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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page%of <br /> Labor and Human Relations <br /> Division of Safety 8 Buildings in accord with ILHR 83.05,Wis. Adm. Code <br /> COUNTY <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but L� <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. a 9' y0'7� )-0 3- �?oo <br /> APPLICANT INFORMATION-PEASE PRINT ALL INFORMATION REVIEWED BY DATE <br /> L <br /> L - <br /> PROPERTYOWNER: PROPERTY LOCATION <br /> - -ro M Y - GOVT.LOT SL01/4 91 1/4,S�JhI T 4+0 ,N,R 1,4 J�M W <br /> PROPERTY OWNER':S MAIL] ADDpESS LOT# BLOCK# SUB_.NAME OR CSM# <br /> ZI311 tCe�,H — <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE )MOWN NEAREST ROAD <br /> ne✓ •J <br /> 54 Yo I l l sco dk unnt7 " <br /> [ ] New Construction Use Residential/Number of bedrooms 7- [ ] Addition to existing building <br /> J4 Replacement [ J Public or commercial describe <br /> Code derived daily flow o o gpd Recommended design loading fate - 7 bed,gpd/ft2 •8 trench,gpd/ft2 <br /> Absorption area required '1.2-9 bed,ft2 3? trench,ft2 Maximum design loading rate 7 bed,gpd/ft2 -8' trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) <br /> Addifional design/site considerations aw ill c7�s I Bm Lam✓ /w.0 K&au.rllev« p•yu'_ P/e ltd Sw(E <br /> Parent material C�*Jk, c�R�ae�6 Flood plain elevation,if applicable A!A ft <br /> S=Suitable forsystem CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem NS CIL ❑S U R S ❑U ❑S 9U ❑S KU ❑S 0011 <br /> SOIL DESCRIPTION REPORT <br /> Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft <br /> Boring# Horizon in. Munsell Qu.Sz.Cont Color Gr. Sz. Sh. Bed ITrench <br /> 6 7 <br /> L 9-16 7.SVrZ `11-4 7 _j' <br /> Ground -7& ZSyi2l/ "` <br /> Syz, ,e as /T -7 .8 <br /> elev. /+ <br /> f78 ft. 7. tZ <br /> Depth to <br /> limiting <br /> factor <br /> 760 <br /> Remarks: /fir �E S� 2 " C n,ctik F.oeozrt <br /> Boring # <br /> 2 s 3/7- �— nr r CS v� •7 • 8 <br /> Z z _ w .�S .mfr CS 17' 7 '8 <br /> 00 <br /> Ground 3 /3-6o 7 SYR '41 6"s .r�2 A ai I -7 <br /> 9e,.7ft. �'G6 7•SY� q%/ A" <br /> `�— ihsba Ase <br /> Depth to <br /> limiting <br /> factorLr: , I <br /> , <br /> 100" <br /> Remarks: �! �E 3B•'L" ane 4„� ..r F /L S <br /> T Name:-Please Print a K Phone: <br /> Address: HIA 59, 00 4M <br /> Signature: gyp,, " 5W Date: L /D 9✓ .7"fr. <br />