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Wisconsin Department of Safety and Professional Services O (� I A <br /> Division of Industry Services IVB H <br /> SOIL EVALUATION REPORT _ Page <br /> _ot_ <br /> in accordance with SPS 383,Wis, Adm. Code -� .' <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan most County J n^ Y4- <br /> include,but not <br /> 4-include,butnot limited to:vertical and horizontal reference point(2M),direction and Parcel LD.ee7.Od Sr-1.90-/z/-C6-S-[Tl7 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest lead. <br /> Please print all information. Reviewed by Date <br /> Porsonarinformation you deride may he used for seconezn Purposes(Privacy Sawa.15.04(1)(mll. <br /> Praperty0wner <br /> � Property Location 0i 1)pryne�� Gom.Lot . 1/4 1145 <br /> Lamborn,Owne_i T s Mailing Address L z/o N R/y ©r© <br /> Lot# Block# Subd.Name or CSMA - <br /> Ciy - State Zip Cotle Phone Number " ity ❑VJlage Town Nearest Road)Y.k7/ <br /> Lal/e..;rle mN Ss'o yy ( ) - S<,7/ <br /> ® New Construction UseEj Residential l Number of cast ems 3 Code derived design flow rate Z/" <br /> Replacement Public or commercial- GPD <br /> Describe: <br /> Parent material 4/¢ Ua / D.aY Flood Plain elevation ifapplicable N//'1 <br /> General comments � // <br /> ft <br /> and recommendations'. .SY•f' 'e'l�`7" y`1'6 'ist" (<a <br /> Boring 4 Baring <br /> Pit Ground surface elev. 94.8 it, Depth to limiting factor -71,1 in. <br /> Soil A fantion Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rome GPD/ff <br /> in. Munsell pu.Sl. Cont.Color Gr.Sp.Sh. <br /> 'EH#1 'Eff#2 <br /> s6/< ,..rl cs 3.+t 7 46 <br /> �M55/c .-•. r Gs 3co ,S— /. O <br /> ,(ms6/< an I G S Az++ <br /> S' S}- 747SyR <br /> Boring# ❑ Boring <br /> Pit Groundemnaceelev. ft. Depth to limiting factor > 6Q <br /> Soil A lication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF <br /> Munsell On,Sz. Coni.Color Ge Ss.Sh. 'ER#1 'Eff#2 <br /> l 0- -( 7S'tR -'/t 7s /- e,6 k- .n l <br /> CS 3^+ . � 1. 6 <br /> A S'- Hd 7.S //=s at—, c/C <br /> .i VJ- V7 -5""? </ sc, / all,,dle6- <br /> `r' 47- 68 7s'r.7°/6 Fs osc <br /> II I'Efluent#1 =BOD >30 220 mg/L and TSS>30<150 mgIL 'Effluent#2-BOO <30mgll and TSS<30 mgIL <br /> CST Name(Please Print) 1, - t Signature p CST Number <br /> �J i 's-1 zJa n„e./J f C�a.w�? 3 zr'� O <br /> Address a' rw Date Evaluation Conducted Telephone Number <br /> ,� 7ve o�:_N:,• . 3s .W abs/.� wrs-y�<,3 8-d x- /71 7/r-dos- v..r� <br /> SBD-8330(1307/1;) <br />