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Wisconsin Department of Safety and Professional Services Page 1 of Or' <br /> A <br /> Division of Industry Services (.—S T . — 1 44 <br /> a 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, Burnett <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. 01422 502900 <br /> Please print all information. view d by �D,atte <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S. 15.04(1)(m)). 10l/Qt?1,2 <br /> Property Owner Property Location ❑ ❑ <br /> Michael Anderson Govt.Lot NW Y< NW ,A S T 41 N R 12 E(or) W <br /> Property Owner's Mailing Address Site Address or CSM and Lot#: <br /> 19099 Fenway Ave N 24760 Anchor Inn Ln <br /> City State Zip Code Phone Number ❑ City ❑Village El Town Nearest Road <br /> Forest Lake MN 55025 ( ) Lafollette Anchor Inn Ln <br /> ElNew Construction Use: Residential/Number of bedrooms 3 Code derived designflow rate450 GPD <br /> 0 Replacement ❑Public or commercial—Describe: Flood Plan elevation if applicable ft. <br /> Parent material Glacial Outwash <br /> General comments and recommendations: <br /> 1 Boring# ❑Boring <br /> ❑■ Pit Ground surface elev.93 ft. Depth to limiting factor48 in./elev.89 ft. <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 10YR 3/1 Is 2msbk mvfr cs 3f .7 1.6 <br /> 2 7-24 7.5 YR 4/6 Is Osg ml cw .7 1.6 <br /> 3 25-48 7.5 YR 4/6 s Osg ml .7 1.6 <br /> 2 Boring# Boring 89.5 <br /> :Pit Ground surface elev. ft. Depth to limiting factor42 in./elev.86 ft. <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 0-7 10YR 3/1 Is 2msbk mvfr cs 3f .7 1.6 <br /> 2 8-24 7.5 YR 4/6 Is Osg ml cw .7 1.6 <br /> 3 25-42 7.5 YR 4/6 s Osg ml .7 1.6 <br /> CST Name(Please Print) Signature CST Number <br /> Dan Burch 253808 <br /> Address Date Evaluation Conducted Telephone Number <br /> N5921 County Hwy K Spooner WI 54801 June 13 2022 715.416.1642 <br /> *Effluent#1 =BOO>30 s 220 mg/L and TSS>30 5150 mg/L *Effluent#2=BOD,s 30 mg/L and TSS 5 30 mg/L <br /> SBD-8330(R04/21) <br />