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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 7 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on a County 0",,, v'h' <br /> P D paper not less than 8 1/2 x 11 Inches in size.Plan must <br /> Include,but not limited to:vertical and horizontal reference point(SM),direction and Parcel I.D.0 7 0 3 6 d 40 17 3 G S,t -r77 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0/1000 <br /> Please print all information. Reviewed by 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 /> Ju m C1 SO l b e r Govt.Lot 1/4 1/4 S 36 T 40 N R r 7 E(or <br /> Property Owner's Mailing Address Lot# I Block# Subd.N or CSM# <br /> 66/3 Sherm4n L K Rd / -fhe�/frS <br /> City State Zip Code Phone Number ❑City []Village ®Town Nearest Road 8 uYd <br /> o LaK`s IM41 -Pro38 ( ) ' Gcn10n P,.er Era! ,«P <br /> ❑ New Construction Use:(@ Residential/Number of bedrooms 4. Code derived design flow rale 300 GPD <br /> ®Replacement ❑ Public or commercial-Describe: <br /> Parent material_ G lac/a / 001-4 Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations: Syd• e l e✓• `I009t.90 Eo 9f.00� <br /> talc++- na l"- c <br /> © Boring# ❑ Boring <br /> ® Pit Ground surface elev. If H ft. Depth to limiting factor > 78 in. <br /> Soil Application Rate <br /> Horizon DepthDominant Color Redox Description Texture Structure Consistence Boundary Roots GPD <br /> RF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'ER#1 'ER#2 <br /> / 0-4 7.6YR 3/t — /3 6"sb/c . 7 1- 6 <br /> of 4- 36 7.syR #/It — /1 ,fm<6k «, I GS 3co . -7 /, 6 <br /> 3 36-S-6 7•r9,z 4/,f — S cvSG r i I G .5 A. + . 7 <br /> H 56-717 ZS"IRS/'f — S bSe, l — - . 7 /. & <br /> Boring# Boring <br /> © pit Ground surface elev. 9S. b R. Depth to limiting factor > in. <br /> Soil Amlication 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 /> o-a -11A — /.5 / s6/< ." I c s 3 M "7 1, 6 <br /> q- Y0 7•fY/74/y — /J olrv36't rti f Gf gto '7 /. 6 <br /> 3 9e-r0 7s9a4/y _ s o-if G rel Gs aM . 7 /. 6 <br /> M '113 <br /> Effluent#1 =BOD >30<220 mg&and TSS>30<150 mg/L 'Effluent#2=BOD <30 mxA and TSS<30 mg/L <br /> CST Name(Please Print) Si ria <br /> �1G1»es 5 l�nnr m/S s � �sT Number <br /> di 734) 0 <br /> Address Date Evaluation Conducted Telephone Number <br /> � 77(o4/{w 3S �L/P65fr. w2 S4&�i3 cl- d� — <br /> 16 7/S-- Pdb- 4/S7 <br />