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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> INDUSTRY; -- <br /> 7969 <br /> LAQOR AND P.O. BOX <br /> HUMAN RELATIONS PERCOLATION TESTS (���) MADISON,WI 533707707 <br /> (I LHR 83.09(1)&Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUB (VISION NAME: <br /> 5k!)/ 36 /T9 N/R/6E (p S /SS / Csrl ✓ // !/oC3Ly$. 36 <br /> COUNTY: OWNER'SBUYER'S NA"': " <br /> S SNU /y"N Sy v W , spa <br /> USE DATES OBSERVATIO tIS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: <br /> PROFILE ESCR TI NS: ER 0 TIONTESTS: <br /> [Residence 40 ❑New 'Replace / rl 9 / �/ <br /> RATING:S=Site suitable for system U=Site unsuitable for systema7 <br /> ONVENTIONAL: MOU D: INGRO N6PRESSURE: SVSTEM-I II I LLHOLDING TANK: RECOMMENDED SVSTE :(optional) <br /> $ ❑U $ ❑U $ ❑U EISU Lis Zu eage &P / -3 <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: �//VI// Floodplain,indicate Floodplain elevation: <br /> 414 <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, C LOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B I ,S3� > 3" s " ns <br /> B- 9 >48 <br /> B-.3 $ 3 >8? . <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIoD PERIOD2 PERIOD PERINCH <br /> P- ,E JA 3 <br /> P- ao P— 3 <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 di ances. 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 bo Ings and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION 9/, Y3 <br /> 4 <br /> BM - Sorfedi of s hlAi; -Sk) Of HOUSE -EL /ao' <br /> w <br /> Olt <br /> e <br /> V o o sMeg <br /> APa ,' 'wFu DRWE Q T N <br /> �. 9 <br /> e FERC 7'Es7'z' <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 WER COM E ED ON: <br /> ADDRESS PCE1 <br /> RTIFI ATI N NUM ER: PHONE UMBER(optional): <br /> SIGNATURE: <br /> Original and one copy to Local Authority,Property Owner and Soil Tester. �- <br /> 5395 (R. 10/83) —OVER — <br />