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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 <br /> HUMAN RELATIONS <br /> IILHR 83.0911)&Chapter 1451 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> 1/4 1/4 6 /T 39 N/R 16 E(or Meenon Townshi 1. Gov't Lot 1 <br /> COUNTY: MAILINU AD <br /> Burnett Arnold Jensen 27135 Jamison Road Webster, WI 54893 <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS.: COMMER IALDESCRIPTION: A N STS: <br /> ®Residence 4 --_-_--__ ❑New ®Replace oct. 2, 1991 N/A <br /> RATING:S-Site suitable for system U=Site unsuitable for system <br /> ONVENTI NAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) <br /> ❑S ®U ❑S ®U ❑S ®U I ❑S X❑U I ®S ❑U I Holding Tank <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: I Floodplain,indicate Floodplain elevation: N/A <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPTHTOGROUND ATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.H I G H EST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B-1 42'1 98.1 28" 9" 0-9" Dk Bn ls; 9"-42" Gy cs w/R mot cmd <br /> B- 2 40" 99.1 40" 18" 0-88" Ok Bn ls; 8"-18" Bn ls; 18"-40" Gy csR w mot <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PER OD 2 PERINCH <br /> P- <br /> P- <br /> P. for an kind of soi sorption sy tem <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 ------ Scale 1"=40' <br /> � I I <br /> Bz T <br /> Yell <br /> - + <br /> rt2 � 1 N <br /> -ro ` I r Garage e <br /> Elm <br /> I - <br /> I j <br /> _ _ <br /> !7' -0 �enchR�rk, Bottjom f si& <br /> - - -1rJ L <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 /> Wade Rufsholm October 2, 1991 <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMB ER(optional): <br /> 24702 Lind Road P.O. Box 514 Siren, WI 54872 3583 (715) 349-7286 <br /> CSTSI/G/NATUR E: <br /> 46 <br /> DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Buil Tester. Q09 I , (� •/ 5� <br /> DILHRSBD4395(8. 10/83) —OVER— � 0 • <br />