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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> (I LHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP LOTNO.:BLK- SUBDIVISION NAME: <br /> W%5w'/ /T00 NMI I (or)W a � a„ Nk l�� N'A <br /> COUNTY: OWNER'S BUVER'S NAME: MAILING ADDRESS: <br /> igoP1 r Ivt ^ w-a657-e­,Y w ; . <br /> USE DATES OBSERVATIONS MADE <br /> �tNO.BEDRMS.: COMMER IAL DESCRIPTION: rrte�,,New ❑Replace PROFIL DESCR PT ONS: PERCOLATION TESTS: <br /> L�r'R esidence � 1�7 <br /> RATING: S=Site suitable for system U=Site unsuitable for system O <br /> CONVENTIONAL: MOUND: <br /> IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> T <br /> ®S ❑U ❑S ©U ms 0 ❑S ©U ❑S ©Q (" o Ute/ <br /> SIGN RATE: <br /> If Percolation Tests are NOT required DIf any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),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, ELEVATION OBSERVED EST. HIGHESf TO BEDROCK IF OBSERVD (SEE ABBRV.ON BACK.) <br /> l^ <br /> B- I 7 �)- 9 5- <br /> B- <br /> B- <br /> B-B_ 3 S -2} <br /> B- y 7� Sl t l -,> 7 a— <br /> B' C <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. PERIODI PERIOD PERIOD-3 PERINCH <br /> P_ cJ `7 <br /> P fu <br /> P- 3 2r <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 tion at all borings and the direction and percent <br /> of land slope. ) <br /> SYSTEM ELEVATION Ta-7� <br /> a �em � �tsr TRf� p <br /> 0 y I1 <br /> SIdUnU " � Qv,�611A U�IJI�$ � SOo <br /> 4 i /B ' <br /> R �4d 4r = C� <br /> TN <br /> St ' F rn 0 v,,— <br /> '-r <br /> �f¢ •-i >e, cr�o7' <br /> d rY. d <br /> I,the undersigned, hereby certify that t44;l a.?reported on this form1weld'mTde 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 /> NA riot) TESTS WERE COMPLETED ON: <br /> o r`► r r T' <br /> ADD ESS: CERTI FI CAT ON NrJMBER IPHONE NUMBER(optional): <br /> CS NAIN AI UCf� �. <br /> ON <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />