HomeMy WebLinkAbout032-2167-47-000 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.
/� 11
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. V
Please print all information. Zwed by Date
Personal information you provide may be used fo eS(Privacy Law,,-s.15.04(1)(m)). �Z
Propert wner k P operty Location
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- �' Govt.Lot s. 1/4 d 1/4 S T N R 9 E(or&G
Propert Owner's Mailin Address of# Block# Subd.Name or CSM#
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City State Zip Code Phbhe Number ,- ❑City ❑Village jgtown Nearest Road
P4 New Construction Use K Residential/Number of bedrooms Code derived design flow rate GPD
❑Replacement ❑// Public or commercial-Describe:
Parent material Flood Plain elevation if applicable ft.
General comments
and recommendations:
Boring#
❑ Boring
Pit Ground surface elev. 99 ft. Depth to limiting factor 3 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
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s S
❑ Boring# r❑ Boring
LiY Pit Ground surface elev. 3 ft. Depth to limiting factor 3/ 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
A 7C
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Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L
CST Na a lease rin Signa re CST Number
Address Date Evaluation Conducted Telephone Number AW
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SBD-8330(R07/00)
AW
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Property Owner !£ r�' � Parcel ID# Page of
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❑ Boring#
❑ Boring dot"y7
Pit' Ground surface elev. ft. Depth to limiting factor in.
[Loll Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft2
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
K —
F] 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/ft2
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
❑ Boring
Boring# Ground surface elev. ft. Depth to limiting factor in.
F-1 0 Pit 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
I
*Effluent#1 =BOD5>30<220 mg/L 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 alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330(R.07/00)
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