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7----- --------------D CM E 6C <br /> cAtuuk*It42Y e5`7=23 - 2tu <br /> • pt.�df SIfet�r d'13f6LI• <br /> .rvices SOIL EVALUATION REPORT Page of <br /> i-', of Safety and Buildings <br /> Burnett County in accordance with SPS 385,Wis. Adm. Code <br /> County BURNETT <br /> Attalcbrrodr8pl®t� [tlp,less than 8 1/2 x 11 inches in size.Plan must <br /> -trft f00�, no no r�ertical 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. 'e Date—rf <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). l'• I l a j')`Y?3 <br /> Property Ow�1er Property Location • / it- ���"`���lll <br /> 6Il//le r A)e5.5 �e//,�5/i/,' Govt.Lot it/6-1/4/t/E-1/4 S// T 37 N R A, E(or) <br /> Property Owner's Mailing1 dress / Lot# Block# Subd.Name or CSM# <br /> v2 1897 5 ,ri ii.k it us — — _ <br /> City State Zip Code Phone Number laity OVillage ®Town Nearest Ro d <br /> �l er^/c. IlAr 19017A(715 )56‘:g/°11 17-; %' Z444"- _ Is/O,-,f 2-.k Ra/ <br /> DNew Construction Used Residential/Number of bedrooms Code derived design flow rate GPD <br /> 0 Replacement Publicpr co mercial-Describe: <br /> Parent material cT/�T C/ ' / 0(I 7- 74 Flood Plain elevation if applicable i2/4- ft. <br /> General comments <br /> and recommendations: .,2 <br /> © U/ /ou5 e___. 0/11/ <br /> 8 IBoring <br /> Boring# <br /> Pit Ground surface elev. /60 ft. Depth to limiting factor U 3* 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 /> / a —S' 7 3-7/f, ^ . /- - - , 7 /- <br /> ,z 8'3,Z iOf v7/ -- 45 — - . 7 /-C <br /> 3 3..?-a fvYie y/5/ s/ ___--- , y , 7 <br /> 4/ 66-ii' /og n - G-c s ------- - , 7 1. C , <br /> Esi Boring <br /> Boring# p0 ft. Depth to limitingfactor pp in. <br /> LI Pit Ground surface elev. / p !O <br /> I 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 /> 01/ 7-i-Q /5 — , 7 !6 <br /> //-, W /o7, y// _ /.S - , 7 (-6, <br /> 5 , s'77/sy' ply — / — , y , <br /> 77-2f f74 /6, _Gr-5 , — , 7 /.,4. <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 ZO 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514, SIREN,WI 54872 /ie.y 7_a 3 (715)349-7286 <br /> SBD-8330(RI1/11) <br />