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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, �. � DIVISION <br /> LABOR AND. N ' PEPCOLATION TESTA? (115) MADISON,WI 53707 <br /> HUMAN RELATIONS/MAN �4KQ <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/ OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> IUaY w'/ o/T'6N/061IVIGOW 0�� <br /> CO NTV: IMAILINU ADDRESS: <br /> scTlA'j <br /> USE DATES OBSE VATIONS MADE <br /> .BEDRMS.: COMMER IAL DESCRIPTION: r� PROFILE A ESTS <br /> : <br /> P❑Residence J:f j ,/ ` L�0-042,14 <br /> New ❑Replace <br /> RATING:S=Site suitable for system U-Site unsuitable for system <br /> NENTIONAL: MOUND: IN-GROUNDPRESSUREYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM (option 1 <br /> S ❑U ®S ❑U : S <br /> ®S ❑U ❑S ®U I ❑S MIM I r, Q, <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> 9 � 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 PTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPfH IN, ELEVATION OBSERVED EST.HIG TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- P'� 96. � o FY " > °-r °�42 bS'_icre, s/, /6-z9ReN +►s/. <br /> /IIdA1F _yo 1Q <br /> B- 2 3 9C.z o No f_ P3")` <br /> 13. 3 r7 94, $_6 I /V n N E p1r > 0 0 c l r _2 �ti-. o .SG, So47. <br /> B- y 7L 9y o /tle nlF_ 7�� -1 pK9r/S� 7-/3<t A-. /.T, /.J- x s/ a-9.W...f1 4. s <br /> g-S �`� Qs 7o Na 'u�— 7Y-> °- j',okyr. /, -av<r p� /s, av- aakdNst, <br /> g_ yet-. Y6 tif4A..S� y6-7V A.Clisi <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-I H S RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 P RI D 2 PERINCH <br /> P- J j v <br /> P. y o o y <br /> PETI.jif /V d o r <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locationsofpercolation 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. 4 -S = 9d.9o-lJcy�o a /) ,S E <br /> SYSTEM ELEVATION ��Yo 7 ,l� t T�(J1 u <br /> I <br /> d/� 7 <br /> #JAY Ph <br /> r _ TN <br /> or <br /> , <br /> M <br /> , <br /> t <br /> �--L ( I iP►-espee. � i A � � � I - <br /> r <br /> 1, 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 ITESTS WERE COMPLETED ON: <br /> ,4r7 _ .0'4 *P- / - 90 <br /> ADDRESS: CERTIFICATION NUMBER IPHONE NUMBER(optional): <br /> i y z u t 2C67 . N 17/4-:-- <br /> C I A U <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD$395(R. 10/83) – OVER – <br />