HomeMy WebLinkAbout002-1040-30-100 (2)
WiisconsinDepartmentofCommerq-6,ANf SOIL EVALUATION REPORT Page of
Division of Safety and Build' r)p in ordance with Comm 85, Wis. Adm. >
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Attach complete site plan o ~ than 81/2 x 11 inches in size. Plan must
include, but not limited to: I and horizon% Reference point (BM), direction and I I. .
percent slope, scale or dimensions, oornw, and location and distance to nearest road. A
"''pnnt all information. R views Date
Pl
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Govt. Lot ,/UU) 114)liJE 1/4 S ~ Ta N R E (o
Property OwAer's MailingpAddr s Lot # Block # Subd. !Name or CSM# - I-0
el. - 1~ V6 11417- -
C' State Zip Code Phone Number ❑ City ❑ Village o n Nearest Road
❑ New Con tion Use: B<esidentiai /Number of bedrooms A Code derived design flow rate GPD
eplacement ❑ Public or commercial - Describe: ,t
_ - tt•
Pare enal L o e-st d oet, It Flood Plain elevation if applicable A JA
General comments „ Q F
a %t Con our- 4~ k
/,G.SE. 6 Sa zc wn c@cr- uPPev- O 0, ( (
and recommendations: S~1z- ,
Q /s,.y~sJe Elev _ q6,,3 / G(
!"l p (.t_V~ CX / V ~X-i-( ~7~"^"c~ r ~ ~ W4S7~•Q~Q f~' ~Q ~
Boring # /
Ft I rp ring
tGround surface elev. ft. Depth to limiting factor (g V in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fly
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
sill U
wee L-d v 8
3 o Y s LJ - e 1,
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5-1 Boring # ❑ Boring
e pit Ground surface elev. ~ ft. Depth to limiting factor 3 Q in. Soil A lication 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
p-1la 10)z- 5i! 6k CP 8'
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' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (P Print) Signature CST Number
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Address y ) ate aluation Conducted - Telephone Number
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Property Owner I C ~r Parcel ID # Page of
FT Boring # o Boring
Pit Ground surface elev.. ft. Depth to limiting factor .5- 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
'S fix IN
rv )f 00
3
s~
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F-1 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/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
V T
❑ 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
* Effluent #1 = BOD* > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODE < 30 mg/L and TSS < 30 mg/L
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