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Wisconsin Depart(nent of Commerce SOIL EVALUATION REPORT Page Iof 3 <br /> Division of Safety and Buildings <br /> 'n accordance with Comm a5,Wis. Adm. Cade <br /> �u✓H a 7� <br /> Attach complete site plan on paper not It w than 81/2 x 11 inches in sire.Plan must 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 arta distance to nearest road. DatO y3oat. 0XV00 <br /> Please Print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Lew,a.15.06(1)(m)). !9 JoL -'07 <br /> Property Owner Property Location <br /> ,E poen &4-e - GovL Lot SE 1/4 NW 1/4 S d T 40 N R /,6 E(or� <br /> Property Owners Mailing Address Lot# Block# I Subd.Name or CSW <br /> (v So! b'u dsr-i 4 K /2 <br /> Gly State Zip Code Phone Number ❑city ❑Village ©Town Nearest Road <br /> Darfbo- Wr 15487 ( 7r•+-) As;- 3y99 k/on o/ 1 Neya✓rn C/c /?c1 <br /> ❑ New Construction Use:® Residential/Number of bedrooms_� Code derived design flow rate 90o GPD <br /> ®Replacement ❑ Pudic or commercial-Describe: <br /> Parent material j';/A4,,t/ t ver Flood Plain elevation if applicable N/A ft <br /> General e/B �/z19 <br /> . 0 160 y(,.90 <br /> nts <br /> and recommendations: <br /> ons: SJ'/• ( ) Xr'� <br /> MAftD AS 6 WI-/U6 SAA (399 0 <br /> Boring# ❑ Boring <br /> © pit Ground surface elev. 77 9 ft. Depth to limiting factor 7 70( In. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' <br /> in. Mfatsell Ou.Sz. Cont Color Gr.Sz.Sh. I •EH#1 •Eff#2 <br /> / o-N 7-fV/?•i/ati -- /S 11.14 /c ", / c s a,• 7 1. 6 <br /> J• 'f- 36 7s-ri? % /s 1..rs6.�- ,,,, / Gs s», . 7 /. 6 <br /> 3 7G- 7J4 7ryR%9 r/ <br /> ® Boring# ❑M Boring <br /> ❑ Pit Ground su ceelev. •918 ft. Depth to limiting factor 7 78 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W <br /> In. Mu isel u.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •E11#2 <br /> 0 y J6 71 Ylt yly — '�s 7 / G <br /> Effluent#1 =BOD >30<22 mg/L and TSS>30<150 mgfL •Effluent#2=BODs:5 30 mglL and TSS<30 mglL <br /> CST Name(Please Print) _ - Signa re CST Number <br /> a.nps S wa„•e4r 0473 0 <br /> Address fDate Evaluation Conducted Telephone Number <br /> 04 7 76Q !yw -S' A Ve4.0 fv✓ kv2 jrV f 7 7� /7 0 7 7i.r BIrG- gls-7 <br />