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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY& BUILDING <br /> INDUSTRY, DIVISIO <br /> LABOR AND PERCOLATION TESTS (115) MADISON WI 5370 <br /> HUMAN RELATIONS <br /> IILHR 83.0911) & Chapter 145) <br /> LOCATION: SEC N: TOWNSHIP/ OT NO.:BLK NO.: SUBDIVISION NAME: <br /> `{iUc), _1 / / /� -VN/R/�E IPL �/r/Cry <br /> C.C�(.//,'I1/ MAILIN ADDRESS: <br /> USE L TES OBSERVATIONS MADE <br /> NO.B�EDR'MS.: RCIAL DESCRIPTION <br /> : PERC�TIUN�7 : <br /> ' Replace <br /> / {Residence '47 "?7 <br /> 7/1 <br /> / <br /> RATIN(G�:S=Site suitable for system U=Site unsuitable for system (�p O/J,u1, <br /> pO STl NAL: MOUND: <br /> J� IN-GO S gY E: SVa I��L 041St SG❑� .R�✓(/'/�//, SYSTEM:(optional) <br /> U Iqui DESIGN RATE: si T <br /> If Percolation Tests are NOT required If any porion of the tested area is in the <br /> under s. ILHR 83.0915)IW,indicate: FloodPlain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL 12EPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTF <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST.//HI' T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B 7 �/ �h iii � i_ � r �Y <br /> — SOL 4 -9- moi/ /5 /A//z rncl c 2 t <br /> El /(/C"Y7✓ <br /> D 71'1'4n /-s; 7"--el-7" 1 G /.v//c IT7777 <br /> 13 <br /> 8_ 5 711 <br /> B_ <br /> PERCOLATION TESTS <br /> EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RIOD1 PERIOD 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 suitable soil areas. Indicate scale or distances. Describe what are the he <br /> zontal and vertical elevation reference points and show their location on the plot r Ian. Show the surface elevation at all borings and the direction and Perm <br /> of land slope. <br /> SYSTEM ELEVATIONti <br /> /✓/ _/�. U �/ �Chrr)ar.�., �t/Qi n bC>.�c: v� �"��, , I <br /> 1, the undersigned, hereby certify that the soil tests reporte on t ,s form were made by me,n accord with the procedures and methods specified m the Wisconsi <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 f�/ e//> > ��nif�i /9 <br /> ADDRESS: � CERTIFICATION NUMBER: PHON�UMBE optionali <br /> 11�61. Z51 --Z'_/(�/- <br /> CST SIG TURE: <br /> DISTRIBUTION: Original and one copy to Local Authonty. Property Owner and Soil Tester. <br /> DILHR-SBD6395 (R. 10/83) — OVER — <br />