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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of.3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code p a r fit /,rcam_ <br /> � <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must t <br /> County <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. Rev! Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.06(1)(m)). <br /> Property Owner Property Location <br /> don Pel a5er1 Govt.Lot WiE 1/4 NE-1/4 S 3 p T Zf/ N R /Jj E(or)W <br /> Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# <br /> /lntar(c Ln �osr �cr✓s <br /> city State Zip Code Phone Number <br /> ❑City ❑Village ®Town Nearest Road' <br /> r �►1/l/ SS'a/ (Gs/ )JS 7 v,ts7 SN.�ss G- Lake aw k /1W. <br /> ® New Construction Use: Residential/Number of bedrooms 3 Code derived design flow rate S s`O GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material 6-1a c r a( cl,a;)& Flood Plain elevation if applicable W A ft. <br /> General comments <br /> and recommendations: 51A C/r✓• `eP'ei- 1747'- <br /> /0 we r <br /> /r7'•/rwer <br /> Boring# ® Boring 96. <br /> E] pit Ground surface elev. 7 ft. Depth to limiting factor -5�8 in. <br /> Soil ADDlication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> of 7-3s` 7.S-'rR y!g M S os G, GS 34fo . 7 /. <br /> 33-V--S7 I 7-sfR v/` — 5 os6 m 6r 5 lee .7 /rA <br /> 19 r/y S OSG „, l GS 1!o . 7 /•� <br /> P. Boring# I❑ Boring <br /> J31 Pit Ground surface elev. Depth to limiting factor W'O- in. <br /> Soil ADDlication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 -Eff#2 <br /> / o-9 >.sr.vs/,c — !s 1, 661< oP( c5 -3 40 7 /.d <br /> s� <br /> 51-37 ;1'5-'rol y/ -- S e,5 6- ( C- 5 160 '7 /, 04 <br /> 37-6o 7.-5w y s DS( r, l GS 1C'o .7 ldt <br /> Fo-63 7sY?% C�-d3yX �y S 4SG- •�, l G s (cv - 7 1, d <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BOD <30 mg& and TSS 30 ng& <br /> CST Name(Please Print) Signature p CST Number <br /> J/9rnEs ✓�.�hr�(J _S��r.u� d.73y,�rr <br /> Address V Date Evaluation Conducted Telephone Number <br /> d-7760 b ?S- we 7517 JA/r- <br />