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Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REP A Page_of_ <br /> in aroordance with SPS 383,Wis. Adm. Code r F <br /> County —7,b / <br /> Attach complete site plan vertical <br /> paper not less than 8 reference <br /> x 11 inches in size.Plan must <br /> pence,slope,but dlimitedlto:dimensions, <br /> s,port acro al andlocation nt(distadirection toand Parcel LD.o�olbd- `!O-/S-,}6-S vS <br /> percentslope,scale ordlmensions,north arrow,and location and distance to nearest road. _ oaY - 0/7000 <br /> Please print'all'information. Reviewedby Date <br /> Personol information you Prwlde may be used for seconder,prase s(Privacy Law,s.15.04(1) m)1. <br /> Property Owner property Location <br /> /0Ar, l< • / ev. man GOO.Lot fla SEtla Ga6 'T'yoN ft /S �r© <br /> Property Owner's MailingAd ss ,Lot# Black1 Subd.Name or CSMA <br /> o . 0-13 14, l vit3S <br /> City Slate Zip Code Phone Number aity ❑Village WTeon Nearest Roads 7616 . <br /> YNrrnefor Ka MN Sri ii ) �4/21en of L<e F jzd. <br /> EINew Construction Useo Residential/Number of bedrooms_ / Code caused design Flow rate /x00 GPD <br /> ©Replacement ❑ Public orecomercial-Describe'. <br /> Parent material G/i4.izl Or,i t,y Flood Plain elevation ifapplioeble N/f/ R <br /> General comments Y Wr r SAR o}a 0.7 <br /> and recommendations: .5 S. C 'E <br /> Boring <br /> 17 Binding# 9c.d <br /> © pit Ground surface elev. ft. Depth to limiting factor > 87 in. <br /> Sail Application Rale <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Radio GPD/1f <br /> in. Munsell Ou.So. Cont.Color G,So.Sh. 'ER#1 I 'Eff#2 <br /> 0- ,4 7.S1'rZ J'1X — / S //„ai/< r,., l <S 3,1 -7 1.6 <br /> 1- 4–)a 7.r•/i7 ` g, — / Sblue s 6 7 /. 6 <br /> 3 ,L6_r/97J Y/�v/6 S O Sb {rS rp(r� . 7 /. 6 <br /> 7 /. 6 <br /> P Boring# ❑ Boring <br /> © Pit Goandsurfaceelev. 96.X it Depthtolimitin,blediir > YO In. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Retlox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Ga.So. Cont.Color Gr.Sz.Sh. 'Eff#1 'ERRS <br /> 7.XYR 3/A — /S /—, A/< ... 1 c s 7, . 7 /. 6 <br /> sb/< /.-, / I 4 S Jia .7 /, 6 <br /> 3 v- S,L 7.S-7/i!"/ — s - 0 5 a-' ,:r f G s ;l n . 7 1, 6 <br /> 'Effluent#1 =BOD >30<220 moll antl TSS>30<"a mg/L 'Fall...ol"I=loo, <30 mg/L and TSS<30 moll <br /> CST Name(Please Printf Signature CST Number <br /> sJ <br /> 7-?el <br /> Address Date Evaluation Conducted Telephone Number <br /> x7760 f�,. 3rWti.6�{<� w� Sr-I�S3 <br /> war <br /> SB0.3330(R07/13) <br />