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WiWonsin Department of Indus", 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 /> COUNT( <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include,but <br /> not limited to vertical and horizontal reference point(BM),direction and Y of slope,scale or PARCE I.Q.# _ <br /> dimensioned, north arrow,and location and distance to nearest road. 09 0\�SoL <br /> APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION REVIEVIED BY DATE <br /> mlk �?'3\ <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> 9.y- /p"_jf p/j,�s p GOVT.LOT -7ZL 1/4 /'U F1/4,S .ST f/(J ,N,R/:! E(orc <br /> PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK# SUBD.NAME Oil CSM# <br /> S P 3 3 r w,^--) < E� <br /> I - — <br /> CITY,STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE GOWN NEAREST ROAD <br /> '6"rC9e*1 ru /PFrh (6�7) s6o—</$S�3 RckS0.'v L�eJt <br /> I I New Construction Use Residential/Number of bedrooms ✓� I I Addition toexisting building <br /> L,Replacement I I Public or commercial describe �— <br /> Code derived daily flow `/-:t�—Ugpd Recommended design loading rate 7 ed,gpd/ 2 . V trench,gpd/ft2 <br /> Absorption area required 6'/3 bed,Ill 51-P trench,it Maximum design loading rate gibed,gpol 2 �trench,gpd/112 <br /> Recommended infiltration surface elevation(s) 9 7- > ft (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material 6: C_ 'w/ lood plain elevation, it applicable ft <br /> S=Suitable for system CCOONVENTIONAL MOUND N-GROUND PRESSURE AT-GRADE SY TEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem ¢4 <br /> $ ❑U S ❑U ®S ❑U MS ❑U ❑U ❑S [gU <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color Mottles Texture Structure ConsistenceBoundary Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed ITiandth <br /> 15 tv <br /> Ground 3 -jo Id'117 SSG s 0 % L _ -wc- -7 <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> Boring# <br /> 002 "' s-a8 7, s"yRY/Z — 15 .t, 6k rnJf cs -cz, 8 <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> SJ <br /> Remarks: �3 <br /> CST Name:—Please Printl�rt 410, Phone: <br /> Address: PO /3 o X S,l Y Sir^ ,> 4..... S—V'ill ,3O 9 S' <br /> Signature: / Date: CST Number: <br />