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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HLMAN RELATIONS <br /> (ILHR 83.99(1)& Chapter 145) <br /> CCATI N: [/ SECTIO%Tyzrl/R�SEIn TOWNSHIP/MUNIC IPALITV: LOT NO.:BLK.NO.: SUBDIVISIO,N(NAME: y <br /> 4l IV <br /> CO NT V: MAI LING ADDRESS: <br /> tt r D(a lrC nau�+J / II1ar�t ��, S S pS/ <br /> USE DATES OBSERVATIONS MADE <br /> NO.BE"': <br /> COMMERCIAL DESCRIPTION: ONS: PERCOLATION TESTS: <br /> Residence ❑New 5eReplace 6 -_;1y 9'l 6 <br /> RATING: S=Site suitable for system U=,Site unsuitable for system .. <br /> ONVENTIOONNAL: M®ND:.OU. IN-GROIN ❑�. E: SV,STEM-I®ILL O❑LDING_ZAN.K:RECOM NDED StYSTEM.loptional) <br /> Lder DESIGN R Lill <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ibl,indicate: � � Floodplain, indicate Floodplain elevation <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER t7F SOIL WITH THICKNESS,C TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION .OBSERVED EST. IGHE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.). <br /> B- / �3 `� n �3 y" ; 79 " <br /> B- ,?- 7vi 'K-Z-7 nom- <br /> B-3 �a g�-s' n-Il > 7a u/3/5 � f 6 o <br /> B-y id' � 73 L . 6 q, ,!. <br /> B- <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. PERIOD 1 PERIQP2 ERIPER INCH <br /> P. 33" 4ryu kt.,Im, 3ft <br /> p <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicatescale 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 /> ! 4 <br /> SYSTEM ELEVATION <br /> — T- <br /> 104)I <br /> Afto -HI <br /> .� <br /> � <br /> } `` `+lam•^ S Sa <br /> = /'iE�JC _ __ 1 <br /> p <br /> y I 7p f � � . TN <br /> F'z 45Iy /3ar4.4 -4- -- -- <br /> } !T —.` .. <br /> J � - <br /> drr�m ;dq-i¢d 9j y¢a __ o8 03113 <br /> 016W OP &QD <br /> a `��?olty <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me inaccordwith the pro ure d hods specified in the Wiscbnsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and IeLf. <br /> l LilC67 � 9„ <br /> NAME(print): TESTS WERE COMP ETED ON: <br /> A !l2 u 6-d <br /> CERTIFICATION UMBER: PHONE NUMBER(optional): <br /> as ? 3 461r1 crc Svflo o 3 s - <br /> CST <br /> NATURE: fr <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD$395 (R. 10/83) —OVER <br />