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ORIGINAL <br /> Wisconsin Department of commerce SOIL EVALUATION REPORT Page__of_ <br /> Division of Safety and Buildings <br /> in accordancewith Comm 85,Wis. Adm. Code <br /> County u r n C 1-e <br /> Attach complete site plan or,paper not less than 8 1/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel 1.0, <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Oil ' 975'0 ®d, 106 <br /> Please print all information. Reviewed by Date �[ <br /> Personal information you provide may be used for sewndary purposes(Privacy Law,s.15.04(1)(m)). /6 3 <br /> Property Owner Property Location <br /> j-e 11 / C 14 ern a Govt.Lot NE 1/4 JVW 1/4 S IS- 40 N R Is- E(or) <br /> Property Owner's Mailing A15dress Lot# Block# I Subd. Name or CSW <br /> 0%9"Lt r rout 5 r(rl Of- <br /> City State Zip Code Phone Number Cl City ❑Village ®Town Nearest Road <br /> taY J`41fr30 (7rs•') d3'`7-780¢ L)Ac )Tour' S raur 0r. <br /> ❑ New Construction Use:® Residential/Number of bedrooms� _ Code derived design flow rate_ f d" _GPD <br /> [�Replacement ❑ Public or commercial-Describe: <br /> Parent material G/ac r A ir /J r^i{T Flood Plain elevation if applicable �� ft. <br /> General comments gars• z h ti 3. 8 <br /> and recommendations: <br /> 1 /7 Boring# ❑ Boring 9 �� <br /> ® pit Ground surface elev. I v` t. Depth to limiting factor 40-3 in. <br /> Soil Application 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 /> 1 <br /> 0-3 7.3-Y231r m s 055 d I c 5 J• m ,_7 1, 9 <br /> 3-49 7,SYR 3'/rt mS '055 m 9 5 art 7 1 <br /> y1-43 7,s-M `Xf Y,,, S o s 5 rh I I 9 S — 1 -7 / <br /> G3-66 7,5-9 r/v Elf s-yR�/g m 3 Y.-t I rA <br /> Boring# ® Boring <br /> pit Ground surface elev. ft. Depth to limiting factor rtein. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> / v-3 7rr4R3/ Yn 5 t 7 lr� <br /> a. 3-YS- -7,S-Yl!y/ — rn 5 7 /, A <br /> It • 43 7,s Y/? m 5 .7 /a/t <br /> 43-6 7,5-YA -/ elf 3"YA -V9 vr,S 17 18A <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg& 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L <br /> CST Name (Plaam Print) 1J,9 h ,t Signature �7 H� <br /> ber <br /> tJr m�s S. l <br /> Address 0 Date Evaluation Conducted Telephone Number <br /> J 7 7 6 0 fr!K 3 s w 6'13' 1 - ,t 9- 00 7�S X66—YiS'> <br />