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Home My WebLink About47-26Wisconsin Department of Safety and Professional Services K, o' I 1 Page I of Division of IndustryServices `1. SOIL EVALUATION REPORT SOIL TEST # county 47- a� In accordance with SPS 385, Wiis. Adm. Code j3,g..( PIE Lt Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, parcel I.D. 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. 2_-O 23� Please print all information. Ree iiewed by �DDaate! Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Y/II {( (/ffJ ILO/ID fI7661o2, Property Owner Property Location ❑ pa q— GAIL L\ -I -o V 2e JL Govt. Lot % Y. S OZ. T t{? NR O E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: toy F 1 ELtS7-OAr e LIJ Ca`i4'Jv V-1 Lar+CG L4(CC 22) City I State Zip Code Phone Number ❑ City ❑ Village ,® Town Nearest Road ir4Af-P-! - jLC IL % OIN0 (ZIg )Si23 R°"-' jZ\✓cv` w Lo N(y C'91Cc \2t New Construction Use: ®Residential/Numberof bedrooms3 Code derived designflow rate -tSO GPD ❑ Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. Parent material 6 VTW MW - General comments and recommendations: a CS I c Pd —7-0 CI © Boring# ❑Ptnng Ground surface elev./?'Oft. Depth to limiting factor >9in. / elev.'/' trt. Soil Annlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' Eff#1 'Eff#2 I o -Y, s,1S,\ — Ls o5C Ml 1 O,) /./a Z 'b —v( ?'<- 4 S MZ 0,7 /.4 ZY-95 .5 "F S es6 M - J-_ on /. MAY 127326 uaynela co. ❑Boring Planning and Zoning Agency Boring # Pit Ground surface ele.00_QI ft. Depth to limiting factor >95in. / elev Z Soil Annlinatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 'Eff#2 6-/0 )jrt.'--`/ — cS oS6 nn 6W z v4 r% l,0 7- /0-77 .d YLy / "-- .C 6 6W a-7 /.G Z - 7.57ay/6 — oSG r /, CST Name (Please Print) I SignatureI CST Number OOO ZS Address Date Evaluation Conducted I Telephone Number 0 1Jrtc 66 C/-r?C +Wr- s / t /s-'S7-7?SS ' Effluent #1 = SOD > 305220 mg/L and TSS > 30S 150 mg/L ' Effluent #2 = BOD, 5 30 mg/L and TSS S 30 mg/L SBD-8330 (R04121) Page of 3 ❑ Boring p C q Boring # lam Pit Ground surface elev. O , 6�ft. Depth to limiting factor> 8S in. / elev / SWt. Rnll Anal lireHnn Aare I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 -Eff#2 o.4' ?,≤ z.sr - Ls 6SG Gs' d.) i.G z 6 -iy S Y,�_v/q — S S n.jA Ir• I o .7 . z 8s 7.S c'4 S o56 / I o,7 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Anil Annlil r Linn Rnfn I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. SoilAooli Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 •Eff#2 Effluent #1 = BOD > 30 5 220 mg/L and TSS > 305150 mg/L * Effluent #2 = BOD, 530 mg/L and TSS s 30 mg/L RECEIVED MAY 12Z026 Bayfield Co. Planning and Zoning Agency CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. 3 x❑ SOIL EVALUATION Scale: 4'0 40' ❑ SYSTEM PAGE 2 OF 0 60 SITE MAP 80 PLOT PLAN PROJECT NAME: DESIGN FLOW: ys 6 GPD , (109 grid) 3 L- 10 Attach design flow calculations for commercial plans. PROJECT ADDRESS: 6 ( l s U W La" 6 L47CC aD Pipe Material I ASTM Standard (Tables 384.30-3 & 384.30-5) /Ov • O BM Symbol: BM Elevation: FT Sanitary Sewer: / BM Description: Hi4' L / r3rTeN !Z'r AA4i-�'LL- Force Main: / Slope % O Indibate north by P ( ) Well Symbol (d applicable): 0 drawing an anov of Tested Area: IMPORTANT: Show ground elevation contours at suitable intervals. on the appmprite line. d1)ue._ = 't a- G/L. �ct10�zcfL A b -LZSC r14U"NG L-'tt-L cR tr-°N Rf=t Wcr--- LLLML-- •. %'1.t.5 T RJb N L_'/"� L dcHC.t_ S GZ —r Lr % N g o Br uJ 1A2c jL%= Z 0�33 Qe-ifiLCb moo. RECEIVED MAY 122026 Bayfield Co. Planning and Zoning Agency fi r: v<-vrtq Trt J LarJL ♦@,rt �� LSo' 07) 9ocC �L8 'GSM too .O 13, - 99.c- t- foo.8l '33— 9•65 Ss c1 - q(v S ICANGC %S•$/ - `ji.a 5U.T)r PL_ Nc o -''r-1( oN ? f Ei6 9'o. o N IinL IN 12• M/1G lL B 4 YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: SCHOUREK, DAN E & GAIL ANN SR -00412 404 FIELDSTONE LN HAMPSHIRE, IL 60140-9672 Transaction Number: SR -00412-47002 Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 15033 Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821 Payment Type: Check Transaction Date: 6/2/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.