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ID CGEW E <br /> Wiis.Dept.of�ajety'and' ssL AI �nrltes SOIL EVALUATION REPORT Page of <br /> Division of Sa !jr ant Buildings <br /> �iE me t 1:11'T abrdanCe with SPS 385,Wis. Adm. Code <br /> County BURNETT <br /> Attach com ete s6 pt iibh'0bpei not Mssthan 8 li2 x 11 inches in size.Plan must <br /> include,but noTiimYed t°o'vet(:cbi acid-horizonfbTitference point(BM),direction and Parcel I.D. 6 7 / a $ L-s <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o — e>3 © CO O <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 3 Z1 M5 <br /> Property Owner Property Location G <br /> -- p Govt.Lot 3 ]�iF� 1/4 S`8 T38 N R `.-5 E(or)W� <br /> Properfy Owner's`Mai/lin M#g Address Lot# Block# Subd.Name or CS <br /> City State Zip Code Phone Number ity 17ViIlage Nearest Road S73 q <br /> New Construction Use Residential/Number of bedrooms Code derived design flow rate GPD <br /> nReplacement / Public or commercial-Describe: <br /> Parent material /�C i R G��'i��T` Flood Plain elevation if applicable /2JL1- ft. <br /> General comments <br /> and recommendations: O u L 6 y 5 <br /> ° Pr I " <br /> ! I I Boring# Boring <br /> L—J Q Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 01 ff#2 <br /> o—4, / /1 4 <br /> i 3/ L-a q/ S 1 7 46 <br /> .3 /Sp 7 y — S 17 ,6 <br /> SD-7 y H-s <br /> Boring# E] Boring <br /> 0 pit Ground surface elev. ft. Depth to liming factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. " ff#1 ff#2 <br /> I <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD <30 mg/L and TSS <30 mg/L <br /> CST Name(Please Print) ignature CST Number <br /> WADE RUFSHOLM 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,W1 54872 (715)349-7286 <br /> SBD-8330(Rl1/11) <br />