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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (H63.09(1)& Chapter 145.045) <br /> LOCATION: SECTION: OWNSH UNICIPALITV: LOTNO::BILK.NO.: SUBDI ISION NAME: <br /> sE �/ 0/ 2 T,}q N/R/6 E (p !/l4FAI N A/ nit P/ S <br /> COUNTY: OWNER'S UYER'S NAME: MAILING ADDRESS: <br /> mNr"TT /V Duo 11940 N, HoldVD u o <br /> USE DATES OBSERVATION ADE <br /> Ir NO.BEDRMS.: COMMERCIAL DESCRIPTION: --��// PROFILE DESCRIPTIO S: ER ATION TESTS: <br /> Residence �/ ,/� ❑ 2New Replace /0 1 / 0 S� <br /> RATING:S=Site suitable for system U=Site unsuitable for system -O D <br /> Cts ou . MOUND <br /> IN-GROOS ❑URE: SV EJULHOLDI❑SG®0 :RE ao 1t1Ub-�//QDED :lytiona_ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.H63.09(5)(bl,indicate: / — Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COL R, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON SACK.1 <br /> B- `70 '/0" `0V0 N' y,r64 Al " )5n Wgws <br /> B Z 62 g9"/o" / �6� „ Z/ ,/, s s <br /> B- 3 60 9F '11 f 60 y'aZ !wmg s6 0,1 <br /> B_ 70 /pp' 9 / > 70 " `f`I/jc nt EO s 66" K sr <br /> B- 6 /00 l I > 6!5 y"�`' r _ s bq"t334 me s <br /> B- 116, 70 /w, „ >70" y"�� n1Ep5 b6'6., rF/E <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SW FEEING INTERVAL-MIN. pE lOD7 -PERIOD 2 P PER INCH <br /> p- i9' <br /> P- / <br /> P- 20 1/ Z Z y c 3 <br /> P- 3 o /! Z Z z G 3 <br /> P- 917 J ( 3 c <br /> P / 2 ' 3 <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. <br /> SYSTEM ELEVATION 98/3'' "wo" <br /> 1MLQ7-0&)Ai! OW <br /> gg is Sy r <br /> vs gr A/C Pier <br /> Pt Ra Ps <br /> tint , ?t g, $2 if s3 <br /> I NNE k3�A!cn�rtlRK . _tel - <br /> �RP,;uRR YoP of SuvA'Ii-L£ 49 �rNE tN <br /> `l°Puc &X,/R7.47 X45' 1z xG�' <br /> )See oew-volif <br /> i <br /> CA,41n 14K6I,the undersigned, hereby certify that the soil tests reported on this form were made y 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 WERE COMPLETE ON: <br /> 0,44 1011156 <br /> ADDRESS: CERTIFICATI NUMBE PHONE NUMB SR(optional): <br /> f,Z I��65rE wrS,��Y�9 1566 915"-866- 1055- <br /> CST SI !AT E: <br /> s <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) —OVER — <br />