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<br /> Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page ou
<br /> Division of Safety and Buildings
<br /> in accordance with SPS 385,Wis. Adm. Code
<br /> County BURNETT
<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.D. A 7 c9'74" :2 V4' /6 �Za 6'
<br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. i-..- 9,31: 0/1. 030
<br /> Please print all information. eviewe by ///1 Date / /
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). /. I Id
<br /> Property Owner Property Location t
<br /> r� 0 ire,
<br /> r L.LC, Govt.Lot 1/4 1/4 S T /Q N R IC E(or)
<br /> Property� Owner's Mailing Address Lot# Block# Su Name or CSM#
<br /> /- a ,QC-... 67 3 — V `3 p 7,2
<br /> City State Zip Code Phone Number
<br /> City �Ilage EFown Nearest Road `7 7�9
<br /> ve9„..:_z i� !i �s I1 - 3 j (7�s')377 J3s`(� c2,4 i -NUJ I / i5: ,.ci-
<br /> 0 New Construction Use[] Residential/Number of bedrooms Code derived design flow rate 63 d GPD
<br /> Z. Replacement Public or covimercjal-Dpbe: /� / C---4-41,/1 Si/ e 1
<br /> i Parent material G �C-,A-, a"'/ r Flood Plain elevation if applicable N A ft.
<br /> General comments q
<br /> �. J
<br /> and recommendations: /1/�q,L, e.y.,-„_s i-;,,,,,, /.fc�f Y < ../...7.)„,,,k
<br /> /'
<br /> r-flBoring# El Boring
<br /> c� 7 pit Ground surface elev. /1, ? ft. Depth to limiting factor / ‘. in.
<br /> Soil Application Rate
<br /> Horizon I Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft 2
<br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> I / 6-c 7' Y, ,_ /_ •1
<br /> in3tk iiki -- .$ 3 c
<br /> i7 /,
<br /> a 5 013 7,53' Y/$1. –_-- /5 /r3/ 1,) � s (-w . 7 L-6
<br /> 3 , 3-It, 75Y �� Y'' 5 as 9i, / 9 514-co- , 7 /,‘
<br /> I
<br /> € Boring# 0 Boring t /
<br /> El Pit Ground surface elev. I b i ft. Depth to limiting factor -> 73 in.
<br /> I Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2
<br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> 1 / o -3 7 S7,F�2 /j //ns4 Ave, 5 3f-� 4-4
<br /> 2 5- , /� ,7
<br /> 3 7.3 7.5Y,% S v "n` ----- , 7 /-
<br /> I
<br /> I
<br /> *Effluent#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L
<br /> CST Name(Please Print) / . Signature CST Number
<br /> WADE RUFSHOL M GO;ter _ - / 227691
<br /> Address l ate Evaluation Conducted Telephone Number
<br /> PO BOX 514,SIREN,WI 54872 / —i471- 1,� (715)349-7286
<br /> SBD-8330(R11/11)
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