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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS PERCOLATION <br /> (I LHR 83.09(1)& Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: SUBDIVISION NAME: <br /> 1/ W 1/4 Zo /Pfb N/R 6 E .pr 4AY.c.x1ND yp 3 �. ILiel�;� �.< <br /> COUNTY: MAILING ADDRESS: <br /> DAVID E?, 11518 ATLAWricT•PAUL MQ- to <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER�DESCRIPTION: X IPROFILE•DES 8 PERCOLATIONTS: <br /> Residence Z New ❑Replace L 4 I I' <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> ❑S W4U ❑S Nu ❑S l�U ❑S U S ❑U NOLD►Nfi 7At4K <br /> If Percolation Tests are NOT re uired DESIGN RATE: I If any y 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 TOTALP H TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- ) S NA Q 0-88//5 $-/SB/�trt�/wgter <br /> B- 2 /S NA I 1 0 98��5 9"/St�� W�WKttcr <br /> B- <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> 1 EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI D2 _-PE-8 PERINCH <br /> P- <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 NA Sc&'e / 1/0 11444-55 WO;2FO <br /> r r <br /> LAKE DRIvE <br /> wen • fb64'. <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 /> R/tHWD HOPKI0.5 - :25- 97 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> w) 54 0 <br /> CST SIGNATURE: <br /> Umj <br /> DISTRIBUTION: Ongmal and one copy to Local Authority, Property Owner and Soil Tester. / TL <br /> DILHR-SBO-6395 (R. 10/83) -- OVER — `/ <br />