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DEPARTMENT OF REPORT ON SOIL _ AND SAFETY& BUILDINGS <br /> INDUSTRY, _ DIVISION <br /> LABOR AND PERCOLATION TESTS (115 ) P.O. BOX 7969 <br /> MADISON, <br /> HUMAN RELATIONS SON,WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) S T.�7 c�Jr <br /> LOCATION: SECTION:T�/ Q TOWNSHIPIM61LI.6Wfl 't." LOT/JVO.:BLK.NO.: SUBDIVISION) SNAME: <br /> .VE '/�E '/ s /•/ WR/-q(or)W (R C d `! AA kW - <br /> COUNTY: OWNER'S/BUYER'S NAME: M ILING ADDRESS: / <br /> r a nI eoZSO S� ryic /?� <br /> USE DATES OBSERVATIONS MADE 01 <br /> I1� NO.BEDRMS.: COMM E RC IALDESCRI PTI ON: - PROFV6EDES RIPTIONS: PER CO TIONT STS: <br /> Residence •� 'New Replace y -if F <br /> RATING:S=Site suitable forsystemU=Site unsuitable for system <br /> ONVENTIONAL: MOUND TIN-GROUND-PRESSURE: SYSTEM-11 -FILLHOLDING TANK: RECOMMENDED SYSTEM (optional) <br /> NS ❑u NS ❑u _ S ❑Q ❑S ®U I ❑S XUG° 0 ip/t/ <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'. 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 E ACK.) <br /> B r q� o� > ys ��v " f�6 `s �6'B .>~t !S rb" s" s <br /> B- o q6.S `I 7 8� D-S"e Y s S= /iB ' L I 80 C- <br /> B- 7 '� `1 (,-S tr Y S �'��Sr'Bn vVS JSrr` tr GS„ <br /> B- <br /> B- <br /> B- _ <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD PER PERINCH <br /> P- a IV o S' <br /> P-2 IV o 7 <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 dist nces. 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 boruggs and the direction and percent <br /> of land slope. <br /> SYSTEM EL VATION 9 3 •� <br /> ycg4e PVTR« d p�� o <br /> irlz yo ' �a] 60�r a <br /> ISL` t� QD 600 4 1p <br /> 3 s w�t14� <br /> IOD / tVi Ofs 0 QFt4 <br /> stat n� 13 M � ,,,-� TN <br /> I !C ` / <br /> / P 4 f4 D e Rfe s D f-T <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 /> NA i� prl c1: NESTS WE MPLET ON: <br /> o erIC � oO fftnS j47 <br /> AD RESS: <br /> CER IF TION NU BE PHONE NUMBER(optional): <br /> CS N UREA � <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Sod Tesler. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />