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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BUCNO.: SUBDIVISION NAME' <br /> '/41/4 /T N/R 16 E ALOs NA N <br /> COUNTY: MAILING ADDRESS: <br /> BAOUT VioLA U 0 W Sy <br /> USE DATES OBSERVAT ONSMADE <br /> 1� NO.BEDRMS,: COMMERCIAL DES RIPTION: 1F1LF6ES`�AIR OLATION TESTS-1 <br /> Jd : <br /> Residence 02 (�/. ❑New XReplace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONV ENT 10NAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDINO TANK:RECOMMENDED SYSTEM:(optional) <br /> �$ ❑U (�$ ❑U 6� S ❑U ❑$ ®U ❑$ SIU (�ouv�n�7 6inf <br /> If Percolation Tests are NOT re uired DESIGN^RATE:/ <br /> 9 / U If any portion the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicis ate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HES TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- ) 3U 97.3 NONe > @. 0 -38IMS 3-15_AUIn5 Ar lS- So 2MsW r^ <br /> B- 2 '30 , I ONE >l& o- - 12BA/ms r /2-So gms w r <br /> B-3 Zo 70 tj O IJ9 I uM10 r 7- So 2rnsw r <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> y EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-IN HES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RI D1 PERIOD2 P PER INCH <br /> P- I Alo 4 <br /> P- 2 o 7S / /3/ <br /> P 300 <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 9y 3 <br /> i e � c SBM loo AL_141l51"SPRUCE 7Rii� <br /> 3 � <br /> 1_ - • $ <br /> r tN <br /> WE - <br /> �ARNGE <br /> S . GLASS ST. <br /> l <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 /> lcuARD /boy1e1AB ___ - 19 - 181 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> i✓EBSZ (�l l S� 9 <br /> 3(o-70 <br /> S - <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. —'•' <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />