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Wisconsin Depadmertt of Commerce SOIL EVALUATION REPORT Page of� <br /> Division of Safely and Bulbtngs <br /> in accordance with Comm 85,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 812 x 11 inches in size.Plan must '" <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Pal LD;310y^O..- f)6 00 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 02 - .210 <br /> Please print all information. Reviews Data <br /> Personal information you provide may be used for secondary purposes(Privacy LOW.s.15.04(1)(m)). / d/ <br /> Properly Owner Property Location <br /> C)c,` S)Cq c A 0.r`F(,J GovL Lot -SE 1/4,4jp/4 S T3 R V E(or)W <br /> Property owner's Mailing Lot# Block# I Subd.Name or CSMN <br /> \3o ) 96 <br /> City State Zip Code Phone Number OCAY ❑YUage Plown Nearest Road <br /> SQLOnec 1"Ne I 6Lr6c)i 1016 )(935' D (P %) civ �d <br /> New Construction UUsseE] Residential/Numbery�ae <br /> lof bedrooms�_ Code derived design flow rate �r��� GPD <br /> Replacement <br /> rental ( �(�Pubic <br /> Im)r)�'��`(r Plain Ptaelevation if applicable ft. <br /> General comments <br /> and recommendations: <br /> ❑ Boring <br /> Boring# <br /> Pit Ground surface elev. 97. � ft. Depth to limiting factor in. Soil licatlon Rate <br /> Horizon Depth Dominant color Redox Description Texture Stricture Consistence Boundary Roots GPDlfF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I -Efl#2 <br /> Q .,t <br /> 2 7S Y — S p. CLL � <br /> 3�- 7 <br /> Boring# Boring o (, l/�� �y <br /> Pit Ground surface elev. 7 r • eft . Depth to limiting factor_S�in. Sod Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cott.Color Gr.Sz.Sh. 'Eff#1 I 'Etf#2 <br /> 0 , 7. , 3 , S bI v ct / <br /> J 7- <br /> 7.J^ r <br /> 'Effluent#1 =BOD >30:5 220 mglL and TSS>30:<1 efZZZIfffluent#2=BOD,:5 30 mg/L and TSS_<30 mg1L <br /> CST Name(Please Print) S' re CST Number <br /> Address Date Evaluation Conducted Telephone Number <br /> PO Box 161; Gordons WI 54838 (�_ _ 715-376-2278 <br />