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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> X11/ E 1/ /T`foN/RIS 1 (or)W ,OL 0 20 IJA FIo o S <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> Duriva CARV5T AoV .1"4 0 SI-rm wI 5'V877- <br /> USE IDATES OBSERVATIONS MADE <br /> NO.hBEDRMS.: COMMERCIAL DESCRIPTION: CC�� PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> ®Residence J ANew ❑Replace L- 2-2- - 27 6- 22-$7 <br /> RATING:S=Site suitable for system U=Site unsuitable for system u <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEMT N-FI LLHOLDI NG TANK: RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U CKS [:Ju [XS ❑U EIS MU ❑S NU CONU'LOTIONAL- <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.091511b1,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 BACK.) <br /> B- > Blks/ 6- K ;5pw Med s <br /> B-2 $° 72 > 86 o-7B/01 7- $o $mils <br /> B- 3 8o q7.q > go 0-78/ksl 7- Se 2?rN mad i <br /> B- 9 So %-5 �. ., ASO 0-83ASI $' Bo Bli meds <br /> B- S '2S 9g. 7 > Ss" G-C Blk sl 6- 85 8,-A.) ,"a s <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NU BER INCHES AFTERSWELLING INTERVAL-MIN. PE RIODI PE OD2 PERIOD PERINCH <br /> P- b Ax) b 3 6 VL 3 <br /> P- 12 No /0 3 3 k13 <br /> P- 3 o /b J 6 6 <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, Po—re— Z ScAli //r-- y01 XC=yf k1k' ' 'Jot"SYSTEM ELEVATION 95.7 Bort a 73M /ao <br /> 1.0,fLlu(r <br /> E T Q/ <br /> 11% <br /> too <br /> • 03 A =- > IN <br /> � I <br /> 1,the undersigned, hereby certify that the soil tests reported on this for were ade 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 rint)) L / t� TESTS WERE COMPLETED ON: <br /> CYOC1•-I C �1 J'FO n fnx 4 — }� -8 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional) <br /> -964-9' -7 <br /> C I NATU <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />