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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS <br /> INDUSTRY, - _ DIVISION <br /> LABOR ANDP.O. BOX 7969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.09(1) & Chapter 145) <br /> LOCATION: SECTION: TOWN SH I P/101CNt0+PAi+FY: LOT NO.:BLK.NO.: SUBDIVISION NAME: <br /> Soy/sw '/4I /Tg6N/R/b11o0W R I 7�esP�r' or� <br /> COUNTY: OWNER'S BUYER'S NAME: , AILING ADDRESS: <br /> n r r S I <br /> USE DATES CMSERVATIONS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: <br /> Residence — �1 — ❑New ❑ReplaceI ej <br /> RATING:S=Site suitable for system U=Site unsuitable for system A �/ (1 U <br /> CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI LL HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> [--Is ou os ou os ou os ou os ou <br /> If Percolation Tests are NOT required DESIGN RATE: <br /> 9 If any portion of the tested area is in the <br /> under s. ILHR 83.09151161,ind IFloodplain, 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 or�(SEE ABBRV.ON ACK.) <br /> (9�6 " i s !o -iS Bn s 'S' a o ne t <br /> B �' 0 vtlJ c 780 Rr, p aa.. 111 RFS S9S' ',' 7c 0 % 8e <br /> ycS <br /> B- <br /> B- <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- <br /> P- <br /> P- <br /> P- <br /> P- <br /> P- F� p � <br /> PLOT PLAN: Show locations Of p i� {�5{5�s Borm s and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- <br /> zontal and vertical elevation reference rJoints and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent <br /> of land slope. V <br /> SYSTEM ELEVATION <br /> w T41, s e _ <br /> 1DWwc1\thS ew 5c� v.. '2'11 be <br /> ^--�� <br /> qs ' P <br /> a 0't <br /> 1� Ip —� <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) L TESTS WERE COMPLETED ON: <br /> 0 erlffC O /n r / 9 — ev <br /> ADDRES CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Lail T. 3 >e Acf <br /> CS N PATUR <br /> t <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R, 10/63) —OVER — <br />