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Wisconsin Department of Safety and Professional Services Page of <br /> Division of Industry Services _ 45-- <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County <br /> ik <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include, ��~ <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. <br /> scale or dimensions,north arrow,and location and distance to nearest road. ' 07-0/2f <br /> /'5 t 5-035 c' <br /> t <br /> Please print all information. (,_ZeçedDate <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Is/J7/ <br /> Property Owner Property Location 0 Xi <br /> /0t y/c geirkul Govt.Lot '/ % S f R /5- E (or) W <br /> Property Owner's Mailing Address Lot#Z Block# Subd.Name or CSM# <br /> 21/y /26 inVC A✓ l <br /> City State Zip Code Phone Number 0 City 0 Village (Town Nearest Road <br /> Cam * o'!t/i ISSiiiig I ( ) I . I 7444,6014 I7c eRevaGt <br /> ($New Construction Use:Eif Residential/Numberof bedrooms L- Code derived design flow rate PO GPD <br /> ❑Replacement ❑Public or corarn erc l-Describe: <br /> Parent material �p 1tCi 4 I V l h1 Flood Plan elevation if applicable/v4'ft. <br /> General comments and recommendations: <br /> Boring# 0 Boring q� <br /> 2 Pit Ground surface elev. .10 R. Depth to limiting factor 2f in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. `Eff#1 'Efr#2 <br /> o-6 70lt'2 , — s itii kA ritl e 207 .7 b a <br /> Z. 6-57 76vies/y - _--- NA 65 if: . 7 /6 <br /> j 7-By 77ya y 5 be 1.1 - .7 !6 <br /> I I I$ I <br /> ,, <br /> f Boring# 'Boring <br /> I ❑Pit Ground surface elev. 944ft. Depth to limiting factor 7/ 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 /> 0-5 7• 5`tie3/z Gy .-7 /‘ <br /> z 5'-S•2 z Ygy/# �- f 1 ' ,7 I6 <br /> 3 61.- 7y 75YQ /4 . 7 16 <br /> • <br /> Effluent#1 =BOD,>30 5 220 mg/L and TSS>30 5 150 g/L s Effluent#2=BOD,>30 5 220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Pl.-se Pri / / Signature �^ CST Number 66.7%_y, <br /> Address Date Evaluation Conducted Telephone Number <br /> SBD-8330(R04/15) <br />