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HomeMy WebLinkAbout026-1097-80-100 (79)Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach compete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LD. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Page ` of Please print all information. lew Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner R, v � •,^ � � J 1-Property Gout. L tL�N n� 1 F4 N� 1 r Y\ �c. V G U '� f' (° R/ 4 SM T 3 0 N R J E Property Owner's Mailing/Wdress Lot # Block # Subd. Name or CSM# y, nj city StaW Zip Code Phone Number ❑ City ❑ Village %Town Nearest Road New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate , D GPD ❑ Replacement ( i Q Public or commercial - Describe: Parent material -T r t f [) 'M_ t1a a S L1 vrn y Flood Plain elevation if applicable ft. and recommendations: .L `'.s �' $"` (� -A 7l 5 r r4 Q U r. � � e T 0.�' / D I , 39 � F-1 I Boring Boring # tf 5, Pit Ground surface elev. q ft. Depth to limiting factor r in. Q„ e. 1, ��.-- --- Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDAf `Eff#1 I 'Eff#2 -II D 11)7l2�a _,. _ t (� ., eis1. / r �' It S YV- 04, 75U tw5t- d F61")l t ® Boring # ❑ Boring Pit Ground surface elev. Depth to lirnkng factor in. lira' n Rate Horizon Depth in. Dorrurlant Color Munsell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Con unda GPD1W 'Eff#1 'Eff#2 d a - of 3a 5 iFJ-'-� �4-- VC` s Y .7 yt1_ s ' `� 5 L a e,5 a � k�- - - y h ' Etiiuent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL ' EfBue = BOD < 30 rngll- and TSS < m9A- CST Name (Please Print) II� Signature T Number o Address .� �+ , Da e Evaluation Conducted Telephone Number 5`foa9� Property Owner!a'm LS F3� Boring # ❑ Boring R Pit �� V G Parcel ID# Ground surface elev. b -7 1 fL Depth to limiting factor & _J Page of Redox Description Qu. Sz. Cont. Color -q� F Boring # ❑ Boring Pit Ground surface elev. Z PD.PD.6 3 ft. Depth to limiting factor 7 in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh_ Consistence Boundary Roots GPDW 'Eff#1 'Eff#2 cosaF , 4, • �3 IR y 6 C1�r - . 4 , 4sr 3 5-3D 151A 4 .�... ... k- I F.sb+c h L�•v I �F . '� , 7 157 - 715 6 Boring # 1:1❑ Bones ❑ Pit Ground surface elev, ft. Depth to limiting factor in. Snil OrvfIinn Rasa ' Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 S 150 mglL ' Effluent #2 = BOD, 5 30 mglL and TSS 130 mg1L 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. SBD4330 (R.07M) r Cod Paw `,/, � t4'o ' i ,. Sec.. � �� •T"3o �-�M V to SW /y� 0W 4i O ' �" Z •cp v► t f G� 0-3 �f ai ►�1 h� 3' , ,S $eG,r A", �r ' �'fS �7 Gtc.►^ t �11►► �w c .�.. a� :. l tJ� a+ 9 " OFeh F,�.1 6m a rcFc..'rCNNf- (� 55 e -� loo,71' 7J I r I o —r t . rl "n.