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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, C DIVISION <br /> BO 76 <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.09(1) &Chapter 145) 76-k5(n— Z <br /> LOCATION: SECTION: .: <br /> TOWNSHIP/MUNICIPALITY: OT NOBLK_NO.: SUBDIVISION NAME: <br /> y y /T IQ N/R 11 E (.0W mss; NA INA 15 AcgEs <br /> COUNTY: MA ING ADDRESS. <br /> BORMEE STAVE C S 0 E • BA5S IX•RD • AnfR��u W( " <br /> USE DATES OBSERVATION ADE <br /> 1� NO.BEDRMS.: COM ER IAL DES RIPTION: PERCOLATION TESTS: <br /> Ip Residence New ❑Replace / _5 <br /> RATING:S=Site suitable for system U=Site unsuitable for systemQNVEN �I f D 1 J <br /> CRS El . MR IN "NS Q0 E: SV❑S IEQL ❑S ZIJLUNV5/M0A11QgL OLDING R (optional) <br /> 7 ' <br /> It 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 TOTALP H T R UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED H T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B-� `7 Z 91.3 ROWE > -12 0 - (- DIMS 6- 12-9111 <br /> B-2 91 91.0 tJC >")2_ 0-6 81ms 6 ?28ams <br /> 13-3 91.4 MOKE >Z2 O-SBIM 5- 17-a ms <br /> B-4177- 99.1 >'72 0- G 1?I ms (D-12- s <br /> B-5- 0 - > 12 0 S 64M 5 - ?zBNms <br /> B- <br /> PERCOLATION TESTS <br /> ti -iwr DEPTH I WATERINHOLE TEST TIME DROP IN WATER LVEL-IN HES RATE MINUTES <br /> f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 p RI D2 P R PERINCH <br /> P. / a/ 3 <br /> P- 3/ <br /> P-31 hin 5 1 7/s i 6kn 3 <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 <br /> direction and percent <br /> of land slope. L• Bt155 LK• T <br /> SYSTEM ELEVATION 95. 0 <br /> i�.',oc C '.r1ft' fIKE#_2.,88$80.q ENST 5iDEof-PP. <br /> 942-R055 PROM DRII/IE <br /> If 0 <br /> TRI11LE1Z _ <br /> 4 <br /> _< F <br /> z� i SSI E I = bo' _ TN <br /> '3e A?0160 NAIL-IN lo"3WINL <br /> - <br /> . LRE <br /> ----- - _ WFLL-To BE->SOFFOM 8 ---- _ <br /> __ - - --- <br /> WEST YL APO _ _3.Iv�/RW.:OF GTR LI K --- <br /> ; <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 print TESTS WERE COMPLETED ON: <br /> 'YICHARD HOPK/N �- 5 - 0 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> EBSTER SIS -3(o6- �5 <br /> CST SIGPATURE. <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> _'+R-SB"395 (R, 10/83) — OVER — <br />