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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 /> Taw r h t✓ i� <br /> Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must County �.J <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. O 7-6 f A'A-40-f.5'3`/- <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. ps.. 001. d 1 q©OD <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Lew,s.15.04(1)(m)). <br /> Property Owner/ Property Location <br /> -reM //a FFa Govt Lot 1 1/4 1/4 S 5?y T y0 N R /S E(or) <br /> Property Owner's Mailing Address Lot# I Block# Sultd.Name or CSW <br /> 970 Lala-e SuSah Wills Or � t/ y PjA <br /> City State Zip Code Phone Number ❑city ❑Village ®Town Nearest Road &A 7.5-1 N <br /> CA AkIA A es e n I M n/ I 5-531 ( ) J&: kso n ");- <br /> [3 <br /> `❑ New Construction Use:® Residential/Number of bedrooms Code derived design flow rate 3o a GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G1F-e rR/ '_4 r/ ff Flood Plain elevation if applicable <br /> General comments <br /> and recommendations: SE : 90.7 <br /> Nd#e< as 439 G - GroyGalwt- Uev>rt�tya �rMpl� <br /> Boring# ❑ Boring <br /> © pit Ground surface elev. . y y' y ft. Depth to limiting factor P 141' in. <br /> 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. •Ef#f1 'Ett#2 <br /> / o-H -7,rvR ��/ /s // r6 E �Q I c s -7 /.G <br /> "/v F s o s 4 aP 15 at co /, 6 <br /> 3 dff-3 -57-t//? Y'/ — /L- <br /> w."'L <br /> v <br /> ❑ Boring# ❑ Boring <br /> ❑ Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> •Effluent 41 =BOD >30<220 mg1L and TSS>30<150 mg/L •Effluent#2=BOD,:<30 mg1L and TSS 5 30 mg1L <br /> CST Name(Please Print) SignatureCST Number <br /> James SCInlels JOG 7-?4d0 <br /> Address Date Evaluation Conducted Telephone Number <br /> 01 <br /> 77/oDffw 3S GtJebSfr. car 548.3 �0 - 7— // his- X66- 4/S7 <br />