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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> MADISON,HUMAN RELATIONS SON,WI 53707 <br /> 11 LHR 83.09(1) &Chapter 145) � L <br /> LOCATION: SECTION: TOWNSHIP/ LOT NO.:BILK. O. <br /> K.N : SUB IVISIONNAME: <br /> V4 !/429 /T Aj 116E(or Oakland Townshi 1 CSM V0" <br /> 1.6, 52 & 53 <br /> COUNTY: MAILING ADDRESS: <br /> Burnett Richard H. Blaker 27599 Jeffries Road Webster, WI 54893 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS,: COMMER IAL DESCRIPTION: PRO DESCRIPTIONS: E A`( AT O� N TESTS: <br /> Residence 2 -----------_ El New ®Replace <br /> August 22, 1991 Ca. 22 1991 I <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONYMINI ONAL: MOUND: IN-GROUNpD�PRESSURE: SVSTEM-IN-FI LL HOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ©`� ❑U ®S ❑U OS ❑U ❑S DU ❑S X❑U Conventional <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: NSA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, OBSERVED EST. IGHE T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 0-5" Dk Bn ls; 5"-63" Bn med. s; 63"-72" Bn med. <br /> B 1 72" 99.1 None 63" S w mot f f f <br /> 0-5" Dk Bn ls; 5"-66" Bn med. s; 66"-72" Bn med. <br /> B- 2 72" 99.3 None 66" s w/R mot fff <br /> B- 3 72" 99.6 None 71" 0-4" Dk Bn ls; 4"-71" Bn med. s; 71"-72" Bn med. <br /> B- <br /> 6- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIODt PERIOD2 P R PER INCH <br /> P-1 2or 2 1/8 2 1/16 1 15/16 3 <br /> P-2 2 1/16 1 15/16 1 13/16 3 <br /> P- Ncn� 2 1/16 2 1 7 8 3 <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 97.4 scale 1"=50' <br /> _. .. T__... . <br /> House <br /> .Well <br /> U <br /> Bl.,6 <br /> PT B2 <br /> 'P2 <br /> Bb�100.0 Benchmark, Bottom of siding. _ <br /> 4 Boring pPerc <br /> ' P3 <br /> i — <br /> I <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(Nlsconsin 7 <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. ,� pvT SE;&7495 <br /> NAME (print): $(P <br /> TESTS WERE COMPLETED ON: <br /> Wade Rufsholm August 22, 1991 <br /> ADDRESS: CERTIFICATION NUMBER: NE NUMBER(optional): <br /> 24702 Lind Road P.O. Box 514 Siren, WI 54872 3583 PHO 715)349-7286 <br /> UbI bllUNATURE: <br /> Uv <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/63) —OVER — <br />