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INDUS T Y, OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, C DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53BOX 707 <br /> HUMAN RELATIONS <br /> (H63.0911)&Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP/MWY6iP#l!"FY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> SE '/454/43 /T N/R/6&tar)W N 5 / 14c,W <br /> COUNTY: OWNER'S BtiY2M�lfRME: MAILING ADDRESS; <br /> J0941 0/4 F Z <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: rrrggqlll. PRO FILE pE RIPTIO N� TI OTSTS: <br /> Ix Residence /Z ❑New Jq�Replace I /!f//— �/�� // ;7 <br /> s� 1 i <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTI AL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:R ECOMMENDED SYSTEM:(optional) <br /> ❑$ U ❑$ lU ❑$ flU ❑$ ®U kYIS ❑U l{o�piiuG T•4ru <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the ,,fJ� <br /> under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: I <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTHTOGROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHFST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 13- yfS S '� /O yS 1 i3n - w c r /17 ek <br /> 13-.-7- /0.:- "Y 7// e-4 m fa s w Ai a T oW rte! <br /> B- y2 /Op. yz /5 y?`l6n H1 t115 f.) 1w r m oi <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> VTESTDEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> INCHES AFTERSWELLING INTERVAL-MIN. PERI D1 PERIOD2 P R PER INCH <br /> O - Cbl T S Cob GO 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. <br /> SYSTEM ELEVATION L uTA/.UF <br /> Zy <br /> ` r _ _jA _ <br /> I t N-ou9E <br /> T N <br /> J . <br /> i , 1 <br /> I <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 COMPLETED ON: <br /> 4FNs�/L'' �a 8z- <br /> ADDREFS CERTIFICATION NUMBER: PHONE NUMBERIoptionall: <br /> 2 It45 5 ss SSS'' <br /> CST SI AT E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester, C(� <br /> DILHR-SBD-6395 (R.02/82) OVER — <br />