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y;. <br /> ` Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT Page_of_ <br /> in accoburce with SPS 383,Wis. Adm. Cede p <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County <br /> O� nKt/ <br /> include,but not limited b:vemcal and horizontal reference p <br /> man(BM),direction and ParCG U-J-yO-/S-1f•S•C _ <br /> percent slope,scale or dimensions,north arrow,and platin,and distance to nearest road. ee /. p/yo/O <br /> Please Print all information. Reviewed by Data <br /> Personalinlormamnynu provirin may 0e read Or secondary purposes(PrivacyLaw,s.15 04(l)pre) <br /> PropertyOwner p Propertylocation <br /> Cv dK�l �u53<l� G.A.Lot 1/4 1/4S �QT /1lJN R/SE� )w <br /> Property Ovmer's Mailing Address Lot# Block A, WW, Name or CSM# <br /> ga9D l/; las Rol I V. .11 RIr <br /> —Y Stale Lp Code Principe Number ily []tillage Town Nearest Road <br /> LO G e C.rr vd I wS S 7 1 ( ) ✓G�(c so„ G/YPr S/c ,C> <br /> © New Construdion Use12 Residential/Number ofbedrooms ,�— Codetlerived design(low rate HSO GPD <br /> Replacement El Public ar commercial-Describe: <br /> Parent material_ G( isa / n !'r Flood Plain elevation if applicable N//V ft. <br /> General comments <br /> and recommendations: <br /> Boring# Going <br /> © Pit Ground surface elev. 7H. 7 ft. Depth to limiting factor in. <br /> Sal 1kruslical Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Du.Sz. Coal.Color Gr.Sz.Sh. 'Eff#1 I 'EPN2 <br /> 0 - 4 7.J Y/7.9/ /e /m$6/< « / CS 7m . 7 /.6 <br /> 4- (d 7.J Y/2 d.r+Jb/< M t G S ace •S /D <br /> /�-S4 7.S ii,/ty/y — S <br /> 74 <br /> Al <br /> Boring# Boring <br /> © Pit Groundsurfaceelev. 95 ze' (t. Depth to limiting factor 7 7t. in. <br /> SOY icalgn Rate <br /> Horizon Depth Dominant Color Redox DescriptionTexture Structure Consistence Boundary Roots GPD/IF <br /> in. Munsell On.Sz. Cont.Color Gr.Sz.Sh. <br /> e - 4 7.6 art? /J //.. e6/c ... 1 cr 3M <br /> d /.% 3 d..+J6/e ml Gs li <br /> 3 IJ- 5O 7S4/24/y S <br /> dos'C <br /> <i o-Y67.S Y/Z�4 S OSE ..- r — —' • 7 /. G <br /> ...fir • .-iR <br /> 'Effluent#1 =GOD,>301220 pi and!TSS>301150 mg/L 'Effluent#2=BOD < <br /> _30 mg/L and TSS<30 mgrs <br /> CST Name(Please Prinll '\ Signa re CST Number <br /> i -S F/cCNr < /J f,/ p/731,Vo <br /> Address Dale Evaluation Concluded Telephone Number <br /> d 7700 )// 3s WK6JYKr wSJ`/&y3 7-dS-/�/ 7/T 6GL-- +•//57 <br /> SBD 8330(1107/13) <br />