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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, C DIVISION <br /> BOX 769 <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> (I LHR 83.0911)& Chapter 145) <br /> LOCIATI Is}: SECTION: ixR& E (o TOWN MUNICIPALITY: OT NO.:81., NO: SUBDIVISIOfrf NAMflP -z7 <br /> (o Lir ►/- <br /> MAILING AU <br /> C <br /> j7 �u�Nl ' ' /8c// ('4 we <br /> USEDATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IALDESCRIPTION: TS: <br /> ❑Residence /']_ �/�. ❑New eplace �A !Li /� 6_ ff"L> <br /> RATING:S=Site suitable for system U=Site unsuitable E]Ufor system <br /> ONYENTIO❑NAL: MQLIN D: ❑U IN-GRO,IIND-PFlESSl1RE: VSTEb1-I N❑-FILL 0❑LDING-TANK:RECOMMENDED SYS�EMaoptional) <br /> �LL�gyJJJI1�(1(e UU L�-(J`JQ LwoIt ��LL��I�I�S U S E'1/t 00.10& 7`lCVA <br /> DESIGN RATE: <br /> If Percolation Tests are NOT required If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: I I Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHESTTO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B- + 9s" `�s`6 �k�bE s" cL sL Ts' /6"CISCC:1 <br /> B- 2 7G`Iti/ S`8G. 5L,IS. A' Cryt' /6�nEn�K,s /e•mEnf;2 <br /> B /t r if <br /> /V ��, 15 / 'csl. aoy4NcA�,z (.!6 rn� �R `CGS 27A S; <br /> ,i <br /> B �J2`I �l �C> S 91,T5 5"C$!�2 /sr' e�?.S:GQCJ`//7c�a' <br /> B ; l <br /> PERCOLATION TESTS <br /> T -TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATTER INCHES <br /> i NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p AIODI P RI D P <br /> P- H <br /> P Y Y I J _ <br /> P 7i n <br /> IV/ <br /> tl y� <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 direction and percent <br /> of land slope. \ <br /> SYSTEM ELEVATION <br /> tHi <br /> Pe°,- /00 <br /> I v I <br /> L <br /> 1`L <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 Pri ,^ TESTS WERET7ETESO ON: <br /> it �/ <br /> ADDRESS.74 / CERTIFICATION MBER: PHONE NUMBER(optional): <br /> -2 _SING <br /> CSTS1 649 EG <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBOE395 (R. 10/83) —OVER — <br />