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<br /> DEPARTMENT OF REPORT ON SOIL OR 4GS A SAFETY& BUILDINGS
<br /> DIVISION
<br /> INDUSTRY,
<br /> LABOR AND PERCOLATION TESTn �,5) P.O. BOX 7969
<br /> HUMAN RELATIONS � MADISON,WI 53707
<br /> •
<br /> ep°rt On''en/
<br /> LOCATION: 'SECTION: - TOWNSHIP/ LOT NONO:
<br /> 4'E1/4' ')A 21/T N/R 8 E(AV �,o��G�✓ I C.S.44, /2 7 9
<br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: A,�
<br /> ti+t 6 Mr Mies. /Y/LL S/MO,v._a�J 64Z-7 /h.85.44-49 �vE. /�'//4 . , L!//SC,
<br /> USE DATES OBSERVATIONS MADE
<br /> NO.BEDRMS: COMMERCIAL DESCRIPTION: r-,/ PROFILE DESCRIPTIONS: PERCOLATION TESTS:
<br /> Ll�'Residence 3 L:7New ❑Replace -3p-iV
<br /> RATING:S=Site suitable for system U=Site unsuitable for system
<br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:loptional)
<br /> D S �,U ES Du EIS E.U O S EU OS f�U� icy_ ,(,,e, 775 2.3 o1/ J
<br /> If Percolation Tests are NOT required DESIGN RATE:SYSTEM ELEV. I If any portion of the lot is in the
<br /> Yoder s.H63�09(5)(bl,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 /> ELEVATION
<br /> NUMBER DEPTH IN, OBSERVED EST.HIGHEST 'TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
<br /> B / /OD. AID A/6- 0--8/s-Y-/o -.l Sic% 24- R , /- -,/-5/49/-1, c 04,
<br /> 7 9 -42 - 5/1v/,>.so% .sf, Gob,q•- - S-Co
<br /> B- Z �r/o Jae),/ ��N� 0-E/54-.S- f3nS.c/-¢/- ,e8n5c/-4 '-8ns/w/
<br /> 7 ��° 56 ,q.'-Sg - ,7s/c.+/�Soz z,f co6,9P_ G _
<br /> B- .3 /d/.4 �/OME �o
<br /> .0-6/.5,/- 1/- 5,,SiJJ-3/— I '5,is /—4% — 8ns/ i/
<br /> .9'- --5( - 8,,,5/ cv/>. % 5,4;6,6,.9"- 74;
<br /> e ?-Z D-8/s•/- q-,8,1s/ / 2 7 - f2a„sc/-37•-8/1-3k/,
<br /> /o3.5 A/Ave. > 7Z S�Ca6,gr - 4/, 5,zs/ /,..So/ ,5/,«6,ge-
<br /> B- �` l033 A / G¢ O-867/- 8- •8.75 4/- 24- •e Bn.scl- ZS -
<br /> t3.1s/ 40/6574,cob, - 84- 0,7s/tv/.>SD9'v ,/ 6,9r -
<br /> B-
<br /> 6.4
<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 ?NCH
<br /> P- 1 24 A10/14 _?0 Z s/rz Z '/s ? 3 /
<br /> P- 2 14 21z Z 2 %$ /4 4
<br /> P- 3 211 'I //4 / SSG / -3/�� - 2 2
<br /> P- 4 74 a 30 1 ''%b / '/ 1' 7 /.S
<br /> P. ! 7s 0 10 4.3,6, �5 4 4 ••3 f
<br /> P— .,c 7 -sr .PcJ.V .4,b s
<br /> rTeSiz PLAN VIEW: Show locations of percolation tests, soil borings and t e chmensto o suitac2,7/1 areas- I f_ scal6 6r distance `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_ BoTro of As= .46G 76
<br /> SYSTEM ELEVATION EL= /as-.0 Se-44-E /:40'
<br /> .M. '.�
<br /> OP of �f 0-44/Cot.' G'SR /299 r I l 1 1 1 1 H I I; r I 1
<br /> ! I 1 I ! l ! I ' ' ,-c -¢GI'! � ! 2 35 7/0
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<br /> Q$6/2"��/A4 03 evasj ! — S�{r. !
<br /> % Gc�icfvNo,' , PT T IA1cc/t0 4tC.9-770 . j: --�� ;E
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<br /> X FG�/cELi c.0 , P 3( T i PUo fN
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<br /> I, the undersigned, hereby certify tfiafthe soil tests reported on this form were made by me in accord with the procedures-methods specified in the Wisconsin
<br /> Admimistrative 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 /> ,�o%—?� A. jo,SfNSav - 8 -3/-45'4-
<br /> ADDRESS: .. ,.- .- CERTIFICATION NUMBER: 'PHONE NUMBER(optional):
<br /> 3523 17V � &v /l e iziasi Mcro vS, -) 2 245 -337-532 '
<br /> -S3S/ CST S=�-?eirexE�
<br /> DISTRIBUTION: Original-Local Authority,2nd page-Bureau of Plumbing, rd page-Property Owner,4th/'/
<br /> 9 page-Soil Tester.
<br /> DILHR-SBD-6395(N.03.11)
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