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Home My WebLink About42-24 VillarinWisconsin Department of Safety and Professional Services Division of Industry Services SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 81/2x11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1 )(m)). ~. —^."/. ^ \ ^ /^^-f'\TT^ Property Owneriwner / , ,. , / T^c-- ^ ^ T T^ U, / I ^ . ,^? Parcel I.D.r^ K 2 z> "^ ^^\r-^ Reviewed by W5 DateI s^W Property Location A ^ '^<- { °^ lct - ^ l^^-^'i Q GovtLot /J«,'1/4 S£: %S /^~T t/7 NR '7 E (or)® Property Owner's Mailing Address ^ c 3 <7/ p re 6 <^ ." ^-i ^ v')rCSMandLot.ft ._ / ,/ ./_^, / //•-T^T^'cT^"^ i s- z^ // ^ ^ ^ ^ - '^ H'^^l CTy | /-f-Z. ^ €^V i G- State^^Zip Code^•-,^$'7 Phone Number(7/ST^/l-^D City .__ D Village {3-Tov/ < I 5^'&-^ Nearest Road'J^T^.l/ 3 New Construction Use: B Residential/ Numberof bedrooms -i- I Public or qommercial - Describe: Parent material 6- l^i€. < •e«.T "T~i < 3a\^ ^d Code derived designflow rate / S~^ GPD Flood Plan elevation if applicable_ft. General comments and recommendations: Boring #QBoringIPit Ground surface elev. J^-^ ft.Depth to limiting factorZ^in./elev, Horizon / z- 3- Depth In.~^~T ^ -Jg ^ - CIO Dominant Color Munsell ic^^^ll %rr^/^ J.-Y?- S-/^ Redox Description Qu. Az. Cont. Color /J &/\-^ /\} 0 t^J'^ ^&/ve Texture SL L5 _A_ Structure Gr. Sz. Sh. 1^ ^ K Z^^iil^ /~C< ^ K Consistence /K l/ -pl'- t-Vt^-'^' /KV'-F"' Boundary c\<: ^5 Roots 3 "^ 2->^-\iIE Soil Application Rate GPD/Ft2 *Eff#1~T •;7ss *Eff#2 .7 _L_LrZT Boring #DBoringIPit •<^t <'Ground surface elev. / /- -* ft.Depth to limiting factor.r!Ln./ elev._ Horizon J_ z- 3_T Depth In. ^-3yTr1^-yo;^ Dominant Color Munsell /^r^3/^ 6'^ 5-/5 7.5-Y^y/^ -$-•7 ^ ^/(^ Redox Description Qu. Az. Cont. Color /<.i p A/<; p c'^e /Jr//<^ p (... ^/^ Texture ^L s L^TT Structure Gr. Sz. Sh. /f^- c /-r^>./ UK Consistence f^V-f-v' /1/7L- V\A \/-p"v rlA ->-t ^ Boundary ^ -s ^ $ c-^ Roots 3^ ^ ^I^ETZT Soil Application Rate GPD/Ft2 *Eff#1~T .-7 (. "7 *EW .^7 /. ^TT~^ CST Name (PleasePrint).,, .«-, , , \^A'lT^T'T^} To /k-^ki Address 'j?0. B&'x. S'2.2-^rc.^ R^r'uUJ: S'¥f^7 s""""^<-'/^<-' Date Evaluation Conducted7I:"^T:u"^y CST Number 2,2. QQ€iO Telephone Number"7^5"' Z^Z.- i<c^" * Effluent #1 = BOD > 30 & 220 mg/L and TSS > 30 s 150 mg/L Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L SBD-8330(R04/21) fc( ^605^4.^^> Boring # D Boring 'it Ground surface elev. / CC ,0 ft.*7 /^TSDepth to limiting factor_____in. / elev. Page £• o~ _ft. Horizon I 7_ Depth In. ^-.5 3 -lc ID-H( m -\ cs- Dominant Color Munsell /c'^/^ ^ R S-/j> 7£--j^ U^ ^-i^ 57^ Redox Description Qu. Az. Cont. Color /U ^,YJ>'> /J^/^e ^ - .^^ ^ c. ,^ Texture s^ 5~L5~M Structure Or.Sz. Sh. 1-^L 0 <^itc l^^k. Consistence (.K V-T»' ^tL yv^\ ^i V-^-i Boundary ^i^ ^.J C-S Roots ^. ^-I^YT^T1^ Soil Application Rate GPD/Ft2 *EfW177T .7 . -7 ^ *Effiff2 .-7T7F ^H£_sx Boring #D BoringD Pit Ground surface elev._ft.Depth to limiting factor..in. / elev.__ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr.Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Eff#1 *Eff#2 Boring #D BoringD Pit Ground surface elev.-ft.Depth to limiting factor..in. / elev.__ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft2 *Ef?1 *Eff#2 * Effluent #1 = BOD > 30 S 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS £ 30 mg/L 3\ ^ '? ' ° (^ O x - 0— - - 0 ^ — .r " ? ^' ( 0 (6^^ ^ ^- u IA / ^ ^i "Q S' f ? 1 6uft '< ^^ — / - 3S ' 3 ^s- — < t > z~ : 5 . "s p 4' ^ j' 3 , - g p? ^ i i j- 1 f i ^ t ^c : - r ^ ^ ^ i ? ^ £ ^ ^• > '1 - ? < / > ^ ^K ( s * ^ ^ ^ ^ ^ -h 5 S Q & ^ S ^' ^ ^ ^ - -^ & - y ^ <2 »^^ Q r w^~< v\ rtl t > ? Of c 5 ? , ^ y & . 4 ^ < 1 a tS P i > € , O . & . ' f - a . ? / e j^ ' t? ^ §t L ? r . IT ? . ? a « & P - f ' i P ? • ; C . ^ - w ^ . w I g - 2 - ' | ^p ^ 's W r u , e . i ' ' e > s ^ s . 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Vs ^ os ^ w. s 0- I- ^s BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): El Check List El Index Page / Title Sheet (Optional) El Original Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers) IZf Original Plot Plan D Cross Section Soil Profile Sheet (optional) D Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) tZI Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used 0 property Owner's Information (not prospective buyer's name) 0 Property Location (Accurate Legal Description with Sec/Twp/Range) 0 Road Name (where driveway is/will be coming off of) 1Z1 Floodplain Elevation, Flow Rate, Comments and Recommendations 0 Complete Soil Boring / Pit Information El Date Soil Evaluation was conducted 13 CST Name, Signature, Number, Address and Phone Number D *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) Ei Bench Mark (Description, Elevation and Location) 0 Contour Lines (Example = 98.0796.0794.0') IZ1 Pioperty Location (Sec/Twp/Range/, Accurate Legal Description) 10 Borings (Locations and Elevations) \S Percent and Direction of Land Slope 0 Well Location (Including Neighboring Wells, if applicable) l/i Location of Wetland Areas, Floodplain and Navigable Waters [2 Buildings, Driveways, and Structures (Location and Descriptions) 2J Location of Property Lines Ef Existing System Location 1ZI Address Number and Road Name El Current Surface Elevation of Wetlands and Navigable Waters ^ CST, Owner and Property Information North Arrow Fee: G^ Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforcsts