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HomeMy WebLinkAbout008-2009-09-000 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings ~ acTofdaiice it linc VVf s. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 1'1 s in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location aid distance to nearest road. I Rev' ed Date Please print all informafion.~ Personal information you provide maybe used for secondary purpose6 (Privacy Low, F. 15.04 (1) (m)). 2 & J Property Owner Property Location Govt. Lot r- 114 E 1/4 S T a N R 6 E (or (W) 1 Property Owner's Mai ing AdTess ^ Lot Block # Subd. Name or CSM# City state Zip Code Phone Number [I City ❑ village own Nearest Road tti S~~tf s')~9 - Yq3 >cc, W G~f l ~.-70 yo28 t71 [2-New Construction Use: 9? Residential / Number of bedrooms Code derived design flow rate 0 GPD ❑ Replacement I ❑ Public or commercial - Describe: r Parent material 5,/4 6 v e% / r Flood Plain elevation if applicable 4)11- -fL General comments 6Y1011 ~ and recommendations: (.c d C dV,- f-0 Ue- S r, (a{/yyT~~ ryLtir+ . CNl DUO' L76.1 8 Boring © Boring Cy'Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPQN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Cj , -3 - ~ 3D oy s~75~ s C 6- k vn~( I ~`F (o Boring # 041 Boring in I I t Ground surface elev. 9~/ 3 ft. Depth to limiting factor Soil Apoication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? ~r in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~1L -fir 5 ~ L ( . 25-3 5~- -5 0 69 1,4q L) --fr ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 30 mg/L CST ame (Please Prin Signatur CST Number Address 77~ 1`\ A~e Da/Lv~atwn y acted Telephone Number u Property Owner P6 t t 1 V ~l~ C Parcel ID # Page of F-7-1 Boring # rp ing Ground surface elev. 93, / ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDhf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sffh.II 'Eff//#1 'Eff#2 - I S i S b ~c (ivt~r L t J b • 6 7 ~Y2 ~`6 SQL ~k II y b 3 o`l f 3 D n Boring # ❑ Boring _J ❑ 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I E I 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 GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 I r i I~ • Effluent #1 = BODE > 30 < 220 mg/L and TSS >30:< 150 mg/L ' Effluent #2 = BODE < 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. S R U-8130 (R.07/00) Lot of ptv,-\.e mllga ows j~ 1 A 1 ~ ~c~~Vlt r C/'e(.c.-I lVC Soles e e eso a a ~a r. T l~ rs 37- c \ o Q i I-of bar o PL's ~95~ `j"oP J Re ~~pe ~/©rg, ~~bbo ~-Ol Cornet-