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HomeMy WebLinkAbout018-1096-02-000 (2) wsconsin Department of Commerce. SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S~ . C Attach complete site plan on paper not less than 8 1/2 x 11 inches 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 and distance to nearest road. 671, - `O'Y(o - 02 -f56 Please print all infonnation. R ie by _ Date Personal infonnation you provide may be used r seco 15.04 (1) (m)).~ Q 3 tP7 Property Owner operty Location Govt. Lot N E 114 N Vv 114 S T 2 9 N R 1-7 E (or Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ttk P eras + ~d City State Zip Code Phcg@iq ""FFICE ❑ City ❑ Village Town Neardst Road -Ic ,k~.o~d Syot 5(-lk5 ) -166 - 4A2-1,, 1 0611 A e B New Construction Use: [ Residential /Number of bedrooms -S-U Code derived design flow rate 41,Y6 / 4,&2 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 7-1'(1 Flood Plain elevation if applicableft. General comments SYS i' v c (-e v ~ /001 O v and recommendations: f u r e-k e- , d-7~ &V /VE, Gt/p,zF/ Sit DQAC, ,yiPOl Ar /v027N Jb F I Boring # ❑ Boring / Q_Pit Ground surface elev. 771 w ft. Depth to limiting factor Zc{ In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Ef1#1 •Eff#2 2 5 i I Zw6u ~r -zj l® 14 C cs14 gq2- cap F2--1 Ong # ❑ Boring Pit Ground surface elev. q9,26) ft. Depth to limiting factor a D in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 O-zo to 31z ~<< k vv, r c IvT .5 8 -361 - 3 i ~I r cS - L-l 3 c Sd 3M50k yy ~ _ Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = GODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number AdnW 1 2 Address Date Evaluation Conducted Telephone Number IL 1-3 -8o' ~~i5~zy7-YOOF Property Owner &n4 -e- Parcel ID # le ~ Z Page ~ of © Boring # ❑ Boring ja pit Ground surface elev. % 7. 76 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDtft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2 (l-2 ~ sic) bk ti r c5 - 3 (t~ s C3P 5 kc An SC-! _ 4.4 a Boring # ❑ Boring ❑ pit Grout d surface elev. ft Depth to limiting factor- in. Soil Application Rate Horizon Depth Dominant Color - Redox Description Texture Structure Consistence Boundary Roots GPD/1`12 In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 'Eff#2 ❑ Boring # ❑ Bones Pit Ground surface elev. ft Depth to limiting factor in. El Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtft2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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 608-2648777. SBD-8330 (807/00) PAGE 3 OF 3 NAME r e LOT# X LEGAL DESCRIPTION N h YVw Z,S 129 ,N,R, 17 E(or SCALE: 1"= yD BM I ELEVATION BM 1 DESCRIPTION foe o-[ 1J tIc P'O e BM 2 ELEVATION ff, Z (D BM 2 DESCRIPTION ~oP r) 1 evc SYSTEM ELEVATION a d SYSTEM TYPE M n v vi ck Sy Sty r+'l CONTOUR ELEVATION 9.60 _ I o; ~l .c S'2 v pa3 1 I p g/ 1 SIGNATURE DATE - 9 - oZ L