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Wisconsin DepartrnentofCommerce SOIL EVALUATION REPORT Page I of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code Ca+tly <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must �� n e Y/ <br /> Include,but not limited to:vertical and horizontal reference point(SM),direction and Parcel I.D. <br /> percent slope•scale or dimensions,north arrow,and location and distance to nearest road. 02-0-4323- (J U 3 O 2 <br /> Please print all information. Reviewed by Date <br /> Personal infatuation you provide may De used for secondary Purposes(Privacy law,s.15.01(1)(m)). <br /> Property Owner Property Location <br /> .�1>rmES LZ�ApOr W P ft (L\C!(_ Govt.Lot G 1/4 1/4 S 13 T L/O N R /6 E(or� <br /> Property Owner's Mailing Address Lot# I Block# Subd.Name or CSW <br /> 212o pRso FtOc) =433 <br /> city . State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road -Ag/91 <br /> a-esi Lq 0 1 55025 1 ( ) o folia P/ s. JGII 4300 LK l?� <br /> ❑ Naw Construction Use:® Residential/Number of bedrooms Code derived design flow rate -?0 0 GPD <br /> [B Replacement ❑ Pudic or commercial-Describe: <br /> Parent material C/a r;,_ / iw•'Fy Flood Plain elevation H applicable 111/4 ft. <br /> General comments GY4/�. L e,'�Y o n .40 e <br /> and recommendations: <br /> M911tat at 44 61- Grc h - f6rw(a 6-AIC : 4%.1>D (/Z ii m Skres) <br /> Boring# ❑ Boring <br /> © Pit Ground surface elev. 97. O ft. Depth to limiting factor d d in. <br /> Sal kation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP <br /> in. Munsel Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> I a-V 7.SYR �/d — /f /»,sb/[ /,., I G 5 3•'"' .7 / b <br /> ,( H- Iy 7.S y/� y/H (T-S ps6 y,., 1 G S 36 6? <br /> 3 /4- /8 7,S'9/7-Pw <br /> y /g -old SYR S•/N — c / 3 rs.6/< ,,., F•; G W /,./_ , ll 6 <br /> .S- JA- 3H S'Y/2 ` Af Ltid s 4A' -le G )m b/lf w F,' — — J .3 <br /> Boring# ❑ Boring <br /> ❑X Pit Ground surface elev. 117.0 fL Depth to limiting factor Al in. Soil Application hate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 <br /> 1 75'Y/? 3/J. — /s /,.r4&/< „„ l G r a,n . 7 /. 6 <br /> y, /6 7.5Y/? %H — /FS osb , 1 65 3Go Is- <br /> 16%2,9 <br /> s- <br /> 6-20 7.5-Yi? %H — /FS /<s6/< . I G cri m . S` /, 0 <br /> `I l 0 ,1.1 S'r/i' ev c/ 3Fs4.e „{; tw I „F . 9 . 6 <br /> S- Id- 31 sw? `/4 GJ cP Skil ;VS, C <br /> Effluent#1 =BOD >30 1220 mg/L and TSS>30 1150 mg/L •Effluent#2=BOD <30 mgrL and TSS<30 mg/L <br /> CST Name(PleasePrint) Signature CST Number <br /> GM es S 66,71e /S Qw w�2 734)0 <br /> Address Date Evaluation Conducted Telephone Number <br /> c-4 7760 f//w 3S Gtl�b3 fr, ttir .-4843 0 8 7/r r66- 4/s7 <br />