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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR P.O. BOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> 0LHR 83.09(1)& Chapter 145) <br /> L CATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: SUBDI VISION NAME: <br /> E'/S '/ IG /TqON/RI F. W sc <br /> COUNTY: MAILING ADDRESS: <br /> I'KoNY U 0 .IR P 2 O <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PERCOLATIONCHIPTIONS: TESTS: <br /> Residence .7 ��. xNew ❑Replace I /1 i2 2_ <br /> RATING:S=Site suitable for system U=Site unsuitable for system ( L I <br /> ON❑V ENTI®AL: <br /> '10 111'O:❑U IN GO �� E. SO l -�L ❑�C'�U - Rmoo/VE)D SYSTEMaoptional) <br /> If Percolation Tests are NOT required DESIGN RATE: ® If any y portion the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicis ate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P HIT ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKN ESS-7 COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED E T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- � too , oNE $ �-5B1ru5- 383arns 38 -�tyBans�..l �m No <br /> `f'FSR�W12C-memot <br /> -5NTis s-35pterr,s 35- {sIwylswT;Z mo <br /> B- 2 0 ,6 0 1Z_ q ok V <br /> B 3 2 I$ $ 2 O-10 I?lIM5 i!o- 2 '9NMS -3-4,- t{Z Nmsw m <br /> B- �} Z Q�� 3b b-St31ms 5- 3o6rms 30 Ll2T3rvmswTZcfn <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN TEST NUMBER INCHES AFTERSWELOLING LE INTERVAL-MIN.ME P RI Dt DRO I WA RRLOVEL-IN HESP R RATER INCHES <br /> P- )y2 7b <br /> P- 2 Z 5 3i 57 <br /> P 4 1 s2 <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 <br /> l � <br /> `L 2 <br /> ADM ton NAIL.IN 6-/W N tf� Nf <br /> C�T,N _ �. � <br /> B(Ey�,�sz- s[�K�M MQ/ur?n a <br /> . . . . CIIoPz �C-f•J.ti.✓ �UJI ...�r W.Y _.A <br /> _ SHGRyP N�FlfiS C�f`1�'TF]R <br /> } <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pro ures 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 /> 1C HR R D HOPk/ALS 1 9- 2-2- - <br /> ADDRESS. �CERTI SCAT©N NUMBER: PHONE NUMBER(optionaW <br /> 3 I <br /> �i/II VUL4 7 + CSGNATURE: <br /> i <br /> DISTRIBUTION: Original and one copy to Local Authority,Property nd Sal Tes <br /> DILHR-SBDZ395 (R. 10/83) — OVER — <br />