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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, C DIVISION <br /> LABOR ANBOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (I LHR 83.0911)&Chapter 145) <br /> LOCATION: SECTION: TOWN HIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> W'/ '/ /T pN/R1E (or)W I Nft) S G.1_•I I C 1A VSb <br /> COUNTY: MAILING AODRESS: <br /> v ( LINnA_ o So PJ 200 E. zND N. Sso33 <br /> USE DATES OBSERVATIONS MADE <br /> XResidence NO.8EDRMS.: COMMER AL DESCRIPTION: New Replace PROFILEDESCRIPTIONS- A IONTESTS <br /> -Z )�, : <br /> I � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ON ENTI❑� . M �.�� IN G_ �1� ❑�RE: SY- ST� 1❑�L COMMENDED SYSTEM: <br /> NT (optional) <br /> )ONWL <br /> If Percolation Tests are NOT required ID�pE lISI RATE: <br /> 4 If any portion of the tested area is in the <br /> under s. ILHR 83.09(51(b),indicate: Floodplain, indicate Floodplain elevation: N <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL 71, GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPfHINELEVATIGNVEDIF OBSERVED ISEE ABBRV.ON BACK.1 <br /> B- 72 9q• E2BN sB -Z Ir 5B-3 " q 0- 581 s 5- � ZSN s <br /> B-5 �.5 >?z b -�Bc�S -72SNfs <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 RI D1 OD2 P R 3 PER INCH <br /> P 3 <br /> P- 1 it 6 <br /> P- II rr -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 and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. eq t� �z 1 'N LE,5j NK--cD <br /> SYSTEM ELEVATION9 �• . g,� <br /> X111 P - <br /> fNI I <br /> flpRoX >Sa - - <br /> I <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 s cified in the Wis ns/n <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. w,fq ,;• 17 SC f„gip <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> (c++fl rZD p/< N <br /> ADDRESS: 0 W� CERT/Vv NUMBER: P NE NUMBERIo�t//a/ll:3s' 13, <br /> CST SIINATURE: <br /> 9 <br /> S O�jV/d <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DI LHR-SBD-8395(R. 10/83) —OVER — <br />