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Wit.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page_of_ <br /> Division of Safety and Buildings <br /> in accordance with SPS 3M.Ws. Adm. Code <br /> count' bfNL{7� <br /> Attach complete site plan on a paper not kris than12 x 11 inches n size.plan must <br /> include,but not landed to:vertical and horizontal rekrence pont(BM),tlireaYion and Recall LD 67-032-L-Yl' 6' ->•-/f-1Myl-en <br /> percent slope,stale or dimensions,north array,and location and distance to nearest road. ovitez0aw <br /> Please print all information. Reviewed by Date <br /> Peroval infommrt you provide may be useofor tewrMary puryosm(Pora,,Law.a.15 W(1)Im)lI-043 <br /> Propeny0 nen (� .,/1&- property Lawtion <br /> /!re ahNe,dGyri.Lot 114 114 SJpp6T Nl N R /6 E(or)® <br /> Prope0 <br /> er' Maaing Address Late Black Subic.Name or CSW <br /> 39 7. <br /> CM State Zip Code Phan.Number ❑City ❑Village Town Nearest oad Z� <br /> !vr 462 (6 / ) 1-7/16 G r <br /> ❑ New Constmclnn Use w Residential/Number of bedrpeasCode criminal design floe rate - HSo. GPD <br /> Replacement / ❑ Publico/r � 11r/nertiaI-Describe: <br /> Parent material_ s�j/RC161 t k 7 T>'' Flood Plain elevation if applictibk W10 ft. <br /> General comments <br /> and recommendations'. <br /> ST' 13' l27 <br /> Bonn,# ❑ B,mN �,/ <br /> P'1 Gbmndsurfaceekv. q715" k Depth to limdingtaaor 7 4/ tn. <br /> Soil Application Rale <br /> Horizon Depth Dominant Color Redox Description Texture Structure :oten. Elotaclary Rads GO <br /> in. Munsell On.Sz. Conn Color Gr.Sz.Sh. R#1 11#2 <br /> D 75eFIZ — GS / k tV4 C5 z -7 1. Z <br /> - #ef 7572y/H 5 //r G5 IM . 7 <br /> 94 fq 7. az��i S r7c 65 .7 lz <br /> ZBoring# ❑ Boring p <br /> 2 Pit Ground surfaceelev. /� ft. • Depth toEmitilgfactor >96 in. <br /> Soil Aptchcation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure istenre undmy Roots GPDdt ' <br /> Munsell Du.Sz. Cont Color Gr.Sz.Sh. R# '1 ff#2 <br /> 041, <br /> 7.5r )'/Z G r 5 144 Z+'7 '. / . <br /> p- 'l. <br /> 'Effluent#1 =BOD ,>30<22011.A and TSS>W <150 mg& '=nt 12=800 <30 mgrL aM TSS 30mar- <br /> CST Name(Please Print) // mat CST Number <br /> oris %Q�a�da �. , elt-lawl <br /> Address Del.Ev baton Cooduceic Telephon.Number <br /> Z71Z0>9rnsa lea .l✓ iit.'v 593 7 7rSSAS �zo2 <br /> SBDA330(IN 111 1) <br />