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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON W 53707 <br /> HUMAN RELATIONS <br /> (ILHR 83.09(1) & Chapter 145) <br /> LpCATION- SECTIOv%� w �► �� L NICIP : <br /> LOT NO.:BLK.NO. S BDIVISIOdN <br /> NAME:1/ VN/11/61 lorlWHAOP <br /> COUNTY: OW R'SBUYER-S NAME: MAILINGAADDR SS <br /> USE HIIVC,K MV 5, � <br /> D ES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: ��qq PROFILE DESCRIPTIONS: PER OLATION TESTS: <br /> ®Residence � 1 ANew ❑Replace I 8 h Z—Q7 <br /> RATING: S=Site suitable for system U=Site unsuitable for system (! K. !! / <br /> ONVENTIONAL: MOUND: IN-GROUNIPRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ®S ❑U ®S ❑U NS ❑U ❑S ®U ❑S A <br /> If Percolation Tests are NOT re wired DESIGN RATE: <br /> q If any 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 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- SO 9g' / 006 b -7 8/k ^(" S 7' 80 BrN Af-dc s <br /> 6 ?� r1 /ha nS t7 a p�t� 44 ^112d S � " SD ,bra Meds <br /> Affi-AW5 -SA <br /> It <br /> B- I I - SU e1w Ale d s <br /> B- � ll d I 14 <br /> B- d <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1P RIOD2 P RI 3 PER INCH <br /> p- 0 <br /> 57 P- 116 <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. ShQv the surface elevation at mall borings and the direction and percent <br /> of land slope. r(.-p CALF �N y0'Fxcegt WA.ere- uokt <br /> SYSTEM ELEVATION q6. 9 B : PK /DO Pill /a 4A5E Of $"J4d j;N6 <br /> LJ"E <br /> Ze` <br /> `C �a <br /> gM• � n3 S <br /> Pr <br /> 61 96D(, I 1 N <br /> Propbsed <br /> w�N <br /> Lo!~ tf,Ge 7;3q <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 (pn t): TESTS ERE COMPLETED ON: <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Ll3 <br /> CS UNATURE. <br /> ♦ 1 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> D I LH R-SBD-6395 (R. 10/83) —OVER — <br />