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' Wisconsin Department of Srfety and Professional Services ORIGINAL <br /> of Industry Services <br /> SOIL EVALUATION REPORT Page_of_ <br /> is accond nce with SPS 383,Wis. Adm, Code <br /> County �wrn< jf' <br /> Attach complete site plan vertical <br /> paper not less than 81/2 x 11 inches Msize.Plan most <br /> percentclude,but slope. able ramenicalandhth acro al reference point(distance <br /> ediren and Parcel lD.OT O�a•d'Y.O-/ .4 ^r <br /> percent slop¢,scale ordimensions,north arrow,and location and tlistance m nearest read. O S-'005- O,(41 OD <br /> Please print all information. Reviewed by Date <br /> Porsonaline-mon yaupmvfde may versed for secondary powosos tPdvary raw,s_15o4(1)(ing. <br /> Property Owner Property Location ❑ <br /> ✓`ZA In Wa✓h Qr"t. Govt Lot 54 114 114 s A 37 1,101N R /bE(or)w <br /> Pra_pert Owner's Mailing Address Lot# Sides Sul Name or CSM r..,. <br /> N q.{I '1 ' /0/ace' s/ - /N 91/1 v.2t'. P.`9/ ; <br /> Clry Son, Zip Code Phone Number ' airy E]Ullage Town Nearest Readagp 4`f <br /> MA le +ova I/HN I.SS36'J I ( ) ' 'S'J�b , , <br /> ❑ New Construction I-cri Residential l Number of betlrooms 3 Cade derived design now rate -�%�0 r GPD <br /> ®Replacement � Publico ,,dna emild-Describe: <br /> Parent material G(�ar'i( �..Ifbe Flood Plain elevation ifapplierble /V/p K <br /> General comments <br /> and recommendations. SyJ. QIeV 9Y,� <br /> ❑ Borin9# Boring <br /> p <br /> ❑k pit Ground surfaceelev. 96, 8 ft. Depth to limiting factor 2/98 In Soil Aprillicamon Rate <br /> Hr ri a Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRf <br /> in. Munsell On.St. Cone Color Gr.Sz.Sh. 'Eft#1 'Effp2 <br /> / a-6 7..SY/7 /S /..,S6K <br /> ,( 6•YP 7.Syy? 6 /F..r ,I..,.rb /< r.+ l GS .( �, rS !.o <br /> �5 yr- co 7-1r-a v ( s J. sble Gs 7 /,6 <br /> Lill /0- 49 7SY.t Fy — -5, 6SG M 1 _ . 7 /. 6 <br /> Boring If <br /> F1Boring <br /> ® ® Pit Ground surface eay. 96. 0 ft. Depth to limiting factor 7 6-7 in. <br /> Soil April kation Rate <br /> Hot Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKIF <br /> in. Munsell Ore S. Cont Color Gr.St.Sh. 'Eff41 I 'Eff#2 <br /> / O- S' 7SYd 3� /J /^JS/f M/ CJ 3! n . 7 6 <br /> di. 8- YB 7.SY.? "/S' / S J—XS/< — / GS 34d <br /> 3 c/s� 68 7sYi1`A/6 /-S -) . S6 /< , I c s 7 /. G <br /> w/+5 11a 7.s`Y/TY — IVY$ ./ia-.e/ <br /> 'Effluent#1 =BOD,>30f 220 mgIL and TSS>30,150 mgIL 'Effluent#2=BOD <30 mg1-and TSS�30 mgIL <br /> CST Name(Please Print) Signal re CST Number <br /> Ja rr, '.-5 -d- vanr•t/t f �an l�/S } 7,3 C7 <br /> Address Date Evaluation Conducted Telephone Number <br /> d 77Lp ></ 3S. we6a ><,.,, Wys%89,� /a. /c!-/Y 71S-86G- v.3-7 <br /> SBD-3330(1109113) <br />