Laserfiche WebLink
Wisconsin DeparlmentofCommerce SOIL EVALUATION REPORT Page--_of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County u� <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and pamel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Q — O � <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). �( „0 <br /> Property Owner Property Location <br /> ldpWi Govt.Lot 1/4 1/4 S 25 T N R /6 E(or <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> W /9 / <br /> City State Zip Code Phone Number ❑City ❑Village P Town Nearest Road <br /> Li e Aef I W" 9 ( 7/6-) -z34S CO U <br /> New Construction Use:Q9 Residential/Number of bedrooms— Code derived design flow rate #15-0 GPD <br /> ❑ReplacementPudic or c/��mmercal-Describe: e <br /> Parent material /1L Qc--101 G� Flood Plain elevation if applicable ✓U✓/ ft. <br /> General comme <br /> ts <br /> and recommendations:ons: <br /> Boring# Boring tip <br /> ® pit Ground surface elev. /o ft. Depth to limiting factor 77Z in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> I o-,q ,�a Z m d k /hL ee2Z 7 /r6 <br /> 5 5/ —� rf76 5 11771 65 1 OF 7 <br /> FilBoring# Boring <br /> pit Ground surface elev. .9`90 ft. Depth to limiting factor 1 in. Soil ication Rate <br /> HorizonkDepthDominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -Eff#1 'Eff#2 <br /> r-- 1 L G 5 1/77 - 7Z3 / mL 65 1VF 7 / <br /> 'Effluent#1 =BOD >30:5 220 mg1L and TSS>30:5 150 mg/L 'Effluent#2=BOD,:E 30 mg/L and TSS<30 mg/l. <br /> CST Wne(Please Print) Signature CST Number <br /> l4 �i�s <br /> Address Date Evaluation Conducted Telephone Number <br /> Z7 a �.� � We W. - -D" / - y <br /> ,, M . <br />