HomeMy WebLinkAbout004-1057-95-000 (2)w
vh5swnsan Department of
commerce SOIL EVALUATION REPORT Page --/— of
Division of Safety and Buildings
�n accordance wish Comm 85, Wss. Adm. Code
Attach complete site plan on paper not less than 9 1/2 x 11 Inches In size- Plan must .!
horizontal reference point (BM}, direction Fart�lI.D.include, but not limited to. vertical and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Revi®were O (4Iasi — Q7' oar
please print all Information. ,
Personal information you provide may be used for aocondary purposes (privacy Law, a. 15.04 (1) (m)).
Property Location
Property Owner Prop"
1/4 /v �' 114 5 �S' T � N R J S E ( W
Govt Lot
Property Owner s Mailing Address Lot # Block #[S7Lbd Name or CSINM
-� W `� Nearest Road
City State'Zip Code Phone Number ❑ City Q Village own
hew Construction Use: CDResidential ! Number of bedrooms
Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
` Flood Plain elevation If appliaabie
Parent material ` '''
General comments ? ' 'r `�,� -e
and recommendations: `
y �1
C.ccvi
Boring
Boring # Ground surface elev. :I- ff• Depth to limiting factor --I,- ^ in. Soil ication Bata
lam" A i t
Bering #
Bonnorin
�
`3
elev..,,_ ft.
Depth to limiting factor
in.
Soil
cation Rate
lGPWflf
-•,
it Ground
Y Dominant Color
surface
Redox Description
Texture Structure —Co;nsistence
Boundary
Roots
�Efi#2
Horizon fin.
Munsell
Qu. Sz. Cont, Color
Gr. Sz. Sh.
(
`xu f ��
S
- C�c
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c5
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' Effluant #1 = BOD > 3o < 220 mg/L and TSS >30 c 150 mg1L
CST NarnB (Please Print) SI ature
Address
Effluent #2 - BOD, _< 30
and TSS <_ 30 mg/L
CST NwTbw
Telephone Number
■
ti
Property Owner C /� /� u ✓' c Parcel ID #
❑ Boring Boring r
# I�-l�
11c1 Pit Ground surface efev. �i� �1_ft•
Depth to limiting factor 1� _ In.
Structure Consistence Bound
Gr. Sz. Sh.
Honzon Depth
Dominant Coior
Redox Description
Texture
I in.
Munsetl
Cu. Sz, Cont. Color
c;
rc I
5j
--
�- ❑ Boring
Boring #
❑ pit Ground surface elev.
Horizon " Depth Dominant ColorFRedox Description
Mansellu. Sz. Cont. Color
Boring
Boring # Ground surface elev.
❑ Pit
FH,Tnzon Depth7Munsell
Dominant Color Redox Description
in. Du. Sz. Cont. Color
Page � of -'
h. Depth to limiting factor in.
Texture Structure Consistence Boundary Roots
Gr. Sz. Sh.
ft. Depth to limiting factor in.
Texture Structure Consistence Boundary Roots
Gr. 5z. Sh,
Soil Application KB
GPD1fP
'Eff#1 I 'Eff#2
'Eff#1 I 'Eff#2
Effluent #1 = BOOS > 30 � 220 mg?L and TSS >30 < 150 mg/L - Effluent #2 = BOOS _< 30 mg/L and TS5 < 30 mglL
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