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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> DIVISION <br /> LABR A E PERCOLATION TESTS (115) MADISON WIX 3707 <br /> HUMAN RELATIONS <br /> (H63.09(1)& Chapter 145.045) <br /> LOCATION: SE TION: TOWNSHIP/MUAli6+PfrttT- OTNO.:BLK___ SUBDIVISION NAME: <br /> S �/ 4 / /Tyo N/R/S� (or)W TC s <br /> Cu UNTY: OWNER'S BU E 'S NAME: MAILING ADDRESS: /b//c r / n <br /> n (S•e►"e I*V l b 4 lJ c /7" d It A 6 y <br /> USE DATES OBSERVATIONS MADE <br /> I.xNO.BEDRMS.: COMMERCIAL DESCRIPTION: I PROFI E DESCRIPTIONS: ER ATION TESTS: <br /> Residence New ❑Replace I //. �j3 'eO - /j- <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> C NVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> $ ❑U NS ❑U [Z ❑U ❑$ CRIJ ❑S ®U C o ryv <br /> If Percolation Tests are NOT required DESIGN RATE: 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(SEE ABB .ON BACK.) <br /> B- IG U I lU W'f' $ U S ",Bre s sr- `f /P" 'r f .S <br /> B- TO 100 ` t > "ec; /s S" ►,-e S- <br /> 133 jn � � > � � --'W 4s '71 fr /hI—el s <br /> B-Y Vo o I II > $o `;g r, Ls s fed S <br /> B- 3' lgcj I 0 Ir �/S 7S f� v►M Jc/� s <br /> B V V v 1 aV t ( 0 Q .r 47 po n s 7'S f r\ A-A-r— <br /> C! <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 1 PER D2 P RI PER NCH <br /> P_ ju SCJ ^^ y <br /> P- <br /> P- C Q ►C <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 9 <br /> a �T <br /> 7� • <br /> - --1 <br /> �:, +'111 n•� —} I I '- I -- <br /> Q <br /> I <br /> S — --, <br /> : <br /> le' p s a o ra- el <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 /> N (pi APt): TESTS WERE COMPLETED ON: <br /> %et-►L ^ ^ <br /> ADDRESS: CERTIFICATION NU BER: PHONE NUMBER(optional): <br /> 6I T.P-y- <br /> CST SIGN URE: <br /> t <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DI LHR-SBD-6395 (R.02/82) —OVER— <br />