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Property Owner Property Location
Govt. Lot 1/4 1/4 S T N R E (or) W
Property Owner’s Mailing Address Lot #Block # Subd. Name or CSM#
City Village Town Nearest RoadCity State Zip Code Phone Number
( )
Wisconsin Department of Commerce
Division of Safety and Buildings
SOIL EVALUATION REPORT
in accordance with Comm 85, Wis. Adm. Code
Page _____ of _____
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
County
Parcel I.D.
Please print all information.Reviewed by Date
CST Name (Please Print)Signature CST Number
Address Date Evaluation Conducted Telephone Number
Use: Residential / Number of bedrooms __________ Code derived design flow rate ___________________________ GPD New Construction
Replacement Public or commercial - Describe: ___________________________________________________________________
Parent material ________________________________________________ Flood Plain elevation if applicable ______________________________ ft.
General comments
and recommendations:
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
Depth to limiting factor __________ in.Boring #Boring
Ground surface elev. __________ ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pit Soil Application Rate
Depth to limiting factor __________ in.Boring #Boring
Ground surface elev. __________ ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pit Soil Application Rate
SBD-8330 (R07/00)
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330Test (R.07/00)
Property Owner ________________________ Parcel ID # ____________________________Page ______ of _______
Depth to limiting factor __________ in.Boring #Boring
Ground surface elev. __________ ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pit Soil Application Rate
Depth to limiting factor __________ in.Boring #Boring
Ground surface elev. __________ ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pit Soil Application Rate
Depth to limiting factor __________ in.Boring #Boring
Ground surface elev. __________ ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pit Soil Application Rate
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L