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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNS HIP/MHMW+PA4AT-Y OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> '/ 7 /TSI/R/6 E to 02, jblxl TTu��fu /5 — ,L'iver Gi� <br /> COUNTY: MAILING ADDRESS: <br /> USE DATES OBSERVATIONS MADE <br /> NO.BED MS,: COMMER IALDESCRI PTION: IIPR FILE SqC/� (�/ I/ TESTS: <br /> Residence 3New ❑Replace l ne oito� /9d7 t1le <br /> ll � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> p®� ❑� O� �� ❑� ❑ <br /> TI M N�, IN GE: SVSTEM-IN-FILL OLDING TANK:RESV lylaoptional) <br /> ® DESIGN RATE: S U EIS <br /> S U <br /> If Percolation Tests are NOT required If any Dortion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodo in, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GR UN DWATER-INCHCHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HE ES TO BEDROCK IF OBSERVED (SEE ABBRV.O BACK.1 <br /> B- / 7v3 /f /onf > 7W" <br /> ' // Q-7^OE . /s; 7" s7,',E'me,-/s; 37'- <br /> B-,,2 ��" 9� N� > <br /> B- 3 95• .Clone > 2� Mme O� f3/ <br /> B- 5 ��" 95 /L/O/7e >,a„ -S„04,6n T5 <br /> ) <br /> B- 6' 70) <br /> PERCOLATION TESTS <br /> lTEST DEPTH WATER INHOLE TEST TIME <br /> DROP I WATERLEVEL-INCHES R'4 TE MINUTES ES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. pE RIOO1 P E R FaD2 P R <br /> „ S 5 <br /> p- " 5121 Z <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. r <br /> SYSTEM ELEVATION 9-5,3 ��"��� f '160 <br /> a -' <br /> ffiAJ3 <br /> 3 <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) TEST U//f ERE CONI P'LDQN: <br /> Oddd(Y/J <br /> ADDRESS: CE TI FICATION NUMBER, PHONE UMBER(optional): <br /> &V,Z) e 5 61490 <br /> CST <br /> SIGNATURE- <br /> DISTRIBUTION: Origmal and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD6395 (R. 10/83) — OVER — <br />