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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of S <br /> Division of Safety add Buddutgs <br /> in accordance with Comm 85,Ws. Mid. Cade ;7 <br /> County O u r •t N- <br /> Amach complete site plan on paper not less man 812 x 11 incites M see.Plan must <br /> Percentclude.but ttotcalerto:versions.cal area hth wrtalacro ,reference point(distance <br /> nare pa� l.p. o7oJ.0 A40/6O] SOS o/600 <br /> Percent sbpe,style or Dimensions,trorth arrow,and location arpW E{istance to nearest road. /000 <br /> Please print all information- r�3_35Reviewed b Date <br /> Personal mmmmmn rou provide mar as used for secondary numoses(Privaty taw,,15 N(tl Imp_ 0A )3 <br /> Property Owner Property Loge on <br /> 60.r fou Is t- Govt.Lot 1/4 1/4S - T1/0 N R /( E(.)6 <br /> Property Owners Mailing Address Lot N Bbck# S.W.Nacre or CSM# <br /> G43S 6clt lel A V•l8 P/9 <br /> Ciyy Stateby Cade Prete Number ❑City ❑Village ®Town -Nearest Read <br /> Uaab ✓z S'430 Ic CUki..J .. <br /> m New Ceutrutlgn Use:9 Residential/Number of bedrooms 3 Code derived design flow rate YSO GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parentmaterial GlgG t</ Qr:� Flood Plain elevation if applicable Nip fl. <br /> General condiments; <br /> andrecommendabons: S/J. eIC✓- ^lO.20 ('En 9,?..7o� 4e, <br /> Ma AQ ds 399 C CrstII', Sa ct <br /> Bonng# ❑ Soong <br /> ❑X pit Ground surface also. ft, Depthtoprilingfachor 27G in. Solt Appliatsn Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence BoundaryRoots GPOff <br /> in. Munsell Qu.Sz. Cant Color Gr.Sz.Sh. 'Ethel I -ER <br /> 0- 3 7Xir& /s /M46/1 1 cS 3 ✓F . 7 / 6 <br /> Pit 36 76'b2 y/4 — 3 aS4 e., f G 5 73 V . -7 /. 4 <br /> 3 3o-sol 7S Y,? // — s os u G s - 7 14 <br /> q Sd- 76 7swR SJy .S o56 /.,. l — - 1 -7 /. <br /> Ban,# ❑ Bourg <br /> Pit Ground surfaceelev. 91. S- fl. Depth to M1mitirtg factor > 90 <br /> Boll Application Rate <br /> Hot¢on Depth Dominant Cohn Radox Description Tebure Structure Constance Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'ER#1 I •ER#2 <br /> ! 0 - 7 75-YR 3/d — /5 /mi6/4 -7 1. 6 <br /> el 7-4a 75-v Y/ — J oSG �.. 1 GS 3vF 7 /, ( <br /> V6-j: 7..rWit% — -5 o5G rVa 1 — - '/ /, 6 <br /> 4 .sr-vo -Z5- or <br /> Effluent#1 =BOD•>30,220mg/Lantl TSS>30<150,VL 'Effluent ri2=BDD-130 rngrL arW TSS 30 ig(L <br /> CST Name(Please Print) Signature CST NtrMer <br /> ✓at r J. k?as+ rclS `S �173Y <br /> Atltlress Date Evaluation Conducted Telephone Number <br /> X7700 /%.y 3,S" WCbs�cc WT.5YIb53 -j'd9-/3 7/5- 2P46 • Y/J-7 <br />