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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 /> MINIM& Chapter 145.045) <br /> LOCATION: SECTION: OWNSHIP/MUNICIPALITY: LOTNO.:BLK.NO.: SUBDIVISION NAME: <br /> uE '/45&'/47 jjvN/R/Sf (er <ea so^1 ua uA uaa <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRE S: <br /> itzlflESi YiEtiJ 7�.PiuE 4/7 '51. 'P4,14, <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: k-� PROFILEDE RPTIONS: ATION TESTS: <br /> Residence ❑New WReplace <br /> ' � NA- I /D— /DMZ—�� <br /> RATING:S=Site suitable for system U=Site unsuitable for system `� ]4U <br /> IfPercolation <br /> d 7 <br /> CONVENTIONAL. MEVS. Q EISS11 <br /> ❑ ®UDJIN-GROUND-PRESSURE SVSTEM-ILHGTANK:RECOMMENDED ' (optional) <br /> {{ J ❑Qcolation Tests area NJJK <br /> OT required DESIGN RATE: - <br /> Q ` 1 If any portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: N Floodplain,indicate Floodplain elevation: / JA- <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL N DEPTH TO GROUDWATER-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 /> 7z <br /> B 1 91" Novi p" xT. S. 20� FS 2`/' /t' S /9 "BnICS <br /> B- 2 Jr.ego N <br /> `19 9" NoNc > 6y" S`SL TS 31 8ej FS 'RFS- 2"SL 06 5,vGS <br /> B- 3 78" /ao' 6" NvAt� 7 78 " SL TS 23" iN�s 20" RFS S" st -78" 9Nc <br /> B- C T/ ' 6 0R9/ti <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD R PERINCH <br /> P- I 2y n/d✓' w3 ' ,6 3 <br /> P- 2 33' NOAA6 /47 3y 3L 3/ <br /> P- 426 -VOe/6 O 3 9 1j 3 <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 eievatioi at all borings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 97= D" <br /> ZT,� �KohyerY <br /> I <br /> . E}IgniLWF� �' <br /> e f I <br /> llam ! T N <br /> LAKE, 9'C.z r , <br /> e> " (� <br /> I, he undersigned, hereby certify that the soil tests reported on this form were made by rd with the procedures and methods specified in he Wisconsin <br /> ministrative 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 /> ii• <br /> ADDR SS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> !�— 3 L/70 �f}�:� lq� GJi. STlB d X165 is zv�!-Sso <br /> C SIGN UR <br /> u1 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R.02/82) -OVER - <br />