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Wisconsin Department of Safety and Professional Services 1p" <br /> Division of industry Services <br /> SOIL EVALUATION REPORT Pa. 0 <br /> in accordance with SPS 383,Wis. Adm. Code <br /> County Pti i <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches In size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and ParcelLD.-7- CIA 0 'HO-/b-J,9-Sas <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road, nod -O/See6 <br /> Please print all information. Reviewed by Date <br /> Personal information Wv Provide may beuse,for Eecomm,purposes(Pnvocv Lew,s_15 er(1)fml). <br /> Property Owner ProPerlY Location El ElT Govt.Lot ') ew 1/4 Nr 1/4 S )17T 40 N R /c E(or)W <br /> Property Owner's Mailing Address Lot# Blot Subd.Name or CSM# <br /> .g9/$_ S . weed Vr . J U./5 P/79 <br /> Oily Stale Zip Code Phone Number ry OVIlage xTown Nearest Road d7 yg9 <br /> lov" 6.-Y I W--r ISS/JS I (6S/)J - Lt J— OA&/., ;f I tJa�,. 1 /a.. Or <br /> ONew Construction Usefo Residential/Number of bedrooms d Code derived design Flow,rate -7 GPD <br /> F1 Replacement O Public or commercial Describe: <br /> Parent matedal G/e<ia Flood Plain elevation it applicable <br /> General comments <br /> and recommendations: 'r y J, e/e <br /> /✓eft 17lop ,,r b Ae•%Can Ana 6vv ^ r•>ser i ✓+Q rar Ps/e iia.r-r Ce in Y, <br /> .vn me//Irf a,5j re0 -izFTJ <br /> rN ! <br /> Boring# n Boring , <br /> © Pit Ground surface elev. 9L. 7 it Depth to limiting factor > 5e in. <br /> Soil IicaOon Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD& <br /> in. Munsell pu.Sz. Cont.Color G,Sz.Sm 'Eff#1 'E11#2 <br /> 59,7 `//3 - G jv. -6 /< ,.r l; « 1r^ .d 13 <br /> J 1- 36 <br /> -ft-7e %b /Fe J.n s6/. .-r I G J J/or <br /> 76Y.2 or G r-o l 6 <br /> E Boring# P Boring <br /> Q Pit Ground surface elev. 56. 3 it Depth to limiting factor s' b9 in <br /> Soil A PDxfF n Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDI(P <br /> in. Munsell pu.Sz. Cont Calor Gr.Sz.Sh. 'EHg1 ,'Eff#2 <br /> ^-A3 S`7R R/J C d... rbJ< Ma</ <br /> 013.3 : -r7n' '`/�b. iFS o'.nJ6k r• I (i5 / F S- /•O <br /> -7 3F P9 7-SH/Z' �y _ S - 0SG /...r 1 G S -7 4 6 <br /> 'Effluent#1 =BOD,>30<220 dri and TSS>301150 rdi Effluent#2 BOD,<30 uni and TSS<30 mg/L <br /> CST Name (Please Print) Signature CST Number <br /> -r J .S . -) z a/1 .S✓)A---� of 7,j d O <br /> Address 67 Date Evaluation Conducted Telephone Number <br /> 47766 .! 3.5 6Ve5.t/-.., w,t .ry"Y9 //- //—iY v/s='566-4/,3- 7 <br /> SBD8330(R09/13) <br />