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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> DIVISION <br /> OINDUSRAND PERCOLATION TESTS (115) �^ = P.O. BOX 7969 <br /> HUMAN RELATIONS el <br /> (ILHR 83.090) & Chapter 145) —�rJ MADISON,WI 53707 <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: <br /> /T � �N/R f( E (o ► <br /> CO NT : MAILING ADDRESS: <br /> USE DATES OBSERVATIONS M DE <br /> NO.BEDRMS.: COM ERCIAL DESCRIPTION: S:1PERCOLATIONITESTS: <br /> Residence 0�t�ir/1�7/ l ❑Neweplace / <br /> /v i✓O4A? Yc y <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: HOLDING TANK: RECOMMENDED SYSTEM:(optional) <br /> �Zjs au souIIN-GROUND-PRESSURE:ISYSTEM-IN-FILL�sauas �uos Mu cf�/ / ;/ fc/�)i <br /> If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the <br /> 4 <br /> under s. ILHR 83.09(5)(b),indicate: j!Z/" �7 Floodplain, 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 (SEE ABBRV.ON BACK.) <br /> Ilk �7 <br /> B- 751f ��1`r KktiC- 7�;`' <br /> �1 <br /> B- it "11 `-'I O 1( %L <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 I PERIOD PERIOD PER INCH <br /> P <br /> J <br /> P- )N <br /> P- <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. <br /> SYSTEM ELEV kTION. = 5 " <br /> K <br /> " <br /> 3 c� <br /> r <br /> _. 2it . <br /> f0 <br /> i <br /> o <br /> (/. <br /> I _ o�-A <br /> MI 3 E _ E E j7 <br /> I, the undersiined, h reby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the/�iscpnsin <br /> Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. g 7, ,4 <br /> I <br /> NAME (print)' TESTS WERE C MPL ED ON: / <br /> ADDRESS: CERTIFIC O M ER: PHONE NUMBER(optional): <br /> f� rs.J <br /> �l1 <br /> ICSrlrlrFTE: JV� <br /> Y — <br /> r <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. <br /> DILHR-SBD-6395 (R. 10/83) — OVER — <br />