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ORIGINAL <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 z 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel LD ,r� <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0:7-0 <br /> -V q3 zq 02- <br /> Please <br /> 2Please print all information. Reviewed by 'Date? <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)): r'`3�O d2 <br /> Property Owner ,n Property Location <br /> RFK 9,D Govt.Lot 2 1/4 1/4 S z4T 40 N R 16 E(o W <br /> Prope/rtyOwner's Mailing Address Lot ft Block# Subd. Name or CSM# <br /> l0WI 90.4A/ Q- -- 21U I P. lyp <br /> City State Zip Code Phone Number ❑City ❑Village Town Nearest Road <br /> d)bCE MAI41Z378 I (gs2-)12b-1692 t04j4L.AAJD DAAaEL )<11/ ' na. <br /> '19-New Construction Use Residential/Number of bedrooms __ Code derived deslyn flow rate_ GPD <br /> ❑Replacement q El Public or commercial-Describe: <br /> Parent material_h LqL yr I-$Fr_ _ Flood Plain elevation if applicable ft <br /> General commentsSys- q0• D <br /> and recommendations: 94. 3 <br /> Ro T POL19 A oX t%'-'ALL &eW <br /> Boring# El Boring <br /> I /5 � <br /> Pit Ground surface elev. 7 Z ft. Depth to limiting factor 304#1 _in. <br /> Soil Applicatton Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' <br /> in. Munsell Cu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> I 7• a 2 S uA NA N p NA <br /> 5. 32 -7--f-112 414 !s .99 <br /> 3 32.S% 7-"041L 414 Ms µt S 1 1.7- <br /> 7--!;-j <br /> .7- <br /> 4 z $ 7•-!;ysLsA F+1 1 f•7 1.7- <br /> Boring <br /> .zBoring# Boring <br /> y±y Pit Ground surface elev.2R•s _ft. Depth to limiting factor 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. I 'Eff#1 'Eff#2 <br /> 1-'1- <br /> 63c 7.5 R S S S tc .17 ) -2 <br /> 3 0-4�1 •S a a c Ms 1K t s � r� . 7 t.Z <br /> 4 4q• 8 �. to 5 4 was s .� ).2 <br /> Effluent#1 =BOD >30:s 220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L <br /> CST Na (Please Print) Signature CST Number <br /> til / 17_2S851 1. <br /> Addre Date Evaluation Conducted Telephone Number <br /> 27760 9-99 ) - /(7- 03 Its- Slab- 4as7 <br />