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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, PERCOLATION TESTS 115 DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN REL-TIONS MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: OWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: <br /> 1n/'/ 5E'/ 2 /T N/R E (or W I b A c <br /> COUNTY: MAILING ADDRESS: <br /> 130 tj ZRI IAN ?I1 D(J . 15sq 18 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: R A I ESTS: <br /> Residence �, Vew ❑Replace -IPIILE,L)ESCRIPTIONS: <br /> !) . t) Q - ' <br /> RATING:S-Site suitable for system U-Site unsuitable for system �6 0 <br /> CONVENT(O❑NAL: M�O:❑� IN G�� ❑� E: SySTEM-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> -1'Q�I S U a S �S r U S`I�2��.�Ut N✓ <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> q �_ 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 /> BORINGTOTAL DEPTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPiH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 2 O NoE > 7 7 0- 3C6TA.5w5,­ 30o- `IZRrvtsw r <br /> B--Z- 0 3UiT,05\4 ✓ _ -! Sw r <br /> B-3 �� Z 11 ) I _ > - 7Km <br /> O _(p U fd 5 o— Z m s w -r <br /> B- S �` `� o �1 v5,9115 S -?,-LUIS z- MSU <br /> IB- <br /> PERCOLATION TESTS <br /> FST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI D1 PERI D2 PERIOD PERINCH <br /> P_ I 2I— <br /> p. <br /> P-2- 3 o ll 7/ �/ Y <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. <br /> SYSTEM ELEVATION 96.6 <br /> T— i <br /> —— -- ---Ij I i <br /> t7l <br /> i <br /> I I l i i l <br /> I <br /> it <br /> I l <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 /> ADDRADDR ESQ —�d CERT( (CATION NUMBER: PHONE NUMBER(optional): <br /> hob t;' _U L - s <br /> CS IGyATUR E; <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> r)I IMP GRD AIGR IR In/R' <br />