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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 <br /> • Labor,and Human Relations <br /> Division of Safety&quilsii.ngs. in accord with ILHR 83.05,Wis.Adm.Code <br /> COUNTY <br /> DANE <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but PARCEL I.D.I•not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or <br /> dimensioned,north arrow,and location and distance to nearest road. <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> GILBERT HEIMAN SE 1/4 SW 1/4,S34 ,T 8 N,R 12 E <br /> PROPERTY OWNER':S MAILING ADDRESS - LOT x BLOCK I SUBD.NAME OR CSM it <br /> 4799 MISSOURI ROAD <br /> CITY,STATE ZIP CODE PHONE NUMBER OCITY (]VILLAGE 19TOWN NEAREST ROAD <br /> MARSHALL. WI 53559 508) 655-3798 MEDINA MISSOURI <br /> H j New Construction Use(Xj Residential/Number of bedrooms 4 ( 1 Addition to existing building <br /> (t Replacement ( j Public or commercial describe <br /> 0 .4 2 0 .5 2 <br /> Code derived daily flow <br /> 600 gpd . R n loadin rate <br /> Recommended desigg bed,gpd/ft trench,gpd/ft <br /> Absorption area req d: 1 R n n bed,ftisp„Q__trench,ft2 Maximum design loading rate 0 .4 bed,gpd/ft2 0 .5trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) SEE PLOT PLAN ft (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material LOESS,GLACIAL TILL Flood plain elevation,if applicable N IA ft <br /> S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable for system D O U IBS O U IBS O U Q S D U D S ICU D S V]U <br /> SOIL DESCRIPTION REPORT <br /> Depth Dominant Color Mottles Texture Structure al ROOTS 860415. GPD/ft2 <br /> Boring# Horizon in. Munsell Qu.Sz.Cont Color Gr. Sz.Sh. Bed Teich <br /> ' sil 2fsbk fr 2fm as 0 .5 0 .6 <br /> ',p 3-9 10YR4/3 <br /> :1 )-31 10YR4/4 sil 2fsbk fr lfm Cs 0 .5 0 .6 <br /> Ground ,.R2 11 -SO 10YR4/6 51 lfsbk fr if cs 0 .4 , 0 .5 <br /> elev. <br /> 99.5' +C 50-95 10YR5/6 * sl 1fp vfr 0 .4 0 .5 <br /> Depth toe <br /> limiting <br /> factor <br /> I <br /> ii C•iurt <br /> Remarks: + WITH "lir WitctrU'Siii)A1S <br /> Boring# 'JO/lino-h'rni0� <br /> ; : Pip , -14 10YR413 i1 2fsbk fr 2fm as 0 .5 0.6 <br /> 2 <br /> ti>fi:16.1 <br /> at_14-12 10YR4/4 511 2fsbk fr , lfm cs 0 .5 0 .6 <br /> Ground 2B2 32-5R _ i OYP4/6 __ sl lfsbk fr if cs 0 .4 0 .5 <br /> elev. <br /> 99.5' 7r 5R-101 10YR9/6 * 51 1 f p vfr 0 .4 0 .5 <br /> Depth to <br /> limiting I <br /> N `A I I <br /> Remarks: * WITH "f s" INCLUSIONS <br /> CST Name:—Please Print_ L. HAMMES Phone. (608) 233-9200 <br /> Address: 6219 COUNTRYSIDE LANE, MADISON, WI 53705 <br /> Signature: /) Date: 7/zd/Q CST Number:2 23Q <br />