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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 7 <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 <f-/" <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.07`040,AAf0- 6v3 S •- <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 15- 2oo- 0 r too 0 <br /> please print all information. Reviewed by Date <br /> personal infamiation you provide may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). �J <br /> Property Owner Property Location L <br /> Joh, CS Lv-e Govt.Lot 1/4 1/4 S :3 T 40 N R /6 E(or)g� <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> ggs-.t �<Y'hX !'rt 0 a 0 CII" l <br /> City tate Zip Code Phone Number ❑City [I Village 2 Town Nearest Road 6S-9Y <br /> lZo.Spn oCftf ynAl 1 Ss-oldf I ( ) OaK14"el [yc Rd <br /> ❑ New Construction Use:® Residential/Number of bedrooms 44 Code derived design flow rate G 0 o GPD <br /> Replacement ❑ Public or commercial-Describe: // <br /> Parent material '(9:(l^ f or i 1!f �� <br /> Flood Plain elevation if applicable �I zeg R <br /> General comments <br /> and recommendations: SYJ e I'e v ' <br /> ,Na as P : G hn Sa.aC <br /> a Boring# ❑ Boring <br /> ® pit Ground surface elev. 9S0 ft. Depth to limiting factor 7 7y in. <br /> Soil lication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> y4 7.s`Ir7 `�/� — S 6'-K 0( t G 5 ofwr 7 I, 6 <br /> 3 - 7Yf 7!-VR sy _ s o s 1 — 7 <br /> Boring# ® Boring <br /> ❑ Pit Ground surface elev. �7 y Lf ft. Depth to limiting factor_Y 70( in. <br /> Soil Apolicaton Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/fff <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> I o- ti 7s'71z:t� — is . 7 / 6 <br /> u- qsf 7S-Y/? 4i — S . 7 1 ,6 <br /> 3 8- 7d- 7 rlv-e-f t 5 711=1 % 7 / 6 <br /> — BURNIM <br /> •Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L •EfAunt#2= _ and TSS<30 mglL <br /> CST Name(Please Print) Signature CST Number <br /> J�mr°s sl�ctnre/s S 7.34aD <br /> Address Date Evaluation Conducted Telephone Number <br /> X7760 54 3s GcJebs <p� w2 s4s�� /D - 3— /� 7is- P6G- 415-7 <br />