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Wisconsin Department of Indus", SOIL AND SITE EVALUATION REPORT Page Of <br /> 'Labor and Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> COUNTf <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include,but R <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or P^AR�CE <br /> dimensioned, north arrow,and location and distance to nearest road. W <br /> APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION REVIEWED DATE <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> __YF_ iE L - GOVT.LOT W 1/4 5E 1/4,S T 3Q ,N,R 14 E(o W <br /> .PROPERTY OWNERS MAILING ADDRESS LOTa BLOCK# <br /> .0 . ZZ <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE MOWN NEAREST ROAD <br /> ILf5l_KrS IL . 3 ( ) Euo RIDER RD . <br /> [ I New Construction Use [A Residential!Number of bedrooms 3 [ ] Addition to existing building <br /> X Replacement I I Public or commercial describe <br /> Code derived daily flow 457 gpd Recommended design loading rate /• Z bed,gpd/ 2 /.Z trench,gpd/ft2 <br /> Absorption area required 375 bed,ft2 375 trench,ft2 Maximum design loading rate L z bed,gpd 2 /.2 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 103. 29 ft (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material G it ACIA L 'DRIFT Flood plain elevation, if applicable NA It <br /> S=Suitable forsystem CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem ❑S U ®S ❑U ❑S U ❑S U ❑S U ❑S U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bolx>dary Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench <br /> I 0 8 S 4K nv-Fr c 2,r4 .'7 8 <br /> 2- 00- 11 7.5,4p, ^--" s tit bk M 4r Cs 8 <br /> Ground 3 17- 7-4 7-5111Z 4 q I� S R S S IS M bk rt V•fr CS <br /> elev. <br /> IOp•bbft. 7 -31 5 R 4 cf Czd SIR 619 Se- m Ntfi — NP ! ,z <br /> Depth to <br /> limiting <br /> IS or <br /> Remarks: <br /> Boring# <br /> I 0 9 7.5 Q 31- Is MbI< Mv�r C5 Zvi <br /> 2 1- 177.5 R `} N �� �s Mb 14 V4 cs ^ 7 • .� <br /> M::,:.:a..a:.: 3 17-27 7.5 2 q.1 4 t 1� S\jK </8 15 J M d k M VTr CS .7 <br /> Ground <br /> elev. yl -51 K r{ y C2cl R `d SSI V �rnn MSA <br /> I�ft. <br /> Depth to <br /> limiting <br /> fac rr <br /> Remarks: <br /> CST Name:—Please Print 1�rc.r{,9R0 iDYKi145 Phone: 715, (06• Y/S7 <br /> Address: 7-7740 w 11 V 3S5 QEMMX t^Ir . 4W S 13 / <br /> Signature: DatNumber: <br /> / 347O <br />