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INDUSTRY, <br /> OF REPORT ON SOIL BORINGS AND SAFETY & B DILDINGS <br /> VISION <br /> LABOR ANQ PERCOLATION TESTS (115) �- P.O. BOX 7969 <br /> HUMAN AELATIONS O ` MADISON,WI 53707 <br /> (H63.09(1)& Chapter 145.045) ,/ <br /> LOCATION: SECTI N: OWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> � /T4/N/R/ E (c ,W � I <br /> COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: <br /> boel)V7- i��� <br /> USE DATES OBSERVATIONS MADE <br /> NO.BED <br /> RMS.: COMMERCIAL DESCRIPTION: 1PERCOLATIONS: <br /> Residence ( n PROFILE DESCRIPTIONS: TEST New ❑Replace 1 7_ -7 9 3 -7 '7_ 3 <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CO®STIEA . M®S. �� IN G®� P❑�RE: SY�EM-INaFILLHOaLDING TANK: RECOIL ��/�N�►�Nq tall <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s.H63.09(5)(b),indicate: /v-P— 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 EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- t � 7 1��6 //'q- ? '7Z `, 6(, �S r8`' 8 ''R� <br /> B 7� ���6.. 7 �z ' �" t�< rs , l rz+ s 2�'` r�N-i-s -7" <br /> B- 3 6z t s, 1 T' 2 Fs , 2-6" r3N Fs . IT' ale Psatj� <br /> B 5 b0 97-4" WEDS +�ti <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD PERIOD 2 PERIOD 3 PER INCH <br /> P- hio A) <br /> P- <br /> -� i l 3 /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 05-1 <br /> Do Ci Lr� L�tic <br /> I I <br /> 3 I <br /> 33a' <br /> 2 Jf 0 <br /> VM it 110 <br /> OF <br /> '� c_ t) tlr <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 /> NAM nT <br /> 2TESTS WERE COMPLETED ON: <br /> 21'W �1 pNAh/� �" �ROf��7' 7- 7- �.-3 <br /> AQDRE S: CERTIFI ATION NUMBER: PHONE NUMBER(optional): <br /> L/70 Q191 l � to; �el y3 U 465, iql- 35—e <br /> CST N TU < <br /> r <br /> DISTRIBUTION: Original and one copy to.Local Authority,Property Owner aud.Soil Tester. <br /> u[L�;:�-613U-5d95 (R.02/bA OVER — <br />