HomeMy WebLinkAboutCST-2023-267 004-1021-20-000Wisconsin Department of Commerce SOIL EVALUATION REPORT
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Page 1A of 30
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Division of Safety and Buildings C T -2QZ
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in accordance v�itn Comm 85, Wis. Adm. Code
Attach complete site plan on paper not Tess than 8 1/2 x 11 inches in size. Plan must County c':o
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include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
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Please print all information. Rev/i�eWi��
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Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 ) (r,)). /
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Property O ner
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Property Location
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Govt. Lot 'Ki 1/4 S
T N 4 S E (or) W
Property Owniri Mailing Address V N
Lot i
Block #
Subd. Name or C.'SN4 #
City State
]j Zip Code Phone Number
A0 I �_C;o DZI
ity Village ■ Town
EAQV
Nearest Road
A_
on Useo Residential ! Number of bedrooms Code derived design flow rate
�� GPD
Replacement ❑ Public or commercial, - Describe:
Parent material J Flood Plain elevation if applicable i
ft.
General comments
and recommendations: .--�^ � wit` � Q�• {
B 1
Boring # ❑ Boring �T
Ground Depth �
■ Pit surface elev. ft. to limiting factor in.
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ff
'Eff#1
'Eff#2
�.
Zff%uVL`.
, �lo
M233
Sir 2 .�
C Z �1 '��
C
I
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7
l?, d2.
Ivn'
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-fit,
G L Boring # �--� Boring [],j+1 1�
LV ❑ Pit Ground surface elev. __ L� . ft. Depth to limiting facto
6,-, t-- I �---�
� Snill Annlit`afinn
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consisten
ndary
Roots
GPD1ff
'Eff#1
'Eff#2
L
l
ftj
�7
f
�}
11
Or
' Effluent #1 =: BODS > 30 < 220 mgJL and TSS >30 < 150 mg1L Elluent st= BOD, < 30 mgfL and TSS _< 30 mgr'L
CST Name (Please Print) Si a CST Number
Lewis Biork wis _ 253976
Address Date Evaluation Conducted Telephone Number
E7818 County E Menomonie W1 54751 — b 715-2 -� 1-7375
Property Owner n Parcel ID
� Boring
�Boring � # y
Ground surface eev. ft. Depth to limiting factor in Wpit
Page —7 of
ClZnd Annliratin—n Pnin
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu.,,Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDMf
'Eff#t
'Eff#2
z�
fa
ri1 ` 1/:
'
S
(' S/
vn
--�
a Boring # Boring pit Ground surface elev..^---
ft. Depth to limiting factor ^ in.
Soil Aoolication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDlft'
'Eff#1 I
'Eff#2
Boring
Boring # Ground surface F7elev.»_ ft. Depth to limiting factor _ ___�__ in.
Pit Soil Armliration Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Stricture
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDlff
'Eff#t
'Eff#2
Effluent #t = BODS > 30 < 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 = BQD, < 30 mg/L and TSS < 30 mg/L
The [department uf'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 M' 608-2644.8777.
SM,S17010t (RR07;00)
CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE.
SOIL EVALUATION o Scale: V 40' 6L 0 SYSTEM PAGE 2 OF
40 SITE MAP �f "" -� PLOT PLAN
PROJECT NAME: `
.10, DESIGN FLOW _00,
GPD
Attach design flow calculations for commercial plans.
PROJECTADDRESS;�`7' �"1 l �•r� Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)
NSanitary Sewer I_
BM Symbol: BM Elevation.__ FT �—
Face Main
BM Description-__;,�t�� t c—_--,—
°6) �) Indicate norm oy IMPORTANT:
Slope Gradient
( Well Symbol (if 0 }� drawing an aria. Show ground elevation contours at suitable intervals.
of tested Area on the approwite Ina,
art 1,
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64
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