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INDUSTMEN70F REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX <br /> 969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> ((LHR 83.0911) & Chapter 145) 6/3-__Z/0 14 <br /> -__Z/o14 J q <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> y 1/ /TyoN/R 16 E W p <br /> COUNTY! MAILING AUDH - f / <br /> USE DATES OBSERVATIONSMADE IS //NO.BEDRMS.: COMMER IAL DES RIPTION: T <br /> Residence 2 ❑New ®.Replace r-I - 20 -$$ •-1- 20 - <br /> RATING:S=Site suitable for system U=Site unsuitable for system I <br /> O®STI❑� . M 11 �.❑� IN-G I S OESSURE: SVSOTEM-I®ILL OL❑DING®NK-JR ECOMMENDED SVSTEM:(optional) <br /> ® DESIGN RATE: S U S U <br /> If Percolation Tests are NOT required It 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 TOTALP H TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I 9� $ No NE > 77- o-SBI msS-31BNMs 31 - i223om5w r <br /> B- 2 $rj 01• 2 N0NE >`3s o- `{Buns N-333Nm 33-S68rims w f <br /> B-3 7Z l I NoA)E >7Z o-SBI ms 5 -2'7 ms 27 - 231Jm5 w f <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME D I WATER LEVEL-INCHES RATTER INCHES <br /> NUMBER INCHES- AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D <br /> P- / i 3 <br /> P- 2 47 kb 2%8 2 <br /> P- Sit Alo <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 q5 .3 <br /> IJ6009,S we-11 <br /> RIF-T2RP A BN 100 IJAILIIJ Zq,,KED Q9K <br /> 1 <br /> L_o7 U N>r <br /> �� y 2o�bN <br /> BLDG IL <br /> L-A Kt <br /> •C1 I <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 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): ITESTS WERE COMPLETED ON: <br /> lel�If✓�1zD oPC S - 20 ' Sao <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> W SI- 3 3� v - - <br /> CS GNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. �. <br /> DILHRSBO6395 F. 10/83) - OVER - <br />