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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 85,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 8=x 11 inches in size.Plan must cL r rl 2 // <br /> Include.but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scala or dimensions,north antow,and location and distance to nearest road. ('fid - 9.300 - 0/,30o <br /> Please print all Information. Reviewed by, A Date <br /> Personsi informfion you provide may he used for secondary purposes(Privacy Law,s.15.01(1)(m)). G✓CO/ 7 !T[J <br /> Property Owner Property Location <br /> Al l-her)Y 162e- <br /> dnG GovL Lot 1/4 114 S 30 T !f/ N R / $' E(oryc <br /> Property Owner's Mailing Add Lot# Block# Subd.yanie or CSM# <br /> /S 9D e fr7 5;- A/ 3� Seim <br /> Gty 31ete Zip Code Phms Number ❑City ❑Vlllepe ZT&M Neerest Rad <br /> -Sf"i//w Al O SA I ( ) .5-w r 35- 1 Selma 'e <br /> ❑ New Construction Use:® Residential/Number of bedrooms o( Code derived design flow rate 300 GPD <br /> ®Replacement ❑ Public or commercial-Describe: <br /> Parent material /4 L/a / Dc r v�� Flood Plain elevation 9 applicable if/ fl <br /> General comments /e ✓• <br /> and recommendations: Sy1• (; 91•S O ('9/ 33 4.6 93.50) eie� <br /> MOPek ds ('r f ' 58y, 3 3 <br /> a Boring# ❑ Baring <br /> ® pit Ground surface elev. qy S ft. Depth to limffing factor > 7V in. <br /> soilGcatiori Rate <br /> Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 <br /> 4 7.sYR-VIA — /S /,.1s6k `r cs a^ . 7 A (� <br /> N- 7o 7SYR9/y — as e- P" G S 3e 7 (. 6 <br /> 3 3o-sa 7SY/z%v S asp /vi / G S ,I .� -7 /. 6 <br /> /i sol-74 7syR% — 1 _7 1- 6 <br /> ®Boring# Boring <br /> © Pit Ground surface elev. 5-r 0 ft. Depth to limiting factor > 8'd in. <br /> Soil lication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IP <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz Sh. 'Eff#1 I 'Eff#2 <br /> � O��/ 7.Srf/? -4�i /J Jsr+3/j/C !•/t / L 3/rl . 7 � (� <br /> d y-30 7.-5'5'1? sco . 7 /, 6 <br /> 3 a- Yd 7svR % S oSG / 4 1 .t,,, > /. <br /> `t yL-*,9 7$-51/'?4;y. 6 osG r> 1 — - 7 /• 6 <br /> Effluent#1-BOD >30<220 mgfL and TSS>30:5 150 ffKA 'Effluent#2=BOD <30 mg/l.and TSS<30 ingfL <br /> CST Name(Please Print) - Signature CST Number <br /> Amvm es 5 Llan/e/S S 7-f90?0 <br /> Address r Date Evaluation Conducted Telephone Number <br /> 7760.//.✓ 35- Web6)/re +-ter 5-'48.3 9- Y-OS 7/r Fdb-- 415-7 <br />