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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS q MADISON,WI 53707 <br /> (I LHR 83.09(1) & Chapter 145) <br /> LOCAQqqQ �� y����/ S'C�IDN:T�IDN/R///��6_E lorl TOWNSH� U ylf`Pr%8 ITV: L LO .:C6}KQ �y ? BD%I$(1�0► �N/A(/E�,QOG�f�U� ' <br /> LN.(Nr Y1e-IT TY WOr1Q I� S NLTU(A V/N p//p GA&All1UGtr � Jv DJ® vL/•1'+0'/`�7/l'! / <br /> USE l� !� DATES OBSERVATIONS MADE <br /> NO.B MS.: COMMEQC'IALD/�ESCRIPTION: yyy���yyy PR FILE DESCRIPTIONS ER OLATION TtEES <br /> Residence 1 //�{ ❑New 0(J Replace11 � �/ —� <br /> RATING:S=Site suitable for system U_=Site unsuitable for system ` TaX AID. 0 6310— </3'// -0 /—3400 <br /> CO V s 1:1N6 . U S. ❑u IN Gp �1�N❑AUE/RE/:I EITEM-IN-FILLHOLDING TANK]RE �D SVSTE :(optional) <br /> q DESIG/ _ // / ,L�j y YJ Csoodpl <br /> If Percolation Tests are NOT re uired If an portion of the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON ACK.) <br /> 7 9S-9" 73 " 58 " SS" „ 5 15I <br /> Ad G w <br /> B-Z 73 It 95'9 73 " 59 5g "anS f5 5 <br /> B-3 73" 735 g " 5�„�nS /5"11 5 <br /> B 9 7 ,1 95-9` 73" 58'” 58 `'611.515 j�s <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. PERIODt P I oz FE_F1 10 D3 P RINCH <br /> P- .2 A1e>LR_ „ in m <br /> P- e2A . i. y <br /> P- a ;n 6 <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and illa'dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and ow their Iloa pirijdn the popAn Show the surface elevation at all bori gs and the direction and percent <br /> of land slope, L l� <br /> SYSTEM ELEVATION <br /> iii= Al Wcorner �ia'3 ' ( roc l yid <br /> Of k lk(AS�e. &+4'orA a`/ B3 s / ,4crl:!j <br /> oTRgdsid1n99 I rP.�� <br /> QSSGYYIL(� e /V. `�l00"_ I. 35 rar. /' vX <br /> /3 7 <br /> well ?5d <br /> sysf�m �+ o aL IF- _ 32_ 1_ TN <br /> pp S zsi r /'rojo. I �6 /rlSysicm <br /> lerx /3,sfr,/ _ f,E-2o Ad:fF.]k s1wfic A//D <br /> PercZ y �trzZ Ex A ,0 limclJ . <br /> fltrC,3 l3\J &X3I�PrO�C NGµs� I D yKlel' 1.3 6hly <br /> syslen, a YAG �. n, r k <br /> / Z'X3Sr M1N�'�In! c�IkE <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and r ethods 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 (print): �� TESTS WERE C MP ON: <br /> ADDRESS: CERTIFICATION NUMBER 7M� ?lo1/Op.tionall: <br /> SOX <br /> �fE L 2 S��.35_710 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />