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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR P.O. BOX 76 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON W1 5379079 53707 <br /> IILHR 83.0911) & Chapter 145) <br /> LOCATION: SECTION: TOWNS HIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME:�J '/ '/ / /T N/R ( t)W JAcK58� Nj ti� <br /> COUNTY: MAILING ADDRESS. <br /> U Jo IJ o <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRNIS.: COMMER IAL DESCRIPTION: PROFILE 15E$ A ESTS: <br /> Residence 2 XNew ❑Replace p� <br /> RATING:S=Site suitable for system U=Site unsuitable for system p <br /> CO�f=NTI O❑N� . I T%S.OU IN-GROUND QES11 SVS❑TEM;IN-FILL O❑LDING�K: RECOMMENDED SYSTEM:(optional) <br /> If Percolation Tests are NOT required DESIGN RATE: S U If any portion of the tested area is in the <br /> under s. ILHR 83.09(5)Ibl,indicate: n - Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORINGTOTAL DEPTH T GROU DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHESTTO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- $D 9. 30 7$O o•SBNs _T-SO 9M3 <br /> B- 2- 72 > 77— a S-NIs 5 7 Z-9 ns 5 <br /> B- 11 > 7Z- 0-136 -6SRr-s 6$ -72,50m3 <br /> B 80 > gb 0-4$!I5 q-67Rnas <br /> B S « '777— <br /> PERCOLATION <br /> 7ZPERCOLATION TESTS <br /> EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD PERIOD PERINCH <br /> ff <br /> y Y 3 N <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 q6 <br /> VO <br /> ��U , � .1��►Alr<t,U1�kF.aDAK <br /> S_ nyec . <br /> �0� •� s/o �;BnRE ' <br /> G+9 <br /> 0OZ6 z .>so'fe1 S/ST€M <br /> 14 tN <br /> 1115?f 6fZqDE. 5LJ93 _ <br /> LDr uta <br /> y <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): / TESTS WERE COMPLETED ON: <br /> ADDRESS: CERTIFICA 10 N MBER: PHONE NUMBER(optionall: <br /> w- r S -3b76 <br /> - 6- <br /> CST GN TUR <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. / <br /> DILHR-SBD6395 (R. 10/83) — OVER — <br />