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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> PERCOLATION TESTS (115) MADISON <br /> HUMAN RELATIONS ,WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWNS H IPMISY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> St)Jy r t/ l7 /T38 N/R �r(oO wz NA NA 4/4 <br /> COUNTY: MAI LINU ADDRESS: •• <br /> mg 7T N'5 V S AW /✓yKc E L Ll�if 87 <br /> USE DA ESOBSE RVATIONSMADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: IIPROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> L�esidence ❑Replace l / _ 9,Z / 9� <br /> RATING:S=Site suitable for system U=Site unsuitable for system l <br /> ONVENTIONAL, MOUND: IN-GROUND-PRESSOR EM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> C S"❑U [IS 0 [:]S <br /> $ EIS DU ❑S311T e0Kv<N7 dr,Ac <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> g / If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.711IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 7Z /o`/ !✓o/VC > 7,;l, 8,vs 7-s o-3/ QN Cs 3 -/2 /P s /7-yo fees yo-7,L, <br /> B-o?— GTy /04: `1 Py N s %S k Ls y- /3 s /3 -jCv, /e c5 36-SY <br /> B-Y /0y9 Bc/ /ysTS o -4/, k4 -v- IYJ ke .5 /g -y/ Rc5 y/-yy <br /> B- c2– o`/0 7 7� Ns TS o -.3 PLs 3 - /y, As /171 'K61 .hes y0 --i <br /> B-S 7 7.2-- BN S !s o `/ B.V 15 y— /d i S 1.2 RC 5- 30 -7,2 — <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD 2 PERIOD PER INCH <br /> P- v / <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 /04 y <br /> -- T - - - - <br /> p yydz j <br /> D+ <br /> .pQ- d D� a Z-r�V,A7iaN ! <br /> J ,-- (_. <br /> IN <br /> _ <br /> i <br /> — <br /> _ t /p <br /> r � 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 /> -/- 9,7— <br /> ADDRESS: ' } CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> 7 !tE[G c GGi 7 /S 3S �� G <br /> CST SIGNA URE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) —OVER — <br />