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HomeMy WebLinkAbout030-2131-12-000 (2) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S'r - ~O , 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. _ ^1 -aA percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Date Please print all inf rmalikli G x K Revie by Personal information you provide may be used for secoi ary purposes (Privacy Law, s. 15.0 0) (m))- -2v 3 Prope Location / 5-1 Property Owner COLrri 4 Govt of N 114 )f--114 S 2 T~ N R 2v E (o Lot # Block # Subd. Name or CSM# Property Owner's Mailing Add reds i ~ -42-J 6 ,s 6,1~ ~ 2 Ski; I t ~ 131 City State Zip Code Phone Number ❑ City ❑ Village E] Town Nearest Road NN Z. (6 N ) `-i 39 .24 (L4 e h few 3-S ~ New Construction Use: ® Residential / Number of bedrooms 3 -y Code derived design flow rate DSO Q O _ GPD Replacement ❑ Public or commercial - Describe: Flood Plain elevation if applicable A ft. Parent material General comments Cam, -sk 9G/, 3 and recommendations: 7 © Boring # ❑ Boring ® Pit Ground surface elev. C1926 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD Etf#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. o-la 2 - Zrr k n4r CS IT .5 •S 0 -ZS 10 Y- 'A 14 - fc-I 2 ry)pr C- g _ . ~ . log 2 3 21-`I% 10 C `LP "1. r 4 le, Si C- I kk f~ C- S 4 ms r I !.2 y `is-► t s r ❑ Boring Boring # pit Ground surface elev. ~ (k) ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPDtft Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 6-10 lC~ y- fj 2- 2 woA n-~r cS 5 I 2n-a:L 1 li Y- CS D -5q -7 5 •2'' ~ h Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODs < 30 mg1L and TSS < 30 mg/L CST Name (Ple Print) Signature CST Number ber Add ss L I l 25 Date Evaluation Conducted T e !phone Number Property Owner lAri Y al I Parcel ID # Page 2 of Boring # •❑1 Bor ng ~ . ' Pit Ground surface, elev. ft. Depth to limiting factor log Horizon Depth Dominant Color Redox Description Texture Structure Soil Application Ra Consistence Boundary Roots GPD/W In. Munsell Qu. Si. Cont. Color Gr. Sz. Sh. S-11 Eff#1 •Eff#2 l~ ~I /-n b<, 1'r C S Q z 7's- b-I l I- a Boring # ❑ Boring ❑ pit ' Ground surface elev. ft. Depth to limiting factor in. Sail Application Rai Horizon Depth Dominant Color Redox Description.., .Texture Structure Consistence Boundary Roots GPp/fl= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a Boring # ❑ Boring ❑ Pit- - Ground surface elev. It. Depth to limiting factor In. Soil Application Ral, Horizon Depth Dominant Color I Redox Description Texture Structure Consistence Boundary Roots GPD/fir in. Munsell Ou. 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 = BODs 30 mg/4 and TSS < 30 mg/j. r 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. SM1330 (8.07/00) J 1 i .3 3 PAGE OF 1AD" ax'r i cc cA 2 LOT#~ Z LEGAL DESru rvrin~T,Ucy ~5~ ~ S Z3 T 3G N R ZG E(or~ SCALE: V'=- y0 BM I ELEVATION l40 U BM I DESCRIPTION o Q DP BM 2 ELEVATION ~q MI6 PGA Z-~~---- i BM 2 DESCRIPTION n 1 SYSTEM ELEVATION y~.30 SYSTEM TYPE ow, c r4,b Y c, r- CONTOUR ELEVATIONS -s 1c) 1 ~Sr1aQG ~ ~~Z b ~ eti • SIGNATURE-- 114 DATE _