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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> INDUSTRY, <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 <br /> (1 LHR 83.090)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK NO.: SUB DIVISION NAME: <br /> Iq fl)'/s) '/4 /T oN/R� L. _)pcKSON Np A119COUNTY: MAILIN ADDRESS: <br /> bvylouf TONY1.7-130-3 4I5 13 !P = V <br /> ATIONS MADE <br /> USE DATES OBSERV <br /> NO.BEDRMS.: COMMER IAL DESCRIPTION: PROFILE UESCHIPMONS: PERCOLATION TESTS: <br /> esidence ff^`_� ❑New Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system o I V 1 <br /> ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDINGTANK:R ECOMM ENDED SYSTEM:(optional) <br /> ZS ❑U ,SIS ❑U r7S ❑U ❑S 1U EIS911 NV,9Nf0A1_ <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: I /\---. 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. <br /> HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- I77 377 > 2- OSUIMS 6'72SI/M.< <br /> B- 2 ?Z 13.0 VOtjE -27Z 0-Ol/Ms 4- '71- SA*5 <br /> B-3 77— 19.3 1 AW1E �Z 0 LII/ 6• z 6AJA1S <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> LTEST DEPTH WATER IN HOLE TEST TIME DR 1 WALEVEL-INCHES RAPER INCHES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI D1 P RI D <br /> p- I Z O 3 % 2 V� <br /> P- 2 2$ AO 5 / <br /> P- 3 No •r/ 3 <br /> P- <br /> P- <br /> LP- <br /> PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate stale 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 95 <br /> [.of Ivve <br /> KE' d <br /> _ + _ <br /> Oo <br /> i <br /> -r- <br /> 4+ _ .. / ' <br /> + 4+ N, <br /> DR�v _ <br /> vR <br /> - <br /> - � a <br /> L4#6 _ l <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 /> ICH �D IIo�KINS __ <br /> 2 - P - 11 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> E 57C WI 5y$ 3h� a 15 - 6-`fls <br /> CST SIGNATURE: <br /> i = <br /> DISTRIBUTION: Ong,nal and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD,6395 (R. 10/83) — OVER — <br />