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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> I'NDUSLABOR N PERCOLATION TESTS (115) DIVISION <br /> LABOR AND P.O. BOX 7969 <br /> HUMAN RELATIONS MADISON,WI 53707 <br /> (ILHR 83.0911) & Chapter 145) <br /> LOCATION: , SECTION TOWNSHIP/MUNICIPALITY: LOTN .:BL�NO.: SU DI VISION NAME: <br /> / 61 (p 3ncKsc j R <br /> COUNTY: MAILING ADDRESS: <br /> 0 E LEoniAFo EL_NEIZ 2 0S MADN. <br /> USE DATES OBSERVATION <br /> NO.BEDRMS.: COM MERCIAL DESCRIPTION: PROFILETIONS: PERCOLATION TESTS: <br /> I <br /> ❑Residence I KfNew ❑Replace <br /> - q <br /> 6- zsz b- z5 - 92 <br /> RATING: S=Site suitable for system U=Site unsuitable for system <br /> C N ENTI❑� . M lJ $. ❑� IN-GIR�O/�UND-PRESSURE: S.VSyT�EM-IN-FILL HOLDING�T-anNK:RECOMMENDED SYSTEM:(optional) <br /> S ® LA!$ ❑� 1151$ ❑� ❑$ LXJ� C0r4d6NTIDtJlf <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion the tested area is in the <br /> under s. ILHR 83.09(5)(6),indicate: J Floodplain, indicis ate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTAL DEPT TO GROUNDWATER,]NCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED SEE ABBRVV.ON BACK.) <br /> B- 1 92 �. N014E >)Z o-6_$// �-IS BNS - /Z!/,V,yJ•✓y`- <br /> 13-2-- Nonir X72 O-6�//s ?oBni/s Z<s-7 /3.1 �is�✓�r <br /> B- 31 IT- 0 >77-- o 7�1/S 7-/.YBl< /8 72_B.✓-hlr <br /> B- '� �. o� > Z 0-41-19113 6-2/ $,t! ,Z/- 77, l.Ms►✓ r <br /> B. 5 Z o D-`5�3/* � Zo3 Z -723.�MS�✓ ✓ <br /> B- <br /> PERCOLATION TESTS <br /> TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTER SWELLING INTERVAL-MIN. pERlOD1 PERIOD2P PERINCH <br /> P- 1 b 'S IY / 3 <br /> P- 2 O Y: v <br /> P- 26 AO $ rZ c <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. SclqLC )rr= q O r <br /> SYSTEM ELEVATION T_` SBM 00 5UMM of 51n1N6 <br /> r y <br /> 2 N <br /> PRlil <br /> wow <br /> �RflrLr2 <br /> o �L <br /> I <br /> I,the undersig ed, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methgds specified iiVhe 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): TESTS WERE COMPLETED <br /> COAKe OGKIA6 <br /> ADDRESS: 2776 CERTIFICATION NUMBER: P ONE NUMBER(optional): <br /> o w �S' IE1� W I. Sof 893 0 - !S <br /> i,; CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) -OVER - <br />