Laserfiche WebLink
Wisconsin Department of Safety&Professional Services Page of <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis.Adm.Code County 9LYA16/-/- <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, <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. 032—,7�,Z/I�j'� z 03',to--013[b0 <br /> Please print all Information. Revipwed.by Dat <br /> Personal Information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). I.1� I7 <br /> /2 el <br /> Property Owner n� � R� Property location <br /> //C/ Govt.Lot A Y. S Z T /i f N R 115— E(or) W <br /> Property Owner's Mailing Addre s Site Address or CSM and Lot* <br /> 5215 /-a�� ZI,5 26 <br /> City, ate, ip Phone Number El city El Village Town Neares Road <br /> qN W: S�f�3o La 26 <br /> ❑New Construction Use:ISM Residential!Number of bedrooms�_ Code derived designflow rate 1�5b GPD <br /> Replacement DD ❑Public or mmercial—Describe: Flood Plan elevation if applicable��_ft. <br /> Parent material elf'C'41 On <br /> General comments and recommendations: <br /> ❑ Boring# Boring <br /> ❑Pit Ground surface elev.�✓ft. Depth to limiting factor(2 1 n./elev. ft. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> 2 3-6Z 7,iYe4 — <br /> ❑Boring <br /> Boring#1-7 []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/Ftz <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> CST Name(PI Print) Signature �' CST Number <br /> Zcoy lie r/ / 961 gsy <br /> Address Date Evaluation Conducted Telephone Number 66�f7 <br /> "Effluent#1 =BOD>30 5 2-20 mg/L and TSS>30 5150 mg/L 'Effluent#2=BOD,5 30 mg/L and TSS s 30 mg/L <br /> SBD-8330(R03/22) <br />