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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, G DIVISION <br /> LABOR ANX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON O 53707 <br /> (ILHR 83.09(1) & Chapter 145) 61'Z- 9z2.- 1002 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BHE.d9t <br /> N/R IbE to W 2- .� VOL. 3 0 <br /> COUNTY: MA LING ADDRESS: <br /> �E o o L. fnitVMN. S. v <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMM ERCIAL DESCRIPTION: R TONS: R ATION TESTS: <br /> ❑Residence �7 r�� ❑New ,Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ON ENTI❑U . �J ❑U IN J ❑11 E: SY J I❑ULH❑JGl..7CJU ECOMMENDED SYSTEM: <br /> Ohl✓Ef�/D/JK}l.._(optional) <br /> E <br /> If Percolation Tests are NOT required DESIGN R —ATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: N1� <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. IGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 219NotJE > 72 O-N ,jfms y- Ll- �n s `42 -5D Rsl So-72 )s <br /> 8- 2- '12 99 .5 NONE ?2 O - �/MS S- 5Bum� /15-Sb1�siSb-7ZK15 <br /> B-3 72- 19.4 /,16NE >'7Z 0-56NYn.s Si- HO 3,)Ms yo - 7-L91.5 <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. RIoni P RI D2 PERIOD 3 PERINCH <br /> P- I 2- o S <br /> P- 2 No S b <br /> P-3 2 o Y <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 <br /> �E�It_5 <br /> -4hjMlDPBDTpDMDF .$1D1n� '�d� ,' , <br /> �� y q}/ <br /> I,th undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures an mit( oBs sp�eczi/fied in t e Wis/coQns,yp,' <br /> Ad nistrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief 5�' /b_n <br /> 11 <br /> NAME (print): TESTS WERE COMPLETED ON: Lir <br /> 1CH19RO vP S -5 - 92 <br /> ADDRESS: CER IFICATION NUMBER: JPQONE NUMBER(optional), <br /> '7 S �85`r W 3 Go S- &6- 1 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />