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Wisconsin Department of Safety and Professional Services Page of <br /> • <br /> Division of Industry Services C -*2-1) -13-7 <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, /�� v.' <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D._�-4/-LS-•16-S"OS-oo5- <br /> scale or dimensions,north arrow,and location and distance to nearest road. V'v O ff - 0)S-Coo <br /> Please print all information. R iew d by- yat <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). i/2x20 <br /> Property Owner Property Location <br /> Mc Gk ire ram i I'y AG L^lr . L.L,L Govt.Lot S % '/ S ,t(. T y/ N R /4"" E (or) W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> / 441 As-4) , J 0,47'rJ <br /> City State Zip Code Phone Number 0 City 0 Village 0 Town Nearest Road d/647,1 9 <br /> 13kGy,Avt,...., ims 'j 7 I ( ) I I ,Su•rs,s I Gskcs Dr;t : <br /> ® New Construction Use:E Residential/Numberof bedrooms 3 Code derived design flow rate 41S"o GPD <br /> 0 Replacement 0 Public or commercial-Describe: <br /> Parent material 6./Le [w/ 0c?- Flood Plan elevation if applicable iv/Aft. <br /> General comments and recommendations: Sys e i es' 92. 9 9A•t <br /> I <br /> Boring# 0 Boring c1 y,y N. -7O <br /> ©Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> / 0- 6 7.s-`YR 3//, — /5 /?y,sWc- s., i C s 3i" . / / 6 <br /> a G-ati 7,s'YR �9 /5 )ms.6/ ..-- 1 £5 leo •7 / G <br /> 3 .,1q—70 7. 5"1rneczy t b.S ,n ► — a m . 7 <br /> 1 Boring# <br /> 0 Boring 44 <br /> 2 Pit Ground surface elev. ��1, ft. Depth to limiting factor 1 � in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> / O-- 6 7 SYR 2 — /5 I'm _chic N, ) G S 3 A, • 7 /. di, <br /> ..Z 6- , 0 7•3-'1/7y ...— J$ 4/1 sb," r, ) G- s 7CO . 7 / G <br /> 3 ) f7%y s Ofd r.- / • — . 7 i 6 <br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD,>30<_220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Please Print) Signat re CST Number <br /> J 6 'es s JA (t __�. 5 �� .-� 771-MLJ <br /> Address as D /7 -v 7 0 i n E <br /> ti, 77 D Evaluation Conducted Telephone Numb ' v <br /> SBD-8330(R04/15)I <br /> (e3 J 2 3 2020 t <br /> >�ay <br /> -- lUll <br /> pii-.- o 1 Burnett County <br /> I --Land Services Department <br />