HomeMy WebLinkAbout032-2193-11-1504 G�3��C��MEUI
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WIS. Dept. ofs6tv SOIL EVA CATION REPORT 1/7
Division ofsafeiy- PMM 01
in accordance with SPS 385, Wis. Adm. Code
Attach conoete sfte *n on p"r not less than 8 1/2 x 11 inches In size. Plan must Pr
Include, but not firnked to: verWal and horizontal reference point (BM), direction and P*cel I.D. ZI I
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
R
Plea" print all Informatiorr. wed by Date
PemonW lnkKmWn you provide my be used W xecwWwy puqxwes (Privacy Law, 3.15.04 (1) (m)).
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Prop" Owner property Locatim
Govt. Lot 114 1/4 S N R E (o,4;
S
PropeOwnees Mailing Address Lot # Block # Subd. Narne or CSWW
City State Zip Code Phone Number City Wage fi3Town Nearest Road
Ilk-
L
10—
Now Construction Use: Residential / Number of bedroom Code derived design flow rate GPD
0 Replacement PuPJL- or �Ze Descn*be:
� - ft.
. jf Fk)od ftin elevation If applicable 444-
Parent material a� I
General oomrwts U
and recommendations: Z o Cc
Boring
Bodng # . ft. Depth to firntfing factor ZZ[j in.
pit Ground surface also. 10 �
I Soil &0!2LOw Rate
horizon
Depth
DwMent Color
Redox Dear r"kYbown
Texture
Struchtum"re
nsistence
Roots
QP.Wft 2
ff#1
M
In.
Munsell
Qu. Sz. Cont Color
Gr. SZ. Sh.
Z—
zA' ,I
In
Ekxing Ground surface also. Depth to limiting factor
Pit zL in.
Soil Appficadw Rate
Horizon Depth Dominant Color Redox Description Texture Structure slstence Roots GPD/ft 2
1
Q011i � Gr. Sz Sh. (MI ±02
In. Mansell Qu SZ. t. color
MR
--/ -�n- C215
A,,
C7
Effl*t $M = 13M S > 30 < M ffqL WW TSS >30 5150 mWL ument;rz = tsuu < sJ MWL aM 100 au IIVL
CST Na Print S CST Number
fzl� /-f-
AddrM Me Evaluation Conducted Tekg*Km Number
J2
4�L - - t L 4 - I
-�Zd rVV%V'%
aD"-0-)jV I MI it i I
Parcel ID #
Pit Ground surface elev. In), ft. Depth to factor" In.
Page of
I
Soil Ar"ication Rate
4 F
0:6
9 - #74 017-7 =671 6-:4
GPD/ft 2
M
WMA
MM
MM
0 pit GnxnW surface elev. fL Depth to Umiting factor In.
0
Redox Dm*hw
Qu. Sz. Cont. Color
ji
&wing
Borhg #
0 pit Ground surface elev. ft. Depth to Wtifing McWr in.
EfflueM #1 = BOD 5 > 30 < 220 rrKjA- and TSS >30 < 150 mg/L Effluent #2 = BOD 6 !i 30 mg/L and TSS :n 30 mg/L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay.
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