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HomeMy WebLinkAbout008-2009-03-000 (2) Wisconsin Department of Commerce SOIL 'L/ UA ON REPORT Page ~ of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code' County Attach complete site plan on pap r~ n 1 inches in size. Plan must include, but not limited to: vertica r point (BM), direction and Parcel I.D. percent slope, scale or dimensions, non and ~as,tanse to nearest road. (i(4 ~.(JCJ Please print all information. 4 vie`" Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z G Property Owner Property Location paw( ke6 - Govt. Lot V~- 1/4 1/4 S f T-Z~ N R ro E (or W Property Owner's M sling Address n Lot # Block # Subd. Name or CSM# "e McLAlc'LL7s city state Zip Code Phone Number ❑ City ❑ Village Town Nearest Road tU~ (,vr 6-Y0a$ ( -)-y4,/-3 taw.Il e - a o 74(, New Construction Use: esidential / Number of bedrooms- Code derived design flow rate (a er') GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material y~~S D U Cis / Flood Plain elevation if applicable ft. General comments n C c~ and recommendations: uS~ CO s(~KO'C f < hG~~tr~~ Q+2 a ~ i Mou")d S S-~,e - F~eU. 9Y, 5- Boring Boring 'AD in. I ❑ Pit Ground surface elev. T ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 6 (`j k C-S i _ ~t L( e I^'l 102 y S r ~ c ,h (0~ 1 y h ❑ Boring Boring # v, ft. Depth to limiting factor in. Pit Ground surface elev. Sots -App§cafion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/lY in. Munsell Qu. Sz. Cont. Color Gr. Sz. ISh. 'Eff#1 -Eff#2 Q-13 ~Su~ iV ~n O ft- LA) c' a /3 - S iC Y/-,33 1 LU y 24 h,\, o Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 130 mg/L TName (Please Print) Signature CST Number o-DC30--) %G Address Date Evaluation Conducted Telephone Number c ~ 7,70~1, LIC, fle-~' 7 7 I. T IAMI\\ i Property Owner j/j_` d\ lSC`~(~ Parcel ID # Page c-.) of Boring # ❑ Boring 37 ~7 ~lt Ground surface elev. , ft. Depth to limiting factor 32 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 r -J(o v-ik s ~s6k 4 w IO - 5 k rn~~ir L") r~ o R id .svks 3 ~~o t Sc i~~ Boring # ❑ Boring l~ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i I I 'r i ❑ Boring D Boring # 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 i 'i i I I ! I Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS 30 mg/L and TSS < 30 mg/L 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. SI U-8330(R07/00) 3 a~ 3 Plot Plat- hv, ( e ol;) 19-) i l UC Pr TOP Bf Pe qq, 00 S A70 fil. `S ca- f i