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Wisconsin Department of Commerce SOIL EVALUATION REPORT page ) of -3 <br /> Division of Safety and Buildings <br /> in accordance with,Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must <br /> include,but not limfted to:vertical and horizontal reference point(BM),direction and parcel I D <br /> percent slope,scale or dimensions,north arrow,and location arta distance to nearest road. OI a - �, ` () OC <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.06(1)(m)). /V <br /> Properly/OOwner Property Location V <br /> (, 0 r Y /46 n i" GovL Lots 1/4 114 S d to T 40 N R /S E(or)(9 <br /> Property Owner's Mailing AddressLot# Block# Subd.Name or CSM# <br /> I 9 8/ /htti 5 7 <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road 4/8t <br /> le wood /Y/d) SS-iB9 ( bsr ) ysy - ` ,V79 jAar<4on Green rrntl <br /> ❑ New Construction Use:® Residential/Number of bedrooms Code derived design flow rate e1.f-zo GPD <br /> ®Replacement ❑ Pudic or commercial-Describe: <br /> Parent material e'-/ac is/ r J F'Y-- Flood Plain elevation if applicable <br /> General comments <br /> and recommendations:- Sy.S• ,°l<✓• t-p p•c~ 9.SS 30 (9514* '?7,V) <br /> rower 93. 00 ( 6e gg•00) <br /> A80Q aS �&h&Atj i L01114Y 5&tt -363G <br /> FBoring# Boring <br /> Q pit Ground surface elev. ft. Depth to limiting factor 7 7A in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz Sh. •Eif#1 •Eff#2 <br /> '.s-vR '/A — r 5 /»,sbk .=r l c s �.•-, 7 t. 6 <br /> J y-3o <br /> -7..'S-y,1? 40 — /�s e2w1s6k l S 3co s- r. o <br /> 3e-GD 7.Sy/?'Y� — (FS .(.«sb/� 'f.•• ( G•5 M . S'- /, D <br /> go <br /> w 7,5-4/7'14 — r rf.nS6k l — S' A &7 <br /> w.7r5 i" S'JiTrr/3 — /F,Sb .r.P: mufy - • 5 '/.Q <br /> Boring# ❑ Bones <br /> © Pit Ground surface elev. 8 ft. Depth to limiting factor > 90 in. Soil ADDGtion Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> In. Munsell Qu.Sz Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 <br /> / e-N 7$'$,R r/.• — /s /n /e / c s 3 0" . 7 / 4--- <br /> 'f- <br /> 4'f- 3(' 7•s•Y/f — /.C�f .4� s6/c ,, I G S 3c v S- <br /> 36-Sr <br /> 36-Sr 7.JyR e/b — rFS .1.- S4* ,, I G S .1 wt , S /. o <br /> A 0 <br /> Effluent#1 =BOD >30<220 mglL and TSS>30:5 150 mg/L •Effluent#2=BOD <30 mg/l.and TSS<30 rrg/L <br /> CST Name tmease Rim) Signature CST Number <br /> Groes s66n,e/'S S� 734aD <br /> AddressIf Date Evaluation Conducted Telephone Number <br /> � 77Goh4 3s Gclebs><w wS �zres3 to-a-o lir- X66- 4is7 <br />