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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> P.O. BOX 7969 <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: NAME:'/ N E Y4 1 /T3$N/R 17 E (or)W I E 5 R N ACRES <br /> COUNTY: MAILING ADDRESS: <br /> 150TWETr '91CHRK12 ST fl EL 20-3 WHLDOYA RD . 31REA , W1 . SL106"72L <br /> USE DATES OBSERVA IONS MADE <br /> NO.BEDRMS: COMMERCIAL DESCRIPTION: 1c�1 ESTS: <br /> Residence �� ❑New Id.Replace ( IIP - <br /> L I I - po t 1 /1 <br /> RATING:S=Site suitable for system U=Site unsuitable for system � I �V I.1 <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑S ®,U ❑S ZU ❑SKU ❑S 1KU ,®S ❑U HowING -rail,* <br /> . r <br /> If any portion o <br /> If Percolation Tests are NOT required DESIGN RATE: f the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: �� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P H T R UNOWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHESf— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1 3D $ 5 0 O-G*bicJ (o-9KCI q- 3oRe�wR�rrgr�o <br /> B 2 31:00 - I Z o- (031 �' �' 12 �\ z- 3Z ReA w m6-i <br /> 11 <br /> p -'� atc'N I - 10 cl lo- clwRcm rtio <br /> B-3 � loo. o I- <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> 1TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD P R PER INCH <br /> v_ <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 NO <br /> EIM w- . F 1 N K RD. <br /> st <br /> - WEII j <br /> _ BLDG <br /> N <br /> SLALE ! = J(pb 11r(L-05 NoTED <br /> Zrl-, SMloa $o7JQh1 Of 51DlN6 _ <br /> n <br /> B-2 <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) ITESTS WERE COMPLETED ON: <br /> R1c�IpZ� 19PK/n/S /- 1b - 90 <br /> ADDRESS: CERTIFICATION UMBER: PHONE NUMBER(optional): <br /> wEasT�� -146- is <br /> CST IGNATURE: <br /> i <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SB"395 (R. 10/83) - OVER - <br />