CHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PERIOD PER INCH <br /> P- ! 306 rn /v X3'%0 3 /ru t3 /b- 3 <br /> P- 3 3?0 Ir 013 -Xv3 a 3 3 <br /> P — <br /> P 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 refinance 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. llca/e - AI C'5 f AQ""nJtU <br /> SYSTEM ELE"TI N 9�. a 011' iu/i:se 40 SCa/G <br /> .6/7=/W.O iF , NOT/ i,7 /0.5c of�"l°oo• /� � ^ G���O�po� <br /> J <br /> �1% _ <br /> TN <br /> he <br /> N <br /> ,gYl ape Cb' 3q0 <br /> I, the undersigned, hereby certif 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 /> �0bc5 <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> u/ade /Fho%n p.eA 7, /97P <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> X o?a?J Nt/e far, It/I 3Z/�93 15SIU <br /> CST SIGNATU//R E: <br /> DISTRIBUTION: Original and ore copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD6395(R. 10/83) -OVER - <br />