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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page LOf12Z- <br /> Labor and Human Relations <br /> Division of Safety 8 Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> COUNTY r� <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include,but F11fie74- <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope, scale or PARCEL I.D.# <br /> dimensioned, north arrow, and location and distance to nearest road. <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE 9 <br /> .. '?-.22. <br /> PROPERTY OWNER: PROPERTY LOCATION / <br /> b rl a a e rc"Q h Z GOO-IDT LC' 1/4 VV114,S3�T Z1I ,N,R /tp E(or)W <br /> PROPERTY OWNER': AILI G ADDRESS { LOT# BLOCK# SUBD.NAME OR CSM# <br /> e e Sau �irs <br /> CITY STATE ZIP CODE PHONE NUMBER [ CITY ❑VILLAGE [OWN NEAREST ROAD <br /> a is M/I/ Ss / 1642) Wes+RV+ Scv;ss i' erd <br /> (�New Construction Use Residenfial/Number of bedrooms PY't✓ t [ ] Addition to existing building <br /> j ] Replacement [ ] Public or commercial describe <br /> Code derived daily flow gpd Recommended design loading rate -^ bed,gpd/ft2 "-' trench,gpd/ft2 <br /> Absorption area required — bed,112 trench,ft2 Maximum design loading rate — bed,gpd/ft2 — trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s �• r'Of- fee ft (as referred to site plan benchmark) <br /> Additional design/site con derations h ✓ o ri n <br /> Parent material GCCCi a� /Y Flood plain elevation,if applicable 41A!� ft <br /> S=Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem 11 El ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft <br /> .................. <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Twich <br /> ................. <br /> .................. <br /> ................. <br /> .................. <br /> p- -7S /f3la. /s <br /> Ground 3 36- s//' /tom .S <br /> elev. �1 <br /> 35 t. I 57- 7s C S <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> Boring # <br /> 13 <br /> Ground <br /> elev. <br /> ft. <br /> Depth to <br /> limiting c' <br /> factor ' <br /> Remarks: <br /> CST Name:—Please Print Phone: 7/3 65 3- 2 3rd <br /> K <br /> Address: WOW CREEK RD. <br /> Signature: yo Date: O CST Num6:4 r <br />