HomeMy WebLinkAbout018-1098-14-000 (2)
wiscgnsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Divis,an of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code ~y
County 1. r0-/ 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 1.13 l
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. / p - OUv
Please print all information. Rev' d Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). + 2
Property Owner Property Location
Q)c1 (6- sibo- Govt. Lot SW 114,(f(4_j 1/4 S 3o TZ q N R / -~t- E (or)
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
I' 53 -ee T. I r,,s
city State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
I 61ta c~15 ) 5W40731 1 /-4a M w.oic~
New Construction Use: ® Residential / Number of bedrooms 3 - Code derived design flow rate $Z? 16 D U GPD
❑ Replacement ❑ `Public or commercial - Describe:
Parent material i t I Flood Plain elevation if applicable ! ft.
General comments S y_S4-c w\ .C I cv,
and recommendations: CO~~o r cf~~ 00
f
❑ Boring F Boring #
/ ® pit Ground surface elev. ?F ,9',O ft. Depth to limiting factor 2
Soil App tion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence B ' nda ; Foots \ D/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 *Eff#2
6-(Z I /Z 2rn56k rn~r ~S I v 5 .5
Z i -Z3 IU )q - Sip/ 3bk- r c5
3 Z - 10rl- l4o CZP 7.5 rylq 5L m5bk i - _ 5 9
0 .Z
Boring # Boring
F-1 2 pit Ground surface elev. ft. Depth to limiting factor 36, 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
_Vr
I a ~Z i) f)/ ,j 2m_sbk C5 I .5
Z lZ-3l lq 5id Zm Pr_ c -
3 _yv 1 aP7Z r 14 5L I ~ ~ -
v
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print Signature CST Number
d4 ,maker > 253369
Address Date Evaluation Conducted Telephone Number
2 113 A 7-)
- 3brne 5E4 01 cf6Z5 /2-/7--0/ (-7i5)2y7-yao~
can_azzn rrzmrnn~
Property Owner' Parcel ID # Page Z of
Boring # ❑ Boring aU Z~
Q pit, Ground surface elev. it. Depth to limiting factor c 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
D-11 /v~ Z - si r ~s v-~ 5 S
Z 11-3 I0 r l ~l y
3 -y l y~ C2~7 S y L i -
I
❑ 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/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
F-1 Boring # ❑ ❑ Pit Boring
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
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.
SBD-8330 (R.07/00)
PAGE 3 OF
NAME .~4O J LOT# ~ W LEGAL DESCRIPTION sw /,yw Y 4,S -30 T Z T ,N,R, 1 ~ E(or(W
SCALE: 1"= q0
BM 1 ELEVATION
BM 1 DESCRIPTION o ~✓c -I-
BM 2 ELEVATION %`9. -<-O
~1 Sec
BM 2 DESCRIPTION ~p a -
I " c_
SYSTEM ELEVATION ! /O
SYSTEM TYPE 0100 ^cdL SYS
CONTOUR ELEVATION F. UCH
M ~ I~Od
10 O
6 3 4~ da
SIGNATURE DATE S -15' U
Q~