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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> (1LHR 83.0911) & Chapter 145) do-�1i�o Q �- ato <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> '/ /T o N/R E lar A I <br /> COUNTY:V: MAILING ADDRESS: <br /> CORNTY: EARL MU 3 u 8 3 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEORMS.: COMM R IAL DESCRIPTION: IIqq -P iR FILE-DES A I ESTS <br /> []New IC� : <br /> O <br /> ®Residence 3 �� Replace I ' _ 2-oo T <br /> 08 16 _ 20 - O <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: —FIN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑S ®U Mow ❑S �U osmu osmu <br /> ou►�7 <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. (LHR 83.09(5)(b),indicate: I Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH T GR UNDWATER-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 foo _( ONE s 6-5- SZ-6G&v�'s <br /> B- 2 (00 uo 80mg3 D 5B//4s 5' SD-6 <br /> B- 3 b 0 Nme <br /> B- 60 9S ONE <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> tiESi DEPTH WATER IN HOLE TEST TIME D IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RIOD1 PERI D2 PERPER INCH <br /> P. 1 2-40 2 / <br /> 69 <br /> P- 22A 10is I <br /> P- 21 10 /16 2 1 ` <br /> P-2-iiiii. 10 <br /> r 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 hon- <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 9$ 7 <br /> / C <br /> j A W it I <br /> yo . <br /> $l�G Aiii)W #) 21�" OAKS <br /> N <br /> )Duuovi 'Wex <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 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 COMPLETED ON: <br /> ADDRESS �r CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> WEB 5 8 3 3670 S S7 <br /> CST SIGNJkTU E: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBO-6395(R. 10/83) -OVER - <br />