Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> 7� <br /> Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must County 8"r 71 e <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. Q <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 03 I f OS'o-3 oo <br /> Please print all information. Reviewed b Date <br /> r <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.06(1)(m)). 164 0 of <br /> Property Owner Property Location <br /> 1?6 k Nelsom Govt.Lot NE- 1/4 IV 114 S ,L4 T yl N R144/-7E(or) <br /> Property Owner's Mailing Address Lot# Bbdc# I Su Name or CSW <br /> /6'4'-'57F�edeen Gt d- (Sc' <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> /1/tu/ 13ri kvr% {m Al SS/4 (6Sl ) 633-86J�0 SwiS5 1.1/ I (rri <br /> ® New Construction Use: Residential/Number of bedrooms .t- Code derived design flow rate 300 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material Glob 1a I &;E+- Flood Plain elevation if applicable /Y�/1t ft. <br /> General comments S. etv. 1/.7 <br /> and recommendations: St' <br /> Boring# Boring <br /> © Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/T <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eft#2 <br /> / e_y 7.S-1`44` /S 4msM- / Gs 3ev . 7 X <br /> y.37 7.S-Y/1 "Yef 1 15 os G- ,,. ( e-S 1cf 1 , 7 /A <br /> r- .7 1,.4 <br /> Boring# ❑ Boring <br /> © Pit Ground surface elev. ��'g ft. Depth to limiting factor in. <br /> Sal Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 '0142 <br /> / o- "Y7.s YA!?yA- — /S as� A" 1 C 5 3C0 . 7 /..l <br /> d. 4- Y4 7s YR �"f — s asG ► GS Seo . 7 AA <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mg1L <br /> CST Name(Please Print) Signature o CST Number <br /> 1Jpm cJ s 4h f10/5 A= 5� ? 73 L/#&-U— <br /> Address V Date Evaluation Conducted Telephone Number <br /> 7 bo Awvis- <br />