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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 (H53.090)&Chapter 145.045)SECTION: MADISON,WI 53707 <br /> /.o -3 <br /> OWNSHIP/MUNICIPALITY: T NO.:BLK NO.: SUBDIVISION NAME: <br /> '/ '/ 4/ /TV/MN./R,/51 (orTLv NA ^4 /4-1/4COUNTY: OAME: q <br /> ll ING ADDRESS; _' <br /> 4e Sri e,,JrvjFS, ST ss--o7 -- <br /> USE DATES OBSERVATIONS MADE <br /> ❑Residence ❑New ❑Replace PROFILE <br /> G - 9-87 DESCRIPTIONS: PERCOLATION/3,4 TS: <br /> RATING:S-Site witaWa for system U-Site upnwMabM for syabm <br /> ❑ee ❑U MOUND:❑es ❑U IN ❑J ❑U ❑S ❑U ❑S nll RECOMMENDED SYSTEM:(optional) <br /> Percolation Tests are NOT required DESIGN RATE: <br /> It If any.Portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: 1J.4 Floodplain,indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL ELEVATION ND A E -1 E A THICKNESS,COLO EXTURE,AND DEPTH <br /> NUMBER DEPTH IN,--OBSERVED T BEDR K IF OBSER ED SEE ABBRV.ON BACK-) <br /> B- / �� NONE > 72- <br /> 2, <br /> Z D-6 D s S- Ye n MtCIS <br /> fY -72 6n cS <br /> B. L 7o Not,E 7 7 o <br /> O-9r DK 13 nS1 9- n ^4 <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIM RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERINCH <br /> P- <br /> P- <br /> P- <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 /> I _ � <br /> _ 1 _ N D R <br /> : A ) JA <br /> -TINEsE: Soil. ire rk-I co <br /> Fr T <br /> L_ 1 c _ F { - - �� <br /> v C _T uu <br /> l. .o_ IR L —_,t.._ - .._ E �- — HIS ►i}1F -- tn <br /> �M <br /> TV T1 0" �5 l _ E �€ �T <br /> }I <br /> _ SFE F � Cts L <br /> S -L _- _ <br /> f <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 date recorded and the location of the tests an correct to the best of my knowledge and belief. <br /> NAME(print): TESTS WERE COMPLETED ON: <br /> it 6-,-$F- <br /> A CERTIFICATION NUMBER: HONE NUMBER(optional): <br /> 3 6 3,6 <br /> SAT E: <br /> Zile <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and So" <br /> DILHR-SBD-6395 (R.02/82) <br />