HomeMy WebLinkAbout018-1099-38-000 (2)
Wi."C, nsin Department of Commerce SOIL EVALUATION REPORT Page _ i of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must t
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 4~111 percent slope, scale or dimensions, north arrow, and location and
distance to nearest road.
I lei
Please print all information. eview d by Date,p
Personal information y u rov- a may be d for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ! / J
'7A A Property Owner Property Location
I N R E (orJ
ram l I GoIA. Lot ) 1 /4~ 114 S -1 T Zn
Property Owner's Mailing Address Lo # Block # Subd. Name or CSM#
1C~ - S-~ • A ~~d ~ IsT'
C' State Zip Code Phone Number City ❑ Village f-Tpwn Neares Road
[vp New Construction Use: R Residential I Number of bedrooms Code derived design flow rate 0 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Fl od Plain elevation if applicable T_1~-_- ft
General comments S S~Q 2 /G v. q S`v G ` dc- -A ~ 3!i
and recommendations: `
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor J I - in. Solt A lication 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 0-12 IQ 31-5 5S I m4r 5 I . 5
)Z - (o - S G k yy-)Tr- y
-la 1.5 `I C2 P `J r`i L f^~ 5 k _ ~j
F Boring # I~n7 Boring
L Pit Ground surface elev. ~5 5U ft. Depth to limiting factor 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
b ~o iot Ir3~~ S' I ZrrY-~ te r- C S v~ 8
Z t0-Z Ip - 5~-) kr c 5 - `f
3 2[~- I r5/ L S Zm_-5bl_ - .-7 1.2 fyiJr F
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) CST Number
Schu o.ker Signatur 2,S-330
Address Date Evaluation Conducted Telephone Number
I13 S-0 SL ere kJ/ SY/vZS'
Property Owner !~~fYl 1 r11 Parcel ID # Page of
F--31 Boring # ❑ Boring ! 2!~
Pit Ground surface elev. _!_O _-_s_~ ft. Depth to limiting factor 2 _ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
0-12 I S' 2mahF l~~r c /V-C 5
Z. 12--. lD l ~ 5 c 3mS . m-~' c - so
13-
-FsZ S/ L S s Z
❑ Boring # ❑ Boring
❑ 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
Boring
F-1 Boring # 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/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
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.
SsD-8330 ra.07i00r
PAGE 3 OF 3
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BM 1 ELEVATION h D . O
BM 1 DESCRIPTION 10 p Q--( //u ' ~eC ( IZo-p
BM 2 ELEVATION ~J9• -30
BM 2 DESCRIPTION
SYSTEM ELEVATION - Sz'
SYSTEM TYPE M 02 nd 94- - ra dA _ + -
CONTOUR ELEVATION , o u
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SIGNATURE ~r~ DATE G
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BM 1 ELEVATION /nQ,
BM 1 DESCRIPTION / j2 tZlIP
BM 2 ELEVATION 79, 3v
BM 2 DESCRIPTION ~o0 o 1 %y CLee / loci S ~'G
SYSTEM ELEVATION 9 -7 . S-0 ~I
SYSTEM TYPE 111 o nd Z 14 - (r ra ~t t _ -
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