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INDUSTRY, REPORTREPORT ON SOIL BORINGS AND SAFETY& BUDIVDS <br /> LABOR AND P.O. BOX 79 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) ,pdgplSQ4 %All 37 <br /> ULHR 83.0911) & Chapter 145) VX �1 ,I�JI U �) '` <br /> LOCATION:N: SECTION- UWJ� T NO.: lC NO. SUBDI VI I_ON NAME: <br /> (u/� G LY/ ,�/V/� / � / rO <br /> COUNTY: <br /> MAILING ADDRESS: <br /> AillerC e// III,) I,ef / �x IrS�S� iino� A/ '51ien, kxz-_<N7 <br /> USE DATES 013SERVATIONS MADE <br /> NO.BEDRMI COMMERCIAL DESCRIPTION: IPPDfILE DESCRIPTIONS: PFRCULATION EST9 <br /> %Residence New ❑Replace <br /> RATING:S-Site suitable for system U-Site unsuiuublle for system <br /> 0T ryU . MOS: u IN-G❑S M11 ROUNDPRE;MROS N-FILL OL SG❑Q .R�OzN� SzOl),ib all <br /> 0 V TANK[Xil <br /> If Percolation Tests are NOT required DESIGN RATE: U 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 GROUPDWATER-INCHES CHARACTER UF_01C WITH THICKNESS,COLOR,TEXTURE, AND DEPT <br /> NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> 7'-.4yo"67/'.3 µ1/4 /no CLY, /3,. <br /> B- 3 3(0' �/ /�3" �SQ�C�rne 05 4-A <br /> B- <br /> B- <br /> h PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATEI EVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p RI PER INCH <br /> P. <br /> P- <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 h <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 pert <br /> of land slope. <br /> SYSTEM ELEVATION �� <br /> _ r— _f T__�. _.__� __r___. .-_�._ _—___ <br /> I T � I 1 I I 71- � - <br /> I <br /> 7-- - - —'--- - <br /> UU <br /> 1 <br /> — - t <br /> r --�- +---}-- --r-- <br /> I i I T <br /> Gti'7/Q7.o Q�ixhmClr Tho o eC rC m <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 Wiscons <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 /> LzLt l5l'I _ ?2 - <br /> ADDRESS: CERT FICATION NUMBER: P ONE NUMBER(optional <br /> to / C �. 10D. ,B x zo llh&i� 6//I �/�93 35d3 5 ;' f <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBO-6395(R. 10/83) —OVER — <br />