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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 /> Attach complete site plan on paper not less than 8 1/2 x i 1 inches County �v-u l size.Plan must <br /> Inude,but not limited to:vertical and horizontal reference point(BM),direction and Pyres I.D. <br /> include.percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 07-4 3115 63 WD <br /> Please print all information. Reviewed byDate <br /> Personal information you provide may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). 5i 9'O <br /> Properly Owner Property Location <br /> Govt.Lot�p 1/4 1/4 S'S T N R 14 E(or W <br /> Property, is i Address Lot# Block# Subd.Name a CSM# <br /> 5S1 SAnrr' S- <br /> uly State Zip Code Phone Number ❑City ❑Village own Nearest Road <br /> ( ) task t} <br /> New Construction Use Residential!Number of bedrooms _ Code derived design flow rate _GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material_A L& a l Flood Plain elevation if applicable <br /> General conerlerft <br /> and recommendations: <br /> Bori <br /> n <br /> g# Z Boring 11 <br /> ❑ Pit Ground surface elev. _ft. Depth to limiting factor 7 2 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 'Eff#2 <br /> 07flyw 3h /s <br /> Z Z /lit <br /> /J—�� Boring# ❑ Boring <br /> �(' <br /> l 'J � Pit Ground surface slev.L7S ft. Depth to limiting factor (f in. <br /> Soil ftiblication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R <br /> In. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. •Eff#1 I 'Eff#2 <br /> I D-4 • /S /W1 s2A, • 74- 4 7svir 471. /,2 <br /> .7 / Z <br /> L A41 . 7 <br /> 7 /.Z <br /> Effluent#1 -800 >30<220 mglL and TSS>30:E 150 mglL 'Effluent#2•BOD 130 mg&and TSS<30 mg/L <br /> CST WM(Plem PnM Slim .�.7 CST Number <br /> S <br /> Date Evaluation Conducted Telephone Number <br /> 2-2,760 WL 5fV3 -5-4a-0/ S- - 4157 <br />