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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLLATION TESTS (115) S () MADISON,WI 53707 <br /> LOCATION: SECTION: O TOWNSHIP/ LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> NW '/ EY 3;. /TyoN/R/6` IorIW 09 .Z�� S �e��er� �es <br /> C UNT : OWNER'S BUYER'S NWWE: MAILING ADDRESS: ,/ /7 <br /> qey �n!-e �. If i-f,, du b sr. Y"�i4 � <br /> k�nt n <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: <br /> RO L DES IPTIONS: PER 0 TIO TESTS: <br /> Residence r) XNew ❑Replace d F <br /> RATING: S=Site suitable four system U=Site unsuitable for system 7 <br /> CONENTIO❑NAL: M®S. ❑U IN-TINP❑QRE: SVS❑TEM-IN�-FILL HOLDING TANK: RECOMMENDED SYnSTEM:(optional) <br /> SJ` UU DESIGN RATE: S U EIS2U C d IeV/(J <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09151161,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) If <br /> 'D &^ <br /> r '/ - bo yc S 0 - 7d <br /> 13- <br /> r W o t L o <br /> 7 9 9 S �I (0o s 1q'1yL I- r / <br /> B- o !q 9. <br /> D-'/ " f3n.vwr r F "- S8r' YGI SP '-7d <br /> p-y" 8h r�s�-. sy` ye s s-9 ' -7.1;' = <br /> k-u <br /> B- WA <br /> PERCOLATION TESTS Vk, <br /> R <br /> DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVE R MINUTES <br /> INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERI D2 P R ERINCH <br /> /s// <br /> - <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 /> SYSTEM ELEVATION I f <br /> .as- I ilT14-eeti fQ� *s Pprce <br /> Wl rh /Sf �4Se,�n�-e n'r �01`�f a <br /> TC' L>34 <br /> 0 <br /> �F.sr <br /> too <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 /> ,NAM (prin TESTS WERE C MPLE ED ON: <br /> 1DDRESS: CERTIFICA ION! UMBER: PHONE NI <br /> � s7-c 71" <br /> C NAT RE: <br /> rRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> OVER ' <br />