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Wisconsin DepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page_of_ <br /> 'Labor end Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> CO <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but >"4'e' <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PAP EL I.D.# 2 a <br /> dimensioned, north arrow,and location and distance to nearest road. VO /3✓ —0a2 �� <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION RE EWEDB W DA�TE <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> �� GOVT.LOTI6�� 1/4 1/4 ,13T y0 ,N,R 16 E(oryo <br /> PROPERTY OWNERS MAILING ADDRESS LOT# BLOCK# SUBD.NAM OR CSM <br /> .Sn) 57� _ — <br /> CITY,STA E ZIP CODE PHONE NUMBER [-]CITY ❑VILLAGE ®GOWN NEA EST ROAD <br /> [ ] New Construction Use-j>.1 Residential/Number of bedrooms -3 [ ] Addition to existing building <br /> Replacement [ ] Public or commercial describe — <br /> Code derived daily flow "TD gpd Recommended design loading rate 7 bed,g /112 ' trench,gpd/ft2 <br /> Absorption area required (y/5 bed,ft2 5— .5 trench,ft2 Maximum design loading rate 7 bed,g /ft2—,_X—trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 9 It (as referred to site plan be chmark) <br /> Additional design/site considerations <br /> Parent material /,+c iW cl/"'{t Flood plain elevation, if applica Die lq—)4 ft <br /> S=Suitable for system CONVENTIONAL I M UNDIN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable for s stem SS ❑U ❑U S ❑U ;ELS El ®.S ❑U ❑S ®U <br /> SOIL DESCRIPTION REPORT <br /> Depth Dominant Color Mottles Texture Structure Consis nce Roots GPD/ft <br /> Boring# Horizon in. Munsell Qu.SZ.Cont.Color Gr. Sz. Sh. Bed Trend <br /> ro ?` <br /> fr I 0-5" 7.5 YR 3/2 --------- is lmsbk mvf I es 3f—co .7 .8 <br /> I e�' <br /> g 2 5"-32 ' 7.5 YR 4/6 --------- is lmsbk mvf r cs 3f—co .7 .8 <br /> Ground 3 2"-40 ' 7.5 YR 5/8 --------- gr-1s lmsbk mvf r gs 2f—m .7 .8 <br /> elex5 ft. 4 0"-80 ' 7.5 YR 5/6 ---------- s osg mvf — 2f .7 .8 <br /> Depth to <br /> limiting <br /> factor <br /> >80" <br /> Remarks: <br /> Boring# I O-5" 7.5 YR 3/2 ---------- is lmsbk mvf j es f—co .7 <br /> 8 <br /> 3` 2 5"-37 ' 7.5 YR 4/6 --- is lmsbk mvf cs f—co .7 .8 <br /> 2 - <br /> cu$4 <br /> 3 7"-47 ' 7.5 YR 5/8 ---------- gr—Is lmsbk mFvfl gs f—m J .8 <br /> Ground 4 7"-76i-7.5 YR 5/6 --------- s osg mvfl 2f .7 .8 <br /> elev. <br /> 9R_I ft. <br /> Depth to <br /> limiting <br /> factor <br /> >71i' <br /> Remarks: 3 <br /> CST Name:—Please Print j� /� r Phone: <br /> Address: Qom"<%t/l yGf S //'e. / bv:-� Y.�;off <br /> Signature: / Date: CST Number: <br /> �/ <br />