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U 7—L100 <br /> DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY; DIVISION <br /> LABOR AN4 PERCOLATION TESTS (115) MADISON W1533;0; <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) &Chapter 145) g �339 <br /> L AQ.Q TION: 1/ ION: <br /> N/RISE ( I TOWNSHIP/MUNICIPALITY: OT N0.:841EfN0.: vOL <br /> COUNTY: / MAILING DURESS: f+ <br /> I U.- Ro o t4 11423.5 SK-MViEv RiLngSK-MV )r16 q•S o <br /> SE DATES OBSERVATIONS MADIf <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: OFI DESCRIPTIONS: PERCOLATION TESTS: <br /> ❑Residence 2— �� XNew ❑Replace I10 ,1S , 92- 10 ,15— U_ _ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> O VGNTIQU . M S EJQ IN-GDqS ❑U ROUND -TEM-ILH❑SGTANKMU R ECOMMENDED cmitegnoryp LM.(optional) <br /> SS ® DESIGN RATE: ®S ❑U <br /> It Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09151161,indicate: �-- Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALDEPTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED ErT.7rTHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I 2- ADNE > 72 0 - (0 31ni - TL5Nm5 <br /> B- 2- 'Iz •O NOAE > 77- o- (.51r_S 6' 726NTn-S <br /> B-3 2 '/. z E X72 0 -5nlM5 <br /> -?jOBN1215 30- '12$N{� <br /> B- 4 S S.6 0 E > 6 - 27-5mmi 22 -'I913N-rs <br /> B5 <br /> B- <br /> PERCOLATION TESTS <br /> EST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. IOD1 PERIOD R PERINCH <br /> P- I 1JoNE $ P RP/8 ----15 /t. 3 <br /> P- 2 o r4 1- 9 I K 9 1. <br /> P- 3 tjorieS 2 ?/ 6 <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 an show their locationon the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. AW14; 144 N1_r <br /> SYSTEM ELEVATION ff 3 9S 5- <br /> T -1�. z <br /> �I V <br /> R <br /> 4JARNi✓ <br /> �Sc �LF . ( '=,b, Y LAKE <br /> A.$M,IOC• W1 JL IN. 1470119 1( <br /> TN <br /> I , 2 • 8l..V6 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedur and meth ds"sp�ecifie in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of m I ge an el f, µ{,g,1 Sc <br /> NAME (print): STS ERE OM LETED ON: <br /> IC AfZD DP �nl0 S- z <br /> ADDRESS: CE TIF(CATION NUMBER: PHONE NUMBER(optional): <br /> 7-1 -760 35 3670 15_ 6- <br /> CST SIGNATURE. <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R, 10/83) —OVER — <br />