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DEPARTMENT OF - REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (ILHR 83.09(7) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BILK.NO.: SUED VISION NAME: <br /> SW'/a '/a 2 /T N/RI5Ein )w cC Nw K1 <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> KV L F65 IN$g3 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFIL DES R TI NS: PERCOLATION TESTS: <br /> Residence Z ^� ,New ❑Replace I _ �1 _ Q _2, ?8 <br /> RATING: S=Site suitable for system U=Site unsuitable for system / L.. U O o <br /> CONVENTIONAL: MOUND: IN-GROUND�PRESSURE: SYK: <br /> STEM-IN-FI LLHOLDING TANRECOMMENDED SYSTEM:(optional) <br /> ®S ❑U �S ❑U NS ❑U I ❑S ®U I ❑S ®u 1 Low , <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: l�/ Floodplain, Indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, CO OR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIONYOBSERVEDEST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B_ 1 72 q� 67 72 0-5BIMS 5-b5$Nms 65-728 nswR��f MStt <br /> III <br /> B- 2 13 . q5 0-6'61 M5 S' 6 g UMS b`1 -?2 N nes W-R- ff MD-h-B- 3 "12 . I11 0-(0'5I M5 �0— 6,2 �N MS Q— 7 l�iN MS W h D <br /> B- Li 1 `12.5 (� E I I $AvAe P6U' 1 <br /> 13- 5- `t 93. 6 0�1 II 0- s — qt, Bpi m59o- 26Nm5 WR qMb <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 PERIOD --PE—RIOD 3 PERINCH <br /> P- 1100 ti / "f(0 3 <br /> P- 2 3 I Sig ' `t <br /> P- 22 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 dist inces. Describe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plat plan. Show the surface elevation at all bori igs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 91. 1 <br /> R LD�� DAD <br /> trox loo' --L�2�d� <br /> SC fl L>✓ l''�l' <br /> LSM IOP 0 ¢00-n0l& SIDG <br /> 0Fxc- TN <br /> #- aboj6 I s7o l <br /> W9LL 7-0 8.6 > 5b' ANA FOM 501 TAjX6 A2Eft <br /> All L07 LINf-S 7 /DO/ AWAY 5 2 <br /> 3. <br /> g 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 r iethods 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 /> Y10ARD o N5 4- 27- 38 <br /> ADDRESS CERTIp CATTION NUMB R: P;ONE NUMBER(optional): <br /> CS IIG AT RE: ' <br /> w— <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />