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ORIGINAL <br /> ' R of Safety&Professional Services Page of <br /> Division oflndu iices <br /> �� � 2 20�1� SOIL VALUATION REPORT <br /> In accordance with SPS 385,Wis.Adm.Code County <br /> - Pi <br /> Altach comple&0t*0lfii06h1j:pper not les than 8 1/2 x 11 inches in size.Plan must include, <br /> bt it not rimntal ref rence point(BM),direction and percent slope, Parcel I.D. <br /> s ion and distance to nearest road. Oa 07 <br /> -L/0-�Y eZfl S �5 fibY'4�$/ <br /> Please print all information. I Rev'ewed by /D tkk qo^ <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s. 15.04(1)(m)). <br /> Property Owner <br /> _1_ Property Location ❑ Fai <br /> 1 ' `-1 CX,a �r X t Govt.Lot �S Y. Y4 S 496 T N R 141 E(or) W <br /> Property Owner's Mailing Address Site Address or CSM and Lot#: �"/" <br /> 0 v ► IV Li L-39/o ga S Qr. 33-71 <br /> Ci State,Zip Phone Number ❑ City ❑Village Town Nearest Road <br /> p�m St A) 03 ( 3/ Sco <br /> ❑ New Construction Use: 'Residential/Numberof bedrooms�_ Code derived designflowrate -750_GPD <br /> Replacement ❑Public or commercial-Describe: Flood Plan elevation if applicable ft. <br /> Parent material bit ashz <br /> General comments and recommendations: <br /> © Boring# j❑Boring Q <br /> Pit Ground surface elev.Lb ft. Depth to limiting factor3-7—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. j*Eff#1 I -Eff#2 <br /> o-S ! Yea 5L e9m CS aL, 1, 0 <br /> a - Yk to S Oso, eytL C S 1. 6 <br /> -s/ 7 4 Y L7 jG �i ds sL r CS (. 0 <br /> ® Boring# ❑Boring Pit Ground surface elev.q0QQ <br /> •o ft. Depth to limiting factor 3(� in./elev. ft. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munseli Qu.Az.Cont.Color Gr.Sz.Sh. "Eff#1 *Eff#2 <br /> t O-S �O�t (" m kywi C s avb <br /> -31 itri MIL CS <br /> WQS s SL mq 1,0 <br /> m 414 vy, - . <br /> CST Nn(Pie se Print) Signatur CST Number ��Cxr 12AS <br /> Address Date Eva(Uat'iod Conducted Telephone Number <br /> stb A�. Cone Or. 2� l.a s _ 'a 6 ` 99 <br /> Effluent#1 =BOD>30 5 220 mg/L and TSS>30 5150 mg/L 'Effluent#2=BOD,5 30 mg/L and TSS 5 30 mg/L <br /> SBD-8330(R03/22) <br />