HomeMy WebLinkAbout026-1294-31-000 (2)
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O IL EVALUATION REPORT
Wisconsin Department Commerce C 9
Division of Safety and Buildings ~ ,
~ In ante with Comm 85, Wis. Adm. Code County
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Attach complete site plan on paper not less than 81/2 x 11 inches in size. PI -06b
include, but not limited to: vertical and horizontal referenc porn Parcel I.D. G
percent slope, scale or dimensions, north arrow, and loca on a oad.
n ! Date
Please print all informat; n. Rev' ~ ~ - / C✓
Personal information you provide may be used for secondary purgpses (Pr a s. 5. t
Property Owner Proparty Locatio
I ST. CR 01 CpF TY 1/45L 1/4 S p~g T30 N R E (or
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Ge~al . sM.-tc,
Property Owner's Mailing Addre o o Subd. Name or CSM#
qp e N W 31 at O F 1c 11 M c <<
City State Zip Code • Phone Number ❑ City ❑ Village ® Town Nearest R oa~~ s~
FIK 9,4ep, IAN 30 ( • 8 K;' N M 1p'f
Code derived design flow rate GPD
C9 New Construction Use: (5 Residential / Number of bedrooms
❑ Replacement ❑ Public or commercial - Describe:
Parent material __.ACLN-~-L4L s h ' Flood Plain elevation if applicable
General comments S v s g L s'F 3 _'ir a r c.k~ S , `I F o!" V` S
and recommendations: t 9 3 J -r y (5 S • D
S',-te1 ST.S (91f•S(,) ~~tu~► (y
1,3
F 1-1 Boring # Boring
tg pit 40.00 Ground surface elev. n• Depth to limiting factor -in.
1!*Eff#l il Iicatior Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fFE2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh,
l - ~OYP L c. b rr,~r ~w ,
_ H< L4 - Y- C thl I , l~ I Q
7 5 ~l2 f
1 5 K t~~ r Cw 4
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t
3
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Boring # Boring
_ Soil lication Rate
pit Ground surface elev. n• Depth to limiting factor S in.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'E GPD/fFEff#2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
~ D - ~ I DYR3~a _ L_ s b mfr C. ~ a~ ~ (o
-7,5 rR,'i 5 i'~Lr cw , to
-mly Li Lo
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• Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOO 30 mg/L and TSS 30 mg/L
CST Number
Signature
T Name (Please P 4~ fJ
M
Add ate Evaluation Conducted Telephone Number
a~~ o -~9-aS `115 aq8 3588
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Property Owner Gera ek S'1'1 '4k 1 Parcel ID # _ Page G7'f of _
F,-31 Boring # ❑ Boring
Pit Ground surface elev. _ IDs y 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
1 U' YR L IM m4r F y (o
a 3 5 Y(2, - K M 4Y' C W 1 v Co 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 'Eff#2
Boring # ❑ Boring
F-1 ❑ 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 -Eff#2
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = GODS < 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.
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