HomeMy WebLinkAbout008-2009-05-000
VJis3ortsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in a rdarK~t4FVri 89 Wis. Adm. Code
County y
Attach complete site pi otae 81 /2 x 11 inches in size. Plan must
include, but not limited : ve ' n reference point,(BM), direction and Parcel I.D.
percent slope, scale or dimensions, nor and toaa(ion and distance to nearest road.
I R iew Date
Please print all Lnfomatipn,
ersonal information you provide may be used for s ndarypp"ii;Xs (Pl00849>1-aw, s. 15.04 (1) (m)). Z f0
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Property Owner Property Location C, `
p~~ ~ e- pG1 Govt. Lot /V 1/4 ~E_ 1/4 S TAO N R t~ E (or W
Property Owner's Mailing Ad ress Lot # Block # Subd. Name or CSM#
Bn6+ok t t ~ ~ M ea,~oco s
City State Zip Code Phone Number ❑ city ❑ Village awn Nearest Road
I (e, yes (7iS") 0---e-) 3 w 6 ~ I ~o +h Ao 2,
New Construction Use: Residential / Number of bedrooms Code derived design flow rate Od GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material 8e-55 oc)e-l- 7-'111 Flood Plain elevation if applicable ft.
General comments Lt pp ec- e Cp l
and recommendations:
C olt tDC-t~ 9 7 `
rp ring
117/ Boring Ground surface elev. 7Jr, d ft. Depth to limiting factor -Q in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2
t,J a
C)
fr LJ /v -lo
V1, 5
- loy~Z s l-
o ~Y2 5 r L) ` Y
Boring # ❑ Boring p c
❑ Pit Ground surface elev. / S, a ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fE
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2
~cc> dU
/ D- o Yk S; k
"
3 29 a - S k -rl/ • Y • ~
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 30 mg/L
ber
CST Na (Please Print) Si9nature ~C T 73
nc!~ h "e- v~ i 2 e e.
Address Date Evaluation Conducted Telephone Number
s`"y 7,6
Property Owner f GtC l U e `~L Parcel ID # Page a of 3
Boring # Boring
37 E] Pit Ground surface elev. ft. Depth to limiting factor a s In. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
L L
toy `r ) 6 ,
_ Io r, !U e
Z' LJ - S` C L_ 1 L r o 3
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
I 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
i
a Boring # Boring
Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
i
t
Effluent #1 = BOD5 > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD6 < 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.
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