HomeMy WebLinkAbout026-1139-06-000 r
Vftconsin Department of Commerce SOIL EVALUATION REPORT Page I of
Divi wraf Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not rimitW to: vertical and horizontal reference point (BM), direction and Parcel LD.
oZ /39 - 6- -m
percent slope, scale or dimensions, north arrow, and locaton.a~ to nearest road. J~
Please print am I R by Date
(m)). /
Personal hdonnation you provide may be used for seconq Mfosea ONO" Law. s: 7 4k
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Property Owner • ~ ~ ProliqWLI?cation
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`W L4 1/4 Ntu114 S fo T 3C3 N R E (or)~Q
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# # Subd. Name or CSW
Property Owners Mailing Address
City State \ Zip Code v F ~P Village 7TWn Named Road
waoc9 Inv. is (G1'
New Construction Use IR Residential / Number of Code derived design flow rate VS"O /l/ tO O GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material 4-aI Flood Plain elevation if applicable ft
General comments Sys +--t m e It. o O :5 4evn vw
and recorrnmendatloms. C O I r -t)~r CITY • 4 s'• d o U'
5 Boring # ❑ Boring
® Pit Ground surface elev. 0 ft Depth fo limiting factor _ 5qin.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 *Efl'#2
as 16 UY--.ljz 5i k - Z •3
I 5i M-C g c - 8
S~~ e o
# ❑ q
a pit Ground surface elev. ql!~- Q ft. Depth to limiting factor Z U In. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'EfM *Eff#2
I z ffig-R t 5r/ 2rnabk c • 8 -s h4 -Y -Z 2MQhk MOP .5- , S .
CZP7 to V•~ Im bk _
' Effluent #1 = BOD > 30 < 220 mg& and TSS >30:5 150 mg& * Effluent #2 = BOD < 30 mg& and TSS < 30 mg&
CST Name (Please Print) nature CST Number
3G
Sc e
2- S-
Address Date Evaluation Conduced Telephone Number
1 l O *16 5 w ( • /a -z - cJ ~l~S zy y
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Property Owner -/'.l-: Wl Parcel ID # ~ CJ Paw 2- O
F3-1 Boring # ❑ Boretg
® Pit Ground surface elev. 9,S-L.16 ft. Depth to kni" r 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. *01101 *Eff#2
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2 p c
:Scl 3axsbk P' o
,rte
a Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth tD limiting factor in. Soil ICetiOm Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Boring # ❑ Boring limiting factor in.
❑ ❑ Pit Ground surface elev. ft. Depth tD
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *01#2
* Effluent #1 = BOD, > 30 220 mg/1- and TSS >30 150 mg/l, * 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 atternate format, please contact the department at 608-266-3151 or TTY 608-2648777.
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SBD4330 (8.07/90)
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PAGE S OF
NAME ; m LOT# LEGAL DESCRIPTION q/w '/4Lw'/4,S 3(T~S0,N,R 19 E (or) 49
SCALE: I"=
BM I ELEVATION ~QC7 • C) K
BM I DESCRIPTION ha ; n ~f ip nfz ~~F
BM 2 ELEVATION ~o (o
BM 2 DESCRIPTION}o Q o ~y c,Cn6„k
SYSTEM ELEVATION 00
ALTERNATE ELEVATION
CONTOUR ELEVATION OCR
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SIGNATURE DATE