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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR P.O. BOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> II LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: <br /> TOWNSHIP/MUNICIPALITYO.:Nij Y % / larW <br /> 40 AWF_q <br /> COUNTY: T oG ADDRESS: K <br /> "qqU <br /> USE DATES OBSER ATIONS MADE <br /> WResidence NO.BEDRMS,: COMM R IAL DES RIPTION: <br /> µ>J /� _ ❑New Replace I QI I%� I TS: <br /> RATING:S=Site suitable for system U= ON <br /> /Site unsuitable for system o U <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSLIRE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:loptionall <br /> XIS ❑U ®S ❑U NS 0110S [KU 0 JKU env nra�Na► <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: I Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH T ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HEST TO BEDROCK IF OBSERVED IEEE KNEES ON BACK.) <br /> p- 1 IIS `1 - 39Bre5W5 39 . 17- dwy <br /> B- 227 cn. a- 0-'1-61Is -1- 4I bo 15w 41- `12 KZCAwgr <br /> B- > 1Z O-$Blls `3`�4BIJ1S 3b - 12(Zsclw r <br /> B- <br /> B- <br /> e- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WA ER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN, PERIOD 1 p RIOD2 p R PER INCH <br /> p- 1 t/Z 12 3/1ti <br /> q L3 <br /> P. 2- osi � �Y S <br /> P- <br /> LIP- <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 /> Cn _ <br /> RO , _GAEzae� <br /> .Bt'4 toe$61tor1 S�z)NG wr�1 t N <br /> vx EZc <br /> a <br /> •.3oRe _ I�xs+s-r,+�rs-' Y BHRIJ_ ' <br /> RI1 !LOT LANES AKE.>_IOC FROMBEA , ; 5ysjv'm <br /> 140 f1c7lE~S - - - - - - <br /> d. <br /> 2 <br /> d <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) ITESTS WERE COMPLETED ON: <br /> ADDRESS. deigS <br /> CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 1� <br /> CST GN TORE: <br /> I <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 fR. 10/83) — OVER — <br />