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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND, PERCOLATION TESTS (115) P.O. Box 7909 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (ILHR 83.0917) & Chapter 145) <br /> LOCATION: SECTION; TOWNSHIP/MUNICIPALITY: OT NO.: S BDIVIS O E: <br /> S �4 7_& /T N/R/SE (p I Stow <br /> / <br /> COUNTY: MA LIN DDR S: <br /> VINa kw ScH010F5215 2- e <br /> USE 5 6 — 3 S 23 DATES OBSE RVA How MADE <br /> NO.BEDR : COMMERCIALDESCRIPTION] <br /> Residence 2 r New ❑Replace — <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> ONVENTI NAL: MOUND: IN- ROUND-PRESSURE: SYSTE - N-FILL OLDING TANK:RECOMMENDED SV TEM:Ioptional) <br /> MS OU S ❑U S OU IS OS 1A L <br /> III 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 P H TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS COLOR, TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) <br /> B- l ell 2 X72 D-SSlns 72Bums <br /> B- 2 85 q .y " -.> '0� o- Fi//hs y '9St3,lJ�rlS <br /> B- 3 80 a. <br /> '1 -7*0(3 o- '/ m - 80 SAIMS <br /> B- 2 9`0.3 ?2 0- ->AII S S- 7 7-607u <br /> B <br /> B- <br /> a PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LhVt:L41Htb RATTER INCHES <br /> fff NUMBER INCHES AFTERSWELLING INTERVAL-MIN. I DI P I <br /> p- 1 30 1 mt S 7/ <br /> P_ Z, 11 / 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 o 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 apt/al borings <br /> �annd•�the direction and percent <br /> of land slope. SCnz. /yT= v AVIFSS AIMFO <br /> SYSTEM ELEVATION q-S •1 A Aqi40 Ngi1- /0 6"0 a P/uLe <br /> 33 <br /> ' vRdPos <br /> 1 � O <br /> I, thd undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures�pnd 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 be <br /> NAMEprint TESTS WERE COMP ETED ON: <br /> ADDRESS: CERTIFICATION N M ER: PHONE NUMBER(optional): <br /> WEE Of 3670 ` WS <br /> CST IGNATURE: <br /> -DISTRIBUTION: Original and one copy to Local Authority.Property Owner and Soil Tester. <br />