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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 &awrr <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Pym I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. Reviewed by Date/l_$ >O <br /> Personal informalion you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ;_ `7 <br /> Property Owner Property Location <br /> Govt.Lot 1/4 1/4 S.06 T44 N R E(oQ <br /> Property Owner's Mailing Address loot# Block# Subd.Name or CSM# <br /> 06 O O Ma2n P-0. OUf v. P. 45 <br /> City State Zip Code Phone Number ❑City Village Town Nearest Road <br /> ��1n�Et0df 4 3S 4S c ,trZ) 551 .5 bliss M 10W CIE- <br /> New <br /> cR- <br /> New Construction User Residential/Number of bedrooms i Code derived design flow rate GPD <br /> Replacement ^ ❑ Public or commercial-Describe:y <br /> Parent material fel/ �( MW Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations: <br /> Boring# ❑ Boring <br /> .,pC]{l Pit Ground surface elev. I`'$ ft. Depth to limiting factor 7!9 in. <br /> Sot 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. 'Eff#1 •Eff#2 <br /> I d� S <br /> Ale <br /> .Z <br /> 2 71 s 414 S /•211 <br /> 3 26-fd Aeo 6 Alirs A%! C$ 7 /•Z <br /> 2 Boring# ❑ Boring <br /> Pit Ground surface elev. /' ✓ ft. Depth to limiting factor in. SoiApplication 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. 'Eff#1 'Eff#2 <br /> 0 -3' z A0 . 7 �.z <br /> A44 cs /co • 7 •Y <br /> 326-4b 4 -010 A l * . 7 /-i <br /> lies M4 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30:E 150 mg/L 'Effluent#2=BOD,:E 30 mg/L and TSS<30 mg/L <br /> CST (Please Prim) — — Signature CST Number <br /> u! / 2 ZS$S1 <br /> Addred Date Evaluation Conducted Telephone Number <br /> 27760 � SSW W 1. S4$9� 2- 2a- 07- 71S �6-445-7 <br />