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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUIL <br /> INDUSTRY, DIVISIONSION <br /> LABOR ANO PERCOLATION TESTS (115) MaDlsoly,WI X73909 <br /> Hd1MAN RELATIONS <br /> (I LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/fAW#0G PAMY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> NE114 NA)14 3� /T3rN/R/7E 1 ) cs <br /> COUNTY: OWNER'S NAME: MAILING ADDRESS: <br /> NEA <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDF?MS: COMMEALDIESCRIPTION: PPOFILE ESC PTI NS: PERCOL ITIO TESTS: <br /> Residence �-�7J New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system !¢ J oY0 <br /> COOtMENTIO❑NAL: MOU D:❑� IN-GROU D-P�URE: SVS❑TEM-IN-FILL HOLDING TANK: RECOM�ND ED SYSTEM (optional) <br /> I,�4,//J1,,SS UU S S U S U S C/� / 3S ' <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required ,s ' /J If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)16),indicate: //!10/�(,/J_ Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,CO OR TE: EP H <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV,ON SAC .) <br /> B 9',s-as — > 7 y'Ws-1 tea" s/ -s--6 s <br /> C-0 Rol <br /> a <br /> B 7 5?S-69 / > 7-71 ws/ ao„ s/ tniu <br /> B_ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P l t -PERI-OP-2. _PFRL0753 PER INCH <br /> P- <br /> P_ / <br /> P- <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 borir gs and the direction and percent <br /> of land slope. <br /> SJYSTEM ELEVATION <br /> SCAT — I &OC -00"' <br /> IN <br /> PiQoPosEn 5AI- A 1/1 IN AJ11M <br /> �C I °pp So/ BaRA�/6S t N <br /> bei- 4 PSR tFsfis <br /> MY <br /> fIE�L m BE >5a' <br /> Nem F,Pe/y rrABLE ArPE� <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 WER COMP TED ON: <br /> ,qFL .3 aG <br /> ADDRESS: CL TIBE PHONE NIBE�(optional): <br /> IERON NUM <br /> CST SG TUBE: �/��`-777"//ys <br /> 7 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. f <br /> D I LH R-SBD-6395 (R. 10/83) —OVER — <br />