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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, _ _- DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. WI 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (I LHR 83.09(1) & Chapter 145) ��S��� <br /> LOCATION: SECTION: TOWNSHIP( LOT NO.:BLK.N SUBDIVI ION NAME: <br /> /4'I'�/SWI/4 JfON/R / &.')W Delo- 1- ^ ,� I�� t/ <br /> CO NTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> rpt r C✓ �iN WT_ Li )�; w ' <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PRO ILF DE;CRIPTIONS: PER O/LAT (7N TESTS: <br /> I Residence ^ New ❑Replace I�/C/ (p`� / /6/ I� <br /> `RATING: S=Site suitable for system L=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> �S ❑U ®S ❑U ®S CU ❑SXU ❑SSU o III <br /> If <br /> Percolation If are NOT required DESIGN RATE: If 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. HIGHEST— TO BEDROCK IF OBSERVED (SEES ABBRV. ON BACK.)B ' ft � ��lU `e > So d^ �BN� T � �S rQh �Y �U `� f <br /> B-a-- > 8'1j , y gh v '- is"BN c f s a if X RA .mss <br /> > 8a "BKt: �J// <br /> B -EO " S'Br [c S : /y"`6 /Y`r-r0 " �m �d s' <br /> ♦t <br /> F 0 <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. PERI ofcc PFRIO P R D PERINCH <br /> P_..I--- O S P O3/3w 3 <br /> P- PU t_n r a <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 borings and the direction and percent <br /> of land slope. q <br /> SYSTEM ELEVATION L S— 7 N y <br /> � c` C..c- I t} t to, INd NC 0 <br /> 1t(,(,'ss jutMA <br /> r <br /> 37e ` <br /> I / 7-o dP/ So' <br /> PO VVA S 4; a b 1`P <br /> ar rq TN <br /> Ole Tt` <br /> P 4;L ZN 18':ry 06 rya 17 res <br /> Red 0% rr3Oo ' /e <br /> 1, the undersigned, hereby certify that the sc.i ' sts repo ed orkhis 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 cc <br /> tion of Ttte tests are correct to the best of my knowledge and belief. <br /> NA;N M (� NESTS WEST COMP}-ETED ON: <br /> ADDRESS: CERTH` CCATIO NUT PHONE N UMBER(optional) <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.LHR-SBD 6395 (R. 10/83) —OVER — <br />