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DEPARTMENT OF <br />INDUSTRY, <br />LABOR AND <br />HUMAN RELATIONS <br />sw-�%-J/a <br />OUNTY: <br />EURAia744 <br />REPORT ON SOIL BORINGS AN <br />PERCOLATION TESTS (115) <br />(H63.09(1) & Chapter 145.045) <br />_.ION: TOWNSHIP/W:4l /: LOTNO,:BLk <br />i /T.?9 N/R W s /- �✓,4` a <br />JNER'S Bli'+ER=S NAME: MAILING ADDRESS: <br />T jof Rey TC� STiP4 1 e4A/G er i3 Sjlc�e / <br />DATES OB ERVATIONS MADE <br />IPROFI E CRIPTIONS: ER ATI <br />SAFETY & BUILDINGS <br />DIIVISION <br />P.O. BOX 7969 <br />MADISON', 1 153707 <br />NO.: SUBDIVISION NAME, <br />09 11,1119 <br />iE <br />NO.BEDRMS.: COMMER AL DESCRIPTION: <br />LOResidence <br />tcv New El Replace <br />RATING: S= Site suitable for system U= Site unsuitable for system <br />11zS <br />ONVENTIONAL: MOUND• IN -GROUND -PRESSURE: SYSTEM -IN -FI LL HOLDING TANK• RECOMMEND D SYSTEM:(optional) ❑u as au . as au ❑s du os u <br />If Percolation Tests are NOT required DESIGN RATE: [Floodplain, <br />f any portion of the tesfed are` is in the <br />under s.H63.09(5)(b), indicate: indicate Floodplai elevation: <br />PROFILE DESCRIPTInnIS ---- <br />BORING <br />NUMBER <br />TOTAL <br />DEPTH IN, <br />ELEVATION <br />D PTH TO GROUNDWATER <br />-INCHES CHARACTER OF SOIL WITH THIC <NESS ,COLOR, TEXTURE, AN DEPTH <br />EST. HIGHEST TO BEDROCK IF OBSERVED (SEE <br />OBSERVED <br />DEPTH <br />INCHES <br />WATER IN HOLE <br />AFTERSWELLING <br />TEST TIME <br />INTERVAL -MIN. <br />DROP IN WA <br />BBRV. ON BACK.) <br />PERIOD 1 p <br />P- <br />Ne NP <br />z <br />F <br />B- 2 <br />78 <br />99's-, <br />B- <br />-B <br />GAl— <br />2– <br />P_ <br />P - <br />B. <br />B- S <br />rB- <br />PLOT <br />rthUULATIONTESTS <br />TEST <br />NUMBER <br />DEPTH <br />INCHES <br />WATER IN HOLE <br />AFTERSWELLING <br />TEST TIME <br />INTERVAL -MIN. <br />DROP IN WA <br />PERIOD 1 p <br />P- <br />Ne NP <br />z <br />P. <br />,? <br />Ne Ne <br />2— <br />P- <br />P- <br />GAl— <br />2– <br />P_ <br />P - <br />PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. I <br />zontal and vertical elevation reference points and show their location on the plot plan. Show the surface <br />of land slope. <br />SYSTEM ELEVATION <br />i <br />7/4:4 L <br />yff� S- <br />�t- 3 a <br />. lo'lo <br />cry ' <br />�ztide/? <br />:ate- cafe or distances. Describe what's a the hori- <br />'ati at all borings and the direction 4nd oercen <br />t <br />E/Pv �oe.o� <br />I R�•�• /9 Ac.,e�s <br />t <br />I, the undersigned, hereby certify that the soil tests reported on this form werelmade by me in accord with theIpro dures and methods specified in the isconsir <br />Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge nd belief. <br />NAME (print): TESTS WERE OMPLETED ON <br />/,',a <br />ADDRESS: C� _ <br />CERTIFICATI N NUMBER: PHONE NUMBER (optional): <br />CST SIGN U/%%% —"" <br />3ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Smi Te5tet. <br />