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INDUSTRY,' OF REPORT ON SOIL BORINGS AND <br />INDUSTRY,' <br />LABOR AND PERCOLATION TESTS (115) <br />HUMAN RELATIONS <br />(H63.0911) &Chapter 145.045) <br />SAFETY & BUILDINGS <br />DIVISION <br />P.O. BOX 7969 <br />MADISON, WI 53707 <br />LOCATION: <br />5W45 <br />SECTION: <br />2 6 /T39 N/R /b E.br) W <br />TOWNS HIP/l\444N,@%l10Ft4TY: <br />�ygENON <br />LOT NO.:BLK. <br />3 <br />NO.: <br />N� <br />SUBDIVISION NAME: <br />/1/A <br />COUNTY: <br />OWNER'S/B & NAME: <br />MAILING ADDRESS: <br />�/ TT <br />L,/C E <br />756 WA N oA F4OeA1 To <br />o Ae- Ci+e IF— � .-.— I le Qi+u —... i+.hln fn a to <br />UA 1 EZI U t5JCRVA I IVIVJ IVIAVC <br />PROFI E DESCRIPTIONS: PERCOLATION TESTS: <br />COEISTQIy�. <br />NO.BEDRMS.: <br />COMMERCIAL DESCRIPTION: <br />* ❑Replace <br />Residence <br />Z <br />N14New <br />EST. HIGHEST <br />o Ae- Ci+e IF— � .-.— I le Qi+u —... i+.hln fn a to <br />UA 1 EZI U t5JCRVA I IVIVJ IVIAVC <br />PROFI E DESCRIPTIONS: PERCOLATION TESTS: <br />COEISTQIy�. <br />TOTAL <br />DEPTH IN, <br />M.v`1U <br />ING�J PXURE:S❑S <br />IAULHXSG❑U <br />TAN :REC1eLD/N4 <br />OMM ENDED E/At�X) <br />If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br />under s.H63.09(5)(b), indicate: /V1+ Floodplain, indicate Floodplain elevation: NA— <br />PROFILE DESCRIPTIONS <br />BORING <br />NUMBER <br />TOTAL <br />DEPTH IN, <br />ELEVATION <br />DEPTH TO GROUNDWATER <br />-INCHES <br />CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br />TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) <br />OBSERVED <br />EST. HIGHEST <br />B- <br />32 <br />/�� `• <br />�I/oNE <br />// �• <br />/I 't <br />/0 s'L Z2 �d3h lnt.Os ©r�o7 6'� 3Z oljy'4 <br />P_ <br />P- <br />o N <br />v <br />/D �94 sL /9 ax -4,F,0o h,,;r/3 <br />B 3 <br />a <br />;/ <br />99 9 <br />,, <br />�, /, <br />Z st .= 5nF o rhot iz - sqcme <br />B -y <br />241 <br />99, <br />945- /6/1an <br />B- <br />B - <br />PERCOLATION TESTS <br />TEST DEPTH <br />NUMBER INCHES <br />WATER IN HOLE <br />AFTER SWELLING <br />TEST TIME <br />INTERVAL -MIN. <br />DROP IN WATER LEVEL -INCHES RATE MINUTES <br />PERIOD 1 PERIOD 2 PER OD PER INCH <br />P- <br />P- <br />410_ Co <br />AT101V TE5 <br />S CDAJ40UO -FQ 04f --- <br />,EP- <br />P_ <br />P_ <br />P- <br />o N <br />v <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. <br />SYVEM ELEVATION #O/-0IiUG 7-4/Vk RG' -4 UIRF'o Zf:9T e1A.) - AAAgo3e ,Unna <br />kN <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 thj 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 COMP ETED N: <br />l3� AISDAI <br />ADDRESS: 7- ��CC� S��K VI�I� S��f9� CERTI 15F16 NUM R: P/O/N'E—9641NUMBERI`pt (optional): <br />4r - <br />DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br />DILHR-SBD-6395 (R. 02/82) — OVER — <br />