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Wisconsin Department of Commerce SOIL EVALUATION REPORT Pageof <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must GAJ <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. r� <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. ,? 93�,7 © ��v <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location / <br /> rCJ Q(�ff Govt.Lot 1/4 1/4 S T 1410 N R` E(c <br /> Property Owner's Mailing Addressi /� Lot# Block# CSM# <br /> 32 / L o r .v �J r- Z V 810 32 <br /> City State Zip Code Phone Number F]city ElVilla eTown Nearest Road <br /> p►�#1e 10o ( ) <br /> [ New Construction Use:®--Residential/Number of bedrooms �` Code derived design flow rate -3 e7 e-) GPD <br /> ❑Replacement ll❑ Public or commercial-Describe: e—� <br /> Parent material �`i4 c i;-t-- Flood Plain elevation if applicable w Yq- ft. <br /> General comments <br /> and recommendations:Cc^.) Q sHAty�`Z Glow o v <br /> 19 <br /> -)bEsPEs-r sysrEem Q; q+to 4� <br /> El Boring <br /> Boring# 7 <br /> Pit Ground surface elev. /q/i I ft. Depth to limiting factor -;'77 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> -2 9-7,9 , 6 <br /> Boring# ❑ Boring <br /> ® Pit Ground surface elev. 2e , 7 ft. Depth to limiting factor 7in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> S 7i o <br /> r/ cS <br /> 9 -5 er <br /> 4-P7` V O rY e -- re-ca 7 <br /> *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD5<30 mg/L and TSS<30 mg/L <br /> CST Name Please rint) Signatu CST Number <br /> t 4 �1/aca�e� <br /> Address Date Evaluation Conducted Telephone Number <br /> SBD-8330(R07/00) <br />