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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND ' AP.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS `115G) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> NP: �� 8';'! Y4 1 J40 11/1115WIN JACK-EON 3 Dl/A N/A <br /> COUNTY: MAILING ADDRESS: <br /> ',]AaHBURN LAllOTQNA LYON RT2 BUX228 HINCKL1sY, PIlV 55037 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: TS: <br /> ®Residence l n7/A ®New ❑Replace 11/09/90 11/09/90 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONV ENTIONAL: MOUND: OUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SV STEM:(optional) <br /> ❑S ❑U IN-GR❑S ❑U ❑S ❑U ❑.S ❑U ❑S U CONV;NTIONAL 205 .'SQ i�T <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ibl,indicate: N Floodplain, indicate Floodplain elevation: N/A <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P H TGROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HIGHEST— TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B- 1. 76 96. 0' NON > 76 4"7.5YR3il sl ts ,4-76"7.5YR4/4 med s . <br /> B- 2 26 96. "1" NON:'. > 76 E AiTD AS 1`1 <br /> B- 3 76 96. 1' NON", > 76 s7ATJr;, AS ;;=1 <br /> / > 76 1/8"�J. Y� /6lbanc, at7�9 .5YR4 4 me s , w <br /> B ). 76 95.8 NON 7 <br /> e- 5 76 95. 1" NON'," > 76 AS „`4 <br /> B- <br /> PERCOLATION TESTS <br /> DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RIODt PERIOD p . PER INCH <br /> P- 6 -16 none 1 3 <br /> 77 39 none 1 <br /> P- 3 .. none <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 9'� .O' ALT. 92.9' <br /> ' `=,►1 NOT ": NO 'SCAL <br /> QB114 Ti V. ` 10`6. 0) <br /> �uf^ qD (NAIL. IN 11b" NOPi4;­AY) <br /> NO tr :l UN ,S'IGH'S <br /> I T IGHBORING JhLL LiCAT ;ll <br /> t`t ad" >�` �N <br /> �y <br /> I <br /> 1, the undersigned, hereby certify that t ported 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 COMPLETED ON: <br /> KT 7, J. �'RGU'ON _ 11/09/90 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> HCR59 BOX478r' SPOON ;R, ail 54801 669 715-635-7482 <br /> CST SIGNATU E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> LHR-SBD-6395(R. 10/83) —OVER — <br />