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HomeMy WebLinkAbout020-1464-22-000 • Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of 3 Division of Safety and Buildings in accordance wiih Comm 85, Wis. Adm. Code County ~ C :rOl 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 LD. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. U Please pfint-a htruatlrl, o Reviewed by Date ZUd 5 Personal information you provide n acy kow, s. 15.04 (1) (m)). lar in rr Property Owner Property Location ' ~ChCQrC~ { ? ' ! Govt Lot 114 114 S T Z q N R E (ora) Property Owner's Mailing Address Lot # Block # Subd. Name orCShjj/j ~2 II City State p ❑ City ❑ Village ;Q Town Nearest Road r C) L 1-~vd r~ l,~l 70 r~ e New Construction . Use: ( Residential! Number of bedrooms _ Code derived design flow rate _l Q GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable _-iU r ft. General comments S\/ e e v r0 and recommendations: 7 -s4 (f m i Borin # Boring r~ry © g Llt pit Ground surface elev. 7"& ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fR in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh- 'Eff#1 'Eff#2 I p-(© Io 12 S1 t Zrm_.. mfr ~S I V. 5 g 2 1~- IU r y ly - S~ c l 2m~bk f`f Y- c-0 - CA 3 2-IZO Iv r-141 S Y-n I Boring # Boring ® Pit Ground surface elev. ft. Depth to limiting factor in. Sot? 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 O-(I 1 312 1 Z.im--bK r CS v $ Z [1-33 4I - SQL 2rn v~ r C - Effluent #1 = BOD > 30 < 220 mg/L and 13S >30 < 150 mg/L ' Effluent #2 = BODt < 30 mg/L and TSS < 30 mg/L r,ST Name (Pietse Print) Signature CST Number Address Date Evaluation Conducted Telephone Number Page of _ Property Owner Parcel ID # ❑ Boring Q 31 Boring # lid Pit Ground surface elev. ft. Depth to limiting factor in. Sol A ppl ication Rate Horizon Depth Dominant Color Redox Descrfpton Texture Structure Consistence Boundary Roots GPDKf° in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d-t 2 ~0 (-312 try, C S ~ v 5 2 12 - l 0 r - 5 i C-1 Z(r)Sbk C S - L4 , (o 3 -121 16 - 5 OS I ' - 2 Boring # F] Boring ❑ ❑ Pit Ground,surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfiz 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. Cent Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mglL and TSS >30 < 150 mgli- " Effluent #2 = BOD, < 30 mg/L and TSS < 30 mglL 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 3 ] 51 or TTY 608-264-8777. SBD-8330 (R 07/00 PAGEOF3 NA 1 LN,R, I S ~U1/4 S E(or)0 ME: In ~ e LOT# LEGAL DESCRIPTION~ 1/4~~. LT~` ~ SCALE: 11 f3fA'ELEVATION: 100 - ' BM I DESCRIPTION: 4v o 1-40-VC- BM 2 ELEVATION: T7,3 D 1( BM 2 DESCRIPTION: 4- f a o vc- P 'P e D Z ELEVATION: YSTEM S SYSTEM TYPE: on U e ~n 4 .~Jhol p 0~ v r g_t 0 ~LA. A z e ® gr. pM Z z SIGNATURE: DATE: