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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page J--of 1 <br /> Labor and Human Relations <br /> Division of safety a Buildings in accord with ILHR 83.05,Wis. Adm. Code <br /> COUNT" <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but kr e <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 REVIE DBY L.D(T� <br /> PROPERTYOWNER: PROPERTY LOCATION o <br /> 'ra 4d ; e- k GOVT.LoTq v4 1/4,S 13 T 3 N,R j q E(os;,'�5 <br /> PROPERTY OWNER':S MAILING ADDRESS pLpT BLOCK# SUBD.NAME 0 CSM <br /> o "Ip- v e W . gc) � <br /> CITY,STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE MOWN ERRE T ROAD <br /> f F, (64-114 eS 3 4 0 <br /> [� New Construction Use [ ] Residential/Number of bedrooms Addition to existing building <br /> [ ] Replacement [ ] Public or commercial describe — <br /> Code derived daily flow 3 0 o gpd Recommended design loading rate . 7 bed,gpdM2g trench,gpd/ft2 <br /> Absorption area required 113 bed,n2 -3 75 trench,n2 Maximum design loading rate - 7 bed,gpd! 2 , g trench,gpd/n2 <br /> Recommended infiltration surface elevation(s) ')9. o ft (as referred to site plan bench ark) <br /> Additional design/site considerations -- <br /> Parent material /w C', -,I I I Flood plain elevation,if applicable N ft <br /> $=SUltable fOr System C NVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem S ❑U ❑S U l�S ❑U S ❑U ❑S U ❑S U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistenc 9 Boundary Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench <br /> -54 <br /> iO <br /> s 4 R V6 — 5 4� s ml C, S Imo' 7 '9 <br /> Ground c 19-y7 5 L, 2 <br /> elev. <br /> dao.! ft. 7_72 S rz Y S s V� 1 . � <br /> Depth to <br /> limiting <br /> factor <br /> Ll <br /> Remarks: Ch's o„ba <br /> Boring # cts <br /> s ^ <br /> g -1Sl <br /> 5 y 2 �� --- S s T a. 5 vR , -7 &" <br /> Ground _ <br /> elev. 51 70 5 yle y//o S -5 <br /> /ol.Dn. <br /> Depth to <br /> limiting <br /> actor <br /> Remarks: 14 o <br /> CST Name; Prinl Phone: <br /> n. G. �%'�') D e n r 8 5 <br /> Address:-53 <br /> 16 -G. S1,j <br /> Signature: Date: CST Number: <br /> C, z/-/3 - ` s C 7 oZ068 <br />