HomeMy WebLinkAbout45-24 Rucker"%. .^ ^, ^_B./^/"'f'^":^'^' ''"-'.'fi'in?;'.!;?- Wisconsin Department of Safety and Professional Services Division of Industry Services Page /-of_ SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code | county 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. /„/..„ .,, ,„(t! Please print all information, t i^-'^-'/y'^f'^'fe^-^-^.Personal information you provide may be u^edforjse^ondagLpurpos^s (Privacy Law, s. 15.04(1)(tfi)). Property Owner ^^e-t^jf^t 0>t-/~c /^S'Vf^ | Property Location Govt. Lot %M^ <^..ec7^/^t^^-6^c:/:^^ ^^/JAPR :^'il? Parcel I.D. T^K ^/^^5T Date.//?57/3 1_^J/ %S/^-T ^ N R ^ D E (or) W greperty Owner's Mailing Address \^^3C /?^/^ ^-^J.Site Address or CSM and Lot #(Y^S~.S~ /^^-C <?^) /<'<^/f/-r/-^ S^/^^-lV o^s/Uj a>^-/>^fiz.^A. f- J'<r^^A*Ax-?<p-?/-(-S-^ City \^e^ /^/^/(S StateH^/Zip Code \^s~~^ Phone Number ( ) D City D Village ^/"fje-s El Town Nearest Road <^3<^I \/^^^^ ^cT New Construction D Replacement Parent material General comments and Use: W ResidentiaUMumberof bedrooms D Public or commercial - Describe: fec/t/OwT^A C/ recommendations: ^Yc^T^'-e-^^< ^ ^.¥s- 4 Code derived designflow rate. Flood Plan elevation if applicable. ^'7 _GPD _ft. Boring #Q BoringEI pit Ground surface elev/^-^ft.Depth to limiting factor ^<^ in. / elev.S^J^C"' Horizon / ^z_3 _z_ Depth In. ^'3 3-/0 ^-f^ /^-/^ Dominant Color Munsell >.^^ ^ 7.<r)^ V5 zj-^e ^ 2..W ^ Redox Description Qu. Az. Cont. Color Texture i S i <. 5 _^_ Structure Gr. Sz. Sh. /^^ ^^r s6^r CD-S^- £>~ ^6> Consistence w.y ^ ^.1^'/:^ -^ L. -K< Boundary ^.l^-> &• C^J (s-Cfj Roots /fcol/^ (^0 V ft /^ Soil Application Rate GPD/Ft2 *Ef?1 .7 _2- _!_.7 *Efl»2 /(; A4 i. ^ /.^ ^Boring #QBoringjapit Ground surface elev. ^*""7-i ft.Depth to limiting factor A?^? in. / etevf^Cft. Horizon ± _^_ _z_ _(zL Depth In. £>-^^/(^-/^ V3 -/^ Dominant Color Munsell •2.s~y^3/k 7,-o-< ii/s Z r><- Vy ?.s~/^ v/^ Redox Description Qu. Az. Cont. Color Texture -; s ^ s 5 f Structure Gr. Sz. Sh. ,^6-^ /^. f ^s'A'- ^-.r^ e?- s 4r Consistence ^^^/( A^^^/€ f^t<^- ^ /_ Boundary <$A-/ ^/t/ 6- t^> Roots ^?£eyt^f: ^Oo- f A^_ Soil Application Rate GPD/Ft2 *Ef?1 _^L _^L .73: *EfW2 /.^ -A^- J^_ A^_ CST Name (Please .Print) ^'r A^ y^ ^u<. cA Signature CST Number ^s7^) Address ll?^ /^ifi'^cffs^ C-^/^ iuj- j-y^-J'f 0<Date Evaluation Conducted ///^y'?^ Telephone Number 7/^<^/-//<?^ k Effluent #1 = BOD > 30 s 220 mg/L and TSS > 30 £ 150 mg/L • Effluent #2 = BOD, £ 30 mg/L and TSS s 30 mg/L SBD-8330 (R04/2 <1^ S'/G-cJ^I A Boring # D Boring0 Pit Ground surface elevY^'<i''ft. Page ^_ _of 3 limiting factor^'9'^ in. / elev. ^ ^^— Horizon _/_ s_3 y Depth In. 0-6 6-^e> ^0-^ ^•C'-^f Dominant Color Munsell -^y-y^A ^.s-^^/? 