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<br /> DEPARTNIE-NT OF. REPORT ON SOIL BORINGS AND SAFETY'& BUILDINGS
<br /> INDYSTAY;k, .. DIVISION
<br /> LABOR AND - PERCOLATION TESTS (1151 P.O. BOX 7969
<br /> -(UMAN RELATIONS 1 / MADISON,WI 53707
<br /> G /'E" (H63.09(1) & Chapter 145.045)
<br /> LOCATION: SECTION: - TOWNSHIP/MUWGH1A- -T-Y: LOT NO.:BLK.NO. SUBDIVISION NAME:
<br /> Y4 c-_1/4 • 7~'/T 9 NCR 71 or)W , -rO/45Li,e,4/
<br /> COUNTY: - • OWNER'S/BUYER'S NAME: ,,.-. MAILING ADDRESS: - -
<br /> 0/4-rl' • ,.. bf�iF�-S 7 C% Z is ,ffA.4/L ;714• . l()A F,c= �7 - �ia/ 6 /j"' iii,
<br /> JSE �.4 _ DATES OBSERVATIONS MADE/
<br /> ND-��: OMER�AL ASCRIPTION: „.,,/ PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> ❑Residence LNew DReplace 2/ — �`�
<br /> GATING:S••Site suitable for system U-Site unsuitable for system G — 7
<br /> .ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional)
<br /> E -SLIU • c. sau EIS” ❑U oScW oSRUJ
<br /> .
<br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
<br /> under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation:
<br /> PROFILE DESCRIPTIONS ..
<br /> 30RING TOTAL ELEVATION DEPTH TQ GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH .
<br /> NUMBER DEPTH IN, OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
<br /> — f' / ;' ' / fp,4-r_s 2'-i,i .-2I- ,Ø oL
<br /> »Z'_
<br /> B-3 �d �3 9 >G c� O- „ /C/,E.' / e.S.0 7S 8._ Ea -<ss-;c'.. e
<br /> . � Ge CSR
<br /> B-4 107. > 7l a `�/cf-,-e 7,3 ,SL rs g 7z /c'P ' 0 s
<br /> 0` '.c•
<br /> B-S 7G 7/. 77Z- 0- 71 /G y;e s'J- Ti�/
<br /> B-
<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. PERIOD 1 PERIOD 2 - PERIOD 3 PER INCH
<br /> P. .
<br /> P. ifh,e 1e._ i,47, ^,../.c..ria--) 72:1„,.5 /,r!E
<br /> P-
<br /> P- - -6 fi• •4/4--cy/ '4 44_2 46./- ¢ G'//��� _L-
<br /> P. l�5 e//745s
<br /> _OT 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 /> ,ntal 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 /> I land slope.
<br /> )YSTEM ELEVATION 4,2" �,;%�2,e/ (S, /s /L2 / e7=,v/;
<br /> -- - - - - -•
<br /> i • i I
<br /> � , /, .g c, 'J ,e�A,: 4.�f , mo /� . ____ __
<br /> 1 .
<br /> •
<br /> ����X, ��. c0!� �/'�/r %c .7--:;e7. fri7 . ./'•c Fes/ t l
<br /> . �__. .�- .Z ��E/. _iii <�,,�i .--. rI? F / /1-/.,t,-, .If e ni--- 'fie./,t-{,1,%�./
<br /> .4. ; &CN mcc:cd4 e.t J.9/ C�'I,c '`Sf's 22c4-1.
<br /> `_'4-1.r, l•t/i'oi.✓ .j .4%,,-;r,,,C� /zee:
<br /> -- /j/ 1 ./../9%&;E-o/ f.C'G, ( L 7X'),`;[fr/ S1GA .- L
<br /> 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 /> dministrative Code,and that the'data recorded and the location of the tests are correct to the best of my knowledge and belief.
<br /> AME (print): �� / TESTS WERE COMPLETED ON:
<br /> --N 7-41/i K�}�j?A.��-//— —/G — JSf _
<br /> DDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
<br /> 2a-F , s,//. . <= ,,,q/4.,1 '._ / ei Aj l!/
<br /> -93 % c z. - e,<;,.
<br /> CST SIGNATURE: /
<br /> c J( 4--o .•[ „,...-t v•,.--,.e.
<br /> ISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
<br /> !LIIR•SBD-6395 (R.02/82) — OVER --
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