HomeMy WebLinkAbout020-1448-35-000 (2)
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County
. Cro 1
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 hodzrintal reference point (BM), direction and Parcel I.D. , y
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
forrrfation. R ad to
Please Prlnl` all fn
Personal information you provide may be used for sectintlary purposes (Privacy Law, s. 15.04 (1) (m)). 1 3
- 116
Property Owner 1 Prope Location
(V ~ Lake ~ t t 1 ~ el S Govt Lot NE 114 SW 1l4 S 32 T 29 N R 19 E (or~►
Property Owner's Mailing Address li Block # Subd. Name or CSM#
Cj )C ~D3 3~ ((lr~x n r'~ s 1s~/~1 l~rc~h
City State zip Code Phone Number ❑ ❑ Village ~ Town Nearest Road
ffuJS(A)t _161Lo fi . kluc6on Carrla e- Lane
45"ew Construction Use:15~Fi2esident)al i Number of bedrooms 3 `'q_ Code derived design flow rate g5YU Z(, 6)(3 GPD
❑ Replacement Public or commercial - Describe:
Parent material Flood Plain elevation/ if applicable ti 4-/~ is !~7 ft
, / ,
General comments k
and recommendations: e I eV a c t.7n 7
s/ate- rh
Boring # Bonrrg
fD Pit Ground surface elev. ft. Depth to limiting factor- I I in. Soil icadon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf
in. Munseli Qu. Sz. Cart. Color Gr. Sz. Sh. 'Efl#1 'Eff#2
I e-12 I 312- s, 12 c (v 5 .B
Z ~2-3y (0 y1 - c1 2rmsb 7Gr: c. W 4 . (p
-Ilg l0 5 s m I - 7 2
mss. "
❑ Boring # 1 Boring
Ek Pit Ground surface elev. Depth to limiting factor in. Soil lcation Rate
Horizon Depth. Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDO
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 6-14, 103I mfr C5 -t)
2 11Q-~ ( Siel 2t. fir' C.W , Co
3 4~-i~ p ~+l s - - / 2
- S/
Effluent #1= BOD > 30< 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2,= BOD < 30 mg/Land TSS < 30 mg/L
Signature CST Number
T Name (Please Print)
,fie Z53
Address Date Evaluation Conducted - Telephone Number
210 goy,S . Smers~ tkjr - C71 766 027
1
Property Owner JA 104 -LQ8 Parcel ID # _ Page _ of
Boring # ❑ Boring Qp
® Pit Ground surface elev. ~O S ft. Depth to limiting factor t in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsei Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
b^~ r31Z sl l 2( rr C
2 11 D Ip CAM Src S r Cw
3 4 c~ S - .1 1.2-
71,
S.
❑ Boring # ❑ Boring
❑ pit .Ground, surface elev. ft. Depth to I'Rniling factor in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsei Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
❑ Boring
F-1 Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BODS> 30 < 220 mg/L aril TSS >30 < 150 mg/L ' Effluent #2 = BODS: 30 mg/L and TSS < 30 mg/-
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M-6330 (R.07/00)
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PAGE_,
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NAME: c(Q P GAL DESCRIPTION:Aje- cal/4,S~T2,N,R,E(or~
SCALE: 1"= go OT#
6^1 ELEVATION: 100 . U 1, mv~l
BM 1 DESCRIPTION: v_Du~ e-
BM 2 ELEVATION: !!Ell, S~ Se e, Z
BM 2 DESCRIPTION: aap o ~IvG U.Y/ G
SYSTEM ELEVATION: ~`T• S'O
SYSTEM TYPE:~p ~1 c/ P o rt~c 1
r ~
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