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- 'Atleconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT /� Page_of_ <br /> in acrnrdde ce with SPS 383,Wis. Adm. Code o <br /> rR.Ied <br /> �.�r•n rfE <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vcNcal and horizontal reference point(B M),direction and l.0.0�'Oa0"d•Ye-/p-amt -01 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 00 0•o N4op <br /> Please print all information. - by "' Dale <br /> Perar-a-I nrormatlon you aravlee anal ha rare far seromel nurnosas lP-1r,Law,s.ls.04(1)ano- 4 j$//r/ 7Zl <br /> PropertyOwner Property Location PLL nv <br /> ')I. 3-4 ` - Govt.Lot NE114 NE1/4 S J 7 T yp N R/p E❑l El <br /> Property Owner's Mail IS Address Lot# Block# Subd.Name or CSM# <br /> Giry late Lp Code Phone Number ity UJUllage Town Nearest Road 6b/7 <br /> New Construction Use® Readential/Number of bedrooms Code derived design flow rate `!SO GPD <br /> nReplacement Public or commercial-Describe: <br /> Parent material G/4reqFlood Plain elevation if applicable N//'/ ft <br /> General comments <br /> and recommendations: S/J. c%� rA•o d.e T1-to <br /> Boring# <br /> Boring <br /> / g <br /> ❑ Pit Ground sodas.elev. 4,{ .7 R. Depth to limiting factor 7 71t in. <br /> Soil Apsheron Rate <br /> Horizon Dept Dominant Color Radox Description Texture Structure Consistence Boundary Roots GPDIT <br /> in. Munsell 0u.Sz. Cont Color Gr.Se.Sh. 'ER#f 'El <br /> l e -ti 7.JYr� J/F 13 /.r5/<r .-. / cl I . '7 /6 <br /> d, H- /T 7.9Y?Y/y /S d.+rtb/c ,,,• / as :I<o . 7 1 /, 6 <br /> 3 /7-J'% 7.3.7r�4/4 — S o.f 6 /.^ / (i S 3 , 77 1. 4 <br /> 41 7Y ZSYR '% — t oS6 — - -7 <br /> Baring# ❑ Baring <br /> ® Pit Groundsudaceele, 93. 2 It. Depth to limiting factor 7 76 in. <br /> Soil A IicaGon Rate <br /> Horizon Depth Dominant Color Retlox Description Texture Struct re Consistence Boundary Roots GPDMF <br /> Munsell Du.S, Coal.Color Gr.Sz.Sh. 'E01 'EMS <br /> 6 -4 ZStl/?'/y — /t "M�6 /c Ml GS 3 ... .-7 <br /> ,7 Y- -lo 7.S Yd v/# — /J do-. A /' a., l G 5 <br /> 3 s.,. . 7 I. 6 <br /> �• Ga 7SY?�X[ — S eS4 <br /> Jr d. -.�.;':t�• ''G"s" . 7 L 6 <br /> 'Effluent#1 =BOD >30<220 ri and TSS X30<150 mg/L 'ET ent#2=B00-s30mg/Land TSS<30mg/L <br /> CST Name (Please Print) Si nature CST Number <br /> .J4.... ,• s s Da., r� /, s ( d 7sv�a <br /> Address Date Evaluatlon Contlucted Telephone Number <br /> SBU83301Ro7/G) <br />