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HomeMy WebLinkAbout026-1155-21-000 Wiscrrnsin Department of Commerce SOIL EVALUATION REPORT Page _ of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ~ C include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, nortt arrow- a7caW n and distance to nearest road. !Teasepid all ijooc~ ~2~`r ~vv NOZ by Data , ~ Z Personal information you provide maybe use for seconoses (Privacy Law, .1& 4 (1) (m)). Property owner 1OZ 83 roperty Location L 1 ovL Lot nl 114 N~ 1/4 S Z Z T 3o N R E (okU11J Property Owner's Mailing Address a 3 n 13 3 Lot # Block # Subd. Name or CSM# gib I ~w~ 21 i~onc) is ~ )0uN5 City State Zip ode Phone Number ❑ City ❑ village ® Town Nearest Road N3'- e 'c -,(dti L,; k- \ (l ) 2 `I (o + 2 5 (2 - i-, rr-)o rirl C + C EP New Construction Use: q# Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: ` - ft. Parent material -~L~- - Flood Plain elevation if applicable General comments and recommendations. v" o F-1 I Boring Boring # Pit Ground surface elev. __7 7 it Depth to limiting factor in. Sod Application 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 1 C~-I Z lU 3 .Z , St / 2rnabl rr, l- c S I VC '5 3 yD {o i C y /3 - s~ r Y, k Y'--4'r Boring # Boring ® © Pit Ground surface elev. 99° ft. Depth to liming factor in. motion Rate Sol 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 -r2 io )Z - 511 2 k cs 1 VQ Z 12-3(o Io ,j r 9I sl'c I 2n,sbk r c_, - ti 3 (~1 ( t Sc_ t 2 r,-)S k m~ r - - Co " Effluent #1 = BOD > 30:s 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' ture CST Number h Z533o9 Address Date Evaluation Conducted Telephone Number 5~ er C4 I 025 ~Q z C-71 5)s q--7 ^YOn Ztr3 T'' Property Owner ~~r~ Parcel iD # Page - Z of 3 F3] Boring # ❑ Boring ❑ Pit Ground surface elev. , ICS ft. Depth to limiting factor in. M#1 on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Eff#2 0-~0 I 2 Zrrabk mr Cv~' S g (--ZTj 1 S' 1 m k m ~r c 5 - (0 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cart Color Gr. Sz. Sh. `Eff#1 'Eff#2 ❑ Boring # ❑ Boring - Pit Ground surface elev. ft. Depth to limiting factor in. E] Sol A lication 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 = BOD5 > 30:5 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD5 a 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. SOD-8310 (R.W/00) cz- t,~ > 3oa 0 PAGE SOF~ NAME C t ! C -c. k LOT# Z (LEGAL DESCRIPTION v c, N j-:X4,sZ Z T 3LT,N,R, IS E(or) SCALE: I"= ! Q ' I ~ BM I ELEVATION X00. O BM I DESCRIPTION Q.0 y~! r y4 c 4 BM 2 ELEVATION 9 S--0 BM 2 DESCRIPTION Scc. Z Z SYSTEM ELEVATION 0 SYSTEM TYPE i.C,aa Q a 4,-o q CONTOUR ELEVATION loo •d (le ffj FN 4g"r `I B~'z ~ N n CIA, b- 3 SIGNATURE a~- Z--Z DATE L