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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_of <br /> Divisiorfof Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County j1 V <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must t� <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. D/h _4 0 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. C d - 277 0 <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 /> �YfnC /� f l7at�f <br /> GovL Lot Nk/1/4Alt 1/4 S k3 T qL7 N R 15— E(or) <br /> Property Owner's Mailing Addrelot# Biodt# Subd.Name or CSM# <br /> Silo (�C 11wo� /�v� 71719 h" II ckjt <br /> City State Zip Code Phone Number ❑City ❑Village IN Town Nearest Road <br /> #1 u /rivood IYI AV. SSI (6r1 ) 771-y9w9 JatC)4 s(J wleI" G7` <br /> New Construction Use.%Residential/Number of bedrooms Code derived design flow rate q. L GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G I ac r a ( 0'-i re-ii- Flood Plain elevation if applicable AIM ft. <br /> General comments u P p e^ c e l l 9 3x <br /> and recommendations: La wt- eel, <br /> qLLr,S— <br /> �OhlzO d, Ih ODr1 vt GAv-t <br /> Boring# ❑ Boring <br /> ® pit Ground surface elev. Q s' ft. Depth to limiting factor � 7d in. <br /> SoilApplication 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 /> d-3 "YJYk JS C 5,? m 1 cS 3c0 . 7 14 <br /> 3 -IS' 7..6-'r/? 055 m I 9 S 3 AV/ r 7 !, <br /> 3 /S- <br /> 3s- 7'ss 4 `'/4 vn S 055 M 9 S 1 vt` 7 1, <br /> �l 3s 76 71sy/q -�'q -- Y775 055 vYt I 95 — - 1 6 <br /> I Boring# a Boring r 1 7 <br /> 11 V° II W pit Ground surface slew. J `0` ft. Depth to limiting factor g n. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundaryk"3hi <br /> GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> j a._y 7,stq 3/ 1S ass 5 17 I. <br /> y_ 7.ssRY ms os I 5s ` 7 !,6 <br /> 3 17,36 7XS '/? 4/ m s O s5 ?n / 195 0 7 1.6 <br /> y 3L 7,5-t/I %ry — mS 0 3j hi I 95 — , 7 1.6 <br /> 1,4 <br /> Effluent#1 =BOD >30:S 220 mg/L and TSS>30<150 mg/L Effluent#2=BOD,:5 30 mg/L an <30 mg/L <br /> CST Name (Please Print) Signature CST Number. <br /> JtfMt-J 5r l t 1s yt� 71. '7 8 q,41.a <br /> Address Date Evaluation Conducted Telephone Number <br /> 77& 3.5' Wiebf rr- G11' 5-Y L!- /6—© -715--r6t- 9/s <br />