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Wisconsin Department of Commerce SOIL EVALUATION REPORT page / of 2 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Cote n <br /> Attach complete site plan on paper not less than 81/2 x'11 inches in size.Plan must ty Qc�r n <br /> include,but riot limited to:vertical and horizontal reference point(BM),direction and paw I.D. <br /> percent slope,scale or dimensions,north anow,and location and distance to nearest road. O'3 et S-)17 - 015-00 <br /> Please print all information. Reviewed Dr Date <br /> Personal into bon You provide may Im used for secondary purposes(Privacy Law.s.15.06(1)(m)). '717166 <br /> Property Owner Property Location <br /> /r+n T er Gov.Lot NE 1/4Jry 1/4 S /7 T W N R /SE(or <br /> Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSM# <br /> /✓ 80 Sytanraee Ln <br /> State <br /> Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> � meµfh MAISS44/ (95d ) 89/- yJy3 Sc yJ3 t-/ 77 <br /> 'll❑ New Construction Use:® Residential/Number of bedrooms ot Code derived design flow rate 3 0 GPD <br /> ®Replacement ❑ Pudic or commercial-Describe: <br /> Parent material li/icG i a/ o'; Fi` Flood Plain elevation 0 applicable ft. <br /> General commentspp <br /> and recommendations: !I'I r Bo r;.I 5 Era r s f.n ro y - e•+ r%t e <br /> V6rj{�ecf ssi l o. Se1`6..ck <br /> Boring# ❑ Boring <br /> ® pit Ground surface elev. 9°f•S' ft. Depth to lirtuting factor 71 in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'Efr#1 I 'Eff#2 <br /> / a-3 7S-r'R r — /S 1a&hlc .,.r I c s 3M . 7 I. 6 <br /> d <br /> 3-.yo 7ss/l4"& — S ose <br /> '3 yo- 7ol. ;'sy/?4/v <br /> ❑ Boring# Boring <br /> ❑ pit Ground surface elev. ft. Depth to limiting factor in. SoilApplication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fli <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Efr#1 'Efr#2 <br /> Effluent#1 =BOD >30:<220 mglL and TSS>30 1150 mg1L 'Effluent#2=BOD,:5 30 mg1L and TSS 130 MWL <br /> CST Name(Passe Print) Signature nn (n� CST Number <br /> LL car e 3 S.Ja n r e/J .S.(/a.•+.�rh 73elA d <br /> Address Date Evaluation Conducted Telephone Number <br /> 7760 // ,s— we6.sfC-r 6- let S7 <br />