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Ws.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page of
<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. e9 7 "«' 3 9/b ";7
<br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. . ,j t,j ,/5'0oc
<br /> Please print all information. Reviewed by Date
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)).
<br /> Property Owner Property Location
<br /> ,67A-p�6 r—j r el Govt.Lot 1/4 1/4 S, 7T3`7 N R/li E(or)
<br /> Property Owner's Mailing Address �� Lot Block# Subd.Name or SM##
<br /> a'/�s H L "lice- I,/i�.� — .v ss(dirk, /°;,,J e.S
<br /> I City State Zip Code Phone Number Erity f Village Blown Nearest Road ‘6.
<br /> l 5ai^N,t) {i✓r!s s'.9-7>1 (�/.z 1,Z6-/`a.,zz /7)ee_..,v�,,-J 1/71,',J/ '—J
<br /> 0 New Construction Use Residential/Number of bedrooms _5" Code derived design flow rate 75'2'2 GPD
<br /> Replacement Public or cprnmercial-Describe:
<br /> Parent material Gi/4 C-, A-/ c r-, f 7 Flood Plain elevation if applicable `v At' ft.
<br /> General comments
<br /> and recommendations:
<br /> Boring# 0 Boring
<br /> / u pit Ground surface elev.77, .5_ ft. Depth to limiting factor 7 in. 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 /> I v 6 7, 6YR5, — I-, — -- , 7 44
<br /> i' y 7--'W%te' —
<br /> i i s , 7 /, 6
<br /> ...7 Sys 775,f y G- 0/5- e si.6- - s _.�- , /7
<br /> { •
<br /> 7 Bor ing# 0 Boring
<br /> LS Pit Ground surface elev. 9 7, ft. Depth to limiting factor .13 in.
<br /> 1 Soil Application Rate
<br /> 1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2
<br /> I in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> / ©--3 7,5y/16 z /.5 77A.fik /9/i1;" C5 J , 7 f, 4
<br /> S 7,5y)Py/� /S /,.7-)A- r174' _13 >f , , 7 /,E
<br /> 3 ,?3 ys-3,e/, c- d57A'-57. 16_5- //77 i Zit rnd��- A= t'— , s— , 7
<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 RUFSHOLM C-Clae41— i "--- 227691
<br /> Address Date Evaluation Conducted Telephone Number
<br /> PO BOX 514,SIREN,WI 54872 ..-/-_,,2.2 (715)349-7286
<br /> 1
<br /> SBD-8330(RI1/I1)
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