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, � Ihir�artrorMivwv.ar�� <br /> oNSITE <br /> Field Evaluation Form ���Qr� ' � <br /> TREATMEkT <br /> PRQGRAM _.'��..,�'C�`1y <br /> 1. Contact Information <br /> L <br /> Property Owner/CHent Client Phone Number: <br /> Address 2650 Fox Street,Orono,MN 55391 <br /> �,y.1,y,�,, ,,,�, <br /> �BCC��"7:f�GV�.�i�'.h��.i: Weather Conditlons"„_ -. ��y`��� } . ., ,... � i".�,'�,�,y:s ,� ��='��'_�, s�'��'��,.� � A} L'� �tv f}�°��vr <br /> � �" h� <br /> 2. UUllty and Structure informaHon <br /> Utility Locations Identified ❑Gopher State One Call ❑Any Private Utitlties <br /> Property Lines ❑Determined and Approved By Client ��,�q�j�1�'St����{y x�r C(leni's Approva((initial) <br /> ❑Determined But Not Approved <br /> ❑Approximate <br /> ❑Property Lines Surveyed <br /> Locate and Vertfy(see Site Evaluacfon ma�) <br /> ❑Existlng Bufldings ❑Improvementr ❑Easements ❑Setbac}cs <br /> 3. Site Informatton <br /> Percent Slope 10` Slope Direction east <br /> Landscape Posi[ion - shoulder , Slope Shape cOnvex <br /> ,.. , . - .. . <br /> Vegetation type(s) ' �r��. , <br /> .. _.., ... <br /> Evidence of cut,fill,compacted or disturbed areas ❑Y� ❑No ❑Locate Areas on Site Evaluation Mao <br /> Oiswss the flooding or run-on potential of site � - <br /> 4� <br /> Identify benchma�lcs and elevattons(Sit�e.E�vo(ulotion Mc�) see map <br /> Proposed soil treatment area adequately protected L-d'Yes ❑No <br /> 4. Generai Sofis Informatton <br /> Ortginal soils �� ❑No <br /> Type of observation ❑Soil Probe otl 8oring �Sotl Pit' •Sol(pit required lf determining loadirtg rate withouf perc test <br /> Number of soil observations <br /> ,�¢v, <br /> Soil observations were conducied in the proposed system location �� ❑Na <br /> A soit observation was made withln the most limiting area of the proposed system �� ❑No <br /> Soil boring log forms completed and attached �� ❑� <br /> Percotation tests performed,forms completed and attached �Y� ❑� <br /> 5. Phase I.Reporting lnformatfon <br /> Depth to standing water n/a inches Antidpated construction issues <br /> Flood elevation n!a feet <br /> Depth to bedrock �;.g;:_ , n%b `.inches <br /> Depth to periodically saturated soil ,i'� 14 inches <br /> Maximum depth of sys[em 221NCHES�AF SAHD'�'inches �� <br /> Elevation at system bottom. 95:2 ` feet Differences between soil survey and field evatuation <br /> Percolation rate -'30."- ''min/inch <br /> Loading rate 0.45" gpdfft2 <br /> Contour loading rate 12"� <br /> Site evaluation issues i comments <br /> �ast Propertyii�e wtll need to be tocated '• <br /> � <br /> I hereby certify that I have completed this worlc in accordance licable ordinances,rules and laws. <br /> Pernel Chip Hentges 2084 <br /> IZ J <br /> (Designer) (Signature) (License#) (Date) <br />