Loading...
HomeMy WebLinkAbout018-1098-03-000 (2) -0 4-1 P-Jad 4,26J616 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County . Ct"0 / include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. ~P1~ O percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V Please print all information. Reviewed bs Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 2 ; , Y Property Owner Property Location ' IIorll }601 Govt. Lot /k cj 1 /4S fu 1 /4 S 3Q T Z N R / E (or) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 13ts3 ALkWE kee Tc 31 ~ r--, t cQ G r -s city State Zip Code Phone Number ❑ City ❑ Village [2Town Nearest Road d n u S,46 to I (115 )549-0,-N /-Cr M Ica ex C1 r sa -tl s-l• © New Construction Use: [ Residential / Number of bedrooms 3 _y Code derived design flow rate Sa Zr O d GPD ❑ Replacement ❑ Public or commercial - Describe: 7 Parent material T sr Flood Plain eleva ' n tf,applicable General comments S S f t h~1 e v, 9 9 S6 ' and recommendations: Boring # F1 Boring Ground surface elev. ft. Depth to limitin Csilrt Q Pit r7 pfactor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure C6nsi$tehce Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 6-1 Z. 16Yr- 32- Zm5hk m~ ~5 I Vf .6 . 2 /z -24 /D r `-ll`f icl 2rn5hk -n ~r 5 - `f 3 26-SS 16 y4 1-5 1 m-5 n"1VIr C5 - -7 2 S-1,6 JA F(1 7. f) ~z r 6/1 L m5 i - ~e •2 S~ ]Roring # ❑ Boring © q44 Pit Ground surface elev.. MVc 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 1 0-I5 1 )2 5il 2a- &k ~r r C5 ! U-~ S 2 I -3D I 141q Sicl h r 5 - ~l 3 -4~ 10 r ~l ~~v L5 I r v-~r 5 -7 1. Z y6-4P5 10 r 5 1& FIE 75 r 51- _ * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Plea le Print) Signature CST Number M ker 25.53,0? Address Date Evaluation Conducted Telephone Number 2113 86-r-b e-} 02-5 7 -0 ~7i5~2 el 7- 4164 c? SBD-8330 (R07/00) Property Owner %o4 Parcel ID # Page of 3 Boring # ❑G Boring 99'4c) F3-1 2 5 CAF Pit Ground surface elev.i 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 o-~d b l2 sal ~b 4 S S Z ►O-Z~ I ~r`I I~ Si cl m 3 3(~ S E-W S~ k mVr _ s 9 7-7 ❑ 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F1 Boring F-1 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/ft2 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 = 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 608-264-8777. SBD-8330 (R.07/00) PAGE_OF~ NAME ~o LOT# 3 LEGAL DESCRIPTIONNey XScw X,S M T Z f ,N,R, /-;z- E(or~ SCALE: If'-- BM 1 ELEVATION . O BM 1 DESCRIPTION /op d -f- / " &c- N BM 2 ELEVATION 99; yU BM 2 DESCRIPTION % y~ e O SYSTEM ELEVATION SYSTEM TYPE m o u n d S,l.S1e m CONTOUR ELEVATION f g, ,-O q' /0 g-~ a ~e-lz67 Q ~ ~8~2 gd,io J ce CI SIGNATURE DATE S- y