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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, G DIVISION <br /> BOX 76 <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.0911)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:B416iJ6: <br /> Y /T-39 /RIJ (or)W MEEA10AI z _A1 MONO 968CO 05,EW #Z. <br /> COUNTY: MAILING ADDRESS: <br /> 50KOEM KepmiTirr o 2N99 IrW PIZ. SI EtJ ► . Z <br /> USE DATES OBSERVATIONS MADE <br /> ,1s./� NO.BEDRMS: COMMERCIAL DESCRIPTION: R NS: A TESTS: <br /> L8F7esidence �_ ❑New X.Replace I '7 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ElENTI- O(11AL: MOUND: IN-G❑N MU E: SVS❑TEM-IMUL E1UTANK:RECOMMENDEDSYSTEM:;aoptional) <br /> SLimon Tests <br /> JC DESIGN RATE: S es Y LVs T LVI <br /> If Percolation Tests are NOT required If any portion of the tested area is in the 1� <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: N <br /> PROFILE DESCRIPTIONS <br /> BORING 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- I -3� 103-5 p �o <br /> o''1 films '1- 3o BfJms* 3D - 3(c, 15Nmsw RemZm_ <br /> O- 1 B l ms '1' 3`� SNms 3 -383Nms..11Zu+Tc1. <br /> 13. 2- 38 fos.6 0 q <br /> 3 0 -$Slips S- 30 Nmsw cm vt1 <br /> B_ <br /> 32 q .2 D 30 - zwATfJL <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERIOD 3 PERINCH <br /> P- <br /> P- <br /> P- <br /> P- <br /> P- <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. , <br /> I SYSTEM ELEVATION <br /> -- T- � <br /> u <br /> - ' y �ML WEK <br /> 3 T3RI�IE LAKE <br /> ,C <br /> 3 <br /> a <br /> b © TN <br /> �O <br /> *Srrt fop �M nF 51or�lG. ,__ , <br /> 1 ; <br /> I I I <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and metho spec' ed i the Wisconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. <br /> NAME (print); TESTS WERE COMPLETED ON: ( s <br /> gicHko Hofti7 5 '1 - g - 1Z <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 2'7 -76D Hwv 3S W�85TEfZ 1�1 . 5`�$�� 3407° •4606-q 7S <br /> tGi. . CS GNATURE: <br /> r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) —OVER — <br />