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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County Qu,,n e Y-Y- <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. cL �� <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. O�C7 y IBq_ <br /> lJ tO103 <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). S/ <br /> Property Owner Property Location <br /> Gam.'eo l Olson Govt.Lot SE 1/4 NW1/4 S 34 T ci/o N R l y E(or GV <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> S-d.09 O Conne( Or-. 3 <br /> City State Zip Code Phone Number ❑City ❑Village B Town Nearest Road <br /> Not.✓41111./ M/✓ 1 1 (763 ) 7014— 47..F _547& sr f e /•v! /�c� <br /> R New Construction Use:© Residential/Number of bedrooms�_ Code derived design flow rate 0100 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material etAzy .l pet-FA- Flood Plain elevation if applicable <br /> General comments SJ,s , 17 7 6� <br /> and recommendations: <br /> Boring# E] Boring q�.0 <br /> Pit Ground surface elev. ft. Depth to limiting factor 6 Z in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> 6-3 7.SYR-'Ik --0-- /S 053 'W / Cs 3w1 . 7 /, .6 <br /> s-y 7.sY�'7�1 -o— /S oss ^I l as 0� <br /> 3 -G� SYR ti� ro— scL �wVk vnvfr C-Z - 4 6 <br /> � 6a-68 7.�'7R y�3 F��`SyQr/� G miV3/c mFr s — •� aP3 <br /> Boring# <br /> Boring <br /> M E] Pit Ground surface elev. gir• 0 ft. Depth to limiting factor >l08 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> 0 -3 7.srrR 3/ -tom /S 'S.04 M / f 3 J rn . 7 1- 6 <br /> d 3 -d1 7..YYR `v/y —0 — /S 0 rr, f Gs J »1 . 7 /. 6 <br /> 3 <br /> .�7I-47.s- Rtk I <br /> Syk ySc G r - <br /> o- <br /> til-4;F 75 m -0- l <br /> / 6 <br /> 7 �. <br /> Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD5<30 mg/L and TSS<30 mg/L <br /> CST Name(Please Print) Signature CST Number <br /> JOL M es S• D .rv/F/ S 7 3 4 0 <br /> Address Date Evaluation Conducted Telephone Number <br /> x- 7 760 #N,y S We bs'`e� U/-r- -574, 51 7iS=8GG- S ,;' <br /> SBD-8330(R07/00) <br />