Laserfiche WebLink
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 /> COU <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but u <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 DATE <br /> -yS <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> SEAM SC-14ARIF GOVT.LOT -9L, 1/4 1/4,S2(0T [ ,N,R /5 E( W <br /> PROP RTYOWNER':SMAILING ADDRESS LOT# BLOCK# SUBD.NAME O CSM# <br /> 0(o Z[o LK- SIP • 37-31 — C5M VOL-. q F. 202. 203 <br /> CITY,STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE 5UOWN NEAREST ROAD <br /> R W $ O 1 SI 6S 3S?2 5 Rfd DR• <br /> QC] New Construction Use Residential/Number of bedrooms 3 [ ] Addition to Existing building <br /> [ ] Replacement [ ] Public or cemmercial describe <br /> Code derived daily flow T gpd Recommended design loading rate . 7 bed,gpd/ft . $ trench,gpd/112 <br /> Absorption area required (P93 bed,ft2 503 trench,ft2 Maximum design loading rate .7 bed,gpd $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 15.1 ALT. 9S.2- ft (as referred to site plan bench ark) <br /> Additional design/site considerations <br /> Parent material 6LAG119L 1)RIfT• Flood plain elevation,if applicable 61A ft <br /> S=Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM Iyy�FILL HOLDING TANK <br /> U=Unsuitable for s stem IRS ❑U 29 ❑U INS ❑U ®S ❑U ❑S 9I U ❑S 44U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon <br /> Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench <br /> az f 0-5 7.5 932 �— 5 C7 MS MI S ZM 1 $ <br /> b <br /> 2 5-63 7.5 VP, 4 `-- - 5 omsojM I ti Z,,,t .'7 <br /> •$ <br /> Ground <br /> elev. <br /> ca,z ft. <br /> Depth to <br /> limiting <br /> factor <br /> 7 <br /> Remarks: <br /> Boring # <br /> 0.5 7•$ rt3 2 C - MS MS )A 5 2.M .7 .g <br /> Z 2- - 40 7.S R �`. Ms ores M1 .8 <br /> Ground <br /> elev. <br /> 6 'I ft. <br /> Depth to <br /> limiting <br /> fac <br /> to <br /> Remarks: <br /> TName:—Please Print 4 HAgp d Fk I r4S Phone: <br /> Address: 27760 w jS5 1146B5169 , W). —91SU <br /> Signature: f z Dat S ST Number: <br />