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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> C,6e, of (1LHR 83.0911) &Chapter 145) <br /> LOCATION: SECTION: TOWNSH I P, IC'ITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> �/ 1—/1/ MY N/R/y o E N� Na a <br /> COUNTY: MAIL NG ADDRESS: <br /> Bir Ns?T KAr#ZEeN /foTeHfciSs x°/7/3 0, S'f/EYL 1Q/rf ld.' a�flk7/ <br /> USE DATES OBSERVATIONS MADE <br /> �� NO.BEDMMEAESCRIPTION: PROFCRPTIONSERAIORTN TESTS: <br /> 145esidence ❑New yyeplace I <br /> _3 \ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI LL HOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑U ❑S DU ❑S ❑U ❑S ❑U ❑S ❑U <br /> TE: <br /> If Percolation Tests are NOT required y If any portion of the tested area is in the <br /> DESIGN RA <br /> under s. ILHR 83.09(5)(b),indicate: ��l Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH 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- No M6 f/L o-( SxIsTs 6-9 /25 9 yo ws yaSfl fs SS-63 <br /> � P� � <br /> B-� 1 '7 �� -;LL 6 - / ¢r1 (s h' meo. s Ys- s6.2 <br /> B-3 7� 9A..3 ;7 <br /> 69/y Zs Ts o s ars S--/1' �nEo s/s-G! fs &1-7 <br /> B- <br /> B- <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. PERIODt PERIOD2 P R PER INCH <br /> P- <br /> P. <br /> P- <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 /> � I r <br /> SYSTEM ELEVA I N <br /> 4:- . Told �or <br /> Lo . ftco . pEs4prSo <br /> 17 <br /> IN <br /> DRY <br /> r` f <br /> sE�`!T` T' <br /> Tt`F TP Be, / <br /> I i. c��[c B�o�eoam I <br /> Nbma <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(printl: TESTS WERE COMPLETED ON: <br /> C,-C;4 3 - aG . 9/ <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> /P Tr 2- s/t'ELL !Alec W;s 41rF7/ �/T9 7�s"/oj5-.3�tYU <br /> CST SIGN A URE:,, <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. �,.,(,� ^ r�� <br /> DILHR-SBD-6395 (R. 10183) —OVER — — vA I4,0, >`� /� <br /> 76 5'zt-6v S�-/4-4P 36.E 3 ! be1o0 5iff- <br />