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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 <br /> Division of Safety and Buildings <br /> in accordance with.Comm$5,Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in she.Plan must <br /> Include,but rat limed 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. O f H -J A 0T -05--300 <br /> Please Print all information. Reviewed by Date <br /> Personal information you proWde may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). L � <br /> Property Owner vwrer V11/o! Property Location <br /> Sa r, Mc Qy}yrc(< Cremj.+ eod: Sf-1/4 ,$1151/4 S 9 T 3 8 N R /S E(or)gJ <br /> Propewner's Mailing Address Lot# Block# Subd.Name or CSW <br /> re 47V DOC-1` 39'7000 <br /> City State Zip Code Plane Number ❑City ❑Village ©Town Nearest Road D"7 1/ <br /> Si✓eh wS s497.1 ((oal ) 9t3-Js7.4 Gare//e /?W <br /> New Construction Use:® Residential/Number of bedrooms Code derived design flow rate 4S0 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G is c i / ✓:{ Flood Plain elevation if applicable w/,4 ft. <br /> General comments <br /> and recommendations:. sl-f, e(e u 9 d. 70 70) 9� <br /> MaPW o4s 3.10 3 - <�-✓e 66� /waw y S")df', <br /> 17 Boring# ❑ Boring <br /> ® Pit Ground surface elev. _ '76•Sft. Depth to limiting factor 7 P6 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/1R <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> o- 4 7.syRV/t — 15 1. sbk . 1 c s 3. 7 /, 6 <br /> -1 Y 5-4 7..SyR `✓/v — /F.S 01w jr6he r ' G S add . -4- /- 0 <br /> 3 $'Y- 1'G 7..svR•74 — /Fs �t...s 6/� ..n I — 'A »• . 5- /. O <br /> Boring# ❑ Boring <br /> ❑ Pit Ground surface elev. 7 ft. Depth to limiting factor 7 7 6 in. <br /> Soil Application7Ttel <br /> Horizon Depth Dominant Color Redox Description FTexdure Structure Consistence Boundary Roots GPDAW <br /> in. Munsell Ou.Sz. Cont.ColorGr.Sz.Sh. •Eff#1 •Eft#2 <br /> e-y 7.d yR /� — /.ns6 F .+� 1 c1 ? w, . 7 /. 6 <br /> 60-76 7S4lZ%Y — 14 refile w J — b .S— /.D <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg1l. •Effluent#2=BOD 130 ng1L and TSS<30 mgk <br /> CST Name(Please Print) _ _ Signature CST Number <br /> GM es 566nre is0alm* A„n,cc-: 73400 <br /> Address 9 Date Evaluation Conducted Telephone Number <br /> � 77100 f/z.. 3S G(Jebs 1/irr �"2" 54893 /i'-4 - 6 9 lis- ddb- 4/S7 <br />