HomeMy WebLinkAbout020-1443-07-000
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Wisconsin Department of Com SOIL EVALUATION REPORT Page/ of 3
Division of Safety and Buildings
OCT U UjWice with Comm 85, Wis. Adm. Cod
V County , S
Attach complete site plan on r t6 Ix 11 inches in size. Plevu~
include, but not limited to: vel Tiint (BM), directi( G~1 arcel I.D. ~y
percent slope, scale or di+ t n and distao / OOJ
Please print all information. AG~ Revie d by Date
Personal information you provide may be used for secondary purpo, 15.04 (1) (m)). V-1
z z3 /
Property Owner O Property Location
Ron 4 --/1 e- C 60 7 Govt. Lot 1 /4 1 /4 N R/ ) W
Prop y Owner's Mailing Address Lot # Block # Subd. Nam r CSM#
, y /(P7-- /
City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
❑ New Construction use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD
Replacement Public or commercial - Describe: s f_ ~fc2 t~/ /t 4¢/2rue✓V
Parent material Flood Plain elevation if applicable ft.
General comments ` J
and recommendations: ~S
GA-
Boring P1 Z # F~ Boring
Pit Ground surface elev. /O02. 0 ft. Depth to limiting factor > /5Z) 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. 'Eff#1 `Eff#2
1- .3 ` /U Y9 d n -e ~ i 0611 ht V
3 EI_ G,? t c V
r e
~I 5 1 rrt t C b,7
79"$a 1 S r itt ( 0,7 9 p o s D .f r rr, 6, 5 o
Boring # F-1 Boring
~ Pit Ground surface elev. 07 "s 7
fi. Depth to limiting factor i jy 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. 'Eff#1 *Eff#2
1 0.-12 /0Y "7A one s'll a bk Mf; a 6 .
q. C r a U
3y,57 IY A -fir C
7 - 00 a~ S a t 0 o.-7
Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 m/g/L
CST Numbe
CSPea ame (Please Print) / Sig uGC 5,
r
u _ .1fe f)~~
Address to Ev uation Conducted Telephone Number
Property Owner Parcel„ID # / Page A of
® Boring # ❑ Boring JJJ
Pit Ground surface elev. ~ « ,"ft, -c;Depth to limiting factor in.
Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
1 - 9 D V o I a O6h, -r; 0 6• Y
I A& M -r C
3 e- 5 f r C-
41 t6 ~E S .r a h1l
7 S p 5
F-1 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/fg
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2
Boring
Boring #
F-1 ❑ 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/ft=
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 depart rent at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R 07/00)
Property Owner Parcel ID # / Page A of 3
F31 Boring # ❑ Boring / •
Pit Ground surface elev. . to ft. Depth to limiting factor 13 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
-/V 0
Cl A&
3
`f :1 7~ r 0.7
la - 7 ¢ S 0 D
h1v
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/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 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/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
" Effluent #1 = BOD5 > 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 departinent at 608-266-3151 or TTY 608-264-8777.
S B D-8330 (R 07/00)
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County f '
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.
~ercent slope, scale or dimensions, north arrow, and location and distance to nearest road. V-/
®
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Of, Y, JLC_~ el Govt. Lot SC 114.5,C 1 /4 S TN R/ ) W
Prop y Owner's Mailing Address Lot # Block # Subd. Name or CSM#
0 Y 1,607 /
City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
8 1- 19
a/V, N rm c ) e),-L T
❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD
Replacement Public or commercial Describe: <~-j W d tGt { 1 10,Lkro, BrfteyV
Parent material Flood Plain elevation if applicable ft.
General comments
and recommendations:
M Z Boring # Boring
pit Ground surface elev. d ft. Depth to limiting factor /3a in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
l C~'~2 ► ~ I's r S ~ r ~o ~ care ,ra~~r i ~ ~ '!-3` /Y ! n e si a , AV
~i
7-~~' t C s a yr c
9j 1 s r t),.
9.3 - D S D r rvt
Boring # ~ Boring
~f Pit Ground surface elev. . V2 ft. Depth to limiting factor 3 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. *Eff#1 *Eff#2
a ~i~ <nt'i None sal ant; rnf~
C/ r a fd * 1 c
3y-51 °i S r C
1S o
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/ * Effl ent # = BOD, < 30 mg/L and TSS < 30 mg/L
ame (Please Print) Sig to CST Number
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Address 06te Evaluation Conducted Telephone Number
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