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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> fNDUS!"RY, DIVISION <br /> LABOR ANDPERCOLATION TESTS (115) P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 537073707 <br /> (ILHR 83.09(1)&Chapter 145) 2_ <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT N .:BLK.NO.. UBDI VISION NAME: <br /> 1/4 1� 25 /T ON/R E (or UNIoN <br /> COUNTY: MAILING ADDRESS: <br /> 1102M MISSipelo MN,SS <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: I R NS: TESTS: <br /> ❑Residence 2-1 �� �,New ❑Replace L n- 10- 73 Q- 1O� <br /> RATING:S=Site suitable for system U=Site unsuitable for system 7 77 I <br /> ONVENTIONAL: MOUND IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑$ �U S ❑U EISMU ❑SSU OS U o <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)Ibl,indicate: �� [Floodplain, indicate Floodplain elevation: N� <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. GHE TO BEDROCK IF OBSERVED Mrr:ABBRV.ON BACK.) <br /> B- 30 96.0N- 25 o -B$1 S S- 255M s 2s- 3o13NISwR(,PlM* <br /> B- Z 2 q&.� o S o-915115 a- 3a 6141S 3$-4Z_B415w RcM m <br /> B-3 37 95.7 NoNE 13 Lf <br /> 012c.m <br /> - SN'll %-3V&ks 34 -3?5M SW ntot <br /> B- <br /> B- <br /> 13- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 R PERINCH <br /> P- , * 0 S E1�Y PAL <br /> P- 2 ao 1: ` 3 <br /> P- 3 24 An `� )off 3/ <br /> 1 4P- <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 97.6 <br /> � 7 <br /> uff <br /> i <br /> l <br /> I <br /> SBM -IORTQ� <br /> �-R1K -To BE > ? 1rR1?tt MQtlD, <br /> t <br /> -- <br /> oC <br /> c� <br /> �- <br /> i - - - t- t <br /> t 1 _ _ <br /> -----1 t 7 <br /> _ <br /> .. a . <br /> I,the and signed, 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 /> Administra ive 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): TEST WERE COMPLETED ON: <br /> - 10 - q3 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 1 J .S�{ 3 ( 0 - <br /> CST GNATURE: <br /> ,IBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> SBD-6395 (R. 10/83) -OVER - <br />