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DEPARTMENT OF iREPORT QN SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> 7969 <br /> LABOR AND P.O. BOX PERCOLATION TESTS (115) MADISON,WI 533707707 <br /> HUMAN RELATIONS, <br /> (ILHR 83.0911) & Chapter 145) <br /> LO� ��1� / SE 10%� u/� C I NSHI UNe IP LITY: LOT NO.:BLK.—NO.: SUB_ DIVISION NAME: <br /> COU1NTnrAI/ OWNER'S BUVEIR''S NAM C: MAILINU ADDRESS: <br /> e <br /> USE DATES OBSERVATIONS MADE <br /> RMS: COMMERCIAL DESCRIPTION: PROF LE D CRI TIONSS: PER LATION TESTS: <br /> �esidence NO.BED3 New �ieplace I-�/� �✓S ���.�.� <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENNTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(opionnal) <br /> �WO h / Lefrr �io <br /> �l //C❑cMU ❑$ A ❑$ IRU ❑$ A VS ❑U «!C <br /> If Percolation Tests are NOT required DESIGN RAT : I If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> i <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICN <br /> KESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> /� <br /> B- 1 <br /> 13 34. <br /> B- is,3 �- /���.�� �/.�- <br /> B- /f/d•t /� o-/� �>� s/ice_ 36 �,� .%���`�/ <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATMINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIODI —PERIOD 2.,_._ PER PEE R INCH <br /> p. z .5 <br /> P- rat cJ 01� a <br /> p- 6 <br /> P- <br /> P <br /> P- <br /> PLOT PLAN: Show locations of percolation tests, so s and the dintf suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference points and show• oca�gp,on he plot plan-.6 surface/elevation at all borings and the direction and percent <br /> of land slope. 5 -3'-7 <br /> SYSTEM ELEVATION �� a <br /> Ly �L PGt +tN tf� <br /> A 901 V X'p /f 4 f.30'x J 0 �a <br /> ^5-0 E/r, / o � `t u <br /> 10. <br /> 01J`o rt q/' q <br /> 5-� <br /> ."'4 <br /> s� 3 - e-3 60 N <br /> o <br /> ® ffe its c <br /> r-. J <br /> I 7 <br /> 6 <br /> 70 <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 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 Iprin TESTS WERE COMPLETED ON: <br /> rort IQ Gl % .5�/6 — <br /> ADDRESS: / CERTI FICATION NUMBER: PHONE NUMBER(optional): <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R. 10/83) —OVER — // <br />