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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABORAND MADISON,WI 533707707 <br /> ND PERCOLATION TESTS (115) P.O. BOX <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNS HIP/ 4e+PA-64-TY: LOTNO.:BLK.NO,: SUBUIVI ION NAME: <br /> E'/ r '11 &4 /T38N/R/8E (p WOM / 9 <br /> COUNTY: OWNER'S BtYFER'S NAME: MAILING ADDRESS: <br /> APAWRAN C t wi. J'7<.z- <br /> USE DAT ES OBSERVATIONS MADE <br /> Na BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESC IPTION PER 0 TI N TESTS: <br /> Ld�Residence 3 n/ New ❑Replace !7 (7 �J <br /> RATING:S=Site suitable for system U=Site unsuitable for system d Q <br /> ONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM:( ptional) <br /> ®S ❑U RS ❑U XS ❑U ❑S CRU ❑S U CUIV ED ' <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09151(b),indicate: AIA Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLO TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBR V.ON BA K.) <br /> B- AR oNE > a 41621sl 10o?Wge " <br /> B- ;I- Ian7s oNE > /aQ 7",B s 3 s/ 5 "vjc46 T'FnS <br /> B- <br /> >/a3 VWS1 <br /> B- / 99.R odr > /";4 irelsll. s" s/ lMrti44 7,?2, <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVELINCHESRATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PERIOD PERINCH <br /> P- l 7,7 4 3 <br /> P- P C 3 <br /> P. .G 3 <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 boring and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 9� <br /> - r <br /> SCALE — l 6/OGK—/Q` CBl/ <br /> Q BM- -roV oiuyrlLy Bak <br /> c° /npf°P3 f <br /> 1 o <br /> W 01 <br /> o 80 GS. _ PRo�rsEn CBS- <br /> ; �� <br /> C ^ick-ImE / HousP�E i-Be�01 <br /> ''�ERyL• �E$TS � o <br /> .V rG,1 <br /> of Gkovr/D <br /> W�c7,0 Be >sQ' 'TO' �h ov s /rAdcE ,vrEA <br /> XRa�f su/ria8t AREA Tod Cvt 'go0fen. <br /> y <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and me taus 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 WER COMP ETED N: <br /> ka S /s07 <br /> ADDRESS: CERTIF CATIO NUMBER: PHONE NUMBER(optional): <br /> ,<gsTE CcJ s 33�� a,A -39 <br /> CSTS GNAT URE <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LHR-SBD-6395 (R. 10/83) —OVER — <br />