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juT ., 7 REPOR1 ON SOIL BORIN SAFETY&BUILDGS <br /> ;�Nt .: '•. �! DIVISION <br /> LARpR AND PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN$ELATIONS MADISON,WI 53707 <br /> r. <br /> LbCATION: SECTION: TOWNSHIP hOT NO. LK.NOSUBDIVISION NAME:•N0) 1/4,441/4,441/4 3(g d N/Rio E(aW pkA/� <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> DANE - Doa4LO B44BM,2 3j67 4/4L14c;'5OA) RD. <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> FgrResidence ❑New PN 3 Replace /74V a/spa- tf/9) /c/s&a. <br /> RATING:S=Site suitable for system U.,Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-G-• D-PRESSURE:SYSTEMTN-FILL OLDING TANK:RECOMMENDED SYSTEM:(opti <br /> NS ❑U ES DU ►� SDU ES1ZU1OS2IUJ a Fi <br /> o <br /> If Percolation Tests are NOT required DESIGN RATE:SYSTEM ELEV. If any portion of the lot is in the AG C 1 <br /> . under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevi<t lotiO0 � �? <br /> PROFILE DESCRIPTIONS �'�` <br /> NUMBER TOTAL DEPTH <br /> OBSERVED OUNDW T.HIGHEST TO BEDROCK OF-SOIL S OBSERVED (SEE ABBRV.ON BACK.1'?i(Po,"'le'AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION E <br /> B- / gy › ky <br /> /00,0 No�� %�`��S -�"sicL/ �Z ..Sc�/ gyp,, sG c�'N �� ., <br /> B- 9- I - goo. i ,ro'e > IL /y.i7; as"s/G4/ /a' 5-c Li 30 '' sS 70� 7I 1)r" <br /> B- 3 i a /o/ H fiowG > ?2 /Z•r -7's 3r". z A("sc 444 <br /> B- / 76 97,0 A i 0 ovc 70 120 7s Zy`'s/c�) yo;.scL(0,.4oyT.fT7o"> <br /> B-s' 76 972 /✓or'r 70 /2'' 7� /8's/GL, Y6'`s«(o, ,o7 �j»o") <br /> B-6 76 77.3 Np,✓r 66 /Y//73" /z''s/cL so'' scL(e, Ao7 -it>'9' <br /> i / . <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING_ INTERVAL-MIN. PEBJOD 1 I PERIOD 2 PERIOD 3 PER INCH <br /> P_ / 3o WO NE /d .1 :_ 77j <br /> P- 7- 3 6 No Na /D .` _ <br /> P-. <br /> r P- <br /> P- <br /> PLAN VIEW: 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 slop. <br /> SYSTEM ELEVATION 9'7. 8 <br /> tt H Ro <br /> 1 ! I i FIN pi I t i <br /> e��a�0 G/l,s* --: ' . —; 1 i i Tp•I. I ■ , F r ' 4744' ! 1 ! I I, ; i 1 <br /> 1_el <br /> ! j j i ' ' 31 i ( j ( <br /> j. <br /> 1Z. ' i pf 3 I ; 1w4)v , ; _,..,..0 w tii <br /> VV <br /> 7: 1C .. Y ; 4s iii.44 <br /> `3-I ! ! '33` ( 36[' , � , 4,, #� P-j0.c4 <br /> --!- I- 3 _; .. __ _.�_. . <br /> o. <br /> t _ 1 i c �. <br /> ' f <br /> I . - 1 + ?-°-' 1 ._. r _ +- 4.-*°"i- --1—_--r- <br /> 1._L_ . 1 .l._ _ ._,.__L____�...__I I 1 l 1__i___ x.. __i.._..L j. 1_._.l _,1__.1 <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsir <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 /> t�o,/�4e.,O Z 64OS,/67< /1741 Y /, /ADDRESS: CERTIFICATION NUMBER:r.2_ <br /> HONE NUMBER(optional): <br /> .�VC)e;- $-7 4 'c7 MidIa" 7 '- 63-x6.2- c3-4 /97g 53/-6/z3 <br /> / CST SI TU - <br /> G� - <br /> DISTRIBUTION:Original-Local Authority,2nd page-Bureau of Plumbing,3rd page-Property Owner,4th page-Soil Tester. <br /> DILHR-SBD-6395(N.03/81) <br />