Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County 13(A r k1 Q 7` <br /> include,but rat 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. Ori q— O 3 yDp <br /> Please print all information. Reviewed b Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 0; <br /> Property Owner Property Location <br /> Don Ali enow Govt Lot Al W1/4sE1/4 S /D T 3`j N R ly E( W <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSM# <br /> IA77 0t +err4r-- 4d- <br /> city State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> wh fe 13eAMAl ISSI/O (loll ) 41.9-76rt17 fiusk /V. Rice Lk 4J <br /> ® New Construction Use:M Residential/Number of bedrooms 3 Code derived design flow rate r!S GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material z-&' is Flood Plain elevation if applicable <br /> General corrtrnents Sys. 93..0 <br /> and recommendations: <br /> F Boring# Boring ej t7 <br /> ® pit Ground surface elev. S ft. Depth to limiting factor 7 77 in. Soil kation 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 /> l a- 3 7•s-fA 3/l. — /S linsak , , / c s 3c0 . 7 /•d <br /> 3_30 7.sYR %y /5 /.,.fs6k ,,, / 65 3co • 7 1.4 <br /> 3 <br /> 30-J-0 7.5 7'/( G 1 m . 7 /.-1, <br /> 60-77 -5 aSG- 7 /..k <br /> Boring# [3 Boring <br /> 9S.S <br /> 131 pit Ground surface elev. ft. Depth to limiting factor two in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IP <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> o-N 7.s YQ ( .7 /19 <br /> 4-ds -I.S'Y/13/4 — /S /r,s/✓c .yt ( G 5 3co -7 /. <br /> 3 818-v� 7•s3�1i %`r S •7 /.a{ <br /> y Yb-V 7,Sr/( :P"/ -S OSS w+ I G S - .7 <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30:5 150 nxA 'Effluent#2=SOD,:5 30 mg/.and TSS 130 ng/L <br /> CST Name(Please Print) Signature CST Number <br /> J�m�s S D.fyr�ls S'Z aAU 5 7341;0- <br /> Address Date Evaluation Conducted Telephone Number <br /> ,--7760 f/w 3s <br />