Laserfiche WebLink
Wisconsin 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. Code <br /> r n <br /> Attach complete site plan on paper not less than 8 1!2 x 11 inches in size.Plan must County /3w <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 07- O D-�(. </0 /b- -3 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o T-oco-0/H 000 <br /> Please print all information. R i wed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 2-a t-1- /,f <br /> Property Owner Property Location <br /> A, !C e NN i®e &s Govt.Lot 1/4 1/4 S 41 T 4/0 N R 1 , E(r® <br /> Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# <br /> 1604s- N• F,.-st 3 1 V. /-7 /'70 <br /> city State Zip Code Phone Number LjCity FlVillage VjTown Nearest Road 7356 <br /> L6,kf e li. I m AJ SSo113 1 (645-1 ) -1 /O - 0H77 Dak/A A or I Ad1- [1,c 1?oe <br /> New Construction Use J3 Residential/Number of bedrooms R Code derived design flow rate 700 GPD <br /> Replacement / ❑ Public or commercial-Describe: <br /> Parent material (rl'l.1c/a Flood Plain elevation if applicable /V/f/ ft. <br /> General comments Q <br /> and recommendations: e SyS. e � ✓. 7.3. L <br /> 17 1Boring# Boring <br /> pit Ground surface elev. 94;- y ft. Depth to limiting factor > 7,:V in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture StructureConsistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. I *Eff#1 I *Eff#2 <br /> 0- LY -7.5-`7/Z J�� /S /.-.,3 61e s,., / C 3 3 M -7 I <br /> 41- 36 7.s- /S a/-nsr6/0 / G S 3c0 - 7 1, 6 <br /> 3 <br /> Boring# n Boring <br /> 0 Pit Ground surface elev. 9G' y ft. Depth to limiting factor > 80 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> 4 7,s yR 31A — /-S M S b/< w1 / C 1 sm . -7 /. 6 <br /> 3 ela-80 1-7-5 5'iZ r/ — S o s G wr I — k m -7 <br /> *Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD,:E 30 mg/L and TSS<30 mg/L <br /> CST Name(Please Print)vSi ature CST Number <br /> h e-s � J�.ni2/S S v oL7'?elAv <br /> Address Jr Date Evaluation Conducted Telephone Number <br /> 7760 �lw. 3� /it/ebs7ys ws SS��i� - d1- 1� -25'- 86 /, < y/S7 <br /> SBD-8330(207/13) <br />