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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY,LABOR � /� C DIVISION <br /> BOX 769 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (I LHR 83.09(1)& Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> *0/4 3 /T N/R/ J'(qr W t /L1¢rrk /an d <br /> COUNTY: MAILING ADDRESS: <br /> upne7t cc / a aIr 0• h 274/ a a �l�Uo6 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMM R IAL DESCRIPTION: IIS�II"' ESTS: <br /> Residence / ❑New t•yteplace <br /> u 7 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONOV CONVENTIONAL: ,, �.� INGO� ®Q 'TEJTS IZUL XS EA RE Q -o /�D/V5 ZE ezi4nal� <br /> If Percolation Tests are NOT required DESIGN RATE: eL7/ <br /> q / If any portion of the farted area is in the <br /> under s. ILHR 83.09(5)(b),indicate: ~/ Floodplain, indicate Floodplain elevation:SIA <br /> PROFILE DESCRIPTIONS <br /> BORINGTOTAL PTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED I EST.PTZTR—Esf_TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> 3o„Bh J w c M R a,oYi of <br /> vre J a� <br /> B a a6" 44 'S" vn e <br /> ,301/ C –a' l3ls/�� I+i/c/trd /? *j>/ -,e 7- <br /> B a �'� 9a -7' <br /> a -a�xd1Xr12 25el'/?,-, r w c�,d �,,r <f <br /> ' on <br /> B <br /> B- <br /> B :JA <br /> - <br /> PERCOLATION TESTS <br /> yTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RI D1 P RI D PERINCH <br /> P- D -/o ao r 7` Cbn c 7 . u ca <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 borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION C a iftsf Ai a .je <br /> �N s //1,44�rjfNw rX � ._ t 4 �tAl�l/`O" s- — 1 <br /> / acr�f _ <br /> �e. <br /> � I I i <br /> B <br /> ooh �grrr / <br /> It <br /> i a6 <br /> tN <br /> fio® <br /> 0-('Ce Mae f t to <br /> P <br /> oIF <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 specified in the isconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. /4V y___ <br /> NAME Iprintl'. TESTS WERE COMPLETED ON: / <br /> /cz coff_ Su FC? <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> CST SIGNATURE: <br /> I <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBOb395 (R. 10/83) — OVER — <br />