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Wsmrmin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT Page_of_ <br /> in accordance with SPS 383.Wis, Adm. Cape <br /> County U - e, <br /> Attach complete site plan ve paper not less than refer x 11 inches Msize.Plan must <br /> percent but not limited di venial and horizontal reference point(BMt,nce to n and pyce{ t p, p 7 O <br /> percent slope,scala or dimensions,north avow,and location and distance to nearest roatl. O / ono a/3oao <br /> Please Print all information. Date <br /> Reviewed! <br /> by ,r'/ <br /> Perapnal inlprtnatan you prpviGe may Da uaeE fpr aewnOerypurposes lPnvacy Lew,5.15.04f)lr)). &M 01 P1W701Ax I <br /> Properly Owner Property Lo.cra�tion G-/ nno�rr C/ ® <br /> '� /}/N� O G GON.L li 1/4/�(t/I/4 S,<Q T3 / N R If E❑(or)W <br /> Property Owners Mailing Address Lot# Black# SuW Name or CSM# <br /> 36 ii s n)C — I — I — <br /> City // State Zip Cao/de Phone Number L_pity - OVillage Town Nearest Road aS9�3 <br /> C DIN/n Lv9 <br /> New Construction UseC] Residential/Number of bedrooms IQ Code derived design flow rate 30.0 GPD <br /> Replacement Dee <br /> Parent material TPC / mNr/7C� '-- <br /> Flood Pitmolevationifappliczblo /'L--'14 ft. <br /> General comments <br /> and recommendations: <br /> Boring p <br /> Baring <br /> pit Ground surface elev. ///5' X. Depth to limiting!actor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Stmeture Consistence Boundary Recta GPD/H <br /> in. Munsell Do,Sz. Cont.Color Gr.Sz.Sh. 'EH41 <br /> ! <br /> 0-1617� .P�� /S rf1G ✓ cS 7 / 7 <br /> 6-3.2 7s7P% — /'Fs ' 6k ✓ s o --1-- 9 <br /> 3 3-z-Y/ 7,Sy.PYG Gaal /P F Fi 15" . 9 <br /> Boring# ❑ Boni /;7 q 4 <br /> ® pit Ground surface elev. -, H. Depth to limiting factor J 0 in. <br /> Solt Application Rate <br /> Horizon Depth Dominant Color Rode.Description Texture StrutConsistencelemmmaryl Roots GPD/ff <br /> in. Munsell Ou.Sz. Cont.Color Gr.S .'Efisl 'Eff#2 <br /> 0-7 , 5 ,Pj7,VWXe- <br /> EMuent#1 =BOD >30<220 mg/L and TS2>30<150 mgrt 'EBluem#2=BOD,<30 mryt and TSS 30 mgt <br /> CST Name(Please Pont) J Sign- e�e .� CST Number <br /> Wndc Rufsholm c[,<*a— 227691 <br /> Address - Data Evaluation Conducted Telephone Number <br /> PO dux 514,Siren, W 154872 'r--_3�_�ey (715)349-7286 <br /> . SUUWJU ptwIUJ <br />