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Wesco at Department of Industry, 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 /> ' COUNTY <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but Rid <br /> ur <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCE`L,I.D.If <br /> dimensioned,north arrow,.and location and distance to nearest road LW�L—c A-L�-?CD <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVI E��PJBY a�ATE <br /> PROPERTY OWNER: PROPERTY LOCATION 'J <br /> L L GOVT.LOT / 1/4 1/4,S T N,R 7 E(o W <br /> PROP TY OWNER:S MAILING ADD ESS LOT# BLOCK# SUBO.NAME OR CSM# <br /> Z S Csm V. r P, <br /> NY,STATE ZIPCODE PHONENUMBER []CITY []VILLAGE OWN NE REST ROAD <br /> LOOMIA HA- 55 1 ( 8 5-00 A <br /> New Construction Use p4 Residential/Number of bedrooms 3 ( ] Addition to existing building <br /> 1 ] Replacement ] ] Public or commercial describe <br /> Code derived daily flow 'f5D gpd Recommended design loading rate I bed,gpd/0_�trench,gpd/ft2 <br /> Absorption area required (P4S bed,ft2,;4S trench,ft2 Maximum design loading rate bed,gpd/ft2 .� trench,gpd ft2 <br /> Recommended infiltration surface elevation(s) T•9 AQ- SIB•q ft (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material GLACIAL Mfr Flood plain elevation,if applicable HA ft <br /> S=Suitable for system C VENTIONAL OUND GROUND PRESSURE T GRADE Y TEM IN FILL HOLDING TANK <br /> U=Unsuitable for s stem S ❑U S ❑U S ❑U S ❑U VS ❑U ❑S ®11 <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft <br /> a� mm— <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trends <br /> ;k.,.>.::. �• 7•5 R 3 x- �- M5 MS FA <br /> t- � 1 <br /> s Z 5- $Z TSR �`� M5 0m 1 <br /> Ground <br /> pev <br /> 1 ft. <br /> Depth to <br /> limiting <br /> 1 V <br /> fac <br /> Remarks: <br /> Boring# <br /> OP sM- I -S Z �- MS ON15 MI CS <br /> M I <br /> 67- P4'" Ms 001 MI 2r+ <br /> Z , <br /> Ground <br /> Qe <br /> lft. <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> CST Name:—Please Print Phone: 715 - S64 - S <br /> Address: �--Mo 9Wv 3S 1A65r0Z VJ) - L 89Z <br /> Signature: / Date: CST Number: <br />