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DEPARTMENT OFREPORT ON SOIL BORINGS AND SAFETY & BUILDINGS <br /> INDUSTh7 Y, DIVISION <br /> LABOR ANP.O. BOX 7969 <br /> HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 <br /> (ILHR 83.090) & Chapter 145) <br /> LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO]TWO.: SOBOI VISION NAME: <br /> y WI/4 13 /T3 N/R I E Ior US /GD 00 S M014- <br /> COUNTY: MAILING ADDRESS: <br /> X77- 7- S� GONG GAK6 ST S'S <br /> USE DATES OBSERVATIONS MADE <br /> NO.BEDRMS: COMM R IAL DESCRIPTION: IPROFILE— _89ESTS <br /> 71 <br /> i7 : <br /> Residence /� ❑ <br /> New Replace <br /> RATING:S=Site suitable for system U=Site unsuitable for system <br /> CONVENTIONAL: MOUND: IN-GROUND�FIESSLIRE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SVSTEM:loptional) <br /> [IS ❑U ❑S ❑U ❑S [1U ❑S E111 MIS ❑U <br /> If Percolation Tests are NOT required DESIGN RATE: iIf any portion of the tested area is in the <br /> under s. ILHR 83.09(5)(b),indicate: I Floodplain, indicate Floodplain elevation: <br /> PROFILE DESCRIPTIONS <br /> BORING TOTALP H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH <br /> NUMBER DEPTH IN. ELEVATION OBSERVED H ST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) <br /> B- � 96 -q IVOM5 > 20 0-S'5/'Ws S--56'&A 36 -4p BN m5 <br /> B- Z /L S 0 7G O -S)BIM15 5_- 7V5tJM5 <br /> B-5 72951 72 0 �Ms �- 40BN►s 0 - 28um5 <br /> B- 41 b oNK / 0-5 31 res 9 -5%$>J►a 3%, -to 8N M5. <br /> 13-5- 72 q Y 7 A10 72 a -661 Ms 7- <br /> B- I <br /> PERCOLATION <br /> - <br /> B- <br /> PERCOLATION TESTS <br /> 1TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES <br /> t NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D2 P PERINCH <br /> P- o D 2 s 2 - 7 <br /> P- /8 410 Pb 2 / /y S <br /> P ZZ NO 0 <br /> P- <br /> 7-- <br /> P_ <br /> PLOTP- <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 <br /> d P�iCC _ <br /> Ll P CIT wel-ro6515to tsvtr Ae�A <br /> 1 L II <br /> TN <br /> >Z0% . <br /> i <br /> i <br /> I <br /> wr Z-1NE <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: CERTIFICATION NUMBER: PHONE NUMBER(opsional): <br /> srz� 0j/ 3670 1715-416 / <br /> CST SI NATURE: <br /> 13 <br /> DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L� <br /> )ILHR-SBDE395(R. 10/83) —OVER — <br />