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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDPERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS \ / MADISON,WI 537073707 <br /> (I LHR 83.09(1) &Chapter 145) <br /> LOCATION: SECTION: TOWNSFLIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> GL 4 (0' i .2011 r4oN/R li Io SAUC sef✓ — — <br /> COUNTV: MAI LI NG ADDR ESS: <br /> U2 = 0►�`l �JF� /'I CIU S B�Sr/ �1�. GU�73$Ib2 tJl: 5�1B9 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: IpRC �� ONS: AA N TTESTS: <br /> esidence ❑New -place '7/ 7/L— <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CON ENTIO❑NAL: MOU % EU <br /> � G121S Ell E: SYSTEM-I N❑-FILLHOLDING TANK:RECOMMENDED rtf�A1 tional) <br /> If Percolation Tests areNOTrequired DESIGN RATE I If an A / <br /> ^\ L y portion the tested area is in the h <br /> under s. ILHR 83.091511b1,indicate: W Floodplain, indicate Floodplain elevation: V <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED ES HES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> R" ( ¢ " !f� NDfJL� 94 " 6 8N, ",L.T5 2`1"/;71/S JO" !a P, "&tl,5 <br /> B 2 9 gl 6' yf�s� �s66u61'J5 .2V6k 0i3AJ <br /> B- <br /> e- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN, PERI D1 PERIOD2 PERINCH <br /> P <br /> p- <br /> P S 1 <br /> P_ <br /> PLOTPLAN: 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 ELEVATION 55 " <br /> �3 t�xC <br /> I Li <br /> - _. 1��()" -�.... .. B•M. loo`.m- AT CORr4'n._k"r G,QraOB _ <br /> - � ' I GW SL4� roe riot-ow Spf�-r, t�H <br /> Noutr •t <br /> i 1 <br /> hrrj � z� r—b e ky J. � ' 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 meth s specif d in/ scQQnsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. cwPsy-,$ = <br /> �(] <br /> NAME t _ TESTS WERE CO PLET DON: <br /> �����Z. � <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(o tional): <br /> �i 3 13� �) v > �1 � as3 p <br /> G <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R. 10/83) —OVER — <br />