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Wisconsin Department of Safety and Professional Services � Page of <br /> Division of Industry Services L1 U I ,2 1"?g <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, eff <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. oC'O-Ol,3©C>0 <br /> scale or dimensions,north arrow,and location and distance to nearest road. 07-c3.t-,1`!i-/4e 35"3 3 3>S38 <br /> Please print all information. Reviewed by Date <br /> Personal information you provide maybe used for seconds purposes Privac Law,s.15.04 1 m •`�. •✓ Zl1 <br /> Property Owner Property Location <br /> B of Ci It"f-0 k Govt.Lot '/. Y< S 3.T 'Y/ N R It. E (or) W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> v,ati pdy3 <br /> City State Zip Code Phone Number <br /> El city ❑Village ®Town Nearest Road (o&990 <br /> /ZO b bindo-le m Al j5g4 dd S a:d Ss Nw of Y.� G<< gof <br /> © New Construction Use:®Residential/Numberof bedrooms Code derived design flow rate 700 GPD <br /> ❑ Replacement ❑Publ'c or commercial-Describe: <br /> Parent material eQr'C i fh 1 1) 1<" Flood Plan elevation if applicable Nm ft. <br /> General comments and recommendations: V. -1 G <br /> 3• 0 <br /> �i IBoring# ❑Boring ,C <br /> ®Pit Ground surface elev, qy eft. Depth to limiting factor �7 in. <br /> Soil A lication 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. <br /> -7 s'If'I/ *Eff#1 *Eff#2 <br /> y- /0 7s�li?`�/H — I S ,�nsb /c I GS 3�0 �7 /, 6 <br /> 10- SS 7�S �r12 `�/mil 6 S G in <br /> y s.- ,s oli? 5 . �,6 <br /> f a s� ,M 1 -- v7 /. 6 <br /> rl� I Boring# ❑Boring _�} <br /> =J ®Pit Ground surface elev. �s' fit. Depth to limiting facto, > � in. <br /> Soil A lication 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. <br /> *Eff#1 *Eff#2 <br /> G-H ti,syR 3/ �- / 1�r, sbl� c S 3w� /, 6 <br /> 3 c0 -7 16 <br /> )1 zl f1 7,s-'E7/7`//c S a S Ci 1 C I rn , 7 / <a <br /> Y-' 70 7,S- Yr ` y f' 6s 6 ,,, _ <br /> • 7 I. 6 <br /> *Effluent#1 =BOD,>30 5 220 m /L and TSS>30 5 150 m /L *Effluent#2=BOD,>30 s 220 m /L and TSS>30 s 150 m /L <br /> :ST Name(Please Print Signa re CST Number <br /> AV, <br /> ddress 60 "'Y Telephone Number <br /> at 77 7� Dat valuation Conducted <br /> w-C 6 s Arm G ��i� '3 �'-',� o^�� 6-- 574' - Z//S"7 <br /> SBD-8330(1104/15) <br />