HomeMy WebLinkAbout10-25STitt T6ST_
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Wisconsin Department of Safety & Professional Services
Division of Industry Services
SOIL EVALUATION REI
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''"i, .^. •l<' In accordance with SPS 385, Wis. Adm. Cc
Atlach 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 stope,
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. 18.04(1 )(m)).
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Parcel I.D.rn3G
Revii Date
'ou^
Property Owner
7 1.^ •ST?->>5~rt?i-) c<-''W<
Property Location
Govt. Lot •/<',4 S /? Tt-|-7 N R tf^
-D~
E (or) W
Property Owner's Mailing Address
>77.S S (3 ^ 1^€^-L^T-V Pb
Site Address or CSM and Lot #:
?:)-><5 J'?->">6i- t'^+t£^b.^6T t CJ^ -ff/t^^ ^^
City, State, Zip
^i-su^ (T-I^C-^/ ^r s-ffyf)
Phone Number
(?'s )^.-^'n
D City D Village ^ Town
1(U/-' ii.\^ejt-
Nearest Road
S^ i f>C^- L/hiJH /?^
Q New Construction Use: [3 Resictentlal/Numberofbedrooms
D Replacement D Pub lie or commercial - Describe:
Parent material n •<• ~n-s 'V h-
General comments and recommendations:
-JL
'bi5 »&./
Code derived designftowrate ^0 GPD
Flood Plan elevation if applicable .^ ft.
-n o.'>
I I Boring #Q Boring
I Pit Cf-j /-•Ground surface elev./ f'"i / ft.Depth lo limiting factor •> ?Sjn. / elev.9&-t'C'ft.
Horizon
I
•L
_3_
Depth
In.
&-8_
e-^&_
u,-- ^
Dominant Color
Munsell
?.r v4-^
7.< ^ M;-»
?.5 ^ t(A
Redox Description
Qu. Az. Cent. Color
Texture
z-s
s
^ hr-~r
Structure
Gr.Sz. Sh.
0-J6
c^G
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Consistence
/w\
7.T
/^t
Boundary
_G»J_
Gi^
Roots
S3
l^t-(
-LL
Soil Application Rate
GPD/Ft2
*Eff#1
6.7
0,~?
6.1
•Ef?2
/.^
).{.-
/.<h
^ j Borings QBoring
Ground surface elev.77.^7 ft.Depth to limiting factory 7g in. / elev.?"'c'7ft.
Horizon
I
-2.
_I_
Depth
In.
0"<<9
(y Zto
ik- ^
Dominant Color
Munsell
'7J-^tV(
?.<. ^ "H
7.JT^VJ
Redox Description
Qu. Az. Cont. Color
Texture
M3~
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Structure
Gr.Sz.Sh.
ob6
-oJ^
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Consistence
/Vvl
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Boundary
^s^
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iUT
<^\^i£;
Soil Application Rate
GpD/n2
•Eff#1
o.~)
o.'7
^-•5
•Eff#2
,.6
/. fe>
i.(^
CST Name (Please Print)•-r^ c.^w<~Signature CST Number
G"?t°?Q(50-Zfi»
Address
f?o /3t y. fc- (v C'-VHLt. ^ ^
Date Evaluation Conducted
9AO/-Z-/
Telephone Number
•AS-^^e.-^ss-
'/ /
Efflueol ff1 = BOD > 30 S 220 mg/L and TSS > 30 £ 150 mg/L
^S°-00 Sl^(Zoz$ l^^* Effluent #2 = BOO, s 30 mg/L and TSS £ 30 mg/L
SBD.S330 (R03/22)
^Kl'"^.^iin Department of SafWisconsin Department of Safety & Professional Servio
Division of Industry Services
SOIL EVALUATION RE
In accordance with SPS 385, Wis. Adm. cW'^
!l^Blt t]^y^'^'tMO'SVtJS
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)).
ius c
ii V; ^
Z'i/"
R,
Page / of
!i^et^on«s8 ti^
|Q/^-<i=it^^
Parcel I.D./^<>3G
Reviewed by Date
Property Owner
T^.-A ^TH-)5'nL ? i-i a-'^ft-y-
Property Location
Govt. Lot %y, s /<? T<-(-7 N R 0^ E (or) W
Property Owner's Mailing Address
>77^ S<3^ bc^i- LI^-(_<> (2-b
Site Address or CSM and Lot #:
>"?->$ je.nCt- L^US (Z-b . ^6T l cJ-^v -^/<jy6- ^^v %
City, State, Zip
,,^.^ (?-| •cK, ^/T J--/^
Phone Number
(?<s )z^~^7'n
D City D Village
l^c,/^ ^\>y€y—
Town Nearest Road
S ? > ^ ti/t- L^f-i^ A^>
New Construction Use: 0 Residential/Numberofbedrooms
D Replacement D Public or commercial - Describe:
Parent material n ^"n~» --y H~
General comments and recommendations:
_^_
"^tS Ib^r T?
