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HomeMy WebLinkAbout006-440-19-5601-CST-2023-198 c;c. � '"� �' � Wisconsin Department of Safety&Professional Senrices � �°A Page�,of� ,,� = Division of Industry ServiCes n =r` $' `'�a� " SOIL EVALUATION REPORT � ,, _ . `���`� ��`��� In accordance with SPS 385,V1fis.Adm.Code Courrty �.::,.;:.-•.;. Attach com lete s8e !an on �Q� �� p p paper noY less than 8 1/2 x 1 i inches in size.Plan must include, but not limited to vertical and horizontal reference point(BMj,direction and percent slope, Parcel f.D. ,� scale or dimensions,north arrow,and location and distance to nearest road. _, �� �L S � � Please riM all information. � ''�'� Revie Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1 xm)). �� I (O ��1_ � Property ner, Property Location Q� ❑ trs7 ► � �Z n� Govt lot � '/. '/. S l T L j� N R �j E(or) W Prope Owners Maifing Addres�4, � Site Address or CSM and Lot#: � ca�ate,Zip ��y�+ Phone Number ❑ City ❑Village �Town Nearest Road ��C[�1v oS at'� �L c 7� � 71 -�� ��t c� C o,,e� R-� �New Constn�ction Use:�Residential/Numberof bedrooms Code derived designflow rate lf G �ReplaCement ❑Public or commercial—Describe: Flood Plan elevation if applicable ft. ( Parent material �' � O' �C�a � � �Q �1��/ I U�� General comments and recommendations: � " � N�(c��n� T�. v2 r'�1�w1� S� S��t -- 1 �Boring pc, Boring# �p�t Ground surface elev.l 1•s�ft. Depth to limiting factor,y�in./elev.�7�•SS3ft. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture S6vdure Consistence Boundary Rools GPD/Ft� In. Munsell Qu.Az.Con2.Cobr Gr.Sz.Sh. 'Eff#1 'Eff#2 � - ��- 7..�/ oZ - C ��'- � r �'.5 a� s(o �O � �,S`l�� � ---, L� —U �v� C�1 1�1�` - �zS�A°4 1.� r — t: in��i C o�� .O � - 3 Ca.� � ' ' � � ' �y - � �Boring c� ���# �]Pit Ground surFace elev./�•�ft. Depth to limi6ng factor,��in./elsvC/b�ft. Soil Application Rate Horizon Depth Dominant Color Redox Descripfion Texture SWcture Consistence Boundary Roots GPD/Ft2 In. Munsell Qu.Az.Cont Cobr Gr.Sz.Sh. •Ef1#1 'Eff#2 � �' 7.S/�� — L l-� /�'1�.►�✓ S .� �O S'Y.S � r .��o .C� ` .C�- Y� _�-- 1�5� � — � �� � � - �"ai.Q .� b �.5 'C� thv�i � 1`� . . CST Name(Please Print Signature � CST Number �,� , � ��D�1D . Addres� �O �� ' 1 Date Evaluation Conducted Telephone Nu�ber _ �� ��� l0 �����f `Effluent#1 =BOD>30 s 220 mglL and TSS>30<_150 mg/L 'Effluent#2=BOD,s 30 mg/l and TSS 5 30 mg/L SBD-8330(R03/22) �S�N �3 - �`�y� �'c��=FJ�:�:A�r�� IJSlJE OF P�rr,il�i I . Pa9e �y �� . a �]Boring f,_ Boring# ❑P�t Ground surface elev.y�I�tt. Depth to limi6ng factor�in./elev.q6.('�ft. Soii Appiication Rate Horizon Depth Dominant Color Redox Description Te�cture Structure Consistence Boundary Roots GPD/Ft� In. Munsell Qu.Az Cont Color Gr.Sz.Sh. `Eff#1 `Eft#2 c�— �1 � L ~ , 3 •� ?- =� � -- [�" ,� — /h �� P � - z_ ,� � � . ;- � 7.s��� -c� ,� � NP 7 ❑ Boring# �BO�� �Pit Ground surface elev. ft. Depth to timi�ng factor in./elev. ft. Soil Application Rate Hotizan Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft� In. Munsell Qu.Az.Cont Color Gr.Sz.Sh. 'Etf#1 'Eff#2 ❑ Boring# ❑ BOri� ❑ Pit Ground surface elev. ft. Depth to limiting factor in./elev. ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture SVucture Consistence Boundary Roots GPD/Ft� In. Munsell Qu.Az.Cont Golor Gr.Sz.Sh. 'Eif#1 'Eff#2 'Effluent#1 =BOD>30 5 220 mg/L and TSS>30 5150 mg/L 'Effluent#R2=BOD,5 30 mg/L and TSS 5 30 mglL ►�Q R��r��"A�T�F1 �- YY , ,-. , ' " '! 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