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• <br /> 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 53969 <br /> (H63.09(1)&Chapter 145.045) <br /> • <br /> LO ATl N:e4 SECTION: Y/R(E(or)w TOWNSI-IIP/MUNICIPALITY: )LOT NO.;BI K.NO.:'SUBDIVISION NAME: <br /> f� t'( 1� V2rm OrIt I CSIt/t,/It <br /> COUNTY:QPNF_ O _ hr VERlf9a/S0 !MAILING A DRESS: <br /> V'�o CC Soo 7)Yn Sae r Rd Ma 645-4n, GtJt s <br /> USE DATES OBSERVATIONS MADE <br /> DOResidence �IDR : COMMERCIAL DESCRIPTION: dew ❑Replace PROF! EE D SCRIPTIONS:'PERCOLATION TESTS: <br /> g3 �6/S <br /> RATING:S<Sits suitable for system U-Site unsuitable for system <br /> CONVENTIONAL:OS FEU MOUND:S ❑U IN Q �U RE:SVE S IML�I ES G II U.RE�0 u b p SYSTEM:(optional) <br /> I If Percolation.Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the <br /> under s.H63.091511b),indicate: Floodplain,indicate Floodplain elevation: <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.HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.0 BACK.) <br /> B- I /7 7S'7" /7N V* dlsl. 9„ ,B't t;l. y'D" °'; <br /> B- 01 3 7/'l/i, ��- '-" ' A Pe �:T y <br /> 7341„ f' ►� <br /> B-3 D 9a /,„ ,��s i 9,r 8��l ar, <br /> B-1/ q� 9./" ,W.,�a.c �i„ 86 sti y,, ,v7 e% Yr -a, <br /> / y / A <br /> BJ s0" 9p7 7/ " !►t'r..•t Ua" 6,r �/y,� 7a <br /> 7 <br /> B-(o ,„4.,, SG„ �I S.I e„ <br /> rld da dl 69" We't' D1s!.ky s',...., J.trq <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. ' PERIODI PERIOD 2.. PERIODS PER INCH <br /> P- / /( ,�•- /o ) ' I /1 <br /> P. // ./ tI �/2 4 .l <br /> P. 3 '/ .i 0 1 i° 4' 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. ibe what are the hori- <br /> zontal and vertical elevation reference points and show their location on the plot plan. how the surfers° levsjpn at all borings and direction and percent <br /> of land slope. �,�Ir �. _ 40 ,OD f++/jt.Lp <br /> SYSTEM ELEVATION l 9 a"`""" <br /> A 7/1111111111111 <br /> P.VilitIMEN-nwilt_ r4' MIUMMEMEIMENI <br /> �� r 4 _ L_ ,#iiipI <br /> ,• <br /> p3 II ■®Iii <br /> , <br /> . <br /> _ . <br /> f i , • — — 1 <br /> a� <br /> 1— 4 <br /> III•111 • .�MINIUM <br /> I,the undersigned,hereby certify that the soil tests reported on this form - •• • t e 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 ' TESTS WERE O TD ON: <br /> :Le R• (VIA.(In kO(2_ S/� 3 <br /> ADDREW: ERTIF ��1�N NUMBER: PH <br /> ONE NUMBER(opt)ona11: <br /> Ggbl e-n-f ri t R-1. f 6.13, rkrx k - SIGNATUR <br /> • . r / / <br /> 4 <br /> / / <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. - <br /> ibil.DILHR-SBD-6395IR_02/821 _ - —OVER— <br />