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• <br /> re."° Wisconsin Department of Safety and Professional Services .. Page .1. of <br /> a , s Division of Industry Services <br /> ;Sp3 1K, SOIL EVALUATION REPORT <br /> ,4, ," �a./ Cou a - <br /> "be�m,,��, In accordance with SPS 385,Wis.Adm.Code ll <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in:size.Plan must include, • A <br /> but not limited to:vertical and horizontal reference point(BM),_direction and percent slope, P cel I. ,/ o <br /> scale or dimensions,north arrow,and location and distance to nearest road. — .OLD—. --•'O �'r -/ — —• r—obil.w <br /> Please print all information. D ,/�. D e p <br /> Personal informatidn you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). GI�%1 - I I o 3/2- <br /> .,..PlOperty Owner" Property Lo / E _ 0 <br /> Govt.Lot % ' S ' T L� N R f 1 • E(or) <br /> P op wn ailing\Address - - ire d ess or CS ando #C, z ' <br /> U ;���L�� � — _ . - J.4 , _ .STD oL _ t 1,/ <br /> City State Cod Phone Number ❑ City Viilag I. wn _ Nearest Road _ t <br /> El New Construction Use: Residential/Numberof bedrooms y , Code derived designflow rate— GPD - , - <br /> 2F.eplacem-en Publr orcco ercial—Describe: Flood Plan elevation if applicable . ft. <br /> Parent material . \`\�.\i \ v <br /> General comments and recommendations: t. \\.4 `,( / ,-c4 ‘)elt • r <br /> Boring QQ�� 1 <br /> Boring.# t Ground surface elev.gU�A ft. Depth to limiting factor in./elev. ft. <br /> . _ -. - Soil Application Rate <br /> Horizon Depth Dominant Color. Redox Description - Texture. Structure.. Consistence Boundary. Roots _ .. GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 <br /> 1. ' ' _. ' ..._ S_ . ( , _ t•,r,� - - C .. \ L ... ./ 1,6 <br /> S JOY, <br /> ---- 3 '6/ 7_ 'YR c �S `=,s i\k\ (1_ _ �- _ , . /,�� <br /> ,f - <br /> .. _ Oporing <br /> Boring# Pit Ground surface elev. ft. Depth to limiting factor in./elev. ft. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell - Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> ('- `, <br /> ST Nam' Please Pn t) S'naty Cal � <br /> k\, 4z Dat Eval ation C "ducted Telephone Number <br /> t , ‘, ‘ <br /> *Effluent#1 =BOD>30 5.220 mg/L and TSS>30 5 150 mg/L *Effluent#2=BOD,5 30 mg/L and TSS 5 30 mg/L SBD-8330(R04/21) <br />