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Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page_Of <br /> Division of Safety and Buildings CS= K'3- <br /> in accordance with SPS 385,Wis. Adm. Code — <br /> Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must county&rw# <br /> include,but not limited to:vertical and horizontal reference point(8M),direction and parcel t D. <br /> percent slope, scale or dimensions,gorth arrow,and locat en and distance to nearest mad_ 07t 0 �� f7-/�j / -y -4 41AGA0 <br /> Please print all information. , IVY Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(r)). <br /> Property Own property Laratron <br /> R <br /> ;Zlve L/e`! Govk Lot 114 114 S,9Z 1T` O N F2Y �.j E(o® <br /> Property Owners Mailing Address Lot Block# Subd.Name orCSW", <br /> Zit Corv�roN lYer 014 <br /> Ci State Zip Code Phone Number OCity_ gqavage WTovtn NearesiRoad'- <br /> r o� d1 WI (6!Z )?az- B7 ,ktt1:r;'0o1 % At <br /> JX New Construction Use:C9 Residential 1 Number of bedrooms Code derived design flaw rate 10!= GPD <br /> ❑Replacement / Public or commensal-Describe-. <br /> Parent material e144 le .UIt-A" Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations_ <br /> t Boring# Boring /] y <br /> �C} Pit Ground surface elev. "!_�it Depth to limiting fades � in. <br /> Sol Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure istence Boundary Roots GPD/ft <br /> in. Munsell Qu.Sz. Coto Color Gr.Sz.Sh. ff#1 ff02 <br /> I - 75YQ -- /M7bk 5 z <br /> z ti-3d 7557C — M4 zm r �! <br /> /M�61� L <br /> Boring# Boring r/ _?7 <br /> pi} Ground surface elev. •B ft. Depth to limiting factor 7� in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure 7orisistence Boundary Roots GPD/ft 2 <br /> in. Munsell Du.Sz. Cont.Color Gr.Sz_Sh_ ff#1 tff#2 <br /> Z �$. .SYQ4/f 5 v f' ds Z <br /> 3�-�915VQ9/�f — J 1171UFle tn 5 ,, <br /> 'Effluent#1=BOD 5>30<220 rng/L and TSS>30 <150 mg/L `Effluent#2=BOD <30 mglL and TSS <30 mg/L <br /> CST Na lease PrjokL Signatu CST <br /> Address Date Evaluation Conducted Telephone Number <br /> 7!5'•!"I�—OZOZ <br /> SlID-8330(R11/t 1) <br />