HomeMy WebLinkAbout032-2174-14-000 (2) r'. Ell,/F
i
Wisconsin Department of Com rue `L. 1 c 2OO OIL EVALUATION REPORT Page 1 of
Division of Safety and Buildings S T.
Z�NIN ' 85,Wis. Adm. Code 1_/
Attach complete site plan on paper not less : • .. 'r .,:. in size.Plan must ___. , �4 x
include,but not limited to:vertical and horizontal reference poin (BM),direction and Parcel I.D.
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0 301, 2/7 V--"/y t, 1)
Please print all information. a Date
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). , t r Vim' I zoy
Property er Property Location t
Govt.Lot 0 1/4 j/f 1/4 147 T ?) N R J9 .W(orrW J
Properly Owner's Mailing Address Lot# BI Subd. or 6SRt# / ��
City State Zlp Code Phone Number ❑City ❑Village J2Town Nearest Road
sr� Li1 l LS1i2 ?5 I ( ) - sa,.�°ies': I �7���7
ot New Construction Use Use:g Residential/Number of bedrooms / Code derived design flow rate 15 ^ l�� GPD
❑Replacement ❑ Public or commercial-Describe:
Parent material Flood Plain elevation if applicable /l/f�- —
ft.
General comments � st4i-, "X 97,3-/ — .5/
and recommendations:
/ Boring# r❑m Boring r�
I Pit Ground surface elev. 7..� ft. Depth to limiting factor SR in.
Sal Application Rate
Horizon Depth Dominant Col• Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2
IMEM �VAM � igil
Boring# ❑ Boring
,.-...77 ® Pit Ground surface elev. 93P, 9 ft. Depth to limiting factor G0 in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2
/ ®' /M / iflZ4 C 'min L 7,4- ' jp, , (-- . 7
I/7 ,W
5 PR AI AIIII IM NTM E1111
el
/P7,Xfio
•Effluent#1 =BOD,>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BODS<30 mg/L and TSS<30 mg/L
"-''y : • (Please Print) Signature CST Number
-` gf,oil f r/rf�( /Jt�-� 23t/J( /
Address Date Evaluation Conducted Telephone Number
3 Fs- / z a o f�r�zbic rWL
2-1V-63
7/5'-2-V7-3z(-'3
Property Owner ,p;;,&/S"` Parcel ID# Page _of
❑ Boring �1 9
3 Boring# pit Ground surface elev. fe . 7 ft. Depth to limiting factor 7/ in.
I Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell
// Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 *Eff#2
a- i . =�/ ,4l• s/ .L Z.sth , c) L , , 9
_ e ®� 4e" •
. 1 1.4 it)
V VI.
0
❑ Ong C Boring# Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rood GPD/ff
In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 _ •Eff#2
# ❑ Boring
Bodng ❑ 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/ftt
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 •Eff#2
•
•Effluent#1=BO;>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BOO,<30 ng/L and TSS<30 mg/L
I
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.
s8D-6330(R.65O)
j24p 30 f
- 0 Vi/NER
tret (-)t .1"e 4
Name -..--7; . icf-4.),/
,
Address
Date /2- /1(-6)
Benchmark 1 kZ, /ma 7f /vcioi,cor,ie.-
..L>.•. Benchmark 2 II, /03,/ /144;/ I., ?oil- y Ai --4.:4---c 0,,‹,--
I Soil Borinu
,--,
,_ , S unable:: Area
1" = 40' Scale
7 I ' 1111111r 1 I 1 1 i i
! '
I; 1 —I 1 1 1 i 11 i I
\i‘
' I
I ! I ■ 1
IsN i i
• I : '
! hi,5 i , ! ! I , 1 I
, I
. . ! 1 ;-.. i " ' • 1
i ! • i , ---4---
. ' ; 1 1 ; • N 1 1 1
1 N1, 1 ;
•
1 Illik .
—1-7------ — ---- . • ,
1 — 1 ,
1 11M ' N; 1
,,, . 1 1 ‘■,)1'‘' 1 A 1 • 1
— 111 1, ; Dad .
. • .
1 r--
!
• , ,
• i
- o . 'tia. i
.
----------
N
. i i 1
i
1 i 1 ' ' i ' ! \ i 1 . : N\■ i . . ! I
• 1
1 .
■ ! 1 i !
• .
1
. t 1 ; . I 1 1 1 • I AI. I N 1 1 i 1 t
1---- i-- 1
‘ '
1 ' .
; i 1•'' i 1 t; iildiimiim s, f i —I-
---;
, i
I
/: •7 011p.- 1
.1 ! 1 ,
1 1 , i 1 : I 1 1 ' i I I ■
--.- ; :,_ _ : • : rib.4 1
i • 1 1
. I '
I •
: , I
1 ; 11 I q> ,0
iii 1.-tr
4451 I 1 1 1 1 1
I 1 1
II : I
! ! IH-
LI III 11 L. D'It I II
, 1
,
f f t 1 1 1 1
-- . --,--
; 1 1 ! I.
■ I I 1 I r I
; --r Iiill
i 1
I I
I ' 1 1 ;
■ ! I 1 1 ; 1 1
1 ; I...."'..-.-.- .- . 1 . 1
' I i
I ' I i . ! i ! i I 1 1 I j 1 1
1 1 I I 1 ! i I 1 1 1 ;
77 ' ' S. i i
I j II ! i i i ..f.___ _
! , . il 11 ' 1 ' 11 III Iii I
jIlj
. • ■ , ; II IIII :II , i iIII
11 I , ■-1-■■■■7,, i.■
1 1 ! I riril
, , • II IIIIi ! I ' ll
1111 ' 11,
ij 71 '11111 , , ,
• i -Ii11511 • • I
■ I I I [ I 1 1 1 I
---4— 1 , I
---1---, 1 • 111--- ! ' It
11 , 1 i
- I 111 ! 1 . 1 -- ■ I ' i 1
i ' , , , , Iii
1 i 1: 1 I
; i
i! II
_, 1 1 r
I I
-- I • ------1-7 ! 11j - III •Jj -7 ' ! I i I