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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABORAND P.O. BOX 796 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> OLHR 83.090) & Chapter 145) <br /> LOCATION SE TION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> '/ 1/ 2/T DN/R Ilo E (o W Q Bj'q Vedoto (aIle Esta <br /> COUNTY: MAILIN ADDRESS: <br /> ug �FA sN L_ x c.LE Pi nl . o 14 <br /> USE DATES OBSERVATIONS MA E <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: I PROFILE V N TS: <br /> ❑Residence 2- � %New ❑Replace g_ 4 _93 <br /> _ 4 -93 `f . 93 <br /> RATING:S=Site suitable for system U=Site unsuitable for system(� <br /> O�STl❑U J�V.J ❑U IN J ❑U E: S�J I❑U L ES G�U TANK R�`n A�%FI✓T�1/1 A/f�SYSTEM:(optional) <br /> If Percolation Tests are NOT required DES/IGN�RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: 1 Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL <br /> NUMBER DEPTH IN.JELEVATIONPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> OBSERVEDEST.TMTHHE TO BEDROCK IF OBSERVED (SEE ABSRV.ON BACK.) <br /> B- J (o( 9?-9 NDNE �(a O- (o(o BNms <br /> B- 2 / M-2 >�� o- 381ms 3- to(eBPims <br /> B-3 (fp(o INDNE > 4p4 O— 3 BIMs '5 - GL 1 tjyg3 <br /> B- 4 (00 qG. DN6 (od O - (00 FWMs <br /> B- 5 6. >�O lo ms <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. —.-PERIOD 1 NF1 D2 P PERINCH <br /> P- 1 5 / 8 3 <br /> P- 2 o 5 4 2 Z 3 <br /> PZ7— 1 Vq 3 <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 location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 95 60 95.0 <br /> I � <br /> 9 a <br /> 4 ' <br /> 200' 3��T . 4 TN <br /> too' LINL NoT�A <br /> ♦3M I0oTnP Of fxJsrlNG Df, _VENT <br /> VJLL Td IV----> ' 'FRoM._Seo . <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 spec tied in the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best fknowledg an Ief. qjl,s0 SE <br /> RpA. 910 <br /> NAME(print): TS WERE COMPLETED ON: <br /> - 3 <br /> ADDRESS 0 2� )wir- �O <br /> CERTIFICATIOwrs�913 -?)67N NUMBER: PHONE NUMBER.JJ. ,A /\ T S <br /> CSIGNA URE: -' b <br /> "; <br /> f-t r <br /> DISTRIBUTION:OrigmaPandone Local Authorav,, Property Owner and Soil Tester. <br /> DILHR-SBD�6395(R, 10/63) M1 —OVER — <br />