HomeMy WebLinkAbout026-1155-23-000 (2)
' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page' of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County c
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 I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 626 -LI SS -2- 3 -oco
Please print al I info V~ E~ ruy R hewed Date
Personal information you provide maybe used fo secondary purposes 1PirvEA., s. 1 .04 (1) (m)). ~/l/J2 6l G 3
i
Property Owner Pr rty Location
Loren Q FEB 2 8 2003 Go . Lot 1/4AJC 1/4 S ZZ T 3UN R I ~f E (oQ
Property Owner's Mailing Address S Lo q# Block # Subd. ~~e or CSM#
!,'~1 Hw G ~ ZO IN(-, COUNTY F1ic F- Z13 I Pbr)[l \/1C1v {Gad6aj.5
City State Zip Cade -rFW9WdM66r-- -1:1 City ❑ Village ® Town Nearest Road
I W ( ) -7 (71 ) 2y - 59 Z!5- 2 c h c/~~ t'
New Construction Use: 14 Residential / Number of bedrooms _-3 Code derived design flow rate --Y45- GPD
❑ Replacement ❑ Public or commercial - Describe: _
Parent material _--ri• / Flood Plain elevation N applicable ft.
General comments SYM .Clt t7. n~!lAhu1,~ N E
and recommendations:
44- 31) q4,2/ -h ua.- 0.'7 Af~•
1°s s- leec~~¢v„J g2~ Q3 eAk- ccae-zQ2v. ati,.d o,-
Boring # Ej Boring ® pit Ground surface elev. J0O.7Q ft. Depth to limiting factor I t o in.
Sad 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
Si' l Zm~bk C I v~'
Z -43 [Cvr -f /q 5i cI k rn-~r c S - `4 ~p
3 ZP 2rn r- c
O -f( - m5 V-Y1 I
F27-]Boring # Boring
Q pit Ground surface elev. 10i -?Oft. Depth to limiting factor -A a-- in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munseii Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2
1 O-. r0 r-3)3 '3/ 2 < c~ (VQ,
2 11-54p /4 s i ms k -ly-L 5 -
1 - 1.2
3 D-IlD 4 /to - m E),0 TVA
= 0 ti
' 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 (Please Print) ignature CST Number
5 ZS
6!~~ d,,,.aker e~Lf
Address Date Evaluation Conducted Telephone Number
21 I 3 S6T . -S e I Z (-715-) Z14 -you
Property Owner Parcel ID # Page of
Boring #
❑ Boring
❑ V1
3 Pit Ground surface elev. 1~. 96 ft. Depth to limiting factor in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg
in. Munsell Qu. Sz. Cont Color Gr. Sz Sh. 'Efl#1 'Eff#2
I Z r e~ ("S S
104
2 I- u q ~ - 5 c Z ms~k mfr
❑ Boring # ❑ Boring
❑ Pit Ground,surface elev. ft. Depth to limiting factor in. !i~fl -ApplkM
Rate
Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-17
Boring
❑ Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Descriptbn Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD5> 30:S 220 mglL and TSS >30:S 150 mglL * 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.
SBD-8330 (R.(17/00)
PAGE 3 OF_
NAME Dc rr; ck LOT# Z 3 LEGAL DESCRIPTIONNT YNF i4 sftaaT 30 ,N,R, ! 8" E(orQ
SCALE: 1"=
I 1~'
BM I ELEVATION /tf • 6
BM 1 DESCRIPTION O1_&".V
.c Igo c~
BM 2 ELEVATION /M. 0 n I
BM 2 DESCRIPTION IO,p Q ,S~< < eo cC
SYSTEM ELEVATION
SYSTEM TYPE Con y t e%4,btia
CONTOUR ELEVATION nd Slope
eel
r_.t Ao Yotc 1 6
6- 3
SIGNATURE DATE Z