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RY, OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, <br /> INDUSDIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O.MADISON W 7969 <br /> HUMAN RELATIONS <br /> (H63.090) & Chapter 145.045) <br /> LOCATION: SECTION: _ TOWNS HIP/M.UQW1IIa&k1WY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> W '10 / 3 /T N/ 0 77-' l,c t ,E <br /> COUNTY: OWNER'S,SLYE'R'S NAME: MAILING ADDRESS: 164C &Ar)'C44 C.'.%►t•,(�C` <br /> &sX rr h t rr kc rf E " ATE _rYt <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: ,�,/ PROFILE DESCRIPTIONS: ER OLATION TESTS: <br /> ,� <br /> IJ Residence '1 LJNew El Replace I� •�/ gyp /� � t/ � <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CON_VEI 10❑NAL: MOUND: ❑u IN-GROUNDURE: SYSTEM-IN-FILLHOINGTAN M EN EDSYSTEM:(optional) <br /> If Percolation TUessts are NOT required DESIGN RATE: rLT J J�❑U 0 S <br /> 4 / If any portion of the tested area is in the <br /> under s,H63.09(5)(b),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.) <br /> 75 <br /> B ,<-- 7` > <br /> B <br /> -7 3 <br /> B r 7.4 <br /> B- Y. d <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERI D PERIOD 2 PER PER INCH <br /> .7- 3 0 <br /> P- .41? <br /> P- ; 3 <br /> P- <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 horn <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 <br /> ,I, is 9 <br /> !RtA ( ► 2 <br /> gl'&A Vr <br /> 1Y1A,A,Kr1) )41X/0;A'4 <br /> /.oT s•;,r e- - <br /> 9."s A <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 <br /> WERE COMPLETED ON- <br /> //C' ON- <br /> � — !J j <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> CST IGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R.02/82) —OVER — <br />