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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR ANDP.O. BOX 76 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) 5T 167 <br /> LOCATION: SECTION: TOW. NN LlI /MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> S w'14 r �/ /T3 4 N/R /,E (or r - _ 1 7-1- mss' Fri, A <br /> COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: <br /> USE DATES OBSfRVATIONSMADE <br /> NO.BED" <br /> : COMMERCIAL DESCRIPTION: PROFI LSE D CRTPtI NS: LATION TESTS: <br /> ®Residence !V�¢ New El Replace /y �' q��J <br /> RATING:S=Site suitable for system U=Site unsuitable for system / <br /> CONVENTIONAL: MM S. ❑� IN-GRO ND-�URE: SVS❑TEM-I N-F,ILLHO❑LDING NK]RECOMMENDED SYSTEM (optional) <br /> 16' <br /> If Percolation Tests are NOT required DESIGN RATE: S U S ®U - <br /> Q If any portion of the tested area is In the <br /> under s. ILHR 83.09(5)(b),indicate: 6rzrT 1� ' Floodplain, indicate Floodplain elevation: N <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALD PTH 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 ACK.) <br /> B- 1 4i,gr IVD/Va. y. <br /> a- 3 lz 93,c, NcIv-e <br /> BNO/V.? 7 �� �nh'N� SI�T.�� .:I,GOB/ ,is <br /> B ✓ 9� g1, 17 /Vol/,z qo <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. PERIOD PERIOD PERIOD PERINCH <br /> P_ <br /> P- 3 4 Aj <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 dista ces. 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 bori g5 and the direction and percent <br /> of land slope. [� <br /> �drJ / /�-rLr/ ;a— <br /> SYSTEM ELEVATION 89,6' F°e !;� <br /> fir Priq,2 <br /> =IBM{ I/hP ORftN1< /VAIL iN FSM 1'8 <br /> 13,4 _5c A 1-x 1 <br /> If TioA/ !corm! <br /> FPoP L (/VaS NodtN <br /> a <br /> ea>c <br /> ea Zz <br /> �f161'vt-4 L 5cN LlFlc+.t- Rd 5 <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and not thods 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 COMPLETE ON: <br /> Gtr C" V P-,r-/9 P7 <br /> ADDRESS: _ CERTIFICATION NUMBER PHONE NUMBER(optional): <br /> �73s>- yz/ <br /> CST SIGNATURE: <br /> f <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395(R. 10/83) —OVER — <br />