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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page/of7 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must Canty <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). d <br /> Property Owner Property Location <br /> e r1 Le, k k e h GovL Lot 1/4 1/4 S 3 S'T 4 J N R / E(or)&,V <br /> Property Owners Mailing Address Lot# I Block# I Subd.Name or CSW <br /> x'1907 Ce4, btvey Lle- Rye• !! �/ Sit <br /> Cily State Zip Code Phone Number 11 city ❑Village LdTown Nearest Road <br /> 29AOLur W Sk430 ( ) Sw1.S5 4�'ranbcrr 6k /�e'v <br /> ❑ New Construction Use:® Residential/Number of bedrooms, Code derived design flow rate ?o o GPD <br /> Replacement // ❑ Public or commercial-Describe: <br /> Parent material U 146(a ( t/r%t 't _ Flood Plain elevation if applicable �,�� ft <br /> General commentss, e/%.✓• 90� y0 (9233 {& 94, 50) "tCi <br /> and recommendations: S X <br /> AldlVdipt 8s ap- Men <br /> Sorin # ❑ Boris <br /> / g ❑ Pit Ground surface elev. 96' � ft. Depth to limiting factor 8o in. Soft Apolication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I •EfI#2 <br /> I o- v 7-ff f/t / -5 /'".s6/c M ! c s 7. . 71 1. 6 <br /> ol, 5/- 40 7.S'1iR4r/N — /1 al,s-,s6/c 1 & -5 co - 71 /, 6 <br /> 3 9o- f49 -7.SY/z 3'a — s os F 1 - - .71 1. 6 <br /> ® Boring# © ung <br /> ❑ pit Ground surface elev. 17.5 7 ft. Depth to limiting factor > $O in. 9.,011 flcabon hate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/iP <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 <br /> o- N 7•SY/7 s/� — / S /. 6 <br /> 3 39-Sa 7--SrL?/q — 5 . 7 /. 4 <br /> •Effluent#1 =BOD >30 1220 mg1L and TSS>30<150 mg& •Effluent#2=BOD <30 rrglL and TSS<30 mgrL <br /> CST Name(PleasePrint) SignaWre CST Number <br /> Jc'w1es 566n/e/s S 734 0 <br /> Address Date Evaluation Conducted Telephone Number <br /> et 7760 ffw 3 S GC/e bS fns Ef - 54893 /7' -oZ 7 ` 6 7/r PdG- g1S-7 <br />