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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SE TION: TOWNSHIP/MUNICIPALITY: OT NO.: LK NO.: SUBDIVISION NA <br /> '41e% // 1/ IWON/R/S I (p J�e�.sr,..v 6oI/ La r <br /> COUNTY: MAILIN ADDRESS: <br /> f3uauz�r C 4 W. Cq�nj��5� �Q��o <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS,: COMMERCIAL DESCRIPTION: �7 <br /> esidence N4– 1:1 New iapiece <br /> RATING:S=Site suitable for system U=Site unEgSsuitable for system / 6 <br /> OPV ST❑U . MOUND:❑� IN-G6aESSURE: SY� 1❑�L [:]S G TANK:RECOMMEpEM ( 1) <br /> If percolation Tests are NOT required DESIGN RATE- If an Iortion !r <br /> n � V Portion of the tested area is in the <br /> under s. ILHR 83.09S)(b),indicate: /U ri— Floodplain,indicate Floodplain elevation: k'�— <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO ROUND TER-INCH CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED ST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B_ -0_1 �oe� �¢' 6 ` �� s��y5 78` /'vN_ f_S- <br /> B- a 6 L 5 k Js . can) <br /> I <br /> B- 3 S" 3- , �S 6" ' at •S 1-`iS 6qt BAJf -I�s, <br /> B. 4 �4� �9° �„ g�si�� <br /> B- s 6r ��� fit. 8� SLT� loD� �3►� �, <br /> B_ <br /> PERCOLATION TESTS <br /> yTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES- AFTERSWELLING INTERVAL-MIN. —PERIOD 1 p RI DPERIOD3 PERINCH <br /> P- 'I <br /> P. 24 <br /> t( s I 70 <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. " <br /> t <br /> I � <br /> I (r <br /> aN <br /> p(r S Dl b N <br /> D <br /> i — ti`j <br /> I, the undersigned, hereby certify that the soil t sts reported on this form were made by me in accord with the procedures and methods specified in theW consin <br /> Administrative Code,and that the data recorded nd the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (p in TESTS WERE C MPL TED ON: <br /> ADDRESS: l��a <br /> CERTIFICAT [J N "BER: PHONE NUMBER Ioptional): <br /> CST '/P-EJB <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> OILHR-SBD6395 (R. 10/83) – OVER <br />