HomeMy WebLinkAbout032-2193-11-2200 . qk
JAN '0 3 2023
Ws. Dep� of Safe ty and0tofesskxW SOIL EVALUATION REPORT 5t Page Of 3
Division of Safety8-10 I3-W0kxw u n ty Sar 171
Community Developmentin �withSP$385,Wts. Adm. Code County owroete site plan on papernot km t1w 8 112 x 11 h%es In size. Plan must I , , .-
include, but not limited to: vertical and t riaa refer point (BM), direcdon and Parow I.D. --2 ZO
percent slope, scale or dimensions, north arrow, arW lotion and distance to nearest road.
Please print all infoo7nedon. R wed by Da e
personw inkmmWon you pmvWe may be used for seaxWivy purposes (PrWecy Law, s. 16.04 (1) (m)).
Property Property Location
Govt. Lot-' -1 A 114 S N R E(orrw
Property Owner's MaWng Addrew Lot# Block # Subd. ; CSW
a." _.' , r
WIWA4
City steft Zp Code Phone Number [3 C'y, ❑ ViVage Mtc�wn Nearest Road
0
New Consftcthn Use. Residential I Number of bedroom Code derived design flow rate GPD
0 Replacement Pub4c co;vvrwcW - Descrk*:
1 ZI/ - - fL
Paint rywe" Flood plain elevation If appficable 1
General comrnents
and recomgmndations:
Boring
Boring # ft. Depth to limiting farAor Z in.
Pit Ground surface elev. Zo
soil ticm Rate
Horizon Depth Dominant Color Redox Edon Texture Structure sistence ry Roots
ra2
p
01
02
In. Munsell Qu. Sz. Cont.. Color Gr. Sz. Sh.
uh
ZZ
Bating # D &WN Pit Ground surface elev. De* to limiting factor
Horizon Depth Dominant Color Redox Description Texture Structure sister
InMunsell Qu. Sz. ConL C;olor Gr. Sz. Sh.
sis t a
.
All;�
'-7
* Eft"t #1 = BOD , > 30:5 220 mq1L and TSS >305 150 mgAL
CST Narne,Signatui
"
Address
In. Soo lication Rate
darn I Roots GPD/ft 2
� - * Effluent #2 = BOO ot < 30 mg/L and TSS < 30 mgA-
CST Nufter
b�aW Evaluabon Conducted Tekoxm Number
SBD-8330 (RI 1/11)
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ptt GOOLind surbM elev. ft. Depth W WnNVV bdOr in.
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# 0 &N*v
0 pit 13mond surlw* 91ov- ft. Depth to IkWft factor in.
Sod k U _n Pift
_PAn��� �wnda_ry Roots i I
HWIZDn Depth Dwftnt Color Redox Description Texture Sire
Oh. 1*AdWbU 4J. OA. CAML CA*X
- -1 1 . - 4 K� t%~%
DOS In, --vY. -,rie T�T S .7�3P
soft
The DoL of Safety and Professional Services is an equal oWrnmity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-.' ZW3151 or TTY through Relay.
SBEWO-M(R11111)
# 0 &N*v
0 pit 13mond surlw* 91ov- ft. Depth to IkWft factor in.
Sod k U _n Pift
_PAn��� �wnda_ry Roots i I
HWIZDn Depth Dwftnt Color Redox Description Texture Sire
Oh. 1*AdWbU 4J. OA. CAML CA*X
- -1 1 . - 4 K� t%~%
DOS In, --vY. -,rie T�T S .7�3P
soft
The DoL of Safety and Professional Services is an equal oWrnmity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-.' ZW3151 or TTY through Relay.
SBEWO-M(R11111)
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