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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O.MADISON WI 53707 <br /> 69 <br /> HUMAN RELATIONS <br /> 11 LHR 83.09(1) &Chapter 145) 12- 4_557 -$5 32 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NA E: <br /> —Q '4 23 /T YoN/RIDE (or)W 0 3 <br /> COUNTTY:Y: MAILING ADDRESS: <br /> rJETC MAR i-j"r-ReID I lsqCARL LN . W . .sT- MAUL N. 5 1 <br /> USE DATES OBSERVATIO SMADE <br /> NO.BEDRMS: COMMER IAL DESCRIPTION: R FI ONS: PERCOLATION TESTS: <br /> ❑Residence /1 VNew ❑Replace it - �7 Q _ 92 -7 - 2-9 (1 27 <br /> RATING:S=Site suitable for system U=Site unsuitable for system 1 L I 1 L L _I <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK] RECOMMENDED SYSTEM:(optional) <br /> S ❑U ®S ❑U ®S ❑U �JS ❑U ❑SOU CONVENTIONAL <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> 9 If any portion ofthe tested area is in the <br /> under s. ILHR 83.0915)Ibl,indicate: (L_ Floodplain, indicate Floodplain elevation: /{••1� <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUP OWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATIGN OBSERVED ES HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B-j Iko S..r. '14o e >&D 0- ('jsh4 - 8aN z.-S- COo M-5 <br /> 13- '7— 690 18.6 Njwlc > bo t>-6.36 3-L- (0OKftts <br /> B-3 $0 .3 1 NvNE ) SO o- 6pN �o-3(, SNfs %- SORms <br /> B- y ?S 101. 8 NdIJ'4_ >1S C-SrBkfs S=30 D'J�s '50- -75-9013 <br /> B--5_ 15 02.0 0N_ >75 o-66116 v - 3S814 �s `6-?S�Ms <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD 2 PERINCH <br /> P- 2 No 7/ 3i U <br /> P Lq 0 No <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope- ALT- <br /> SYSTEM ELEVATION <br /> ----1 <br /> } T i <br /> l <br /> L <br /> '� JoHAISor( <br /> - <br /> I•.rS�t.�oo_rlAhi�1 q`/Nve,t�ny --� ! � 1 _ __ � : <br /> WE.uTa p iso Fi29M$£)v1 TN <br /> 8 -00 <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 specifiedW'sc nsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge nd be"ef. �/-/'-(� N F,f Z <br /> S eIL IG (J <br /> NAME(print): TESTS WERE COMPLETED ON: Ulu <br /> IicNARO oPKIN_5 � - 29 - 6j2 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(opjttt anal). <br /> 27"]6 ��0 33VV DS (UJI <br /> CST SIGNATURE: —t <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner end Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />