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RTMENT.OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDU <br /> INDUSTRY, - - - DIVISION <br /> LABOR AND PERCOLATION TESTS (115) P.O. BOX7969 <br /> HUMAN RELATIONS MADISON,WI 533707707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/ LOT NO.:BLK.NO.: SUBD VISION NAME: <br /> a� /T `//N/Risi.pr)W g �'sr �k �� PA <br /> COUNTY: OWNER'S B�/YER'S N/A�ME: MAILING ADDRESS: <br /> BvrnP ono '� L Qo � rr Sa SYn-rrn¢ rJY <br /> USE DATES OBSERVATIO IS MADE <br /> NO.BEDRMS.: COMMERCIAL DESCRIPPROFILED PTI N5: PER OLATIOTS: <br /> pN TES <br /> TION: <br /> Residence ❑New F,%eplace <br /> RATING:S=Site suitable for system U=Site unsuitable for system 7 <br /> CONVE^`^NTION1A''L: MOUNccD: IN_ -GROUNccD-PRESIIS''URE: SYSTEccM-IN-FILLHOLDIINcNG TANK:RCOMME`DEDSYSTE :(optional) <br /> ©V oV ©J ou ®J EJV 0J ©U EIJ ®U 6 A// VV// <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)(6),indicate: Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALD PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, CO OR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON ACK.) <br /> B j f 9,l JiA e tJ P > S� o, 6 ",6 C S L G "= 8 " 8, ter, Ir <br /> B g t� ? 9a I-7 "B <r( 7" 90 1601 41 L tQ1r <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 PERIOD2 PERIOD 3 PERINCH <br /> P 3 2- <br /> P- N q <br /> P- Al / S <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 unces. Describe what are the hon- <br /> zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all bori gs and the direction and percent <br /> of land slope. <br /> SYSTEM ELEVATIONrc <br /> / �et�o f • <br /> 4) T14 I N 64 S-e If"r r' tl Po. B ! D d �- 06 If r Y <br /> x 7 <br /> 40 f, <br /> V WY ( �a � tN <br /> r` <br /> 100 <br /> 5337 S` <br /> I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and n ethods 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) ITESTS WERE COMPLETE ON: <br /> 1 t <br /> d r Q <br /> ADDRESS: r� CERTIF ATIONNUMBE3 PHONE NUMBER(optional): <br /> uri. S 17 '/'-*3 -7 _y<4-7 <br /> CS <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) —OVER — <br />