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Wisconsin Department of commerce SOIL EVALUATION REPORT Page I of-7— <br /> Division of Safety and Buildings <br /> in accordance with.Comm 85,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 812 x 11 inches in size.Plan must <br /> Include,but rat limited 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. Reviewed by Date <br /> Personal information you provide my be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> Si / ' 6N 5 h wt 4^ Govt.Lot S'" 1/4 1/4 S d/ T 4rO N R /4 E(or) <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSW <br /> /Jibs Jose t r. e 4?ej d v. 1 PJIS,7 <br /> City State Zip Code Phone Number ❑city ❑village ®Town Nearest Road .7523 <br /> /Zosevillc I mN IfF113 H co 1 Geo <br /> ❑ New Construction Use:® Residential/Number of bedrooms Code derived design flow rate 'gee GPD <br /> ER Replacement ❑ Public or commercial-Describe: <br /> Parent material rr/G c r w/ pe i ee>< Flood Plain elevation if applicable N1iq ft <br /> General comments <br /> and recommendations: j 00 C 95.oa) <br /> a " 3g40.6 <br /> Boring# ❑ Boring <br /> Pit Ground surface elev. 96.L) fL Depth to gmmng factor > in. sum Rate <br /> Horizon Depth Dominant Color Redox Description Texture SWcure Consistence Boundary Roots GPDtrf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -Efi#1 I 'E11#2 <br /> o- N 7.,5'Y R3/ — /S /m 06/f / c s 7F' . 7 /• 6 <br /> J. �l- .�O 7•s'v/7`//y /FS amsbK �.,.r / Gs 3rn <br /> 3 o so zss'/> f`/y — s use- A, ! � s ) VF • 7 !• 6 <br /> y sol 7d •7,5-If /v - s o s c 1 - - . 7 >. 6 <br /> a Boring# Boring - <br /> ® Pit Ground surface elev. 97. 0 ft. Depth to limiting factor > 84 in. Soil Application Rate <br /> Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> In. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'Ef1#1 I 'Eff#2 <br /> / 6- 6 7.SYR 15 1M,<Ak 1 tS 3F <br /> of <br /> 6- NO 7.S'J/7 YJ/9 — /FS el^s6K r.,-, l G S f v F <br /> 3 f/O- 4.s- 7.SHRYA/ /FS )^,x6/e m / cS — . S 1. O <br /> tt SyR H/3 — G/t 'he-1&5; <br /> 4 r- 1147.ryR'r/y — S o t G rn 1 — -7 /. G <br /> Effluent#1 =BOD,>301220 mglL and TSS>30<150 mg/L. //�� E((Muent#2=BOD,:5 30 ng/L and TSS 130 ngm. <br /> CST Name(Please Prim) Number <br /> S LKki7l E/S Signature <br /> (/rw,.nti//2 ;7i,400 <br /> � <br /> Address Date Evaluation Conducted Telephone Number <br /> � 77do/�., 3s G(/�bs)rw� r-f'T S 48x7 6-�- 0 9 pis- P6G- 4Js� <br />