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SAFETY& BUILDINGS. � <br /> :PARTMENTOF REPORT ONSOILBORINGS AND DIVISION <br /> OUSTRY, ----- P.O. BOX 7969 . ,4 <br /> �BORAND PERCOLATION TESTS CM) MADISON,WI 53707 <br /> WAN RELATIONS (I LHR 83.0911) & Chapter 145) <br /> q 1 SE TL`/�ON: //r� {� TOWNSHIP/MdPJ+(+rRAt ; LOTNO.:BLgK.�N .: SUBDIVISION NAME: <br /> f / ! /T -AN/r`�lor)w �4C� Cr X) /✓/� vo[ Y' P 3p-39 <br /> MAILIN ADDRESS: .' <br /> J NTV: OWNER'S BUYE/R.-'S-'NytAME: Tl �/ <br /> rn J yr 8 �14/n fh f3 7�U J` rr n <br /> DATES O ERVATIONS MADE a <br /> NO.BEDRMS.: COMMER�.IAL DE$CfiIPT1ON: 'NN'w <br /> Via 5° <br /> iesidence 2� -- /vNuw LJ HepWce 1 O 7 Q <br /> ATING:S-Site suitable for system U-Site unsuitable for system <br /> -------Il MOUND: IN-GROUNiESSURE�: Y,S—T,EM-IN-FILL it ill TANK:RECOMME NDED SV STEM:loptional)ONVENT 1: <br /> �$ ❑U ®S ❑U �S ❑U IElS ®U I El NO I d0Ill <br /> i; <br /> I Percolation Tests are NOT required DESIGN RATE- I If any portion of the tested area is in the <br /> nder s. ILHR 83.09(5)(b),indicate: Floodplain indicate Floodplain elevation: Iq <br /> PROFILE DESCRIPTIONS <br /> ORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTERR OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH e <br /> (UMBER DEPTH IN, ELEVATION OBSERVED ES . IGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.1 <br /> 3 ( 7 � 9, tioW� 77�- a s "FscLr S '= 7r1 " <br /> 3-d— <br /> g3 7a- 6 t` 7 >l 10 s "e4Is s_' �a R �>ht•odr <br /> e_ 9 . 3 t t a-`- d s "6( <s S- 71" •�,, .oar <br /> B-J 9 , 1 77J— p -,s-" dlj_r s "-7rY`r42mnr <br /> B- <br /> PERCOLATION TESTS <br /> T DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAPER INCH <br /> NUMBER INCHES AFTERSWOELLING INTERVAL-MIN. P RRIIQQI 'C / D y <br /> P. <br /> P.- <br /> P. <br /> P. Z O%b S— <br /> P- <br /> 'LOT <br /> —P- <br /> 'LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what an the h r l-- <br /> ontal and vertical elevation reference points and show their location on the plot plan. Show thesurface elevation at all borings and the direction and percent <br /> A land slope. <br /> SYSTEM ELEVATION �' S'C 4 C c /''=y6 ' C <br /> 71 <br /> -� bet <br /> �,aa•J � � -- � �{ 1 �b''�i+d�p r ere <br /> All <br /> tj -STN <br /> II 1 <br /> r-- <br /> 1 <br /> 1 <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 iseonsin <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 /> i <br /> NAM yl 1: TESTS WERE COMPLETED ON: <br /> ^ ( s <br /> ADD ESS: CER 1 I ATIO NUMBER: PHONE NUMBERIop[ionall: <br /> C GN�URE: <br /> DISTRIBUTIpN:Original and one copy to Local Authority,Property Owner and Soil Tester. ) <br /> n\/FR <br />