7.5- y^^A •?.s-y^ ^A Redox Description Qu. Az. Cont. Color Texture ^ <. < 5 ^ ^ Structure Gr. Sz. Sh. ^^ ^ 1^ 5^>/C G-S&- C>- SC— Consistence ^\^-^< _^L^/^_ A <- t^ ^- Boundary 6-1^ 6-i^> <^ L^1 A 1-* i~' ' Roots 2c-f>f/. ^»<^ /£/-/= ^oii 'A|)|i>lication Rate GPD/Ft2 *Eff#1 p ^~T •rj-y *Eff#2 7,^ /-^ ^ ^ /. 6 Boring #D BoringD Pit Ground surface elev._Depth to limiting factor.jn./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 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 d 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, ss 30 mg/L and TSS S 30 mg/L ^^7 /^^^A ^c^t ^ ISro' ^ ^^ ^•/ftn. det;/- ^^-.w^ - Cf^^'Sr- X^o-rA **e/ /^s s^o^ ^ne-Key / ^2 3 & /^QU. 'lcfe.^ ^ T ^ '-A fi^c^'y^ M M ^~jT^ </ •7 :^— , ^^v^f^l^ cc^u^-y TfflM^ 04 ^/-/7<?^- ^^~ ryy^/ w^ P<^ '/I f^T ] t^ $c</ A/£~^y^-u)-e>is- /^^^ -f s>£r^t^ /<^^^- S~€^%1 6?^.>? Fox rJi ^ /')S£- -5^ m^-r /^^ ^ ^[^ o. ^^ y/^-^ - v^^ f5\ v^.^r 0^ 5^^?- ^33 fr.?5- SY^e.^. C< ^MS- ^•;7 ."?^ \A^•^. ^ ^^^ ^ ye^i^ ^^a. ^7- ^?,<r ojpo—ncT ^T- /'/>^. ^{p/^ ?^~<^S~^ ^<; s^'A ^ ^ &l S^: 1^10'<—f ^a-nnn^ ....... .-BAYF!ELD-90UNTL.. —_- ID u-i^'.M^ 7-] CHECKLIST FOR CERTIFIED SOIL TESTS ^ [!!! ;!lj APR ?6?'!//'! W Submit the Following (Use Permanent Ink): a Check List ^. D Index Page / Title Sheet (Optional) D Original Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers) D 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) ETParcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used BTroperty Owner's Information (not prospective buyer's name) E"Property Location (Accurate Legal Description with Sec/Twp/Range) ETRoad Name (where driveway is/will be coming off of) DTIoodplain Elevation, Flow Rate, Comments and Recommendations ETComplete Soil Boring / Pit Information SDate Soil Evaluation was conducted ETCST Name, Signature, Number, Address and Phone Number D *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) EfBench Mark (Description, Elevation and Location) B-Contour Lines (Example = 98.0' ,96.0' ,94.0') BT'roperty Location (Sec/Twp/Range/, Accurate Legal Description) Q^Bbrings (Locations and Elevations) [TPercent and Direction of Land Slope Q^/Vell Location (Including Neighboring Wells, if applicable) Q-1jxation of Wetland Areas, Floodplain and Navigable Waters B^Buildings, Driveways, and Structures (Location and Descriptions) 'Location of Property Lines 'Existing System Location B^Address Number and Road Name ET Current Surface Elevation of Wetlands and Navigable Waters S^CST, Owner and Property Information EfNorth Arrow Fee: Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforcsts