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ECEIIVE <br /> - P sifett Ad F ssi rvices SOIL EVALUATION REPORT Page of <br /> iY i- , of Safety and Buildings <br /> Burnett County in accordance with SPS 385,Wis. Adm. Code <br /> County BURNETT <br /> AttalcttrvdrWtiC''•-t,LI.iiAV. i•1- •• less than 8 1/2 x 11 inches in size.Plan must <br /> ' .••-, •u no imi e• to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. v'evd Date <br /> rye <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). I ,,a f �J?3 <br /> Property Owper/ Property Location / T/- . El- <br /> �//ale r'A)Q55 Fe/X.4).5 / ,o Govt.Lot A/g-1/4/1/6-1/4 S// T 37 N R AS) E(or) <br /> Property QOwnersSM�;�g,�d�ss �� � Lot# Block# Subd.Name or CSM# <br /> City O 1� State Ziippp Code Phone Number ®City Village ®town Nearest Ro,ad <br /> t' errL itd.r i5'f s37 1 (7i5 )S‘l I O`/ 7—A% L�-K� is,4„,7- zc. R <br /> ® New Construction Use Residential/Number of bedrooms Code derived design flow rate GPD <br /> ['Replacement Public r co merciial-Describe: <br /> Parent material it /,4-/ dr, T f Flood Plain elevation if applicable i-1..1 ft. <br /> General comments <br /> and recommendations: © u7/`/ <br /> 4 us 0/4 <br /> #I Boring <br /> Boring <br /> Pit Ground surface elev. /60 ft. Depth to limiting factor 82. <br /> in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> l a--S' 7.�y/f .1 j_j - _ 1 7 /-4 <br /> v2 8'3,Z /Dy/ W — /.s - - , 7 /-£ <br /> 9 3-.? /ye Y/Y 5/ ___---- ---_______. , V , 7 <br /> y 66-SSi /oyi % Gr-S , 7 1, c <br /> Boring# , Boring <br /> Q Pit Ground surface elev. /OD ft. Depth to limiting factor 98 in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> t a // 7-0 31 /5 ' 7 / <br /> z //-,W jog// — /5 ---- , 7 (,6 <br /> 3 0/77 /byR 5/47/ — f - , V , 4 <br /> 77-V /' y,Qy//6 GIs — , 7 ,' <br /> *Effluent#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L <br /> CST Name(Please Print) Signature CST Number <br /> WADE RUFSHOLM ) 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,WI 54872 /. -/7-a 3 (715)349-7286 <br /> SBD-8330(R11/11) <br />