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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY; - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOK 7969 <br /> HUMAN RELATIONS 1 MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOC"1(Tt,&;1W_ <br /> ECTION: TOWNSHIP/MUNICIPALITY: OT NO. BLK.NO.: SUBDIVISION NAME: <br /> 6C /T ON/R16Elo )W c}iclgr7�CO MAI LING ADDR SS:? C°tlt�F2t S f f�Vv7�Jd�J q is D, Dqo " 0r 3n <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COM R IAL DESCRIPTION: TS: <br /> ❑Residence �6M/1 74il ❑New apiece //:/ <br /> RATING:S=Site suitable for system U,,/=Site unsuitable for system 7 T 7J <br /> ONVENTIONAL, MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDI NG TANK:R ECOM MENDED SYSTEM:(optional) <br /> S ❑U S ❑U S ❑U ❑S U ❑S U u rrroA) <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required If any portion of the tested area is in the �� <br /> under s. ILHR 83.09(5)(b),indicate: c&SE S'J7//" sll_ Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALP H TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B ��' a8�'I o�el 75 " �3L SL Ts 6 tt s <br /> B- 2 $7`' too 3Kx)rJE <br /> B '15t1 RD`Qr, <br /> V <br /> B- b" *0 IL <br /> Bfx <br /> - <br /> PERCOLATION TESTS <br /> DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PE RI PERINCH <br /> 1 y c— <br /> If a <br /> P I f 5 <br /> P- N z7 I y <br /> P- <br /> P_ <br /> P_ <br /> P- <br /> PLOT <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 ELEV TION. = 3 `" <br /> j t , - _- G.D - p <br /> t 1 <br /> _ I7 A 7 <br /> . (�b�A <br /> 1� <br /> t _ N <br /> I <br /> b B <br /> \ 2 i 1 t O <br /> � <br /> �. <br /> _ <br /> I ' <br /> VL <br /> C 1 <br /> I i <br /> I,theundersi4ned, h reby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified the Piscpnsin <br /> Administrative Code,and that the data recorded and the location of the--tests are correct to the best of my knowledge and belief. jjwr / <br /> NAME (print)' �/— TESTS WERE C MPL ED ON: <br /> ADDR ESS CE RTI FIC E14 N[ R- PHONE NUMBERIoptionall: <br /> 7n _ <br /> CS E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) —OVER — <br />