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Wis.Dept of Safely and Professional Services SOIL EVALUATION REPORT Page_of <br /> Division of Safety and Buildings <br /> in accordance with SPS 385,WS, Adm. Code <br /> AffectCounty 2 <br /> Nerr- <br /> includ complete site plan on paper not fess than r er x 11 inches( in,dire Plan must f <br /> percent but not limited to:venin and north <br /> horizontal reference point IBM),ante to <br /> and parcel LD. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all lnformation.$r 0-35 Reviewed by smD� i3 <br /> Perel ination formyou pr—de may oe m ed fox ma <br /> purposes IPcy Lav,s.15 M(1)(m)j. <br /> OK <br /> Property Amer Property Loc�a/tion ¢ 417 <br /> _ Govt Lot 2 114 114 S J J T 39 N R )y E(or)Z <br /> Pro ny Owners Mailing Address LM# &ork# Subtle Name a CSW <br /> JOC1 Jb3 v 1 a 30 <br /> City State Zip Code pye Number L1 City Village own Nearest Road <br /> ,.M„v,, Poo MIA 55Y17-1 ( ) QLJ5<- AID oW1t <br /> DJJ ew Construction User Residential I Number of bedrooms�j_ Code derived design flow rate .S GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material aj4zij#j ”NTW/l5 t4 Flood!Plain elevation If applicable R. <br /> General ccommentsvrc <br /> and recommendations: <br /> Gov✓E�+71 D wk r- <br /> Bonng <br /> Bou g# / <br /> Pit Grountl surf..elev. J O O ft pppth to 4rn0rg factor �6 in. Sod lication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistenoe' Boundary Roots GPD/8 ' <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 001 'tfl#2 <br /> o - ,5 a iS zbk m 3 . 7 <br /> Q s- ✓ 2 <br /> 3 ar-y6 .�Yo sy 5 Os 27 <br /> 1 # ❑ Spring <br /> Fz— q� LJ <br /> C,�Pit Ground surface clew. 1 ft Depth to IvnNdorL in.ng fa <br /> SW licetbn Rah <br /> Hp"on Depth Dominant Color Redox Description Texture Structureonsatence ntlary Roofs GPDIR ' <br /> Munsell Q,Sz. Cont.Color Gr.Sz.Sh. fl#1 ' R#2 <br /> D- 7,5 r kL S k M c 5 3-- . 7 6 <br /> 5-34 K —n&z— Gw d — • /. 6 <br /> -Effluent#1=SOD >W0 220 mgr&and T55>38 <150 n4k EMuent#2=ROD W mgr&and TSS <30 mg/& <br /> CST Na S' aIIA CST Number <br /> LAC, <br /> Address - Date Evaluation Conduced Telephone Number <br /> A/571 a-r G% Nu rI K oNzv� L Is -3! i �r r E-rc d a <br /> SKSb SBD.8330(RI 1111) <br />