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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> 969 <br /> LABOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION:� SE <br /> '/ y4 SU <br /> SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: BD VISION NAME: <br /> 3 /Tqo N/RI E (o II tJq FI cos Ti S <br /> COUNTY: MAILING ADDRESS: <br /> wwfr SII? ME. LLElla32 <br /> USE DATES OBSERVATIO S M E <br /> NO.BEDRNI:S.: COMMER IALDESCRIPTION: ROFILE-DESZ` STS: <br /> Residence .®New ❑Replace _ - 19 d L17-200 I`7--200 <br /> RATING:S=Site suitable for system U=Site unsuitable for system O <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSl1RE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑II ®S ❑� X ❑� ❑S 0 EISKU upv. <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.091511b1,indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL 11PTH TO GROUNDWATEFt-INCHES CHARACTER OF SOIL WITH THICKNESS, COI OR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHESf_ TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B- 1 Ba $-8 NONF_ >SO - )►ns�- 292--so <br /> 1-2 -q IT IT o- y s S- 8o ms <br /> B-3 80 f( It q(-3 M5 LILSOUMS <br /> u <br /> B- `f 80 '1. I I) <br /> B-51 So I �1`l 0 I' [I <br /> R E Pis 3- <br /> B- <br /> PERCOLATION TESTS <br /> TESTDEPTH WATERINHOLE TEST TIME DIWAR LVL-IHS RAPES <br /> ERINCH <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. --- PERIOD I P RI D2 P <br /> P. 35 0 5 9 3/ 3 <br /> p- Z 3 <br /> P-3 2 1b , 3 <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 bor nes and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION �5 <br /> Scpit <br /> 5D �StAl OWP4LIN9"Mft?Lf <br /> 07 <br /> 6AK• A 'Pt,� <br /> - <br /> 3 � _ <br /> Alt <br /> I, the undersigned, her by 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 COMPLETED ON: <br /> ,�1UfAk9 1'I- 3C3 <br /> ADDRESS �'1//QQ -y1--x�/77 '.I/ CERTIFICATION NUMB R: PHONE NUMBER(optional): <br /> CS )GNATURE- <br /> { f <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHRSBD.6395(R. 10/83) —OVER — <br />