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T , REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY,RY,. <br /> INDUS � DIVISION <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.: SUBDIVISION NAME: <br /> '/ >r'/ Z$ /T y I N/R E Ipr 1 <br /> COUNTY: bAILINGADDRESS: <br /> 5 _ <br /> USE I f DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMMER IAL DESCRIPTION: TESTS: <br /> ❑Residence ,..rO ❑New Xpeplace Io _ y _�q ►o - q-8q <br /> RATING:S=Site suitable for system U=Site unsuitable1 for system <br /> C N ENTI❑u . �. ❑� ING®S)UN ❑u E: V❑S I®UL ❑SGTANK 1ZUeDM MENDED SYSTEM:N0r_g <br /> . RTIonal) <br /> SS — t lng1;1_ <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)(b),indicate: I Floodplain, indicate Floodplain elevation: <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 HE TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B- 1 1`72 V.3 �>?Z- © - fo B115 b- 72Km5 w <br /> B-2- ?2 _7 17- bh-% <br /> B-3 `72 '1• ->`7Z b-?2 ulRs <br /> B- Lf '72- ?.% <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> FTEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P R1 —PERIOD 2 PER INCH <br /> P- I 2 0 k7- <br /> P. /Ag— <br /> !� <br /> P- 3NO <br /> -�b V /I <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 /> 1Li <br /> n c. n• _ 1� RKING i _ <br /> • Both; ' . � . _ __ c ��?s _� <br /> N <br /> ( � i <br /> XS) <br /> -• <br /> I � � I I <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 COMPLETED ON: <br /> I D KIS-___ 10 _ q <br /> ADDRESS: CERTIFICATION N111111: PHONE NUMBER(optional): <br /> q 6?0 <br /> C G ATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L� <br /> DILHR-SBDE395 (R. 10/83) —OVER — <br />