HomeMy WebLinkAbout018-1098-09-000 (2)
W'seansin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 4. Cro-
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D./~ ~r
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Reviewed)by _ Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l.L✓Ytiti Z- C~
Property Owner Property Location
Govt. Lot 1/4C44.) 1/4 Sip T Z N R J E (or)
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1. 5-3 ee q me nW Acres
City State Zip Code Phone Number ❑ City ❑ Village [3 Town Nearest Road
1W1 1, A4 M
® New Construction Use: ® Residential / Number of bedrooms 3 ' 41 Code derived design flow rate 17' SO O GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material T~ Flood Plain elevation if applicable ft.
General comments 5 y S ern e I -e V. 9 9- S U
and recommendations: (t
Cm~►-lour e) C-V
Gam,
M Boring # ❑ Boring y
Pit ~
Ground surface elev. ft. Depth to limiting factor in.'-"' a t
oil Application Mate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounda Foots GPD/fl? `
in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. - *Eff - *Eff#2
6_9 16 vr317- Sil 2 m r E 5 .9
Z 9-32 ID
3 3Z-~/0 In r3/to C3 7.5 r 'i 5 L 2 rn k r - -
Boring # ❑ Boring 22
F2-1 [0 pit Ground surface elev. ft. Depth to limiting factor 30 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
i d-~o l0 r~12 s; 2 T)o c s
5 g
3;e / 2 - 5~ - z k C5 - y
3 ~o ~l~ c 75 y,~ s k J - s
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
CS4E') (Please Print i nature CST Number
mo~ke~ 2,5336?
Address Date Evaluation Conducted Telephone Number
2-113 :54_ the se-f (,v! `fd2 5 2-/7-0 J C715)Zy7-'/00S/
SBD-8330 (R07/00)
Property Owner Parcel ID # Page 2- of
a Boring # ❑ Boring
Pit Ground surface elev. 96. H ft. Depth to limiting factor 2- in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Calk Color Gr. Sz. Sh. *Eff#1 *Eff#2
d-rz (0 312. s;I Z b r C5 ►v~ .5 a
Z lz-2s 5 S'c/ 5 -
3 z~ 1 31 /3 5L sbk - -
❑ 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
❑ 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/112
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Effluent #1 = BODS > 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.
SBD-8330 (R.07/00)
PAGE_jOF3
NAME ~T b v ~ LOT# 1 LEGAL DESCRIPTION ~ t XSw Y 4,S 30 T -r N.R. E(QdO
SCALE: 1 qD
BM 1 ELEVATION / .
BM 1 DESCRIPTION ke a C v c
BM 2 ELEVATION Y/ , 5O
BM 2 DESCRIPTIONS
SYSTEM ELEVATION -7 Fri
SYSTEM TYPE M w ,n cQ On
CONTOUR ELEVATION 9 O
s
Z C`' c'o
2SO'
,cr
V
a ¢ ~
0
SIGNATURE` DATE ~S -