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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, - DIVISION <br /> LABOR AN L; PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SEC�TpION:T�J� p� e TOWNSHIP(/.- Y: LOTNO.:BLK.N/O.: SUB 1VISION N ME/: <br /> �'�/ Vft/4 / T /1 A N/N6 ` (or,W (( / LO/L 9 �>1 P ul2 , C/ `6 <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDHESS: <br /> 8LIV,lielt4rAar Ire ao £ S7� 7 S7. PCWL Ai h• S'S <br /> USE DATES OBSERVATIONS MADE <br /> II�� <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PR�ICEDES S: PERCOLATION TESTS: <br /> &Residence +1 New ❑Replace - h Oq _ / ..$9 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTI NAL: MOUND: IN-GROUNIPRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SY TE :(optional) <br /> S ®U ®S ❑U S ❑u ❑S ©U I ❑S ©u 114 otin <br /> If Percolation Tests are NOT required DESIGN RATE: 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,CC LOR,TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> SOC q UQk)-r 3 to 0 -8" kr 8'- 3t "R.,, /r <br /> B a 0 /Bd.Y 1 y? a. j, ., Btls b"- Y8" n "v r VY"• bo• srt C.. <br /> et <br /> 0. ro ra " R Ztr <br /> B11 <br /> s�/ 9 �' 3 b eqw <br /> Bt/ SS' q�,� � 1 0 - r0 " <br /> BgCtr io '• 36r Qnn.<ds 36`- SS.r <br /> S i e t_.T • C-mn <br /> B-S ss a 3 h s r4M.< ks <br /> p_9• GCr '7 27 " Sn t 37 $ b" <br /> B- o r b R 7. `1 3 7 r <br /> ' s- 3 PERCOLATION TESTS eso' <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEV L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD PERINCH <br /> P- 1 /U `J S `-- //3'// / 7/ <br /> P- O s / /3 /Vlv /3'/ 3 <br /> P- d / /7 <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or diitances. 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 bo Ings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION / 06 S- <br /> y,rj j - TN <br /> �rL T <br /> (oy, <br /> A Celr sTvfic 8 M a a <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): TESTS WERE COMPLET D ON: <br /> W <br /> rrc / t a6 - & <br /> ADORES­ CERTIFICATION NUMB R: PHONE NUMBER(optional): <br /> r•-� - /s <br /> CS N TUBE: <br /> DISTRIBUTION: Original and one copy to Local Autho: .vner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />