Laserfiche WebLink
Wisconsin Department of Safety and Professional Services Page 1 of -Z- <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, V r n eft <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. O1-07.4-2- •/ -12- -OZ-OY , OI 0 <br /> Please print all information. v'ewed y Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner 1_ Property Location ❑ igz <br /> L i n c o I 1 � 0C..+4-J r Govt.Lot 1% 1/4 S 1 2. Z N R Jy E (or) pU <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 2i5y9 Co Rd 4 <br /> City State Zip Code Phone Number ❑City 0 Village [K]Town Nearest Road <br /> 6poo✓(e r I wx I SLoso 1 I can- )405-sitv I 11ZuS k 11J. Up$t+E (-R RA <br /> x New Construction Use:❑Residential/Numberof bedrooms 2. Code derived design flow rate 300 GPD <br /> ❑ Replacement 0 Public or commercial-Describe: <br /> Parent material 00+ uia5In Flood Plan elevation if applicable ft. <br /> General comments and recommendations: <br /> 0 Boring <br /> Boring# <br /> Ra Pit Ground surface elev.931 ft. Depth to limiting factor 9.2. in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> I O-(o syg y-r-I N 14. 52-L 2N58K Mc2 R 2r •(o • c <br /> 2 Lc,-t. S`LR`-1-3 ni A 5.tL 2 IN 5b>L M F R A Z F •(Q • IS <br /> 3 13-`41 5YR5--4- ► I A L5 2.9u58k M%)rg. GO t J$ .1 I. b <br /> 1-1 '11-92. SY R S- (o W A L-5 ( M58K ',Ay FR C 5 , •-1 ►•to <br /> Boring# ❑ Boring <br /> 2. ®,Pit Ground surface elev.9y9ft. Depth to limiting factor$Z 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 /> 1 I O-L, 510R q-`{ PA 5LL 2M5131L N F1z R Z-F .(o . 15 <br /> 2 (,-15 SYR y-3 IQ A. Su- Zµ SB I&. M F TL Pt 2 F . Co - 56 <br /> 3 t5-`iCo SYR-51p N t4 L5 -23-‘58K My ii2- CS I F. .1 1 .(0 <br /> f-1 y(o 1Z 5Y2 S-(o $J A L S I MSS IL M V $12- CS iv F •1 1.b <br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30<_150 mg/L *Effluent#2=BOD, >30 5 220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Please Print) Signature CST Number <br /> �i C1tio lo,5 Prin. <br /> �i i5 O5S 7Z <br /> Address Date Evaluation Conducted Telephone Number <br /> 2-174O fw? 35 Li- iq - 2Z 1!5-LiI(f- `fpl I <br /> webs4t+' Lox 51-iicri SBD-8330(R04/15) <br />