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Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services C .-2.2- ! Page of <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, ��c r e <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel D. N 0,1_OOe'j-e s 'oe° <br /> scale or dimensions,north arrow,and location and distance to nearest road. 7-O �-;2 N! /b'3r�- <br /> Please print all information. evie ed by1// Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s,15.04(1 m)). < , GVaa <br /> Property Owner Property Location 0 El <br /> Nei/ 6 ct rd h f t- Govt.Lot '/< Y< S 3,1 T 41I N R /(: E (or) W <br /> Property Owner's Mailing Address Lot# III Block# Subd.Name or CSM# <br /> City State Zip Code Phone Number ❑City 0 Village ©Town Nearest Road 7746 <br /> (du e b)4 i/ tiffs I/"A✓ I35 ) / 1_1 ) 1 I .5wrSS' <br /> fiD New Construction Use:®Residential/Numberof bedrooms 3 Code derived design flow rate /.c'GPD <br /> 0 Replacement 0 Public or commercial-Describe: <br /> Parent material l I./ottr A./ r;{''t` Flood Plan elevation if applicable i�/.ft. <br /> General comments and recommendations: <br /> IBoring# 0 Boring <br /> Ell 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. <br /> *Eff#1 *Eff#2 <br /> / C_ aI 7 .5-11/7 4 / s `= 1.h 44 is . fro / G s 3 in .7 /. 6 • <br /> 4/ Li'-.. ),4 --7.5`Yf•Z``eAt /3 )M.5Ak ,„ / 65 'cp , 7 / 6 <br /> 3 A.. SN ,5ifR /G .— S D ! G- S <br /> Li `i- 79 7.S'1i737'Y s S <br /> 1M — -7 /.6 <br /> IBoring# 0 Boring C s--7 <br /> ®Pit Ground surface elev.5 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. <br /> I 6-473`7,?3�� -'--- *Eff#1 *Eff#2 <br /> js /w►jd/c ,.•, f S S .� <br /> ,7 "/ti / b <br /> ?-,tIf 75 <br /> )w►sb /C m ► '5 3 c .•7 f b <br /> 3 ti- 5 7,sy1?1"/4, — S o.s6- r-.. I a. 5 ) m . 7 /,6 <br /> q .So-- 5'( -Z31YI7 7,--/ — .5 C s 6- rn / — — <br /> *Effluent#1 =BOD,>30 s 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 /> ST Name(Please Print) Si natu CST Number <br /> jAis 5 04L1,-. If g 4414 <br /> 5leanre1f, <br /> �73v,� a <br /> Idress a!7 ' 9 fit-y 3S Date aluation Conducted Telephone Number <br /> VI,t,45frr LA1 .5-11 E(4 3 f-/e- 1)' 70-<9/6- 110'7 <br /> SBD-8330(R04/15) <br />