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DEPARTMENT OF REPORT ON SOIL BORINGS LAND SAFETY & B DI VIISION <br /> LDINGS <br /> INDUSTRY' PERCOLATION TESTS (115) �f MADISON WI 53707 <br /> LABO-R PA�-� <br /> HUMAN RELATIONS (H63.09(1) & Chapter 145.045) <br /> LOCA ON� SECTION: TOWNS HIP/AHJPII LOTNO.:BLK.NO.: SUBDIVISION NAME: <br /> 66°� n�)/a. '/a 1 s /T38 N/R/fir,W nAn+l�Z6 ,v,� �✓� N <br /> COUNTY: OWNER'S BU�*ER'S NAME: MAILING ADDRESS: <br /> R -7 t �v �0 3�i� sit?EN lJts f�s�z <br /> USE DATES OBSERVATIONS MADE <br /> NO.BED MS.: COMMERCIAL DESCRIPTION: (PROFILE SCRIPTIONS: ER LATION TESTS: <br /> [Residence 3 New ❑Replace II S- � Cf,- _,�Q'_�.3 <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> CONVENT( NAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> DS ❑U ©S ❑U ®S ❑U I EIS ©U I DS ©U N <br /> ATE: <br /> If Percolation Tests are NOT required DESIGN RIf any portion of the tested area is in the n <br /> under s.H63.09(5)Ibl,indicate: /V4 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 ABBRV.ON BACK.) <br /> i <br /> t <br /> ,g <br /> B- <br /> B- <br /> 13- <br /> B- '22 toz� c" <br /> B- 15 '/2 / 0>' o" I , 2 " / <br /> PERCOLATION TESTS <br /> WES <br /> HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAPER INCHES <br /> LLING INTERVAL-MIN. PERI D1 PERIOD2 PER D3 <br /> ?ur -2 0 3 <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 F(-)O'- o '' <br /> O PE* jFsT <br /> A, ' 6.41 hAZ- W—Ae Al- <br /> ae <br /> .8 10 t y��4 8,45E o� <br /> �PaS ISX35 s6� pa�P 516 h99QICEU Gr11P9/•r1 <br /> L7 rA/ a ' r—��vt7f�B�c ✓ 4619 tN <br /> o � (a A� B� S <br /> 41 3 'd {aQ _ PI �1�7a® Td 6(= 135 PtST/��ti�c <br /> 67 ^ ! 3D <br /> SZ-0 t35r, <br /> 1 tip <br /> El /G �+&Ad y aaa/ <br /> m � <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 (print): TESTS WERE COMPLETED ON: <br /> E�JARo W Sc ���o�R S - 26 - S3 <br /> ADDRESS: nn CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> CST SIGNATURE: <br /> ,c�c• C<l ' <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester, <br /> O\ER <br />