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Wisconsin Deparlment 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 81/2 x 11 intoes in size.Plan must County <br /> include,but not limited to:vertical and horizontal reference point(BM).direction and paw Lp.07.OjLro2•fll•/%-IrF-S fS-.ZSD•oy/pod <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 030 1 OS-01 r00 <br /> Please print all information. Reviewed by Date 11,, <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). i �fi0 <br /> Property Owner Property Location <br /> Q A n Pe#ij Govt.Lot 1/4 va S 2J/ T u/ N R /6 E(or)® <br /> Properly Owners Mailing Address Lot# Block# Subd.Name or CSM <br /> -3 -7903 376 th Ln. /y I I Grew Ar-Res <br /> City State Zip Code Phone Number ❑City ❑Village 0)Town Nearest Road 6So 6 <br /> Sf• Pe-Yer ltn1V 5- 080 (Sp7)330 gG/4 SwrJs I li.ifFGatie <br /> ® New Construction Use:0 Residential/Number of bedrooms 3 Code derived design flow rate GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material lac t 4 / (�M%try Flood Plain elevation if applicable y/A ft. <br /> General comments L1 p_ <br /> and recommendations: y�y . eI8✓ 93 • 00 C'E'•O /��•�) Art <br /> alveA as 365.6- Graylla 5" <br /> ❑f Boring# Boring <br /> ® pit Ground surface elev. 9�•0 ft. Depth to limiting factor 7 �� in. Soil Application 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. •Eft#1 •Eff#2 <br /> o <br /> / - 'J 7"R -0* — /.9 /M.ShA: P" is 3M . -7 /• 6 <br /> ,1 y. 30 7.5ItR%H — /-f Ms AA I Gs 360 •7 �. (tv <br /> Horizon <br /> -s4 7.S7R s oS6 / 6 S °tint , y 6/• <br /> 4 y- . -7 1- 6 <br /> Boring# Boring <br /> © pit Ground surface elev. '4-44 ft. Depth to limiting factor 3 78 in. <br /> Soil liption 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 /> 0 4 7.5YR3/d /f /mj,6/e r 1 ca Sin . 7 1. 6 <br /> 36 7SV X"09 i 3 stile ,,, f L S 7c o ,7 6 <br /> 3 p_ ro 7SYR%b — J d.9 d ,,, I G S d f" -7 !. 6 <br /> 4 <br /> 5'0-7Y '7 1 6 <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30 150 mg/L •Effluent#2=BOD <30 mg1L and TSS 130 mg/L <br /> CST Name(Please Print) - - Signature CST Number <br /> JG <br /> me.s SL�rnr�lS S � 734)0 <br /> Address V Date Evaluation Conducted Telephone Number <br /> � 77100f/r 3S W�37rwr r�rS'48r3 �'30-/O 7/S- �dG- 4/S7 <br />