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DEPARTMENT OF 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 /> (ILHR 83.090) & Chapter 145) <br /> LOCCAATION: SECTION: TOWNS1 P Y: LOT NO.:BLK.NO.: SUBDI ION NAME: <br /> CUN'/ '/ OWNER'/r*N/RA-FI(or)W � eS/BUYER'S NAME: MAIjONGADDR,,�ss-- ' <br /> Lf�'hV � " sl fi-s CV <br /> e,(s /fir L, . <br /> USE DATES OBSERVATION MADE <br /> NO.BEDRMS.: COMMER IALDESCRIPTION: (PROFILE ESCRIPTIO 5: PERCOLATION TESTS: <br /> Residence RNew ❑Replace , _� •� ��r _ ��p') <br /> RATING:S=Site suitable for system U=Site unsuitable for system I {• i <br /> O®ENTI O❑Nu . MOUND:❑� IN-G©S [:] URE: SVS❑TEM-IN�-FILLHOLD INGTANK: REC U I d UNAD.,'D�VSTEMaoptional) <br /> If Percolation Tests are NOT required DESIGN RATE: S U 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,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B-131— '7� 7.P � + 7?r -sa®� cf s '• �En All it /VC <br /> B-q + + 7 �1 0..6',g4<s 6, - l`7" QIYLS 1,7 <br /> -7— <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP I N WATER LEVE -INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD PERIOD PERINCH <br /> P- At G S S <br /> P- ";)- V 0 /,s <br /> P- Q \ S 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 surface elevation at all bori gs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 9 �'. s N4; T u "R-j- A f)It It BM ,dam <br /> 4, oTkiWv C <br /> jsrrc 0 <br /> 0,10 <br /> TN <br /> P <br /> A)01' TA en Q _P P�+`e R d <br /> . IkC k! 40 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and nr ethods 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 /> NA (pr' 0 1 TESTS WERE COMPLETE ON: <br /> e, ric d k- n C / - 8 <br /> RES CERTIFICATI N NUMBER: PHONE NUMBER(optional): <br /> 4?'f- -7 7! - <S-7 <br /> C$YSy' TUR E: �r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-8395 (R. 10/83) -OVER - <br />