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TMENTOF - REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUS <br /> INDUSTRY, - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWN SHIF/IWHWFeff� tIfiY: LOT NO.:ELK.NO.: SUBDI VISION NAME: <br /> SES/a /t /TW N/R/s� OA �9C /t_!ECA .t'l� 4/4 .VA <br /> k J14 <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: µ,- <br /> fful In <br /> USE - ATESOBSERVATIONS MADE <br /> NO.BEDRMS.: COMM ERCIALDESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence / >;�Vew ❑Replace I f/� c- rpr J/ S-43- <br /> RATING:S=Site suitable for system U=Site unsuitable for system `1 O 7' <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI LLHOLDI NG TANK:RECOMMENDED SYSTEM:(optional) <br /> usou OS ❑uI �s ❑u ❑s ®U ❑S ®u cep <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)16),indicate: Floodplain, indicate Floodplain elevation: <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. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 13- 1 r7 S- Flas /v0 w e > js ,,PSS 3 " R FS <br /> B-" � 7f. " 7s_ "B, <r 9 " ofLS 6 a- " RFS <br /> B-3 s- 9 9 �- 7 r y'V /o" if Jr <br /> B 7s- ' ` 77r— 8 " ,PCs 3 " /= <br /> B- ,g-- s F7. I > 7 S' ''esK 4 62 <br /> B- 6 77- /oat ` 775- y "em 4r CLS tea " SFS <br /> PERCOLATION TESTS <br /> TEST DEPTH WATERIN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PER100 3 PER INCH <br /> P- <br /> P- $ o a 3 3/8 <br /> P- 0117 1 Al b <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. / 40 a, 4(t A-,, <br /> SYSTEM ELEVATION 21 1P r r c o <br /> SC 1( 'Ir " = yo �S'o r e <br /> /(o o '-1 A-7 <br /> Sv�'&66e asr��c <br /> TN <br /> w el� <br /> L`T qSQ i� 8" w`1v Ze o <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 /> NAM (print}: TESTS WERE COMPLETED ON: <br /> t 4ir,c Hv - f-9'S- <br /> ADD ESS: CERTIF CATION NUMBER: PHONE NUMBER(optional): <br /> le r_ <br /> T 966 <br /> CST NA URE': / <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />