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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> INDUSTRY, _ _ 7969 <br /> LABOR ANP MAOISON,w153707 <br /> - PERCOLATION TESTS (115) P.O. BOX <br /> HUMAN RELATIONS 707 <br /> 11 LHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/ V: LOT NO.:BLK.f�0.: SU�DI ISION NAME: <br /> E N0/413 /TyoN/WF(orlW sc- <br /> COUNTY:-s�- OW R'S/BUYER'S NAM E: / MAILING ADDRESS: <br /> 84r-hr7 S77 C,^0 )k r-E//s <br /> USE DATES OBSERVATION MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE RIPTIC NS: PER OLATI NTESTS: <br /> ®Residence New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system C b <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-F I L L HO LD I N G TAN K: R ECOM M E N D ED SYST EM in ptio na 1) <br /> ®S ❑U ©$ ❑U ®S ❑U ❑SOU ❑S ©U CO /)p <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 D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> o! •7 <br /> B- q /4/� 7 70 5A)& S=3Y0B„+r.dr 39"• 9D '' ti .rdr <br /> B�­ 7 D . 3 t� ? P7 0 3 10.&tS S"37'Butin-, it 37'"W RS'L Y7t W' R MrJ9 <br /> B_.a 010 100. < < 7 g � 6"8h (t &"-30"S,. -tis 3040 R +r,<da- <br /> B_y fnS 03 t ) TS "Qn Is S=358.... r 3a'"- 9 /Q M+v it <br /> B-_�__ 2' O 0 p,/ II 7 80 .5 "8h(t s'' 1" Bhn s 3d."- 10' hk n, e <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. PERI ODI PERIOD2 P RI D PER INCH <br /> P_ ► 3 7 N o 3 arid/ z. t//Ifl <br /> P- J. <br /> p- lo v / 7� a- 3� <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 her ngs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION Y 7 t h - <br /> SC94e 1 '= Y0 ' T / Senr" a <br /> 4h (<ss elf er• w;se No I•[ d <br /> q rr, <br /> t <br /> - s°�aTN <br /> Nq/L jfu 04sw #6W <br /> r_t 1 0a 1; *9/-4 c as <br /> 1,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 /> NAME(print : TESTS WE E COMPLET D ON: <br /> o -e h [ v tii4 r <br /> 8 / <br /> ADDRESS: CERTI ICATIO NUMB R: PHONE NUMBER(optional): <br /> C NA UR E:� <br /> 61STR1BUTION: Original and one copy to Local Authority,Property Owner and Soil Tester, <br /> D I LH R-SBD-6395 IR. 10/83) —OVER — <br />