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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, � c DIVISION <br /> BOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (I LHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT 11-:1131-K.NO.: SUBDIVISION NAME: <br /> 4 %4 /T DN/R I E (a p — IUE�z oAlcs <br /> COUNTY: MAILING ADDRESS: <br /> lZicRiggo klemiqlliiii 11QD MbUM95L.V D- 1'fl LNSPI. SSI Dto <br /> USE DATES OBSERVA OMADE <br /> gNO.BEDRMS.: COMMERCIAL DESCRIPTION: L PTONS: ATIONTESTS: <br /> ys,l Residence r � New ❑Replace <br /> 2 9- 19 - 92 1 S- IS - 9Z <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> M �t <br /> ONVENTI❑� . � IN G <br /> s.❑u Ff(�US ❑ 1 RE: SI L <br /> ®S ❑ ❑�C'2 (optional) <br /> 61 I.VNVE� 09RL . <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> Q �_ If any portion the tested area is in the a <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicis ate Floodplain elevation: 14A <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- qZ 17 0 NONE > '72 0-s(31nts S- 77-BNms <br /> B- 2 "72 NONE >72- o -(0 films (e - 77_B4r13 <br /> 13-3 2 9�.Lf No4c > ?z C)-(pBlrns 6- '72Bmms <br /> B- � 72 Nog6 -77-8wfn5 <br /> B- 5 172 NONE > 7Z p- (, Aryls G '(z8wl�s <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-IN HES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERI D1 PERIOD PERIOD 3 PERINCH <br /> P. 31 NO5 Iv / J <br /> P. 7- 2 5 2 i 13/to -rj <br /> P- <br /> P. <br /> P_ <br /> PLOTPLAN: 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 /> - _r -T <br /> &''K 1Wwll.-I03 POW 1W 3 I EILOb✓ <br /> W 4L-,TD$E >SarFj{pM RAVER <br /> rIDS - <br /> yR IJE STDG _ <br /> >20�_ TN <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and me hods ecif`ie/d)in 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. �9Y <br /> S - <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> ICHRIZO HOPKIdS S- 1 - 92 <br /> ADDRESS: CERTIFICATION NUMBER: P ONE NUMBER(optional): <br /> 2'7'7/0o 14w 3S (nWE_ssT-ER Wi- _51ill 3 D -866-y1S7 <br /> CST IGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />