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INDUSTRY, <br /> REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> OS <br /> INDUSTRY, DIVISION <br /> LABOR P.O. BOX 7969 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LQA,TIION: ' SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: <br /> 74--14 13 /TNON/RI�E (prlW Isco1 A 6.1. 2 <br /> COUNTY: MAILING ADDRESS <br /> 1 110-5- CRRSON R10—SPOONEX . M. Sq961 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPT NS: ATION <br /> ❑Residence I ❑New ❑Replace I ? _ qz hl/1 <br /> TESTS: <br /> RATING:S=Site suitable for system U=Site unsuitable for system / L I Vf1 <br /> ON�/ENTIO❑NAL: MOUND:❑� IN-GRO N ❑S E: SYSTEM-IN❑-FILL 0 JN TANK:RECOMMENDED'SYSTEM:(optional) <br /> XJ S OU /Vfi <br /> If Percolation Tests are NOT required DESIGN RATE: S U If any portion of the tested area is in the n <br /> under s. ILHR 83.09(5)(b),indicate: �� Floodplain, indicate Floodplain elevation: N// <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL P H T GR LINDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,AND DEPTH <br /> NUMBER DEPTH IN, ELEVATIGN OBSERVED T. HET TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- I `12 101.0 >JaN� > �2 0' 6 iMs 'IzgNms <br /> B- <br /> B- <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEV L-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERI0132 p PERINCH <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 scaleor 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. u r <br /> SYSTEM ELEVATION `1D <br /> �MIDo8d71bM-O� SIOIr1G <br /> � T <br /> i <br /> I I <br /> i <br /> MIDDLE <br /> 27o 17- TN <br /> r <br /> al - '��Wt,P - ' <br /> j3�o flflP�RS , , <br /> 7b 8& '15D W cp , <br /> Ott <br /> ,p <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 n 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 ON: <br /> 10 P V- 3 - 97— <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> S-8Z7Z�o � EBSW . �� 3 6-70 <br /> CS <br /> ATURE: � _ <br /> -yam fw.a,� <br /> DISTRIBUTION:Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />