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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY,. DIVISION <br /> LABOR AND_ PERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,W1 53707 <br /> II LHR 83.09(1)&Chapter 145) <br /> LOCATION: SECTION oTO55NSi IP/MUNICIPALITY: OO :BLK.NO.: SUBDIVISION NAME:� / N/RI6 E WSS <br /> COUNTY: <br /> AILING ADDRESS: <br /> tJ REIfJ F)MOKF qw, 12A <br /> USE DATES B ERVATIONSMADE <br /> NO.BEDR <br /> COMMERCIAL DESCRIPTION: R FI S: PERCOLATION�TJESTS: <br /> Residence �_ ❑New .Replace I <br /> RATING:S=Site suitable for syst m U=Site unsuitable for system > J <br /> OILY STI❑� . MM I � IN-GN S ❑URE: S91J I❑�L FISGZU :RE&N%NDED monAITEM:(optional) <br /> If Percolation Tests areNOTrequired DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: �-- Floodplain, indicate Floodplain elevation: NA <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED ES . HES TO BEDROCK IF OBSERVED{( ASBRV.ON BACK.) <br /> 4ui," — D S — B <br /> B- I IoQ- -7 NONE 1� <br /> A; —As <br /> B- 2- lab 9•'i NorJE 7 V, <br /> B- 31 (4 1.6 1 NONE <br /> B- <br /> B- <br /> 13- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER I HOLE TEST TIME DROP IN WATER L V L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERS ELLING INTERVAL-MIN. _PERIOD 1 PERIOD PR PER INCH <br /> P- '310 5 2 i <br /> P- Z 2 <br /> P- 0 1 Yz 41 <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 /> Wim., <br /> -; <br /> A,�M IDO BpTfOM � 5►QtNG I , __ . _ �_ ; <br /> A ©,&klST1NG flRywEu N <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 sr Rcified 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, x� <br /> qq,z c �WrSf <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> Kirawo fkpK/N53 - 31 - q <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMB R(optional): <br /> E 93 6 7nIS- 6 S <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DI LHR-SBD-6395(R. 10/B3) —OVER — <br />