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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <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 Parcel I. . <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. bjp 29 j 9 a3 P&O <br /> Please print all information. Reviewed bDate <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ..JJf/rte /Q•a3 (f <br /> Property Owner Property Location <br /> /W�A Govt Lot 1/4 1/4 S 17 T N R 7 E(o W <br /> Property-Owner's MailinlA,ddress�s� Lot# Block# Subd. Name or M# 15 <br /> tl�• Imo[/ W <br /> Cj State Zip Code Phone Number ❑City ❑Village ; 'own Nearest Road <br /> 2 <br /> ❑ New Construction UseA:}Resldential/Number of bedrooms Code derived design flow rate GPD <br /> Replacement ❑ Public or commercial-Describe: _ <br /> Parent material aw-&F-A Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations: <br /> F-1 <br /> Boring# 0 Boring <br /> Pit Ground surface elev. /✓tb ft. Depth to limiting factor Zo- in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 <br /> 0- sle, S1 lmosbkv s 2✓ft .4 <br /> Z 4 s/ M�'' — . 3 <br /> � e2d S -- .o .o <br /> 2 Boring# 0Boring <br /> ❑ Pit Ground surface elev. r" ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> 2 a 2 �2d s G <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD 130 mg/L and TSS<30 mg/L <br /> CST NanA(Please Print) n lure f CST Number <br /> d 22.SSsl <br /> Addrest Date Evaluation Conducted Telephone Number / <br /> 27760 W �]�,2 Wl- S '9� - -p� 711866- "PS-7 <br />