HomeMy WebLinkAbout026-1294-29-000 (2)
` Wisconsin Department of Commerce I ,S~-PIL EVALUATION REPORT Page of
Division of Safety and Buildings U J
?1ess r with Comm 85, Wis. Adm. Code County
11, Attach complete site plan on paper not a n 8 1/2 x . a) Y
include, but not limited to: vertical and horizontal referenc point Parcel I.D. ~ q
percent slope, scale or dimensions, north arrow, and loca Ion an ne a road. 6226
Please print all informat n. ~ []oCj Re ' wed b Date
Personal information you provide may be used for secondary pur osas (P~la~5 sp 5.e~r lNT1) inmc)a)•
Property Owner ST. CRO X ~i~Ura rY do
Ger-a.l . SN1 r't'L n ZONIN (W.UE NJ 1/4 JOE 1/4 S aq T3V N R E(or
Property Owner's Mailing Addre ~ Lot # Block # Subd. Name or CSM#
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90 e• lbw JL9 at o F t,c m -a w
-1/1 1.0 city State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Roa
~1K R~~eP, SIN 30 ('7163) YY1 - 9199 R.iLh 3`lT A,) .
[R New Construction Use: S Residential/ Number of bedrooms Code derived design flow rate - s 0 GPD
❑ Replacement ❑ Public or com ercial - Describe: -
Parent material • Flood Plain elevation if applicable -
G
General comments /;j-~' j ~^f r bh 4~` S C , uj ~ r 0 t^ L- c." c• h S ;-f
and recommendations: S (9.1.93,)
T. LI (9-7.6,X) T•a(99.49') 5,4e.D. i.5 (97,18.) Boring
Boring # D 1.5 ft. Depth to limiting factor in.
pit Ground surface elev. - Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0-9 ! O Ya 3/a L b K~, : a tea a , 6 ~ g
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® Boring # Boring
Pit Ground surface elev. D0• ys ft. Depth to limiting factor in. Soil ADPlication 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
I -14 10YCZ'3/a, L r~ S to K r G~ a~ rK
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' Effluent #1 = BOD > 30:_< 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS 5 30 mgfL
T Name (Please P ' Signature CST Number
-Add ss a Date Evaluation Conducted Telephone Number
-7 Is a y$ ,3 9?
5YVa6
Property Owner Gera 16Q Sm Ak Parcel ID # _ Page -~9R_ of _
Boring # ❑ Boring
P d 3.59 ft. Depth to limiting factor I Zk0 in.
Pit Ground surface elev.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-7,5YK V(, _ m 5 L I rn K m~ C t j
5a- I-nL cLO ~ 1,6
m r
"1 f - 121 -7, S YIZ g/ -
L4
S
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/ft'
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
F-1 Boring # ❑ Pit Boring
❑ 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 'Eff#2
F-1
Effluent #1 = BODS > 30 5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODE < 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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