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4y3 y b 3 93 res <br /> DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS VISION <br /> INDUSTRY, - ----- - �7 f /b a P a�1 <br /> 7969 <br /> LABOR AND P.O. BOX 3707 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOW HIP/ mAiii fPFit:iT1': LOT NO.:BLK.N .: SUBDIVISIO NAME: <br /> �/-SE '/4 t o /Ty9N/1111(or)W s c v Tf 7 ,WW x/f� <br /> C UNTV: Of ER' /BUYER'S NAME: MAILING ADDRESS �c / �S^ 3 0(/ <br /> �kr-ftv1 � �ti �( � fv lel /` f1/ 84 !/r� Nom/ d0Vr MIA <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: I- PROFI E DES RIPTIONS: ERCOLATIO/ TESTS: <br /> WiResidence /1 ❑New IGxttePlace 17 / O Q/ 7Zzp /r! <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEMk(optional) <br /> ®S ❑U ©S ❑U ©S ❑U IZSEIUIEISZUI ( - o .vv <br /> TE:N IRA <br /> -SIGN If Percolation Tests are NOT required DIf any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: �/ 4 1 I Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, CO ORTEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (S E ABBRV.ON C, .) <br /> f, Oaf/ r(3U S - <br /> B 1 OU /n3t1 ,ttouc y� Mvlo7' R C M D 7a "-00t' l2c4 <br /> t t 7 8s O's "'01i s-7 i " t t r 7/ t tPs e <br /> B- gO 1014 tI 7 � o-� " B Ls S (� kNrcir// S boC <br /> " S <br /> gq O r (� I' 0 0 0-it, 8-t If (0`�-70r' !+`te df `70 r` ` �0 " CS <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST I DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PER D2 PERIOD PERINCH <br /> P- 0% 0 / '3 / l / / �-- <br /> P- <br /> P- <br /> p- �y -TI 5 Ci r <br /> P <br /> PLOT PLAN: Show locations of percolation tests, soil ratings and the mensio s of suitable soil at s. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and she eir location o the pl t plan. Shaw the so ace elevation at all borings and the direction and percent <br /> of land slope. aI11 I ,L1* <br /> SYSTEM ELEVA ION 10 6-, G y} ! fry <br /> ' <br /> / tf= qo — <br /> 4, /^��1 V /r"� <br /> Q U <br /> r C o <br /> /O <br /> {j �,yStbtr�a �N <br /> Qc ` 'OF <br /> Stf< GG.�4 `6 <br /> I,the undersigned, hereby certify that the soil tests reported on this form re 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): L� TESTS WERE COMPLETED ON: <br /> Fe a/te r-I C 47 A4 � I f h .f 7 f� <br /> ADDRESS: CERTIFICATION NOMBEVITHONE NUMBER(optional): <br /> W � �OSTr ltr/ �c . SyP93 1/3 -7 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />