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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS (I LHR 83.09(1) &Chapter 145) ST 88-33 <br /> V' L �;)— <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> / �/ 3 `/ IUD N/RISS( r)W z-gc,/rr e <br /> COUNTY: fit— OWNER'SBUYE R'SNAME: MAQI L-IIN.G ADDRESQS: �/ <br /> BVhMC fl e f 9� 1 EJO l <br /> USE DATES OBSERVATIONS MADE <br /> PROFILE OLATION <br /> : PEtR/ TESTS: <br /> ®Residence NO.BEDRMS.: COMMERCIAL DESCRIPTION:� �lew 1:1 Replace � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE -IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ©S ❑U ®S ❑U ®S ❑U � ®U ❑S ©U C d N/c/ <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)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 71. Q 6 771- D-s "IS 4,t,,J, S'"/y"Bn , tfr /Y'_2)'"6n G! <br /> B- 3 72 973 `' � 7Y vs" dts'=ao " �l ae ", » • Botts <br /> B-3 -7 ( � (� o -s " BitK in,.d r s"- 6b"e„% y is (0 71" W/ o <br /> B- 7a 6, 7 ) ` (off o _s ' eck, <dl s '_ /a^ 8,, ,,�IN . Cr <br /> jP- vB" en <br /> B -7 1, " ® nts w n.." 7 t.wD <br /> B � 9 tt > > 1 -s'aik�,.dr r '- iv"e,„„< Jr �Y'= �� "RS�f cs <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. PERIOD PERIOD2 PERIOD 3 PER INCH <br /> P- <br /> p. I/ <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. �j-r-C rN I.••l"FLI: ` SCe-6 B fA le 'a <br /> SYSTEM ELEVATION �$'3 . 1./ " 41%rW it <br /> CaGitAb— <br /> I 1 �I S �Ln4ers Nom d <br /> tN <br /> J� <br /> Lvt <br /> Jt S 0 1 Pre .w. <br /> �( S4t lnh (-P 4r-e % <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made W.e in accord with a procedures a d 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 beli f. <br /> NAME(print): TESTS WERE COMPLETED ON: <br /> ieAc bIc Illis `v- R- 88 PH <br /> ADDRESS: CERTIFICATION NUMBER: ONE NUMBER(optional): <br /> l t6P W1 5y q 36 0 �(s 866 y15� <br /> CS"[SJ NAT�U�R'EE <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />