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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) &Chapter 145) _ ZZgO <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SU DIVISION NAME: <br /> I/ �/ 3 /T N/M E 1p I W 0 LA N a 6 l 6teL. <br /> COUNTY: MAILING ADDRESS: <br /> V St ST. WI. S 810 <br /> USE DATE$OBSERVATI NS MADE <br /> NO.BEDRMS: COMM ERCIAL DESCRIPTION: lI�s-z,11 PROFI ONS: PERCOLATIONTESTS: <br /> ❑Residence �- ILLNew El Replace 15 - ( - 93 4 5- I - 93 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ON ENTI❑Q . MNS. E1Y IN GROUN�S �Y E: SVII]1 S 1❑UL OLDI❑JGC7ju .R rpgy .WT10aALDED SYSTEM:(optional) <br /> SS � t N lV <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09151161,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED EST.HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 164, 9DS Noikie > (e(j 0- GSIM3 6 &BNmS <br /> El- 2 (00.0 Nome > 80 0- 11 Ims I -SO&I'n3 <br /> B- 3 (4 9S-4 NON15 > 6o ' D- 1Slwo -1 - W. 3N ms <br /> B-`i s- 00• o N r > X15 6 - G B Ims C - °IS O.+wu <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER L V L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD R3 PERINCH <br /> P- 25 N p 1 i 1, }iy 3 <br /> P- 3 No <br /> P- o S <br /> P. <br /> P- <br /> P. <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surfacerelevation at all borings and the direction and percent <br /> of land slope, 50 AIL I�1, A D H 1�1A <br /> SYSTEM ELEVATION �� y A,�M 100 NAIL. 1n 16 000 (7 YV,•1 <br /> -_ T ------. _ , <br /> W�1 fi Asa �0M i$<V , <br /> �Rlu <br /> 5 <br /> LAZE <br /> ICE <br /> �(o gLO� <br /> 3 , <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 isconsin <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 /> I #7W - 1408kW-5 5 - 1 - 93 <br /> ADDRESS:Z q76, h1 E aEfI '1• ���� CERTIFICATION NUMBER: PHONE NUMBER/(optional): <br /> C W GGO <br /> 70 <br /> CSTNATUHi: [(115 <br /> �l <br /> _..- <br /> DISTRIBUTION: Origins opy Lo L ority, Property Owner and Soil Tester. <br /> DILHR-SBD.6395 (R. +,3A OVER - <br />