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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND - P.O. BOX 7969 <br /> HUMAN F.�LATIBNS PERCOLATION TESTS (115 MADISON,WI 53707 <br /> (ILHR 83.09111 & Chapter 145) <br /> LOCATION: SECTION: TO WNSHIPPAbliNteil Atl'7Y' L047r: K.N .: SUBDIVISIO NAME: <br /> SLC '/ S '/ /3 /T��, N/Rist (or)W L /s 'ti. l <br /> COUNTY: y� OWNt-JE.R'S/tBUUYERS NAME: M,A II SLING ADDREESS: !/ / '7- <br /> r /�� �` 'rt"c "1 ✓, 7 .T- Cu `R / d /' i <br /> USE DATES OBSERVATIONS MADE <br /> I yr NO.BEDRMS.: COMMERCIAL DESCRIPTION: ��) _ PROFILE E .RIPTI NS:1 ER CATION TES <br /> L[A Residence ��--——_-I 12�New UReplace� <br /> RATING: S=Site suitable for system U=Site unsuitable for system 11 7 <br /> CONVENTIONAL: MOUND: IN-GROUN6PRESSURE: SVSTEM-IN-FI LLHOLDI NG TANK: R ECOMMENDED SYSTEM:(optional) <br /> � $ ❑U OS ❑U 1Z ❑U ❑$ CSU ❑$ 121U c e k-'L <br /> If Percolation Tests <br /> ,;NOT requiredDESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)(b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.1 I <br /> B' � o � lo � i11 `� �� �' S d "�l f `7y �'tlyd S <br /> e-� <br /> q9_C c 4 i+ Gc� /6 `'%K 11 /�'" /�� l JI nn.� di <br /> / <br /> B- t Ic �J I ,�L' II 7 ! 0 (V�rX_ " S/ S n / C .1 A Ca <br /> 70 :76 eXI 5 <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME CHOP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1— PERIOD2 PERIODR 3 PER INCH <br /> , 40a- a a <br /> -.5-- <br /> P- 7 -2 3 <br /> P. a l s•/. �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. w :; <br /> SYSTEM ELEVATION 9 �� (� u <br /> 'p r c <br /> 5ccl'tz <br /> A i�cc -T' <br /> �Irc� Chi !ES 4 e. <br /> Prl%p 'ea� <br /> 'let � � Oct. �_ � �:1d areF <br /> O s <br /> / <br /> 73 <br /> 7 <br /> t <br /> � <br /> ' e4't •i <br /> Owe��t°+fI <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with t 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( TESTS WERE COMPLETED ON: <br /> S�- Y- Y �� <br /> ADDRESS CERTIFICATION NUMBER: PHONE NUMB ER Ioptloneq <br /> W e i r T; � S F'F � 3 �3- <br /> CST G�-NA <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. -Tf��C/R.tl.�,/�� <br /> DI LHR-SBD 6395 (R. 10/83) —OVER — <br />