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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGSDIVISION <br /> INDUSTRY, - G <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> ScA,/N SECTIOIN- N/R/ lor)WTOWNSHIP/MtlMfeiP'ACITY: LOT NO.:BETNO.: SUBDIVISION AME: <br /> COUNTY: OpW EH''S BUYER'S NAME: MS�I ADDRESS: S F3 <br /> Ut.i /TUO 'eiT 4q Ince 0`�(� jot .2K lJQ t qJ <br /> USE DATES OBSf RVATIONS MADE <br /> NO.BEDRfvtS.: COMMERCIAL DESCRIPTION: PROFILE DESLR TIONS: PERCOLATION TESTS: <br /> Residence rew ❑Replace I ��� (1 �Q f� �.�� 0 �O J <br /> RATING:S=Site suitable for system U=Site unsuitable for system Vo V O <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U NS (�U ®S ❑U ❑S ®U ❑S ®U C a W <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)16),indicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DE <br /> PTHDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIONEST. IGHEST TO BEDROCK IFOBSERVED (SEE ABBRV.ON BACK.)e 7a- too, S > X1 � 1'IBti4 9 " 8 r 60Qa 3"6 Its ift, 'e r / " std S <br /> B3 Qo 0�. c � 0 4 ''44 / (5 b(o `' A KA&le, S <br /> B' V Q O, 1 '1 / ff ( 0I 19k ' <br /> B-S" 9KZ3 ! 0 I Fa "Bns g " /i4. -0 It8 S <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. PERIDDI PERI D2 PER PER INCH <br /> P <br /> 3o o o <br /> P- a a. IV c? l7 j <br /> P- <br /> P <br /> P- <br /> PLOT PLAN: Show locatio 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 re ere nd show their location the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION - BQ ss f rc a <br /> 44h"-� ,6 arc a <br /> �X c ��t w �t ►-c `_ o <br /> n� oT� d 9,004° <br /> F r / <br /> Ile <br /> 4�tq <br /> TN <br /> t � 0� /N '!. <br /> l�b <br /> V I , <br /> h , <br /> I,the undersigned, hereby certify that the soil tests reporte o chis f m(n•erDmt' b�e in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Code,and that the data recorded and the local io of the sts aliNeg4ect to the best of my knowledge and belief. <br /> NA to it) TESTS WERE COMPLETED ON: <br /> I' i `ehfc 91* 7 -1 v 89— <br /> ADDRESS: r CERTIFIQATION NUMBER: PHONE NUMBER(optional): <br /> 1, S 9 � /T Ta <br /> C NA URE: <br /> � T <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. / <br /> DI LH R-S BID 6395 (R. 10/83) —OVER — <br />