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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 8s,wis. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel LID. <br /> Percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 67 00y' 3? 1& 6q 'Y o 1 000 613000 <br /> Please Print all information. Reviewed`//C� Date <br /> Personal Information you provide may be used for aeoondary purposes(Privacy Law,S.15.06(1)(m)). 444 <br /> b8 <br /> Property Owner � Property Location <br /> 0^If k4eerl /-r1 ndeeseq Govt Lot N6 1/4 SE 1/4 S q T 37 N R /b E(or) <br /> Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSM# <br /> P O 6e x S6/ -4 L/ Iq p 3 <br /> City State Zip Code Phone Number ❑City ❑Village RITown Nearest Road <br /> W2b5fe✓ W5, -g-y fqy ( ) /Yle's d <br /> <;hel.6,0 /7oP <br /> Naw Construction Use:® Residential I Number of bedrooms 3 Code derived design flow rate 300 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material 1"/'-G I& / ,t7,.;t<f Flood Plain elevation if applicable /t//w fL <br /> General comments <br /> and recommendations: Sys, e/e✓ • IF/. (aO (6. 43.60) :�fi <br /> a Ped as 4358 - 6rx Celhr -MertaH CoM 4K. <br /> Boring# <br /> Boring <br /> ® pit Ground surface elev. 9S.O_ft. Depth to limiting tactor > SU in. <br /> Soil licatlon Rate <br /> Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDffF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. •Etf#1 I •Etf#2 <br /> / 6-/A7.SYRy/ --- nsbk M l G 5 — . 7 /. 6 <br /> 7s`YR4/ — s os 4. l G s — 7 1. 6 <br /> yf-Qo s-`ria�7y — s osG r — — 7 /. <br /> Boring# C] Boring - <br /> © Pit Ground surface elev. 9y/o ft. Depth to limiting factor > 7.1 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. •Eff#1 •Eft#2 <br /> — <br /> ,- /, <br /> Jr of 4 .n I e- <br /> y S0- 7 7.SY/7 /_ 6 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 ng& •Eftent#2=BOD <30 mg&and TSS<30 mg& <br /> CST Name(Please Print) S nature G - <br /> Je,1»e.s s�il,e/s S a':"rc0�i 739)0 <br /> Address Date Evaluation Conducted Telephone Number <br /> 7760f/w 3s GcJebsfia, wr S`xr�3 s=/a(-o sir_ X66- 4/r7 <br />