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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND - PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIP LITY: LOT NO.:BLK.NO.: SUBDIVISION NAME, <br /> /S�'/ /MAIR/6ir(or)W 1, n <br /> C UNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> Yry) V �vr � Prl Sd b S Ae' /,c. /j-A- <br /> USE DATES BSERVATIONS MADE <br /> XIpI NO.�DRMS.: COMMERCIAL DESCRIPTION: IIppII PROFS DESCRIPTIONS: E `O AT ON TE TS: <br /> }d Residence yv New ❑Replace 7 d Cr 7 1 dna <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 /> ®s ou ®s ❑u Ms ❑u ❑s au ❑s ou . <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> 4 It any portion of the tested area is in the <br /> under s. ILHR 83.0915)Ib),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- 1Tl -0 9Jr. A)o 7 b O D-& IrOt- L,r � r; �brlB. >„.�r � 6': r4 " C ( <br /> El- � � Oji'. '1 � a` � C>, b �B< < r' rr" v ' ef .�y S yr, , c17' <br /> B- Y PE 9 11 ' 7 d ()• �r�</f � �= ac/ ft 'e ., lj J(/"- "'71 Gr <br /> B-rJ 7,)-- /'Z, k > 7 J 0" eur <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. PER IOD1RIOD p R PER INCH <br /> P- 1 0 N'% r i <br /> / b <br /> P- 3 N o s 7 1F & <br /> P- <br /> P_ <br /> - <br /> a a- <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 . <br /> �or �Prn <br /> I`p i e b 'l 1 s�• <br /> I � 1 <br /> �J (1-U (0 on <br /> s T"�� �/ <br /> rAAx' �jrc- '" Qu�ed re� TN <br /> +f Q�Ns��lar� r )OU <br /> I <br /> I <br /> e 941- 3101 <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 riot : TESTS WERE COMPLETED ON: <br /> 10 rrrf LAT go Ile 7^/w ' C C <br /> ADDRESS: CERTI/FIICATIONNUMBER: PHONE N/UMBER(optionall: <br /> ,_p <br /> GN TUR <br /> 'UY <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />