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Wisconsin Department of Safety and Professional Services Page of
<br /> Division of Industry Services �' -2l a 3g g
<br /> SOIL EVALUATION REPORT
<br /> In accordance with SPS 385,Wis. Adm. Code County
<br /> L3uNnC14'
<br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,
<br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, PA...cel I. ,..rC../6=3 S, e.�5 ..G U3- CJ..GCCG
<br /> scale or dimensions,north arrow,and location and distance to nearest road. C���'�-
<br /> Please print all information. --V- e by / . 41 Daatte/[�/
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1Z K/l
<br /> (m)). V• , I -7!)./
<br /> Property Owner Property Location OP 0
<br /> Ott".F l C 1)7 C i rt i-jr r e Govt.Lot 3 % Y S T yG N R /,S- E (or) W
<br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM#
<br /> ly3s 96t�1 Si.- y U, r l /? i 5-
<br /> City State Zip Code Phone Number 0 City
<br /> rove �5i►r5 ] /i/4' 15 5 0/7 I ( ) I ❑Village I El Town I Nearest Road
<br /> Z„we,' C d � -1,
<br /> vt.cICS�L1 G.�c. G
<br /> (3 New Construction Use:0 Residential/Numberof bedrooms y Code derived design flow rate (C1 GPD
<br /> ❑ Replacement 0 Public or commercial-Describe:
<br /> Parent material /Ct,c( D, {fi Flood Plan elevation if applicable�'��ft.
<br /> General comments and recommendations:
<br /> sVJ of t.. i 3. o� `�d r - c'a4 ,
<br /> Boring# ❑Boring 93�7 70C
<br /> Eg Pit Ground surface elev. ft. Depth to limiting factor in.
<br /> • Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> / G-I/ 7.61R~?/ — /5 , j,n l IS lC /Y, l s 3.e-i ,-7 /,,(y
<br /> 4 W` ,AN 7,c 111 LIAI /S _,I 1.56 lc . t"-, I _ a=j 3 C c% 6
<br /> -? ,Ay- cp, -7 7/Z `r4. /S ,li,.1 S is rv) l d' S J m :7 /, 6
<br /> 4i- ."70 75 ylz-?, — s el 6 ► 1, ,77 1, G
<br /> Boring# ®Boring Gift.
<br /> 7Y
<br /> 0 Pit Ground surface elev. 9's ft. Depth to limiting factor? in.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> 0-LI 1.54r7 V). /.5 .7 /, 6
<br /> J if ,2 y 7,s y/?`e9 /s , 7 A 6
<br /> 61 '/s-7le 75 //?'9"7 ✓' I -7 /,4;
<br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30 s 150 mg/L *Effluent#2=BOD,>30 s 220 mg/L and TSS>30 5 150 mg/L
<br /> CST Name(Please Print?? Signe' re ,l CST Number
<br /> Jaw,.e s S��tt (-c/s .S LJ/ )731-fotO
<br /> Address 7760 �4-r .7- Daf¢Evaluation Conducted
<br /> .1Telephone Number
<br /> )-vn-e-hs,L y j - st, 51 ,- d 3-.) / 7!3--- ' "6- 2//57
<br /> SBD-8330(R04/15)
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