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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND- PERCOLATION TESTS (115) MADISON W 53707 <br /> 69 <br /> HUMAN RELATION <br /> (I LHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLKNO.: SUBDVISION NAME: <br /> A1C '/ E Y 3 /T N/R16E1 r) OHK�ND W� �A A <br /> COUNTY: MAILING ADDRESS: <br /> u N 1'ATR)(,K Sqq3 <br /> USE DATES OBSERVATIONS MADE <br /> NO.B : COMMER IAL DESCRIPTION: A TESTS:Residence NEDRMS ❑New ❑Replace _ <br /> RATING:S=Site suitable for system U=Site unsuitable for system D <br /> ONVENTIONAL: MOUND: IN-GRWND-PRESSURES STEM-IN-FILL OLDINGT NK: RECOMMENDED SYSTE :(optional) <br /> SIS ❑U S ❑U SOU EISCAIDSMICsov. <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: � Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,CO OR,TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED E T TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B- I 72 99. 1 PO►jr > '7 o - 581m5 5 - 23 FM5 73 -72 X15 <br /> 13- <br /> 13- <br /> B- <br /> 13- <br /> PERCOLATION TESTS <br /> CTEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RAPER INCHES <br /> F NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D2 P <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 disi 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 bor ngs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATION <br /> N <br /> - <br /> Ali IDb_fCMtA 111�G <br /> 6ARRG <br /> ➢w�(i)►�� N <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and iethods 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 : TEST WERE COMPL ET DON: <br /> -2I , <br /> ADDRESS: / {� CERTIFICATION NUMB R: PHONE N MBER(optional): <br /> N( V <br /> 300 t]15JU- 4151 <br /> CS G ATUR <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> ',HR-SBD-6395(R. 10/83) —OVER — <br />