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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, _— DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> 3707 <br /> HUMAN RELATIONS --7 ��ADISON,WI 53707 <br /> (1 LHR 83.090) & Chapter 145) 7 /'/f/ <br /> LOCATION: SECTION: TOWNSHIP/RP"ftFCMTtl!TrFY: LOT NO.:BLK.NO.: SUBDIVISIOf�—NAME: <br /> SE t/4 NE 1/4 33 /T 4o N/R i5f/(//W JAI KSS INA RA NA <br /> COUNTY: OWNER'S B""&^'S NAME: MAILING ADDRESS: <br /> BURN= DDBNEY STOW RT 0 10 WEBSTER, VI 54893 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTIOyyy <br /> N <br /> PROFILE <br /> DESCRIPTIONS <br /> ��CRIPTIONS: uPERCCOLLAT <br /> � TESTS: <br /> LResldence NA New Replace y /p� uyy �pIIOON� ,1� <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: IN-G <br /> MOUND: ROUND-PRESSURE: SYSTEM-I N-FI LL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> ❑$ ®U ®$ ❑U ❑$ CSU 0$ ❑U ❑$ CMU I mm "Ww <br /> : <br /> If Percolation Tests are NOT required DESIGN RATEI If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(6),indicate: NA Floodplain, indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORINGrDEPTH <br /> DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV, ON BACK.) <br /> 0-10 3 1 III to, 1 Red s, <br /> B- 194.5 NONE 48 W/ fad 51x7/1' not 0 48% <br /> 0-3 5 3 1 s1 to, 3-54 zed a,B_ 2 96.1 NONE 54 W/zed 57/1 not • 54"B- 3 94.6 NONE 0-4 5YR3 1 sl tap i. 5 as, <br /> 36 W/ zed' iom/8 mot a 36 <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST Trw <br /> HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER LLING INTERVAL-MIN. PERIOD PERIOD2 PER 3 PERINCH <br /> P_ 4 1 <br /> P- 1 < 3 <br /> P- 5 NONE1 < 3 <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 horings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION w► <br /> NOTE: NO SO= <br /> < BM MW 100,0' <br /> i <br /> (B011OM NOME. SIDING•) <br /> Ss:/ 9R tr7 NO VML <br /> CQ s ` APM 12 AD= �N <br /> yNejt i r <br /> 3 <br /> n <br /> f—SSS 4 �f 7G —fit feu/ <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) ITESTS WERE COMPLETED ON: <br /> AISYN J. $ELM _ =1 28 1987 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> KNEI Z 71P WWNMP WI 54801 _ 1 ?!5-635 7595 <br /> CST <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. Y� ��`/C,~•�r•• <br /> DILHR-SBD 6395 (R, 10/83) —OVER — <br />