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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 <br /> HUMAN RELATIONS <br /> 60 i- (H63.090)& Chapter 145.045) <br /> LOCATION: ISECTION:E '/ 1 OWNSHIP/MUNICIPALITY: OTNO.:BLK.NO.: SUBDIVISION NAME: <br /> ` /T /R <br /> COUNTY: OWN R'S BUYER'S A E: M ILIN ADDRESS: <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMMERCIAL DESCRIPTION: ❑New L�dRe,tom/ place PROFILE DESCRIPTIONS: ER EST <br /> ATION TS: <br /> IICI Residence __ I —1 ;_ <br /> ✓✓✓YY` D TJJ O S�-a <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CO ENTI❑� . M❑�. ING❑S YU SVSOTEM-RILL HOLDINGT :RECOMMENDv SYSTEM: �tion <br /> S S U EIS OU <br /> If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the / <br /> under s.H63.09(5)(b),indicate: —� Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) <br /> B- 9�/'© oar 72- - 6 r� 69" rpt s, <br /> B- <br /> r ' <br /> B- yZ'- 7 �77 " RFs, <br /> B- S „ -'7 , Z,, Al- 75 6 <br /> B_ <br /> PERCOLATION TESTS <br /> PTEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> R INCHES AFTERSWELLING INTERVAL-MIN. PER D1 PERIOD2 P R PER INCH <br /> O`r Nlvn-�`� G 9 3PLOT 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 '57/ ' <br /> � rr <br /> �Y2 p <br /> 26 Akive- <br /> P /0,U Dorpe_ <br /> " T N <br /> 3 3s4'e <br /> r <br /> I,the un rsigned, 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 O <br /> ADDRE S: CERTIFICATION NUMBER: PHONE NUMBER optional): <br /> - 3509 <br /> CS B URE: <br /> e <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R.02/82) —OVER — <br />