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REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> X 76 <br /> ELATIONS PERCOLATION TESTS (115)- MAD IS N w 53707 <br /> (ILHR 83.09111&Chapter 145) <br /> yZA TIO SECTJION:�J �f TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISIO NAME: <br /> LINTY: MAILINUADDRES : <br /> lu(LV\e- - 1 J �2 cQ S I CLG N <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER AL DE R PTION: IPROFILE S� <br /> Residence ❑New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> 0NVEccNT10NA L: MOUNCcD: IN-GROUNNcD-PR : S STEccM-IN-FILL OLDIINcNG TANK:RECOMMENDED SYSTEM:(optional) <br /> 0V QU E]J EA EIJ EI� EJJ 0U EJJ EJU <br /> Percolation Tests are NOT re quo-ed DES RATE: <br /> 9 If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: IFloodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH T ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED hsTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B 4 .a Y 11 o n (�(`" /23151 <br /> , s . IS ,,Bast. " ,L rinods tA cs <br /> B- <br /> B- <br /> B- <br /> B <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LE -IN H S RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PER INCH <br /> P 3 , /y, <br /> P. 3- 3S C 13 I <br /> P 0112 <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 t air location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION a - <br /> I —_ Vt Xe <br /> - <br /> C <br /> 81 -0 1 � -- 460,4CA a s o'-clr <br /> I .1 <br /> - TN <br /> I a <br /> ,ry'u t' <br /> I I Je•� <br /> V/ 33 Nin i — - <br /> 1 I <br /> oc G L <br /> I, the undersigned, herepy certify that the soil tests reported on this form were made by me in accord with the procedures and m 'hods 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 /> .,. 1 <br /> NAME(print): TESTS WERE i-0I PLETED ON: <br /> 2 _ i <br /> (0 - s <br /> DRESS: q CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> D - G S( a -7- a3/I <br /> CST AI GNATUR E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner an,� r=star. <br /> D!1 HR-$Rn'"195(R. 1n/83) —1 <br />