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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_of_ <br /> Chi of Safety and Buildings <br /> in aceordence with Comm 85,Ws. Adm. Code <br /> Co my <br /> Attach complete site plan ve paper not less than 8 fer x 11 inches in size.Plan most v r . <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. o7>aTy"L-3Y�IV-/4'S•af <br /> percent slope,scale ori imensions,nor0 avow,and location and distanceto nearest road: `0/4odo <br /> Please print all information. Renewed by Date <br /> Felt.reunmrmdmn you provide may caused mr sidundarypwpoess(Privacy law.a.15.01. <br /> Property OwnerProperty Location <br /> 1, <br /> — Gm Lot 1 1l4 114 S It/ T39 N R E <br /> Propert,Chimera Mailing Address Lot# I Block q I Subd. Naini or CSM# <br /> 3Kir15 a✓util <br /> City State bp Code Plane Number [j city E]Village ®Town Nearest Read <br /> - M ' 5 z E12) E(7 VC 10 ,01cifil 1,K, Qd <br /> [] NawCmmction Use:M Residential)Number of bedrooms Code derived design Bow rate GPD <br /> (Yl Replacement ❑ Pudic or mmmerdal-Describe: <br /> Parent material Flood Plain obvation it applicable - f. <br /> General mm.me <br /> and recommendations: USF Ics "C T^:'/( dc }! Mt- <br /> ani# ❑ Bong <br /> ® pit Groundaunaceelev. q5, y� R, Depth in limiting factorin. Shc icadon Rata <br /> Horizon Depth Dominant Color Redox Description TexWre Structure Consistence Boundary Roots GPD/ff <br /> _ in: Munsell a..Sz. Con.Color Gr.Sz:Sh. -Eff#1 'Eff#2 <br /> 0-3 o ' -� ' —o — L ntl G 3� , 7 <br /> 3- arr 5 _ o — e <br /> '1 Baring# ❑ Boring _ <br /> L Pit Ground surface play, Depth to limiting factor_ in. <br /> —SolAppleddetsm Rate <br /> Homan Depth Dominant Color Redox Desecration Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Mansell Co.Sz Cam.Call. . Gr.Sz.Sh. _'EfW1 'EHp2 <br /> tail G ed" <br /> 6 o _ 5 rn f <br /> if, <br /> - rNl.p <br /> 'Effluent#1 =BOD,>30<220 mill and TSS>W<1SO mgr& ' 'Effluent#2=BOD,f 30 ni and TSS<W call <br /> CST Name(Please Prnt) CST Number <br /> l A:c".a /�/�C! 'r SignaWre GOO <br /> More. Date Evaluation Conducted Telephone Number <br /> l�/ 93 .0 1 5! . WT s/ 21 /(5 7.23 <br />