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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY; DIVISION <br /> 7969 <br /> LABOR AND CC P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON,WI 533707707 <br /> (1 LHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MHNIEIPAttT'F' OT NO.:BLK_Na: SUBDIVISION NAME: <br /> l 14/✓ % a /TV/N/R/ E I i, 7 — eyn i/o/ <br /> COUNTY: AlMLING ADORE S. <br /> /n r s <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMM R IA LDESCRIPTION: '��7 A ESTS: <br /> Residence ❑New Replace �, , /. , i. ,/9�9 �9�/�,/ i <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTION L: M��. �� IN-G N6f�URE: SVS❑TEM-I�ILL OL❑DINGTNK: REC„O�ENDED SYSTEM(optional) <br /> �I�n[[�//JJ)SS S U S U S U C <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: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUINDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> / <br /> B- 3 lC1nc-_ > C!5 <br /> B / /z�0/�� > SClrr� Cls �/ <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> l EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI D2 P R PERINCH <br /> 8 / 5 <br /> P- / <br /> P- �„ 3 11511(l <br /> P_23 " 13 i <br /> P- <br /> P- <br /> LP- <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 �5. � exq�P>< - led <br /> T N <br /> Q � o <br /> S 0 <br /> G [[n '. - <br /> •e�q o Perms <br /> I, the undersigned, hereby certify that the soil tests reported on his 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 : �IITTEESTS WERE COMPLETED ON: <br /> Q <br /> ADDRESSCEFXTIFICATION NUMBER: P ONE NUMBER(optional): <br /> ul �lr Z3 35Y3 <br /> CST S Gt)1�E: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L <br /> DILHR-SBD-6395 (R. 10/83) t —OVER — <br />