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•,,�.urA.�,T ORIGINAL
<br /> ,- , Wisconsin Department of Safety&Professional Services Page of
<br /> ���5 t Division of Industry Services Cam$7—25 -22.7
<br /> �J`� PS 1 SOIL EVALUATION REPORT
<br /> '*Op,_lx>..s'\'''� In accordance with SPS 385,Wis.Adm.Code County
<br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, 1.5Mrh C
<br /> but not limited to vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. y a 1 r/t_5-05-,(jd'7-
<br /> scale or dimensions,north arrow,and location and distance to nearest road. 017-CO-1' 0 i 6000
<br /> Please print all information. Reviewed by 3te
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s. 15.04(1)(m)). L' WAMX S
<br /> Property Owner Property Location 0
<br /> bg,v i/ cl- L y,i v, ll/-c(50 y1 , Govt.Lot 7 '/. % S /I T L/0 N R /5"- E(or) 6
<br /> Property Owner's Mailing Address Site Address or CSM and Lot#: 3
<br /> .)89(t9 fit+dhta z1i. v, 1 o P )17
<br /> City,State,Zip Phone Number ❑ City 0 Village ® Town Nearest Road 2$14- cY
<br /> 1)hnkvy � S` i3d ( ) vc,c,k5ov,
<br /> 0 New Construction Use:121 Residential/Number of bedrooms Code derived designflow rate 3 d') GPD1
<br /> ICI Replacement El Public or commercial-Describe:` Flood Plan elevation if applicable d✓/r/+ ft.
<br /> Parent material (�.'Ac i a / /J►^Z f'T I A/)olkt j O 1,C 51-�
<br /> General comments and recommendations:
<br /> Sys, e l-€v. ci • 6 Tak. 1,1) 522(0
<br /> Boring# ❑Boring 9 F S— 7 Y.j- 4q
<br /> Pit Ground surface elev. ft. Depth to limiting factor in./elev0!•i/Z ft.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> I G- S 75`IR74)- — / 5 /M5SK H.. t' C3 3h, . 7 /(
<br /> A S- 76 7 s4•,? y/4/ — /.j A*,s 1 k 1.,,,1 1 c S fce' , 7 /6
<br /> 3 34 -ro 7.clr? '-'/4 /3 ofri,5.4/< it, / 6 5 3cU ,7 /to
<br /> 1/ Se-;5 7siz57f S a f-., ( — — .7 / 6
<br /> OBoring 7(P.3 86
<br /> Boring# ©Pit Ground surface elev. ft. Depth to limiting factor in./elev.F/.1L/ft.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> / s-y 7$ i177/1- / 3 /M ssk r,-, t c1 '' ,7 /. 6
<br /> o` ef_ 3 V 7s`ji71//4/ /_5 )ms.S/ ,. I G $ ace , "7 / 6
<br /> 3 )o- sL( 7.s�/R7 Lit t' /s d,.,5 S i� iv, / 63 )e c, , 7 1, 6
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<br /> � zs�� '/y 5 c,s , I — - •
<br /> : 7 / 6
<br /> CST Name(Please Prink Si ature ,� CST Number
<br /> t) <M r S .51 Uan l-C lS S %.,. ) 73
<br /> Address P" Soy' Sfj at�ation Conducted Telephone Number
<br /> d ess /
<br /> /41C4s/r- I,A-r- 5705) /l-atz-/- a5 7/5- 733-- 0706
<br /> *Effluent#1 =BOD>30<_220 mg/L and TSS>30 5 150 mg/L *Effluent#2=BOD,5 30 mg/L and TSS<-30 mg/L
<br /> SBD-8330(R03/22)
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