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ORIGINAL <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT Page__of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code -- — <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County Azlen e <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. aj� q5-66 al 400 <br /> Please print all information. Reviewed by Date <br /> Peraonel intonnation you provide may be used for secondary purposes(Privacy Law,s.15.04(t)(m)). <br /> �3 <br /> Property Owner Property Location <br /> Lain SYe Govt.Lot 11141/4 $W 1/4 S A3 T L4 N R /S- E(or)® <br /> Property Owner's Mailing AddresLi Lot <br /> # Block# SubdN�ame or CSM# <br /> Q Cri fR �Y. p� VUt r�qn� /r�p� <br /> City tate Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> ou/u4A I Ind s-aO3 1 (1,18 ) 7dN- 4 38je1`c.lescki I 0" r/anj c 1 <br /> [Z New Construction Use:[9 Residential/Number of bedrooms Code derived design flow rate <S_'O_ _GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G/AL 1 a I U r fY Flood Plain elevation if applicable �1¢ ft. <br /> General comments Sr S r!r v y�! JC <br /> and recommendations: !j 6 <br /> Ir n 5 a 3. /rar�Lp 3 w . av <br /> Boring# E] Baring <br /> © pit Ground surface elev. 'Ir. '7 ft. Depth to limiting factor _ 67. in. <br /> 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#t •Eff#2 <br /> l d- el 7,Y-M314 15 a55 cf ( c5 3 e 17 IIA <br /> X Y- P 7-5*rRs114 — is ass C11 e5 3 �f I , <br /> 3-50 ryl 9/4 — 1•v1 S 055 ivt I CS <br /> q Su- Gal 7,SYR r/y 4s 05S mfr 9S S' t <br /> F T- <br /> ® Boring# Boring <br /> Pit Ground surface elev. 'Yr. 7 ft. Depth to limiting factor r r in. <br /> -- I Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> In. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> 0-4 7,s""/,. 1,f 0s5 d 1 cs 3 1-7 1.,r( <br /> d, 11- AO 7,sY/2 r1w — 13 059 CA L5 3vr `7 <br /> 3 ao-91 s9R `'//I 055 <br /> 51-r3- 7,rr4 r/v — ><s 05S m E� 55 t~ I <br /> sr-E9` 7•sY r/4 FlfY-m Ile ><s 0s5 YYt{i CS S` t <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mgA- •Effluent#2=B D <30 mglL and TSS:E 30 mg/L <br /> CST Name(Please Print) Signature CST Number <br /> j vi m es 9. I.4 SD.v,.9z 61 73 4.A-G-- <br /> Address Date Evaluation Conducted Telephone Number <br /> Hwy 3S websFrY wl syByJ g. a�`f'aa- 7/S=�GIo- �/S7 <br />