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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, _ DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0917) & Chapter 745) <br /> LOCATION: SECTION: OWNSHIP/MUNICIPALITY: LO O.:BLK.NO.: SUBDIVISION <br /> cYLL--' ' � . NAME- <br /> '/4 ✓o � <br /> /� 944 <br /> CO OWNERS B ER'S N,e' MAILING <br /> ri-/ 0S �DO1,L)zV L nWoD . <br /> USE <br /> DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILED/ESCR PTONS: PER O ATIO TESTS: <br /> *esidence I N A. XNew ❑Replace I �/ 's 28' 6z vd <br /> RATING:S=Site suitable for system U=Site unsuitable for system '-3 C;;I— S') V' <br /> CONVENTIONAL: MO�IND:❑ IN-GROUND-PRESSURE- SYSTEM� I❑�LHO❑LDING T•FyNK: RECOMMENDED SYSTEM:(optional) <br /> IL\[YLS [:]U <br /> U fL.([`J1S UEMU ® <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)161,indicate: h- W I Floodplain, indicate Floodplain elevation: IVD <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH N. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- f /,90 rJOti(s fir, s„g15L75 , 3c2 ' 61J cis 41° �tJ MeD S. <br /> B- 1 8 /00 �d •.�uLszT�, 3� a„�c = 38 g ��1�� <br /> B 3 G�� 58 6n �0 S,- gt sLzS. � �" 3o cs 3a' \-3v Ml <br /> B- ® 6 --767() S P7 L S� r5 z )�!,v c.s 8,-- rwt7D <br /> s'6 7 &C� <br /> B- <br /> 13- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1. PERIOD P R PERINCH <br /> P- / lli� Nt,��a 1'� to 4 1 <br /> P- 2 y S it \ N �t <br /> P3 2A& Al <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 /> Strs•'talL il�'(' Al 6r?N'lac- <br /> SYSTEM ELEVATION <br /> sz� <br /> 1 . <br /> PE3 sTn l t S <br /> Zdr � � , ig I 1N <br /> �o be,© S f cd o <br /> 0,e �bQrti , uo r$sMT 7�, <br /> f <br /> i fB <br /> Ip <br /> � � ��,�([yy �mm 1_0„ <br /> 1,the undersigned, hereby certify that the soirFelts porfe3bn 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 (pr i TESTS WE <br /> 6 7 COMP TED ON: <br /> ti <br /> ADDRESS: CERTIFI ATION NUMBER: PHONE NUMBER(optional): <br /> LIJ1, SyE� �4t.3�9 <br /> CST U E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — �— <br />