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TMENT,OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> P.O. BOX 7969 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOC TION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> E '/4 22 /T`I I N/R Ib E (p X' <br /> COUNTY: MA LING ADDRESS: <br /> 15mt4e7 6Rt& W11DE. 3D2 7 \4 S 1 . <br /> USE DATES OBSE ATIONS MADE <br /> IpI NO.BEDRMS.: COMMER IAL DESCRIPTION: n A ESTS: <br /> Residence 2 ��� ❑New Replace s7 , _II 1y� ry('7 -91 <br /> RATING:S=Site suitable for system U=Site unsuitable for system LD l <br /> ONVENTIONA L: MOUND: IN-G ND-PRESSURE: SYSTEM-IN-FILL OLDIN TANK: RECOMMENDED SYSTEM:loptional) <br /> IV, <br /> DU <br /> ,r <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the IV p <br /> under s. ILHR 83.09(5)(b),indicate: �. Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> rB- <br /> TOTAL PTH T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> DEPTH IN. ELEVATION OBSERVED HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 72 X1.3 p >72 o- y'&lT+1s I-1- LkjUmswgr Lt-7- -M bNms <br /> Z 9 7.5 )'�Z?2 1'1.7 p <br /> > YL o-`(Ylms Lk'11-01Bl�msy l5t Li�1 �zs�t uqs <br /> 13- <br /> PERCOLATION TESTS <br /> • TEST DEPTH WATER IN HOLE TEST TIM DROP IN WATER LEVEL-IN HES RATE MINUTES <br /> E NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1PERI D2 R PER INCH <br /> P- 1 b 'si / N5 9% 3 <br /> P- Oo S -I/ Y S <br /> P. 7i <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 orings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION g`f'B <br /> fE{l - - --- _ r _ <br /> ♦8M IDD TOP OF SfeP. <br /> I <br /> 1 SUE <br /> O \ _ <br /> g <br /> t <br /> A <br /> ?L <br /> 3 <br /> i <br /> i <br /> Hwy 77 <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and method gsf�lt�6sc n- <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. /L/D JJ 11 NNNNNN Ps71 <br /> H,7 SE <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> BCH 9D /0 - Zg - `l 1 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBERIoptionall: <br /> o w E I . 3& 0 - S <br /> CS SIGNATURE: , <br /> 'IBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> '0-6395 (R. 10/83) -OVER - <br />