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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 83.09(1) & Chapter 145) <br /> LOCATI N: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:11 NO.: SUBDIVISION NAME: <br /> �/ SC�/ 2 /T J N/R116 E 1 r)W oAKLA <br /> COUNTY: M IL NG ADDRESS: <br /> I <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMM R IAL DESCRIPTION: A ESTS: <br /> Residence 2 xNew ❑Replace n . 24 - �O n_�I„ t�� <br /> RATING:S=Site suitable for system U=Site unsuitable for system ( / -1 <br /> CQ_�TI❑� . MOUND:�� ❑� IN-GROUND-PRESSURE❑� O <br /> E: S SOTEM- N-FILL OLDINGNK. R���EN ED SYSTEM:(ION/'I L (oPtional) <br /> �� DESIGN RATE: S U S U <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.0915)(b),indicate: ( - — Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALP H TO GROUISDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED H-E—S TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B-1 2 91 .00 0 > 12- ® - 5 BI ms 5.72-bi 5 <br /> 13- 2 >�2 I s <br /> B-3 <br /> B-4 75 9`3 . 4 A09C-. > 5-I5 <br /> B'_5 '?2 `a - 77Z O' 2 <br /> B- <br /> PERCOLATION TESTS <br /> lTEST DEPTH WATER IN HOLE TEST TIME DROP I WATER, V L-IN HES RATE MINUTES <br /> f NUMBER INCHES- AFTERSWELLING INTERVAL-MIN. p RIOD1 PERI D2 PERIOD3 PERINCH <br /> P. ) S !;;,I �L P/9P- 2 2 ,S �,' s/= y. 3 <br /> =P- <br /> P_ <br /> - <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 �S 3 <br /> lAs�+l c1J <br /> CALE _I'= 40`VN4'19s' KOTF1_ <br /> AZgtoo ARU-IN_24gRED OFOc <br /> Q <br /> TER(_ <br /> I _ •Bo12G _ , <br /> PL <br /> _ TN <br /> Fu Z QC <br /> I � <br /> 1Do �5 WIDE EHSEMEN7Irk <br /> 1, 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 Wis nsin <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 /> XICHRKD 14OPKINS <br /> ADDRESS: CERTIFICATION NUMBER. PHONE NUMBER(optional): <br /> WEBST� W I 5�t$ 3 3 <br /> to 70 - to <br /> CST SIGNATURE: <br /> r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SOD63951R. 10/83) - OVET - <br />