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EcC LIvI - , 5o <br /> cot <br /> p U 1 202 y ds.r- �---� <br /> Wis. t. Safety and Professional -- . KP .6 SOIL EVALUATION REPORT Page of <br /> Divisi of S rd <br /> urnet. Unty in a rdance with SPS 385,Wis. Adm. Code <br /> ,..and Services Department County BURNETT <br /> Atta s an 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. 0 7 a/8 -2 37 /L /9 3 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 03 co n o//eo <br /> • <br /> Please print all information. Reviewed bby�t�/t, Date <br /> q �j{J� <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). C� - _I <br /> /li I q[ I "I""" <br /> Property Owner Property Location /4)__t <br /> /V/,/< 74C AoA Ji� Govt.Lot 5 J 1/4$(„�1/4 S /gT 37 N R /� E(or)❑W� <br /> Property Owner's Mailing Address 7 Lot# Block# Subd.Name or CSM# <br /> a6.s sf D 3 s - - - <br /> City ' / State Zip Code Phone Number City Village [ own Nearest Road ff//9'j. <br /> Zil)b14ey 1 t4' ISV853cal ( ) /4'I e_.-v c •cJ I G f Rd. Q <br /> 0 New Construction Usep Residential/Number of bedrooms Code derived design flow rate GPD <br /> El Replacement El Public or /commerdaldi', <br /> -Describe: __�-- <br /> Parent material G..//4- C. A. -( c, f Flood Plain elevation if applicable ---19-4- ft. <br /> General comments <br /> and recommendations: y �1 <br /> �!/ T/o N s e_- ,8 or-,•-'5 7y6�P(/, 9 7• �f /9 70 <br /> / <br /> Boring# r Boring qey <br /> Pit Ground surface elev. // ft. Depth to limiting factor 5-6 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 /> l c>_6 7 51/R_ — / _________ __ --- . _7 /,z <br /> 6 St 7.57 e y/y )- 3 --__ . , 7 /--G <br /> 3 5-ktl 75yk 7‘ cA�/.sy/f % sc./ ___—_______ , y <br /> Boring# ❑ Boring <br /> Li pit Ground surface elev. ft. Depth to limiting factor 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 /> 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) / Signature CST Number <br /> WADE RUFSHOLM A-Gie-- 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514, SIREN,WI 54872 3 .2 I .�/ (715)349-7286 <br /> / SBD-8330(RI 1/1I) <br />