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715r-02 3-1 off. <br /> Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with SPS 385,Wis. Adm. Code <br /> County BURNETT <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. CJ 7 0/2 ' 4/0 6 5"-o/ <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. SOS 0 6/ O a O opt, <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). v Q I 7/lo/?3 <br /> Property Own Property Location G 1 <br /> El Or <br /> l(Jd /i e_C./" Govt.Lot / 1/4 1/4 S / T /O N R / S E(or) <br /> Property Ownerrs Mailing Address Lot# Block# Subd.Name or CSM# <br /> � C.4-ti), r, G�/A-y — <br /> City State Zip Code Phone Number Jity tllage down Nearest Road a 9aes� <br /> d�iiciSold i w.15 i/0/C 1 (6sl 7f-`170° �Rc Solo I Co ref <br /> ❑ New Construction Usej Residential/Number of bedrooms Code derived design flow rate 7St> GPD <br /> z`eplacement Public or com rcial-Describe: <br /> Parent material isMc/ A"! d/'/'er Flood Plain elevation if applicable 4-44 ft. <br /> General comments <br /> and recommendations: <br /> DBoring <br /> Boring# q <br /> M Pit Ground surface elev. 97 <br /> ft. Depth to limiting factor •7Y in. <br /> 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 /> i O.— / 7/.5W"/ - /i //Mite ifiWr C-s 3 7 j,1, <br /> a y-`9 7s7, y�f< %S /A,541 mi) i y 5 3t" , 7 /, 6 <br /> 3 /q-ry 7 %� S o 5, ,h/ 3f- ) , 7 /,6 <br /> Boring# [.Boring❑ p Pit Ground surface elev. / 'i ' ft. Depth to limiting factor >79? 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 /> / v- 975,e a — /S ____ _ ____,_____ . 7 J.6 <br /> ,2 `'0712 7 5XeVfe <br /> — /5 - • 7 1,‘ <br /> ao 7a 75,z /6 S . 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) /Signatur CST Number <br /> WADE RUFSHOLM Alas /c 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514, SIREN,WI 54872 7—/o23 (715)349-7286 <br /> SBD-8330(R11/11) <br />