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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY,, DIVISION <br /> LABOR AN - P.O. BOX 796 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY OT NO.:BLK.NO.: SU NAME: <br /> '/ W '/ /T 0 N/RISE (p Jack <br /> orJ /S DIVISION s <br /> COUNTY: MAILING ADDRESS: <br /> ARU Wr_6 -Iz Di S 93 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMM R IALDESCRIPTION: PROFILE DESCRIPTIONS- <br /> Residence IESTS: <br /> ? � XNew EI <br /> RATING:S=Site suitable for system U=Site unsuitable for system L U I <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> 9611 ❑U RIS ❑U �1S ❑U ❑S U EIS U �� <br /> If Percolation Tests are NOT required DESIGN RATE/: <br /> 9 / v If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPfH IN, ELEVATION OBSERVED H ST TO BEDROCK IF BSERVED(SEE ABBRV.ON BACK.) <br /> B- 72 �6 7`7Z '8 / 5 - / .v 5 cu9r /8-Y8 &A.)MS Ij <br /> Z u w ND <br /> B Z O' ) fs -23 'jISne, '23 -50 ip'sw5Y- <br /> rl 0 '50- 72'EiNtvls w 3Ai <br /> B ll q72 li O-9 ) S 7 208N swgr Lo - 43 NM5W <br /> 1-13 - -Ml' / MSW NDS <br /> B- 1( - SAME AS B- 2 <br /> B- Jr f) 9 . 4 4N[s $- >✓ s wtv' Iii - Lt 13 N M5i✓5� <br /> - 2 Q P15 <br /> B- <br /> PERCOLATION TESTS <br /> YTEST DEPTH WATER IN HOLE TEST TIME DROPI yvMIT TrV 7-IN HES TEMINV <br /> f NUMBER INCHES AFTER SWELLING INTERVAL-MIN. p ql D 1 PERIOD Z p q PER INCH <br /> P Q -1 $— <br /> P- Z D 10 % -> <br /> P- s <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 ocatiionn on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION .S 2 <br /> _ <br /> -1 B►�)oo.NAIL SIJ 3'rAJO��w A��lIU� � r r _ <br /> fl Pi5R4 >So ROAD <br /> y <br /> • u_ s <br /> qWA� ADM Su�iig6t£ PRotosFn . _ x _ _ <br /> �3a <br /> 4 <br /> .a <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 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 COMPLETED ON: <br /> lCl{ Dop' _/ s <br /> ADDRESS: CERTIFICATION NUMBER PHONE NUMBER(optional): <br /> (J6 3 J(0 0 - &A - WS, <br /> CST SIG TUBE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />