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Wisconsin Department of Safety&Professional Services Page 1 of 2 <br /> Division of Industry Services <br /> . P; SOIL EVALUATION REPORT <br /> In accordance with SPS 385.Wis Adm. Code County ,��t�yy��,�'� <br /> Vrr <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include. �z"'�!C[v <br /> but not limited to vertical and horizontal reference point(BM). direction and percent slope. Parcel I.D <br /> scale or dimensions,north arrow,and location and distance to nearest road. T(,..% I D. G Z 7 <br /> Please print all information. Rev wed by 'I /_Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s- 15.04(1)(m)). ' V�'� I(e 10I 2021/ <br /> Property Owner t / /y /y� Property Location 0 16 <br /> XVL b. Fjr Jr ' 5�C,A SC L. o(,. 1 Govt. Lot g! '. ' S 36 T/0 N R J5-- 5-ler*W <br /> Property Owners Mailing Address Site Address or CSM and Lot#: <br /> 3 i 7It 5.7.W. 70 i.or I, C S'"`,0.i:70 v3, 17/0V 4/81. /h,a tL.q lw <br /> City.State. Zi I Phone Number 0 City 0 Village In Town j Nearest Road <br /> 1 R�- ii//4 i M NI 55004.0 I ( 765) 24-72G8' i . 4(50A) I Al ki. 4 RD LAKE <br /> ❑ NewConstnxxion U se:g Residential/Number of bedrooms Code denved designflow rate fAb GPD <br /> 0 Replacement ❑ Public or commercial-Describe: Flood Plan elevation if applicable MA ft. <br /> Parent matenal SAN ti <br /> General comments and recommendations EARIN6 9. QuiF P FFR Pfr PR{'Y - /307fl2'4 OP Pr 2S3 Ram <br /> GRADE' <br /> j Bonn # in <br /> Boring <br /> SPit Ground surface elev. Ai Pet Depth to limiting factor 70 in /elev ft. <br /> 1 <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture I Structure Consistence Boundary Roots GPD/Ft: <br /> In. Munsell Qu.Az.Cont. Color j Gr Sz Sh. 'Eft#1 'Eff#2 <br /> iI _5 7.5NR,Z �L 1sOsgi m1 ar5 24 0.1 I I.j'Z. 550 7.S1R�y ' S � 411 - <br /> i 0.7 I. <br /> 3 .50-7O 7.5 1K`+Ab — 5 6 , ail - - 0.7 !.G <br /> ' I <br /> 1 I I <br /> Boring <br /> _� Bon # ❑pd Ground surface elev. ft. Depth to limiting factor in. r elev. ft. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description i Texture Structure Consistence Boundary Roots GPD/Ft= <br /> In. Munsell Qu.Az. Cont. Color ! Gr.S2.Sh •Eff#1 •Efr#2 <br /> , <br /> i <br /> i -4 <br /> CST Name(Please Print) Signatyre ' 17// .ICST Number <br /> MARY JO HUPPERT(Hollister's Soil Testing&Design)' / c26 ? -- /,,'''L 224832 <br /> Address Dane Evaluation Conducted -•' Telephone Number <br /> 25720 Firefly Lane,Webster,WI 54893 C 7—/f, 2i0Z 715-426-1775 <br /> •Effluent#1 =BOD>30 s 220 mg/L and TSS>30 s 150 mg:L 'Effluent#2=BOD.s 30 mg/L and TSS s 30 mg/L <br />