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HomeMy WebLinkAbout020-1464-17-000 Wisconsin Department of Commerce Q SOIL EVALUATION REPORT Page- of _3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code /l County Cr 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. L' Z U Please print all intbrmation. R Date Personal intonnalion you provide ma -(Pnvay Law, s. 15.04 (1) (m)). V PropertyOwner ? R, Property Location 6A0, A 'I C-(- Govt Lot S C_ 114 A)L4J 1 /4 S I( T Z q N R / E (ore Property Owner's Mailing Address Q 2 3 2004 Lot # Block # Subd. Name or I S d - ~i ~-1 1 eve) ' S-fc~S City State Zi 4Cd--. ( ~?4( HFr\ El City El Village ® Town Nearest Road wI NING FFICE V ~ Vic 11-01,Z11 I New Construction Use: ® Residential 1 Number of bedrooms=z} _ Code derived design flow rate _SC7 /~2 C7 0 GPD ❑ Replacement I ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable fl. General comments ~s-/e i~ e Z 2 - V ti G u ' Si/G and recommendations: IW~ Borin # Boring F) g [pit Ground surface elev.. ? Depth to limiting factor- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Con', Color Gr. Sz. Sh. 'Eff#1 'Eff#2 b 1 /f ; I 2m m-G- C I \t .1 Z CH-7 lo 14 r-+j s L 2m n4'r C 5 - 5 9 J 1~-115 ry~cv 5 D. E Boring q p Boring # 7Z- a pit Ground surface elev. -ft. Depth to limiting factor in. - Soll Application Rate Horizon Depth Dominant Color Redox Desciiption Texture Structure Consistence Boundary Roots GPDKF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 p-2 1 l' ) - -A 2r„ r c5 lv; 5 $ Z Iv r 3 c 1 2m Yr r - q6-coz- ) 0 YrS~q CZ -7. 5 9 c 1 zonfbk rn-(~r- Cw - - ~I L4 ~O 2-I ) r q/ 05 - • -7 / . N - r s s ` r~ Effluent #1 = BOD > 30 < 220 mg/L and TSS >60 < 150 mg/1- ` Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) I ture CST Number A d(A Z5~-- ~~t) 0 Address Date Evaluation Conducted Telephone Number X Property Owner Parcel ID # Page -of _ Boring ❑ Boring Pit Ground surface elev.-ft. Depth to limiting factor _~~L in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i b-~ to t© I 51- / 2ry) ~r C S ' v , ry 3 - c 2frl rrr c 2 l0 3Z -L Q 3 32-q p `I , 5 /q - 2 m.,kk na~f w - ~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 GPDff 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 A lication 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 Effluent #1 = BOD, > 30 < 220 mglL and TSS >30 < 150 mg/L ` Effluent #2 = BODS < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. liyou 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. SB D-8330 (R.07100) I PAGEaOF-~- NAME: e e f LOT# I l LEGAL DESCRIPTION: SF 114,vwII4,S71 T Z~JN,R,)q E(orY!g) SCALE: I' i U ~ ELEVATION: 100 BM I DESCRIPTION:n 1` Atlc p "DT- I BM 2 ELEVATION: q 0 wTJt%. BM 2 DESCRIPTION: }r,/a 61 SYSTEM ELEVATION: Z C~ SYSTEM TYPE: C) C) ~ i. loc i r (E 1 f 532 SIGNATURE: