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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTRY, DIVISION <br /> LABOR AND P.O. BOX <br /> 969 <br /> HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 537073707 <br /> KHR$3.09(1)& Chapter 1451 19-3317-05-3W <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDI VISION NAME: <br /> W'/ SC T N/R 6 E (p FANO a� CS/►l i✓' '1 10,, <br /> COUNTY: MAILING ADDRESS <br /> j30Q0 2-5091-"KLV1W PP. . 5 UL <br /> USE DATES OBSERVA .ION8 MADE <br /> NO.BEDRMS.: COMMER AL DESCRIPTION: ESTS: <br /> ❑Residence ❑New .HeDlace / _ IS- 9.5 <br /> RATING:S=Site suitable fes system U=UaAi8eifablefor.system. <br /> 1160 _ 619S ` l� '! <br /> Qom/ NTIOb. MOU pi IN-G�,_OUND-PRFSSl1REi.$,STEM 1❑�L ❑�C� NIR IV�� S TI�L/�71S I[11U 11[C4�'I'(Js I�L/�JL1{11 <br /> If Percolation Tests are NOTre9pued DES(/GN�RATE 1.If any portion of the tested area is in the <br /> under s. (LHR 83.091511b1,indicate: { `� Floodplain,indicate Floodplain elevation, NA_ <br /> PROFILE DESCRIIPTIONS .. _ <br /> BORING TOTAL PTH TO GROUNDWATER-INCHES JCHA R AC R or SOIL WITH T ICK SS;' OLD TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN, ELEVATION OBSERVED BST.HIGHEST TO BEDROCK F RV D SEE.ABBRV..ON BACK-.1 <br /> B- 1 '1Z S•0 NONE > q2 <br /> o-`i 84is 9 - 3 B s 3`1- 12-BN 15 <br /> B- 7- 'lZ 91 •S NONE > ?Z 0"10 $Ifs lo - 4430 s yv- 7zBrJ s <br /> B- 3 '12 .(o I NONE 27Z o- �oPifs IO- �S �H �{S- �Z$Nls <br /> B- <br /> B- <br /> B <br /> PERCOLATION TESTS <br /> R- 7- <br /> DEPTH WATER IN HOLE TESTTINI,E- DRO I WATER L VEL-IN HES RATEMINUTES <br /> INCHES AFTER SWELLING INTERVAL-MIN. p eloDt PERIOD 2 PERINCH <br /> ZS .. . .. / <br /> Z- <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 qs 1 <br /> I ,. .• I I <br /> SCA4 - I = 440 - <br /> 7-RQ <br /> WEII <br /> I <br /> u <br /> jo I 3 <br /> t <br /> I 1 i <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�rin the Wisconsin <br /> Administrative Code,antfthet the data recorded and the location of the tests are correct to the best of my knowledge and belief.+? �E— /� o <br /> NAME (print): - TESTS WERE COMPLETED101115 <br /> gjf-H4kP g0PK1A1S <br /> ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): <br /> Z-7760 j4wy 3S WF_65F" W1 . 813 3670 <br /> CST SIGNATURE: <br /> DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. <br /> DILHR-SBO6395 (R, 10/83) —OVER — <br />