HomeMy WebLinkAbout018-1099-48-000 (2)
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. d A ll
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. /4 '666
R sewed Date
Please print all information. `
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 3
Property Owner Property Location
4 t 0.m til ~~ftJ Govt Lot 5C 1/4 Si1J1/4 S 9 T.21. N . R 1-7 E (ore
Property Owners Mailing Address Lot # Block # Subd. Name or CSM#
IUI I no-J, 4$ h2 n 4 2,d er
City State Zip Code Phone Number ❑ City ❑ village Town Nearest Road
00-wW\o cl v0 ( ) amrmor'Cl lOdTM
New Construction Use: FA Residential / Number of bedrooms- Code derived design flow rate GO GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material, r I-,- Flood Plain elevation if applicable it.
General comments ~ /1n eft V . /D a Sb
and recommendations: y
a [j Boring
Boring #
Pit Ground surface elev. ~n ~1 ft. Depth to limiting factor in. So' Sol Rate
'cation
ots GPD/it°
Horizon Depth Dominant Color Redox Description Texture Structure Consistence g
In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 -Eff#2
1 O~ 10 12 Si I 2 r --Xr
-2 10 i c1 2m m Fr y _ (o
3 N-60 10 r S c i 2,Y,5bK m -fir . y
F 7• r4 Iy L i mSb nn-~' y
Boring # ❑ Boring
it Ground surface elev. l)I . I-56- ft. Depth to limiting factor 5-0 in. ~ ADPlicatiort Rate
® p
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft:
in. Munsell Qu. Sz. Cons Color Gr. Sz. Sh. 'Eff#1 -Eff#2
1 0-9 1014r-,312- S' 1 2ayhy' nqr- I V Y . 5 .8
2 -Z 10 t-I S cl 2 v nXt- C- S
24-~ 10 b ~ Sc 2►nSbk yr' c 5 , . !o
I FIr 5 yl~l c l 3 Y T TV-;
-70
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/t.
CST Name (Please Print) ture CST Number
Ad.am Soh r 25 3309
Address Date Evaluation Conducted Telephone Number
bl z_ s- -a (-71,-5)Z 17-yam .
Property Owner - 1 w'-t) - Parcel ID # Page of -
FBoring # ❑ Boring
Pit Ground surface elev. l UV_ ft. Depth to limiting factor _ ;fl~ - in.
Sol 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
Z $-2 l SI'cl K
C-.5 LI
3 24,N i 5d C 3 - -(4
10 FjFWSyrqjq c-I i - - 4 - Co
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor - in.
Sol Mplication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IF
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
❑ Boring # Boring -
❑ pit Ground surface elev. ft. Depth to limiting factor in.
SoN Application- Rate
Horizon Depth Dominant Color Redox Description Texture S6ucture Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
Effluent #1 = BOD5 > 30:< 220 mg/L and TSS >30:5 150 mg/L • Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD"8330 (8.07/00)
` PAGE___~ OF~ .
NAME U (Ef r+ S T OT# y~f LEGAL DESCRIPTION 5C %Sw 14 ,S ~ T Zr .N.R, / 7- E(or XWJ
SCALE: I = ~/6
BM I ELEVATION /OO • d
BM 1 DESCRIPTION b~ 0 1 S~eG 1,d
BM 2 ELEVATION Y~ 6
~c a
BM 2 DESCRIPTION ylyro4
/y
SYSTEM ELEVATION 16 S d
n u t r~ r`~ l t-
SYSTEM TYPE ea
CONTOUR ELEVATION 161 • a o / o S o
1
G~ C
I
b
SIGNATURE DATE o
WhWonsin Repartment of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
Code
in accordance with Comm 85, Wis. Adm
County f X
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all eviewed by Date
Personal information you provide may be used fors ondarip~eS {Piiv~cp t$vYa s 15. (1) (m)).
Property Owner Propeity Location
u~ T 0.m(\ rU ; ^ GovI.~ot SE 1/4Sk)114 S 9 T 29 N R I? E(or
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1011 1-1 U T. q ph'~~~, 4 12td e. /57- AJct.
City State Zip Code hone N r - -n ty ❑ Village Town Nearest Road
C7.Y`(WV\ C~y~C~ l~ ` ( ) G1Yr~ rYIO~CI I J~ .
[ New Construction Use: FA Residential I Number of bedrooms _='Code derived design flow rate ~_,_-_~,~SQI_ 0 _ GPD
❑ Replacement ❑ Public or commercial - Describe: --~-9 0
Parent material Flood Plain elevation if appl• ble _-__-'L_'~ ft•
-S yen^ e j.-v /oa• 5hwdltst,~Cdy,vfi or
General comments
and recommendati ns. I 1-b 7 ~G~ 7 NOf ~n d0 y
Boring # E] Boring
pit Ground surface elev. ft. Depth to limiting factor _ (o 0 _ in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0- (D r 12 SI^ I 2a-ab rr~P'r c I J 1() q 1,4
3 -(D 10 1 S C 1 2":Sbk m f r C j
rI TS r j ly L t mSbK rn y
2~ rn " YnA W6,
& '
Boring
Boring # ~
® pit Ground surface elev. j0 L~ ft. Depth to limiting factor in. Sol 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
0-9 10 14 r 12 5' I 2 Inner - I v , S , B
Z -Z 10 I S i I z vn-~r c,
3 24---jc~ I Sc Zr"Sbk rr)r C5 -7U I F1~~ 5 r41q CI 3 1 r ~ _ _ (A
vnS
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2l4= BOD < 30 mg/L and T KS < 30 mg/L
CST Name (Please Print) ture CST Number
Adam Sc-h r- 25 524
Address Date Evaluation Conducted Telephone Number
Ztl Z /z-s--az (715 2`r!~^``~~.~~.
Property Owner _ Parcel ID # Page of
a Boring # ❑ Boring (613--Ca 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 p-$ Z I k Yl(~ c5 (VC
5.$
2 2 10 1 sI K C-5
3 24 1 1 5~I 5 - y
~O 4 F1F1!5yrq1q C1 i - - c( Co
❑ Boring may' ' L
❑ 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
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/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30:5 150 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.
SBD-8330 (R.07/00)
L
PAGE ~OF~
,1E WE E lr+S LOT# LEGAL DESCRIPTION SE %Sw 14 ,S `l T ,?f N.R. 7- E(orXWJ
SCALE: I"= y6
BM I ELEVATION /OO , d
BM 1 DESCRIPTION 4od2o ~u S~~c t ,C`'od
. BM 2 ELEVATION jrq 7 6
PC.
BM 2 DESCRIPTION -3/,,( e,91
SYSTEM ELEVATION 16 o S d
SYSTEM TYPE ~'v n v <,-,4, r`0. l t-
CONTOUR ELEVATION /6 t• a o / o s o
I
I
0- t~'~----
I 160. ° `b• Ti.1 /OCZ1 -
soa.s ~ ~
o~ C
.3
~Io
S~
303 .sue yi~v~-~°
SIGNATURE .wfel-5;--~ DATE -~1~ o
• - PAGE_OF_.~7
NAME U 1 ~~r+S LOT# y~f LEGAL DESCRIPTION r XSw i4,S T Z`r ,N,R, /:F- E(or
SCALE: 1"= yG
BM 1 ELEVATION
BM 1 DESCRIPTION o I j'~ G / ,C` o ~P
BM 2 ELEVATION 6
BM 2 DESCRIPTION 17
SYSTEM ELEVATION /G y f
SYSTEM TYPE (,a n u k--
CONTOUR ELEVATION /61. o 0 d/ a (,,s C
I
I
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