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DEPAR-NENT REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W 53707 <br /> HUMAN RELATIONS <br /> GL 3 & 4 (1 LHR 83.09(1)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/ I Y: OT NO. LIC NO.: SUBDIVISION NAME: <br /> 1� 1� 3 /T 40N/R 14FAJ( /W Scott 2 na na <br /> COUNTY: MAILING ADDRESS: <br /> Burnett Grant Pederson 9720 6th St NE Blaine MN 55434 612-784-7046 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMM R IAL DES RI PTION: ATESTS:1 <br /> KgResidence2 na ®New ❑Replace 7/21/92 7/21/92 <br /> RATING:S-Site suitable for system U=Site unsuitable for system <br /> ONVENTII�ONtAL: MOUND: IN-GROUND-PRESSURE: YSTEM-IN-FILL OLDI NG TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑x S LFII ©S ❑u EISOU ❑S EA EISEDU Conventional w/lift pump <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: na Floodplain,indicate Floodplain elevation: na <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO ROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HET TO BEDROCK IF OBSERVED ISEE ABBRV-ON BACK.) <br /> 0-4 dk bn s is w veg, 4-50 bn 10YR3 4 med s sg Sbk <br /> B- 1 72 99.25 none y 72 mfr, 50-72 bn 7.5YR4/6 med s sg sbk mfr w/gr <br /> B- 2 84 99.45 none >84 0-4 dk bn s is w/veq, 4-45 bn 10YR3/4 med s sg sbk <br /> 3 84 100.85 none y 84 0-5 dk bn s is w/veg, 5-38 bn 10YR3/4 med s sg sbk <br /> B- mfr. 38-84 bn 7 5YR4 6 med s sq sbk mfr w r <br /> 4 84 99.60 none 84 0-6 dk bn s is w/veg, 6-36 bn 10YR3/4 med s sg sbk <br /> B- mfr, 36-84 bn 7 5YR4 6 med s sq sbk mfr War <br /> B_5 90 101 .15 none > 90 0-6 dk bn s is w/veg, 6-42 bn 10YR3/4 med s sg sbk <br /> mfr, 42-90 bn 7 5YR4/6 med s sg shl mfr w/gr <br /> 13- <br /> PERCOLATION TESTS <br /> } EST DEPTH .[ WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES I AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D2 PERINCH <br /> P_ 1 26 none 10 na na na < <br /> P- 2 29 none 10 na na na c <br /> P_ 3 46 none 10 na na na <_ <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. 97.00 w/lift pump <br /> Bf <br /> ? 2 Lit umq r qu re <br /> -ed pure B 1 A <br /> t f e & to ie + 7'� 3� I N <br /> A s ' e e n00'.00 I ; ,--t-B�� � <br /> se tY e an and rh-iin <br /> from — B5 <br /> Note: W lllmu t be min <br /> T f`om� r <br /> r f d7 +- j <br /> - - <br /> a t.m lot ire t <br /> � I--c <br /> = I m k <br /> — - ,- <br /> 1 1 Fire #�oK sler R. _ 60 �roa riveway <br /> I, the undersigned, hereby certify that the soil tests reported.on this form were made by me in actor ith the procedures and metho s cif ie in the W sconsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge an belief. <br /> NAME (print): ITESTS WERE COMPLETED <br /> Joan E Daniels _ _ _ 7/21/92 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> PO Box 316 Siren WI 54872 CS MO 3431 1715-349-5533 <br /> CS- IGNATURE:� C� <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> Q11 HR-.9RQA'I95 R 10/1111 O FR <br />