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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, _ - DIVISION <br /> LABOR AND P.O. BOX <br /> 969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,W153707 <br /> 3707 <br /> (1 LHR 83.0911) &Chapter 145) <br /> LOCATION: SECTION: OWNSHIP/MHMStIFBf LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> -S!')/4 s1)/4 c /T /R/sal p s gi1/✓� L l <br /> COUNTY: OWNER'S BU ER'S NAME: MAILING ADDRESS: <br /> -t 4! /Wc 37/-:2- tf/ao0 sC Lauls P <br /> USE DATES OBSERVATIONS MADE S /6 <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILED SCRIP IONS: PER O�TIONT STS: <br /> Residence sI .1 .I� ew ❑Replace I L1:77; �' <br /> J �✓ � 666 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> O��TI❑� . M �.❑U IN-G'MS P❑uRE: SYSTEM-I ULHOS ATANK. ReON1E-B�SYSTEM:(oPtional) <br /> RA <br /> II <br /> If Percolation Tests are NOT required DESIGN TE: If any portion of the tested area is in the <br /> under s. ILHR 83.0915)(b),indicate: / Floodplain, indicate Floodplain elevation: 41* <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 /> B JX. <br /> 7 /u'o�E ''B/s/ S ' S_ �J �cd <br /> B- 07 /6v,Z S' /,fA✓E I'Rls 7"B S ; a M0 <br /> B- 3 79 ,9.>' 40& 7S� 7 �B/S I- <br /> B- <br /> B �� 7� ' 0/% .. 01 <br /> . ii4 S 4/ CC d k Mif <br /> B 7t� 12S <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PER OD2 PERIOD PERINCH <br /> P- <br /> P- <br /> P- 1 AJ E / t r <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 >7 G 7 <br /> Gjh i-AKF RogA 6� SCA LF_ <br /> 1 fi ii <br /> Ind p� if, � ag3 A/E_ C akNEk _FL - /Qo <br /> A sole. BaR1tiGs <br /> TN <br /> 7% <br /> t A FERC yes rs <br /> r 1V/ <br /> Is'D <br /> lv�c4- 7-6 gE >so�FRer/ <br /> 'WA <br /> i <br /> app' P, k(i 7d BE > a5' f'reeN) <br /> �Ifr SRrIO <br /> A" <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): TESTS WERE MPLIVVED ON: <br /> /t/ S gE ,-S� <br /> ADDRESS: CERTI FI ATION IN UMBER: PHONE NUMBER(optional): <br /> Cs -- 3 q;;- d <br /> CST SIGNA U <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and S Tester. _ <br /> DILHR-SBD-6395 (R. 10/83) —O ERw <br />