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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) 0S _31 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> �/ 1/ 21 /T N/RI+E (p W <br /> COUNTY: MAI LING ADDRESS: <br /> RN �onl u E 5`fg`13 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS,: COM^M R IAL DESCRIPTION: I nnn A NTESTS: <br /> ❑Residence �. 9New ❑Replace I 9_ /!' - g3 Q��C"- 93 — <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> 0N/STIOU. M01110' INGNS ❑U E: sysNS I❑UL OOSGMU :RECOMmrNDED 120 VENT-ION19 SYSTEM:(optional) <br /> ®® ® DESIGN RATE: (L1��6/-JIB <br /> If Percolation Tests are NOT required � If any portion of the tested area is in the <br /> / <br /> under s. ILHR 83.09(5)(b),indicate: ` Floodplain, indicate Floodplain elevation: NR <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 REST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 1 ) I. NONE > �� 0.q B s °I- 44 3NI5 k`b -5In 35 Ms <br /> B- Z I U .3 ONE -) 9(' <br /> 0- to $11$ 1D- z 13f�1s u 9r ,52- 9L $umf <br /> B-3 qiL,, 101.3 NaN9 (0 0 $I s 9- 5o Brl 5b -96 S�Ims <br /> B- , A10AIC <br /> B- 50 o . E > q0 °" a 411s Q-SoB�ls 5o g0$rlms <br /> B- RAiNF EA BE CU7— VA20Y -7/7 <br /> PERCOLATION TESTS <br /> PP- 2 <br /> DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVE -INCHE RATE MINUTES <br /> INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD P PERINCH <br /> 3 0 3y[� / I <br /> O 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 9,7• o <br /> _T T Op -- <br /> i I I i6 i <br /> ' <br /> I <br /> N <br /> {.ALE. le' 40r <br /> A►611ill1 10070v •Of {00111146- <br /> y f Eu- -f4 >5D-fROYI OW <br /> r � A11 LDi` 14NO, > 73 - -- - <br /> I I <br /> I,the undersigned, ereby 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.NAME(print): TESTS WERE COMPLETED ON: <br /> IC ARD 1 - )5 - q3 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 27760 Hwy 35 WEBSTEFM1 . 59893 300 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. y_1S-f3 <br /> DILHR-SBD-6395 (R. 10/83) —OVER — " �l e0 9A/ �� / <br />