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REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DEPARTMENT OF DIVISION <br /> INDUS-My, P.O. BOX 7969 <br /> LABOti AND PERCOLATION TESTS (115) MADISON,WI 53707 <br /> HUMM RELATIONS (ILHR 83.0911) & Chapter 145) <br /> SC71 <br /> TOWNSHIP/MNA NA <br /> UNICIPALITY: OTNO.:BLK.NO.: SUBDIVISIONNAME: <br /> L CATION: Et <br /> ION: ^'n <br /> II/ 1>/ /TLION/R I E (°f MAILIN ADDRESS: 'V rI <br /> COUNTY: <br /> Erf P 4f--P <br /> DATES OBSERVATIONS MADE <br /> S: <br /> USE 1c� <br /> NO.BEDRMS: COMMER IAL DESCRIPTION: El New ILtReplace <br /> ❑Residence - -� <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GRWND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SVSTEM:loptional) <br /> ❑S ®U ❑S ®UE]S ®U ❑S ®U NS ❑U OL 'fa <br /> If Percolation Inon Tests are NOT required <br /> DESIGN RATE: I If any portion of the tested area is in the <br /> dere ILHR.309(5)Ibl indicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P HT GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED ST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) ID Bflaw'$ <br /> o- 2DBo15 2O - 3 N 5 W o- 3 W <br /> B- I 50 Z. Zo 4 - o Sa M5 WE UVNA <br /> 0-l0V%f> b-246ac-wK��d 2`l-3o rhsw crld <br /> B_ Z (`i 5. 0 6 30-$O 60 5 c- .J Y c_rv. - (04 a c e <br /> p- 1$lls 1' 7D W 15 7_0 - ZbBoC wRcmd Hutt <br /> B-3 �)$ 02, <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> Fi D I WATER L V L-IN H RATE MINUTES <br /> F DEPTH WATER IN HOLE TEST TIME P RI D 2 PER INCH <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI001 <br /> P. <br /> P- <br /> P- <br /> P- <br /> P- <br /> P- <br /> e dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and th <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 /> : a <br /> ACf-«D. <br /> tH <br /> : <br /> t <br /> r.. y _... r • _yy.. <br /> I � — <br /> ; <br /> - r--�-=1 <br /> 1 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 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 /> TESTS WERE COMPLETED ON: <br /> NAME (print)' <br /> CERTIFICATIONNUMBER PHONE NUMBER(optional): <br /> ADDRESS: ..3 - I <br /> CST SI NATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBDZ395 (R. 10/83) - OVER <br />