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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AHUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: / TOW 0�1MUNICIPALITV: LO'O.I 'VA--NO SUBDIVIS�ION'NA; <br /> 6 L !14 'f �/ 3 /T ON/R E cp —/ ry�c, 1r/ <br /> COUNTY: OWN R'S BUYER'S NAM : <br /> USE MAILING ADDRESS: <br /> ,uerr / mPC; <br /> DAEOBERVATIO MAnF-K • SSS <br /> NO.BEDRMS: COMM ERCIA DESCRIPTION! �Vew IPROFI L�DE$��IPTIONS: PERCO' AT1QpN TESTS: <br /> Residence ❑Replace II /��/ O Z//7/ <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUN6PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> ®S ❑IJ S : u]R s ❑U S ❑U ❑S RU (�vUE7�71VNAL <br /> If Percolation Tests are NOT required DESIGN RATE: [Floodplain, <br /> any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: N R— [Floodplain, indicate Floodplain elevation: N0 <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. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 71st /60to' NOPE 7 72." 5" TS. " 32" &VMAO 5 <br /> B- a6p 59=6 1 &C, <br /> B- 3 60 94 o" �� S gL 5L 7S 30 (3N v2S' ISN mL nS <br /> B- ° /06'0" 7 7l" S' B1, sI-TS 33 ►3rN=5 r P-,o,, ung S <br /> B- S ca" jq '0r' � s� PL S�:TS 3 P—vsT5 <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PERIODPERIOD3 PERI CH <br /> P_ 7 � I <br /> P- ;1, Q <br /> oZ 1 <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 mi <br /> zontal <br /> i- <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 917 �0er y44"60 zl°w2— <br /> iboG�„ <br /> 0 <br /> � f�JLC <br /> 9' ✓✓aQe � 6.n1, ao RSO <br /> 5'PKc t1'�I ee E 4&W <br /> t N <br /> 9 <br /> P , <br /> e , <br /> 60-v <br /> I, the undersigned, hereby certify that the soil tests reported on thi form were me 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 th tests are c rect to the best of my knowledge and belief. <br /> NAM 1 <br /> TESTS WECOpPLET <br /> 0 <br /> ADDRESS: � 7 / qe <br /> CERTIFICAT N NUMBER: PHO <br /> NE NUMBER Ioptional): <br /> S" <br /> 4/ - o <br /> C SI <br /> e- <br /> lr. �DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. , <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />