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DEPART"HENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, - _ DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.091) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> '7/4 s y / /TS/c N/R/b t W o y�4 4,w , "A AIA I PA <br /> COUNTY: OW(N�ER'S BUYER'S NAME: MAILING A/qDR ES o <br /> 8 rM r\ 4SS / LVIDS �P � w ' yo 1� <br /> USE DATES OBSERVATIONS MADE <br /> —79, <br /> O.BEDRNIS.: COMMERCIAL DESCRIPTION: �r PROFILE DESCR PTIONS: ER OLATION TESTS: <br /> Residence "1 ❑New Ip Replace I /// /O/ 6�/6 �7 <br /> RATING:S=Site suitable for system U=Site unsuitable for system 17 G fC <br /> CONVENTIONAL: MOUND: IWGROUND6PRESSURE: SYSTEM-IN-FI LLHOLDI NG TANK:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U ®S ❑U CJS ❑U ❑S ®U ❑S ®U C 0 A/v <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(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 AB//BRV.ON BACK.) <br /> B I <br /> to ,vow-e 7d�o S/Bllr 0 As,.M.ds s6 8h r <br /> B-d- f o " v y"S<<s ;l� Qh e s// Ss 8 At C` S <br /> B3Q ot > o `I4 N C Sv <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 t PERIOD2 PER PER NCH <br /> P- AAO 10 d 8 <br /> P- 37 to <br /> P- N O 10 <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 /> '` 3 0�• 13ere p <br /> aL�� �•c (060 °)C7-" <br /> Miul Qrea <br /> • TN <br /> Q ►�-� <br /> to c <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 (pript): ` TESTS WERE COMPLETED ON: <br /> b d ,.e r- c +0 47� pi . <br /> AD RESS: CERTIFICA ON NU BER: PHONE NUMBER(optional): <br /> tN �l g _e r— twi s. S yP�3 lis- 6- c /J- <br /> C,�61GNPTU E: <br /> J� <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LH R-SBD-6395 (R. 10/831l —OVER — <br />