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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
- Cra!
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
l.~
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. !
Please print all information. Rev' a Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 Z~
Property Owner ECE1VE Prop Location
Govt. of /V E 1/4S W 1/4 S ZO T 30 N R !g E (or)do
Property Owner's Mailing Add" Lot # Block # Subd. Name or C M#
APR 2 2 2 19 ld ~`'fP~tS
City State Zip Code f~ne Nuber ❑ ❑ Village ® Town Nearest Road
/0 /f
j{0! ()J R I L k m, a K/ -Y A
W New Construction Use: 0 Residential / Number of bedrooms 7~, Code derived design flow rate yS-U //o O O GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material 0u4-w-t S 1A Flood Plain elevation if applicabl
General comments 5 ~r I e Yy elf p Y 5`~ u. r q y, SO l a}.--~
and recommendations: Y ~,p gl,,oo I~~,,e gO~od
F1 Boring # E] Boring 6 W Pit Ground surface elev. O 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
I 6- IO 2 - - -5 L- Zrnol)k- r cs IVV 5 ,9
Z - 5 ION, 1-4 LI 5j/ Z rr, r- c5 - 5 .8
3 15-11 t ry C~ ms s . Z
FZI Boring # ❑ Boring
ja pit Ground surface elev. ft. Depth to limiting factor 1 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
0-tZ tb 3(z 5L blyv- , c5 1V-C 5 .9
Z t 2 $ l t) `F S t &-y'aJok i- G5 - 5 8
3 %-iiv l - cd rn 6,5q 11N 1 - - -7 2
Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS 30 mg/L
CST Name (Please Print) Sig ature CST Number
MCLM Schurrr~,ke~ - 253 309
Address Date Evaluation Conducted Telephone Number
2113 7-h 54. e e-1, ~i ~UaZS y-/ -oz C-7i52q7-4o0~R
SNr)-83-1n Mv,110)
Property Owner t k~, 1a rdf Parcel ID # /0 f Page of v
1:51 Boring # ❑ Boring
pit Ground surface elev. q O ft. Depth to limiting factor 120 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
14 312 5L 2mobk c5 t4 5
o-~ 10
7-jZ co 4 1 Z k "r C 5 8
3 I~2-126 10 C, m 1 - Z
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 GPD1ft2
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 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
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
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 608-266-3151 or TTY 608-264-8777.
seD-8330 (R.07ro0)
PAGE 'OF
NAME W4 ld I'd i-~ LOT# I q LEGAL DESCRIPTIONNE A,&-, 14 ,S Zv T 30 ,N,R, 1 ~ E(orl~
SCALE: I"= l/0
BM 1 ELEVATION /a), 0
BM 1 DESCRIPTION jr,p c3 opVc
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BM 2 ELEVATION 163~ Z, U
BM 2 DESCRIPTION jr, p d 1 Q J c- _ S ec, Z U
SYSTEM ELEVATION
ALTERNATE ELEVATION 16 q O U Low -e r TO, 0 c .4-
CONTOUR ELEVATION %,00, q&, cc y ~0~). 169.06 i
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