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DEPARTMENT OFREPORT ON SOIL BORINGS AND <br /> SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX <br /> 969 <br /> PERCOLATION TESTS (115 MADISON,W1537073707 <br /> HUMAN RELATIONS 1 <br /> (ILHR 83.0911) & Chapter 145) �' to� <br /> LOC TION: SECTION: OWNSHIP/M NICIPALITY LOTNO.:BLK. NO.: SUBDIVISION NAME: <br /> I � Ilev7fn if. 'i I <br /> CO T AILING ADDRESS: <br /> USE DATES OBSERVATIONS MADE /Q7 <br /> r NO.BEDRMS.: COMMERCIAL DESCRIPTION: �y PROFILE DESCRIPTIONS: PER OL TI ON TESTS: <br /> RResidence �-- �'LJ`New ❑Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> C0�N^VVII E((N�T10N A L: MOUN(D�:-�,-�} IN-GROUNNpaPRESSURE: SYSTE(�M-IN-FILL HOLD ING TANK: RECOMMENDED SYSTEM:(optional) <br /> UJ MU ❑J JUJU EISSU ❑S -RU 2SEE10 e_os 10, r <br /> DESIGN RATE / <br /> If Percolation Tests are NOT required „/ If any portion of the tested area is in the <br /> under s. ILHR 83 09(5)(b),indicate: �' Floodplain, indicate Floodplain elevation: r� <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 /> B- <br /> B-B- a y <br /> B- <br /> B- <br /> B- <br /> B- <br /> PERCOLATION TESTS <br /> TEBT DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD P RI D PER INCH <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 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 <br /> 6p erf-e�/. cox TN <br /> h� t <br /> Lor5 o <br /> I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedu d methods specified he 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, .O <br /> NAME (print): TESTS WERE COMPLETED ON: <br /> `1 / <br /> ADDRESS' CERTIF : H NE NUMBER(optio nal): <br /> J-�ATION NUMBER / <br /> CST SIGNAT E: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Teste,. <br /> DI LHR-SBD-6395 (R. 10/63) —OVER — <br />