HomeMy WebLinkAbout032-2167-42-000 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85,Wis. Adm. Code
�
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County, '
include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o—?-L — 2---W6
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). �$G
Property Owner -- Pipperty Location
7-3 3
G'vt.Lot 1/4 1/4 S T N R E(or "
Property Owner's Mailing Address Qbt# Block# Subd Name or CSM#
l� j2
City St to Zip Code i Phone Nufrlber City ❑Village g Town Nearest Road
It,J-Z I
c-
� � L
New Construction UseJA Residential/Number of bedrooms Code derived design flow rate Z&V GPD
❑Replacement ❑ Public or commercial-Describe:
Parent material MLZ.,., " Flood Plain elevation if applicable ft.
General comments /
and recommendations:
Boring PQ.ww� SSve
Boring# S �
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/ftz
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2
t -5 10-
Boring# � Boring
Pit Ground surface elev. 3S'ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2
/n L S L
,, _ql - Al l
*Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L
CST Nam (PI se Print / Signatur CST Number
Address ate Evaluation Conducted Telephone Number
SBD-8330(R07/00)
Property Owner G.LSr��J Parcel ID# Page of
E] Boring
F;-171 JC Boring# IIC�II- I Pit Ground surface elev. ft. Depth to limiting factor 7� in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2
� s 9
s A
Z.
❑ Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Poll Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
F] Boring# ❑El pit 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/ft2
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=BODS<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.
SBD-8330(R.07/00)
1
K
lI
� y
v
-> J
1
o e
0
"�' L
__
I