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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, __ <br /> LABOR AND P.O. BOX 7989 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (1 LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTO.:BLK.NO.: S <br /> NUB_IIVISION NAME: <br /> tAl 4�Iwo 1/4 ( /TyU N/1114 E ( , 9 t q� - a I N <br /> COUNTY: OWNER'SBUYER'S NAME: MAILING ADDRESS: I <br /> BvQN�f7 17 014ik/WOJ + 1/63.39 SO, Z t9b,0 u1AIZI• <br /> USE DATES OBSERVATIO S MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFIL DES R TI NS: PER 0 ATIONTESTS: <br /> Residence 4- ❑New ePlace I �-y_/�, � 7—,(/',_�� <br /> RATING:S=Site suitable for system U=Site unsuitable for system / 6 / <br /> CONNV�VEcpNTIONAL: MO-U�UNppD: IN-d�R-(5grNpID-PRESSURE: SYSTEM-IINN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> I`�-J ❑U lLN ❑U LCI J ❑U ❑S RU ❑S 4J U L7o tiU421D A R-_el <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the I <br /> under s. ILHR 83.09(5)(b),indicate: N ili�— Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITHTHICKNESS, COkOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.1 <br /> B- I `1 ? loo 4" wAic 7 2 sL75 g,L <br /> B- 2 c� o" POVE SL-M P5 1,2- r S <br /> B- 3 lo:3 q9=9t_� 6a)" �` sc � FD1, <br /> B- �I `�a� /00'6" -7 SLFSPA, 6 g ' R FS <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIODI PERIOD2 PERI PER INCH <br /> P <br /> P- 2 0 110 Y, 1. 3 3 3 <br /> P- L f l 3 <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 a41 borings and the direction and percent <br /> of land slope. - <br /> SYSTEM ELEVATION LAY� <br /> - s <br /> 45' w <br /> loo`-o'er <br /> TN <br /> ztto' <br /> ds <br /> ��30�" 40 <br /> r <br /> I, the undersigned, hereby certify that the soil tests rep ted ctntis 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): ITESTS WERE COMPLETED ON: <br /> ADDRESS: , ICERTIFICAT ON NUMBER: PHONE NUMBER(optional): <br /> ,c, � � �o r /t/r 6� 72vcf 35 <br /> CST UR <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) -OVER - <br />