Code derived designflow rate ^^0 GPD
Flood Plan elevation if applicable ^V ft.
0.-)
Boring #Q Boring[Pit Ground surface elev.Y^.^ ft. Depth to limiting factor ^ ^S in. / elev.?&'f'^ft.
Horizon
»
z.
_3_
Depth
In.
&-B
e-z-8
i&~ ^S
Dominant Color
Munsell
7.<r r^-^
7.^ ~^- M^l
7.5 ^ iih
Redox Description
Qu.Az. Cont. Color
Texture
z-s
s
S -^J/^r-~r
Structure
Gr. Sz. Sh.
OJC
CL£C
<-\ cS^
Consistence
/^\7T
/Kl
Boundary
G-^
fci^
Roots
S3
/^-^
_L£_
Soil Application Rate
GPD/Ft2
*Eff#1
0.7
on
0.1
*Eff#2
_1_^_
).G
/.^t
z Boring #QBoring
3it Ground surface elev.T7./~? ft.Depth to limiting factor_
Horizon
I
-2-
^_
Depth
In.
Q~(o
(s- z<p
ik' ^>
Dominant Color
Munsell
'7.S^^/(
^ ^ '/^
7,J^V-?
Redox Description
Qu. Az. Cont. Color
Texture
t-sT
5^~T
Structure
Gr.Sz. Sh.
obC
oj^
oSb
Consistence
/Vvl
^1
/^/
Boundary
3^-^
Roots
z^
/^l-^s:
Soil Application Rate
GPD/Ft2
*Eff#1
0.^
o:~!
o-~)
*Eff#2
/.fc
/. ^_
).(^.
CST Name (Please Print)
-7^ cj^^/c^
Signature CST Number
6-7i°?ooo-ze>
Address
F'o 73c^tvdy CA-3U:, i^'T'
:valuation Conducted
7/2^ /-2-/
Telephone Number
>5--7?^~^>^-S'
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1 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 (R03/22)
1_Boring #
Q BoringI Pit Jstw-facGround slw-face etev.;
Page _i_ of
Depth to limiting factory 7S' in. / elev.<9o'^^ft.
Horizon
'I
zz
Depth
In.
(?~ ^
6 ~ Zfc
Zk- ~>5
Dominant Color
Munsell
-?^2-^1
~).s"^ y/
7.-?-^- >/h
Redox Description
Qu. Az. Cont. Color
Texture
L^
_^_
<> l^-'/CA'7^"
Structure
Gr.Sz. Sh.
6SG
OJ6
<^( 6-^
Consistence
"A^T
"AvT
/w (
Boundary
-3K"^
Roots
33l^]f-7T
Soil Application Rate
GPD/Ft2
*Eff#1^T
0.-?
_C'.-1
*Eff#2
/.(^
(.^
/ ^
Boring #d BoringD Pit Ground surface elev.Jt.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 #Boring
Pit Ground surface elev._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
* Effluent #1 = BOD > 30 < 220 mg/L and TSS > 30 < 150 mg/L * Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L
nCHECK BOX A3 APPLICABLE.
SOIL EVALUATION
SITE MAP
PROJECT NAME:
C'L^JLAL 3 St'i^
PROJECT ADDRESS: "~)~~>^ S P \^ t^- <- fi^-^ ^
BM Symbol: -^- BM Elevatton: ^0° - 0
BM Description: /7oTTO/-^ S < b<»^ G
0 ^U^SHEA^OX A3 APPLICABLE.
Scale: 1"= 30' I[ OVQTCM PAGE 2 OFaoBaifield Co. Zoning Dept'7Z/77/
(7.5 ft grid)
22
7.52
zz^PLOT PLAN
DESiGNFLOW "Y ?6 3PD
FT
Attach design flow calculations for commercial plans.
Pipe Material /ASTM Standard (Tables 384,30-3 & 384.3(
Sanitan/ Sewer_/.
»-yF Force Main:
Slope Gradient (%) <^'d,of Tested Area:' ' -' ''*Well Symbol (if applicable): Q Indicate north bydrawing an arrow
en 'he approprjte line.
IMPORTANT:
Show ground slsvatjon contours at suitable intervals.
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