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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON INI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(7) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> - '�T N/R t6 E for e� onl N r1 4 211561 YciA P. las <br /> COUNTY: MAILING ADDRESS: <br /> DAfJ s 1� Owl. S <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMMER IAL DESCRIPTION: PROF TIONS: R ATION TESTS: <br /> Residence ' VNew ❑Replace r - ry. Z_ 5- 7--? - Z7 <br /> RATTIIING:S=Site suitable four system U=Site unsuitable for system J L 1 L _l I� <br /> OLT'STI❑U MOUND: <br /> MS ❑U ING 1s ❑u E: SXS I❑UL O❑JG, !j� IRe0NI L4T)Ot119 LSYSTEM:(optional) __ _ __ <br /> If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the •' <br /> under s. ILHR 83.09(5)(b),indicate: �� Il Floodplain, indicate Floodplain elevation: /V� <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED EST.HIGHE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 7- a NQN� ) 17 <br /> - 0 - (O& M5 L' - !Z BNMS <br /> EB_ �5 <br /> '72 8 .6 > Z o - (9 a1" 6- '7'z 6N ms <br /> `1Z 8.`l E >7Z o - '1131ru 7- 7�Bt-v).s <br /> ?Z � 7 E > o -'I B(ms r1- IZBivfu <br /> /I ` =72_ u- t9 81 of 5 ko 1 Z B pi gess <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD 2 PERIOD 3 PERINCH <br /> P- <br /> P. <br /> P- S 2S h10 ;4 14M 2 <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 9(0 <br /> i <br /> i <br /> LS�l�IE 1r'c IO/ <br /> A,1f4iDD_tJ ILlel_lo°ANAPJNE <br /> F�I.Tfl �E N <br /> >� Rort v y s ; <br /> LOT Gool AARoK - <br /> a 3 � _ <br /> �{©0� b•1. 6F:'�. ��� �01'o3Eo TeA1L� _ <br /> 1 2 <br /> , <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 ryQL Mfttrods spe / d in th�i/s6or/iinn <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge a �ef. <br /> D <br /> NAME(print): TESTS WERE COMPLETED ON: <br /> icNAl?-0 HDPK84s 5- 27- `1Z <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBERIoptionall: <br /> 2-7760 Nw 35 W6S T 1 . _ tgg�13 3� o 15 8�(- s <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBO6395 (R. 10/83) -OVER - <br />