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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR P,O.HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON,W 537707 <br /> (H63.09(1) &Chapter 145.045) <br /> LOCATION: E TION: TOWNSHIP/s•U^ r- p^ ' LOT NO.:BLK.NO.: SUBDIVISION NAME. <br /> Go✓ 1/ 1/ a/ /MN/R !7E`t«tW N r� <br /> UNTY: OWNER' 101.- S AME: ?Pyo-5 <br /> AILING DR SS191 : <br /> Ni E/- nRssr r,,o <A � G3� <br /> JSE DATES OBSERVATIONS MADE <br /> NO,BEDRMS.: COMM R AL DESCRIPTION: PROFILE DESCRIPTIONS: LATION TESTS: <br /> WrResidence Z NR ®New ❑Replace s— .2 r/_ SCJ _ �� f-/J/ <br /> RATING:S•Site suitable for system U-Site unsuitable for systemQNVENTID f <br /> S O� . MEJS-s� IN K� ❑� . ❑� �LHO❑DING TANK: R��N ENDED SYSTEM:(optional) <br /> S_ 11!_�71U1 ' <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under ii.1463.09(5)(b),Indicate: N A Floodplain, indicate Floodplain elevation: Np <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES ICHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B i 7? 97`-G' E } 7z <br /> B- z '79 99 "_C'B- 3 W <br /> t <br /> B- �I 78 5' Gr' If , 9� u" // 3o„z3„ 5 <br /> r <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERI D 1 P RI D2 P R PERINCH <br /> p- / v 3 . 3 <br /> P. <br /> P- <br /> P_ <br /> P <br /> -P- <br /> P <br /> P <br /> LOT 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 /> Lntal 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 /> f land slope. <br /> SYSTEM ELEVATION = '' <br /> i4» 8DRE .7- r5T t.u7- 111ve <br /> ,0 = laegc 7741F-Sr <br /> 13M.- ;VRp - J!usE o <br /> - ^1+tliD rt{�RiNT.. , <br /> Rid f f1Vi a 1244' <br /> SLOP <br /> V. <br /> = �tJU TA•BLF ARIf9 „�� ,�' -T � � � � v k it ' <br /> P 01 <br /> 1 ��_f`�D f k 3 -'�' <br /> _} VA r <br /> — I I F � 4 <br /> L6 Li _- _ Orr. <br /> I I <br /> the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the prozdures and methods specified in the Wisconsin <br /> dministrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> s <br /> AME (print): TESTS WERE COMPLETED ON: <br /> f&,0R.9 S- 2 '/- &y <br /> DORESS: CERTIFICATION NUMBER: PHONE NUMBER(optio <br /> 2 961w �'/O SRrn/ L�kS S%��Z cs7 rya/ s�� nal): <br /> � <br /> CST SIGNATURE: <br /> ISTRIBU TION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> IHR-SBD-6395 (R. 02/82) --OVLR _ — <br />