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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 7969 <br /> HUMAN f.�R/ELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> 0/7 A (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: p� TOWNSHIP�'�,': OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> (/ (/ /9 /T oN/R/ y(or 77- �/ Na Sm - 3 <br /> COUNTY: MAILING ADDRESS: <br /> q n T. l Qo 4S'JEcLlflRr /� <br /> USE DATES OBSERVAT ONS MADE <br /> ,,�y,��/ NO.BEDRMS.: COMMERCIAL DESCRIPTION: S: <br /> 'IJ'RZclence GCNkNotelK I <br /> 291qew OReplace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> PS ❑U C�3S ❑U ❑S Com- El El EICCoN!/PNTorIAL <br /> It 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 DEPTH T R UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPPT/H/IN. ELEVATION OBSERVED H T TO BEDROCK IF OBSERVED (SE�EE ABBRV.ON BACK.) <br /> 13- Fl 0 r� N6*& � A I , NL 7 /yJE S 7.Z <br /> g-� ,I- 7 .� 7 /fes kv /.5 7S Rv,4s U <br /> zos �PERCOLATION TESTS <br /> YTEST DEPTH WATERIN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> T NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI 01 P RI D2 P R PER INCH <br /> P- o 3 3 / <br /> P. 3 NO 3 / <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 /02, 0 <br /> �17 '_�QLZ�"_ _ , � _ _. � ��{,�{1 �Slrr1+4 _�AKg t •_ <br /> -TR / r <br /> Y' <br /> AT t7Ae14—,0t <br /> r <br /> 7' <br /> kX40 <br /> i � o <br /> f _ ... <br /> �-} ( _ } I f/rte ___. ._ ♦- -. 1 _. y .. � : { I...... � .«. .� _.. v .. <br /> I, the undersigned, herebygrtify that the soil sts reported on this form ere made by me in accord with the procedures and methods specified in the Wisconsin <br /> Administrative Code,and tIABI the da orded and the location of the tests a correct to the best of my knowledge and belief. <br /> NAME print : TESTS WERE COMPLETED ON: <br /> ADDRESS CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> e1. E.ZL yi<E WilS" �l /5- S- Wo <br /> CST SIGNATURE: <br /> /U/U <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tesler. � <br /> DILHR-SBD-6395(R, 10/83) —OVER — <br />