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APARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> ,NDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> 3707 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (I LHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BILK.NO.: SUB 111111 ISI ON NAME: <br /> u/ �/,r/ /a ?7 /1rV0N/R/(oE Ip Q2i/onc✓ Tou/n3h <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING,qA�DDRESS: <br /> ,&/hell �r�u fie/ v, P0. ( UX J9S k/ehzAf.-, k/I J X93 <br /> USE DATES OBSERVATION MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIO S: PERCOLATION TEST(S� <br /> Residence New ❑Replace u/7e�� /9d �Jne /�Qd <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUNpD: IN_ -GROUND-PRESSURE: SYSTEpM-IN-FILLHOLDING TTAAjNK: RE^COMMEND/ED SYSTEM: optional) <br /> ®� ❑U ®$ ❑U IN ❑U ❑$ NU ❑$ zu COnVe"746-la <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COL R, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON B CK.) <br /> " 0-?'&/a; s/:as"-69 C5 ui/9r;34" 7=7' <br /> B- 7A " .some GLs 8/ <br /> 0-/0~6//s; 10"-41"14 An a/"- ~cs w/9r; <br /> B- 3 7a„ qP. S� /one > 7a " & M a <br /> 0-/00.B//3; <br /> O <br /> B J 2,?" / d.C� /�+tAit+ > 2�" Q�-� Ji "—�f/ /WI /"- VT caw/9'.; 69"- x?" <br /> wrMS <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD P RIOD PER INCH <br /> P_ / 5" .4/017e /O 'P 1 / S <br /> P None /O / Co <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 burin s and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION <br /> ..6117 /6Y/.O A'rC 6/w,i,, <br /> 4 Ab,,,'Q <br /> V o llyc J <br /> ,P3 ,S 1 N <br /> DB3 <br /> Q <br /> As Rp.7 <br /> V 06/ <br /> ° di <br /> Apwroyi'/1-t�e/y /0 oCrez <br /> � ,C�e✓iY3 Lake �aorl' ` <br /> I,the un ersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and m thuds 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): ITESTS WERE COMPLETE ON: <br /> k/Qde %ufofio/rr1 l/ne axq, /9 <br /> ADDRESS: C RTIFICATION NUMBE <br /> a7Co (ONMBER(optional): <br /> 3JP3 767,26o1!15 - s i <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-8395 (R. 10/83) —OVER — <br />