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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 7969 <br /> HUMAN RELATIONS <br /> (H63.09(7)& Chapter 145.045) <br /> LOCATION: SECTION: TOWNSHIP LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> I , �' /T,3 /R 1y*. <br /> COUNTY: OWNER' 'S NAME: A ING ADDRESS: <br /> F <br /> USE DATES OBSERVATIONS MADE <br /> ,,..,, <br /> �� NO.BEDRMS: COMMERCIAL DESCRIPTION] r�/' PROF( DESCRIPTIONS: PERCOLATION TESTS- <br /> P- El New PP eplace JO ^ yQ yCYx <br /> RATING:S=Site suitable for system U=Site unsuitable for system A O] o O <br /> CONVENTIONAL: E] D: ROUN URE: SVS❑lS N-FILL O❑LD ING TANK: RE c,9^4E,,ue1k TiaIvA�I) <br /> If Percolation Tests are NOT required DESIGN RATE: S If any at , F- <br /> yportion 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 /> B- (o 1743 d L" > 7 !3L zs Trneo �6 c_l -6i CS p <br /> B-X 7�'- 90, F 7 ?1- t /-s' 7S S ad Cy J/ cs--ck 3,0 c <br /> B- 7.1, 0, 5/ 7;- G Ts 3 -/ 3 fr- CS - Cg o;;) - <br /> B- ,�- 0, S is - (o tS 03s 5z <br /> B �' . 7.:4 td C r T s Cs Cs - 6o2P <br /> B- If , 0 7;L— r vs / Cs -'6/2 C' <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN- PERIOD 1 PERI D2 PERIOD3 PER INCH <br /> P- U v <br /> P- / <br /> P y <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 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 0 .a ; <br /> S UN rroN �fotlSE' '14aicu/ <br /> Sty # <br /> !lea' •- ,L/i�r �r�,v� ,t/i��` ttr �/ <br /> '- <br /> !�£Xr5TiN4 <br /> 99 SY.S rFrh <br /> w .5 Cp <br /> L, <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/ rE� (print): TESTS WERE COMPLETED ON: <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> CSTSIGNTUR�/J <br /> &2 <br /> DISTRIBUTION: ro I oral AUthorlt1, Boon., Owner end Sal Tester. <br /> 1711.w' S5l)-6395 :•d DJ/S 2' �e LN - <br />