HomeMy WebLinkAbout026-1155-20-000 (2)
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code ,
County CC i
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel D
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Awmaw-vi ell 0°2,& /•R3 20 -o~ro . `
Please print all information. 7R' ed 15y) Date k
Personal information you provide may be used fo . 5.04 (1) (m)). 7) L.{ ~irjyy~, 3 03
Property Owner O~ Pr perty Location
G .Lot A) 114NE1/4 S ZZ-T 3d N R / gE(or)&
Lo # Block # Subd. Name or CSM#
Property e s Mailing Address F E B 2 8 2003
13i G Qend cw rrt e4dm
City State Zip Code PhOg MM"!k COUNTY City C1 Village ® Town Nearest Road
pcw L * 0J Gj ( Z o o< G 6-
New Construction Use: Residential / Number of bedrooms Code derived design flow rate _ / U G GPD
❑ Replacement ❑ Public or commercial - Describe:
T T
Parent material _ ! L ( Flood Plain elevation if applicable ft.
General comments 8 °T~P / •~tL,.d
Sys~w~ Glct!• ao~ 9!o•Zo Gowar s
and recommendations: ` Lam` o .4 Vx-,~d-
Boring # ❑ Boring O
F Pit Ground surface elev. Z ft. Depth to limiting factor in.
- Z5 Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2
b-IO ((Q),1jr 313 , s'l L m c I~~ 5
2 IU - iC ~ Imo) - S i ~l 2 r - `f
x-10 I - 50 lm~i - y
1. 2
y - i y /C~ - 5 O5 t-n l - .7
-I- • - Z~f ` o
F-z] Boring # Boring
® Pit Ground surface elev. Q :7r 70 ft. Depth to limiting factor in.
- Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
e- 1 s(I 2 C, l vl S
2 -2 ~U - Sr'~I Zms mfr - y
3 0 3lm _ Sc I 2mS1~; r4 I. C s - ~l Co
4 -7q T6 V, r 31(P - i_5 I r - 1 Z
' Effluent #1 = BOD > 30:5 220 rngA. and TSS >30 < 150 mg/L " Effluent #2 = BOO < 30 mg1L and TSS < 30 mg/L
CST Name (Please Print) nature CST Number
25:53C3
Address Date Evaluation Conducted Telephone Number
21 3 ~U21 _ Son-v- e W ( Z C-11 5)2q 7.yvUg
L
Property Owner 1~I~------ Parcel ID#------------------- Page Of
Boring # ❑ Boring
1 -.31 Pit Ground surface elev. _ ?d_ ft. Depth to limiting factor _epn_- in. 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
6-1 l Si Z (a-►-k , Y, P C - I 'j 9
(
'
3 S~ L 2 rn3 r,4 i c 5 - (o
S l m ~'r - _ ' Z
t&o ro 2~ it
►~,c. ~Z,e~. ~ 3 Co " s
❑ 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. 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/fF
in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Ef1#2
' Effluent #1 = BOD5 > 30:s 220 mg/L and TSS >30:S 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg1L
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 608-2648777.
SBD-9330(R.07100)
ii Property Owner Parcel ID # Page of
__~Qyr1C..I Cr
Boring # ❑ Boring d
pit Ground surface elev. ft. Depth to limiting factor _-LL- in. Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ef1#2
( p_~ ( 5 J 2 chk v,, c v~J
3 f Sc l 2mS mA c
- S 1 mfr - ~1 ~•2
- D ~316
~ 24~ it
Sc/
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 *E11#2
Boring
❑ Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Son A ication 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 = BODE > 30:S 220 mglL and TSS >30:5 150 mglL * Effluent #2 = BODS < 30 mglL and TSS < 30 mglL
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.
Sb"3ooe mroot
PAGE___tOF_-,Z'
NAME pt t r lc- (C T OT# 20 LEGAL DESCRIPTION &F X Vi 14 ,S 0'1& T 3Q ,N,R, l !~E(or
SCALE: 1"= yQ
I
BM 1 ELEVATION • d
BM 1 DESCRIPTION ~yaL~ ~a d'
BM 2 ELEVATION 9f,16
I
BM 2 DESCRIPTIONAj d N ~e/ leo o~
SYSTEM ELEVATION -~,i 9G.z o Lows/,Ps bb
SYSTEM TYPE ~oAVtni~,ti~a
CONTOUR ELEVATION 9 70 4' 9~IZ
~ g.
.gam
~.v
SIGNATURE 4 DATE_ /l- l~~ Z