HomeMy WebLinkAbout026-1121-02-000
Wisconsin Department of mmeRECEIVED OIL EVALUATION REPORT Page )of
Division of Safety and Bull ngs
FEB i clbMce wi Comm 85, Wis. Adm. Code County
4 Coun
Attach complete site plan n paper not less than 8 112•x;1: inches in size. Plan must G f~0 r
include, but not limited to: ertical ~nO) Ffp l~renc point (BM), direction and Parcel I.D. l' 0
percent slope, scale or di ensio~~ ~~Iljj}}~~yy,,. d locati n and distance to nearest road.
vasup-rin a information. d Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). all,4
Prope y Owner Property Location
tj,
, ' Govt. Lot sw 1/4 S 1/4 S .S T 3C) N R IS E (or
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
(0 0-~ PC- r r
City State Zip Code Phone Number ❑ City ❑ Village U Town Nearest Road
N « h s o c 15 )R t-, -r P.
New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate GPD
❑ Replacement ❑ lPublic or commercial - Describe:
Parent material c a-c,,,j,.G~ \ fi Floyotd Plain elevation if applicable ft.
General comments a" Suer, s;+ J S+X75' TitE#%Vl S d'o« S,tC
and recommendations: ,r. 98.1.8
For T~e..,e pf~ . ~+a T' CR? G4 ta ej f
~jo re - 7 ✓ha"-tc~-Q. vi-. 5-3
P I IR Boring # ❑ oring y 11
Pit Ground surface elev. 10 1 .C? ft. Depth to limiting factor -70 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
t o-b 16yR a L F&R doh aS a F
a 6-9 1(3 K3/q L Cw F
3 V416 He~Y -?Msek C0 vF ~5 ,S
~.S 9-q IF L a FSi 3S t-) W v F .q
d- o s y~ y y I F543 K ~ 5
y~ IS°o 9rovell
I_J Boring # ❑ Boring
r
1 v` I IL? Pit Ground surface elev. l l~ ! ft. Depth to limiting factor 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
0_g IavR A L (3 F&R dsV, as ar .s .8
a 8-I5 7,5 yR16 - SCL. ams8j< dsk CW ) F •y
SL, FS6K 6sV-\ aW Iv►= y .b
y 304 'SA q14 SL tFSl~k ~ Ct,~1 .y •b
22 1
* Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signatur CST Number
f~)ahV--,a 7'` Scar o?oZ 17
Address Date Evaluation Conducted Telephone Number
alb aOQ Is+ar 1°aw6f t 540ab ~U -a 0- b
SBD-8330 (R07/00)
K w
Property Owner kQIIe 8udaers ParcelID# 0Q~,- 10M-- 0a Page C~ of
E Boring # ❑ Boring
Pit Ground surface elev. 99-so 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
10-9 ImR3a L aF&R 5 as aF ,S
a -1 TS V Iy sc ams d cw IF . q • 6
3 19-a9 `LS V'14 ' Fsa ds a,W Iv F .5 .9
a9-4a s4g yly - - .3 .s
G
14 un.(.Q I &Ae a; 1/70
to 44
❑ Boring
❑ Boring #
Pit Ground surface elev. ! 9• ft. Depth to limiting factor toS 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
1 0-11 16\101a L a* R as as aP ,s
a ii-~Q -7.s\1R "14 SL FS6 ash (a w r . 6
3 SIR41q SL )F59k ds - ,y .b
❑ Boring
F-1 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 GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
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need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
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