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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANP.O. BOX 7969 <br /> D <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (I LHR 83.0911)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:B;WO.: SUBDI VISION NAME: <br /> UI)1/SE '/435 /Tq( N/RlbEcp 5W155 3 <br /> COUNTY: MAILIN ADDR SS: <br /> u RUC ER z fl <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: E TS: <br /> Residence New ❑Replace �- y_ _ CIC <br /> RATING:S=Site suitable for system U=Site unsuitable for system !3 O <br /> ONVENTIONAL: MOUND: IN-GROUND-PH6Sl1RE: SYSTEM-IN-FILL OLDINGT NK: RECOMMENDED SYSTEM:(optional)S OU ®S ❑U LAS DU El U I El U I extiv. <br /> : <br /> If Percolation Tests are NOT required DESIGN RATEIf any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH T GROU DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN.I ELEVATION OBSERVED I EST.HIGHEST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I 50 1 q 6.,3 '> so 0-631 f135 (P - So-&j M.5 <br /> B-2 7 Z 9S. f-( 1( >72 o - 1 s 5 - 9 2"?;Q ms <br /> 13- 3 72 015.9 I1 X72 0- L -6 5 4- 2-6toos <br /> B- If`00 910.5 >8o 0 - 5 1 M S 19 - ms <br /> B-5 �� 5- ! " >72 5 - 72-&rms <br /> B- <br /> e. PERCOLATION TESTS <br /> CTEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p ql D1 P RI D2 PERINCH <br /> P. HO S 3i a 2_ <br /> P- 2 1iNo / 7/S 1ykl3 <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. 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 slope. <br /> SYSTEM ELEVATION q3 . 1 <br /> • <br /> 3CA!-E <br /> -moi o <br /> Bing Hit', <br /> i <br /> I <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 print : TESTS WERE COMPLETED ON: <br /> /2'�HRizD t+oIKtk6 7 - y- <br /> ADDRESS: W635 M WI 5 0 CERT IFICOTION NUMBER: P 1 <br /> CSTSII NE NUMBER(optnal): <br /> ����,, //G��__ ATURE: b <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> LHR-SBD-6395(R. 10/83) —OVER — <br />