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Wisconsin Department of Safety and Professional Services _ n� Page of 3 <br /> Division of Industry Services CS( —cqD -v5" <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County <br /> Burnett <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, Parcel I.D. <br /> scale or dimensions, north arrow,and location and distance to nearest road. 024313601200 <br /> Please print all information. Reviewe by Date <br /> � <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s. 15.04(1)(m)). �`i3 1? <br /> Property Owner Property Location 0 El <br /> Mark Rosenow Govt.Lot NW '/4 NE '/4 S 36 T 39 N 4 E (or) W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 12330 W Hildreth Rd <br /> City State Zip Code Phone Number ❑City ['Village ®Town Nearest Road <br /> Hayward I WI 154843 I ( ) I I Rusk 11175 Popple Road <br /> ® New Construction Use:® Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD <br /> 0 Replacement 0 Public or commercial—Describe: <br /> Parent material Glacial Outwash Flood Plan elevation if applicable ft. <br /> General comments and recommendations: <br /> 0 Boring <br /> 1 Boring# <br /> ®Pit Ground surface elev.99 ft. Depth to limiting factor 100 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 0-6 10 YR 3/1 Is 2msbk mvfr cs 3f .7 1.6 <br /> 2 7-36 7.5YR 4/6 s Osg ml cw .7 1.6 <br /> 3 37-100 7.5 YR 4/4 s 0sg ml .7 1.6 <br /> 0 Boring <br /> 2 Boring# <br /> ® Pit Ground surface elev.99 ft. Depth to limiting factor 100 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 0-6 10 YR 3/1 Is 2msbk mvfr cs 3f .7 1.6 <br /> 2 7-40 7.5YR 4/6 s Osg ml cw .7 1.6 <br /> 3 41-100 7.5 YR 4/4 s Osg ml .7 1.6 <br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30 5 150 g/L *Effluent#2=BOD,>30 5 220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Please Print) Signature t CST Number <br /> Dan Burch 253808 <br /> Address Date Evaluation Conducted Telephone Number <br /> N5921 County Hwy K Spooner WI 54801 10-19-21 715.416.1642 <br /> SBD-8330(R04/15) <br />