HomeMy WebLinkAbout020-1464-13-000
4 ,%V.onsin 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 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. L? J 1, r / ; ,~L~ .
percent slope,, scale or, dimensions, north arrow, and location and distance to nearest road. L-tJ (J
Please print alf Information. Reviewed Date
Personal information you provide m` be u s (P1TC cy Law, s. 15.04 (1) (m)). -10 - C J
Property Owner Property Location
R v--V Cv-C\ Govt Lot $ 114~j_ 114 S T Z N R E (or)6)
Property Owner s Mailing Address Lot # Block # Sub d. Name or CSM#
Ilam. C- Moordd S- k
❑ Village 0 Town Nearest Road
City State p L ber El city
J ONI G OFFICE
44 New Construction Use: Residents! /Number of bedrooms g- _ Code derived design flow rate 0GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material _-5~1 S Flood Plain elevation if applicable h•
General comments S'~/S{e yy\ et? V, qZ, SO
and recommendations-,
F Boring # Boring
® pit Ground surface elev. ft. Depth to limiting factor _L2- in. Soli Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munseli Qu. Sz. Cont. Colo Gr. Sz. Sh. -Effiti `Eff#2
I 0- 1 `f (p r---!, 12. 3 11 2 rn -fir 5 i -C . 5 3
Z- 1$5!) 10r 41y s CI 24n -5 ~s - ~ 4,
3 35-14o 10 rj F P 1, & S 1 mss Fr c
4 4>,eq coyr` / s ~g I
I
Boring # Boring
IV, Pit Ground surface elev. ft. Depth to limi5ng factor in. Soli Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff
in. Munseli Qu. Sz. Cont. Colo Gr. Sz. Sh. 'Eff#1 'Eff#2
0-iy t® x312 5(1 1 2nD5 ► -C,
z 14-2$ `II,4 sj0 ZM5 rn~r C-S
2S -qo (n r31Tq S ~I 3 ms m -~r- c w
Effluent #1 = BOD, > 30 < 220 mg/L and T SS 30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) nature CST Number
2 330
5&lu 0~401C C?
.dqdawyl Address Uate Evaluation Conducted Telephone Number
2163 $d S~. Zory,,. e-4t (-tri 5-ypztT `f--N -o`F -71s-746 ^0 2?y
j. ,
Property Owner Parcel ID # Page of _
Boring # ❑ Boring
Pit Ground surface elev. ft. Depth to limiting factor ' in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2
6-fD 1 C7 5 i j 2m5b mfr C5 1 V-1-
3 Z2-1-05 10)~r~L 5 C7 5 m ~7 l. Z
❑ Boring # Boring
❑ Pit Ground,surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft'
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
❑ Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIW
in. Munsell Qu. Sz.. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mglL " Effluent #2 = BODS < 30 mglL and TSS < 30 mg1L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
Sri D-83301 OV00)
j PAGEaffa
NAME: LOT# )3 LEGAL DESCRIPTION: SC 1/4,t; 1/4,S_U_T2_$N,R Lq_E(or)(FJ
-
SCALE: F'=
~yn ELEVATION: OO - d
Q y~ ~dc O'P e y
BM 1 DESCRIPTION: 46
BM 2 ELEVATION: 9W S-0 I
BM 2 DESCRIPTION: -F-Jd9a_~ I "Jyc ,
~r.
SYSTEM ELEVATION: 9z , Sc
SYSTEM TYPE: o n c e v~ L u e c" l
i
e
ii
E
►IC3
6-3
00
SIGNATURE: c _ DATE
i
"I