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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page,of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County N1 _ <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must �V <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions, north avow,and]oration and distance to nearest road. 2-39-/ -6 <br /> Please print all lOtormatloll. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ,2'Q7—Q <br /> Property Owner Property Location <br /> Dck NckniGovt.Lot 1/4 1/4 S T N R E(or)W <br /> Property Owner's Mailing AddressLot'#,. Block# Subd.Name or SM# <br /> y op <br /> Cityi State Zip Code Phone Number El City E]Village Town Nearest Road <br /> k e// �ar e 7/si#W- ,O e -C Po Lo,ICe <br /> I] New Construction Use:14 Residential/Number of bedrooms 3 Code derived design flow rate 4 S n GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material �i) d rel Dr i T i Flood Plain elevation if applicable ft. <br /> General comments f (� <br /> and recommendations: SY SfB Yr{ g3• "r S �9 �� <br /> .7 So its <br /> Boring# Boring <br /> V) / <br /> pit Ground surface elev. q7.3 7 ft. Depth to limiting factor > in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl' <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> 0. 5 3 S L ZMS N1 Pe GS 2 F <br /> z q N Gr LS I Afi;A K AvF cS ins-2r- I <br /> 3 -122 >,s � 4 5 Os ML - - <br /> rl Boring <br /> Boring# n qq to /� <br /> 0 pit Ground surface elev. 95•V U ft. Depth to limiting factor�ll V in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> 0-5 S 3 1 S L ZM58 <br /> 2 5-3 7.5�( `' L 1M58 MV'F c )M-)F 7 ), <br /> 3 -IOg 75 Yk Ilk 5 <br /> .7 1<69 Al — - . 7 1. <br /> Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD,<30 mg/L and TSS<30 mg/L <br /> OST Nam (Please Pri t) Si ture CST Number <br /> 155 thG 88 f0 7a <br /> Address Date Evaluation Conducted Telephone Number <br /> 21$ G( ar5 • o WI59 O 7 - (�- (7f5) G3�- %538 <br /> SBD-8330(1107/00) <br />