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Wscensin Department of Safety and Profession l Services ® � <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT paged_ <br /> in accordance with SPS 383,Wis. Adm. Code <br /> County <br /> Attachcomplete site plan on vertical and <br /> less than 812xeinches insize.Plan must a`a Ga' <br /> percent but eslimited to:vesions, dhorizontal reference point(distadirection nearest <br /> Parcel lD.mT t>J.0-J's0-/b-J 9-S .,r- <br /> percent <br /> s <br /> percent slope,scale dimensions.north arrow,and location and distance to nearesUoatl. omd -o/Sena <br /> Please print all information. Reviewed by Date <br /> Personal lnlmmamnyou proNOe may M used for seCaMary purpous(Pirvary Law,S.15.04(1)(m)). /CJ /a�/(� <br /> PropertyOwner Property Location ❑ K❑ <br /> T M va/ GON.Lot J !.w 1/4 vir 114 S J9 T 4o N R/6 E(or)W <br /> Property Owner's Molting Address Let Block# Subd.Name or CSM# <br /> 89/Pi S -in weal / 1 U./5 �'/>9 <br /> City Sute Zip Code Phone Number ity �Vdlage aTcwn Nearest Road 17 k? <br /> tv"J b.,—y kv7 1SS/JS (6s/) - 6m7 04/c/..op I <7..,,.1 /c•.. Dc <br /> ❑) New Construction Usefo Residential/Number of bedrooms d Cade derived design flow rate 3°0 GPD <br /> Replacement ❑ Public or conarm l-Describe: <br /> Parent material z:/.cFlood Plain elevation if applicable 0 � ft. <br /> General comments <br /> and recommendations: <br /> /✓eft r9`lProA /J"r+ /6r Arb Ae.%cert /+el6r. n nrm+ u+enrer P//r <br /> n/o m.f/lrf mbJ.+✓e® ,n .Zh.-iza <br /> Boring At Boring <br /> © Pg Ground surface clay. 96. 7 it. Depth to limiting factor > LV8 in. <br /> Shc Apificatkin Rale <br /> Horizon Depth Dominant Coto r Redox Description Texture Structure Consistence Boundary Roots GPDHP <br /> in. Munsell Du.Sri Cont Color Gr.Sz.Sh. •Efftl I •Eff#2 <br /> / 6-J/ J-7'? -//3 <br /> lb/< „-, 1 <br /> Boring# El Boring <br /> © Pit Ground surface elev. 5(e• 3 ft Depth to limiting factor > 8> in. Soil A Ilcation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/@ <br /> in. Munsell 0u.Sz. CmL Color Gr.Sz Sh. •EH#1 'EIf#2 <br /> m-J3 S7R °/J C )— ,bl4 mf; is dm <br /> 4 .13,7 -r7� <br /> -7 31- 9Y 7.5'YR %Y 3 o JSG /.,n 1 G S , 7 1, 6 <br /> 'Effluent#1 =BOD =30<220 mgi and TSS 130<150 mg/L •Effluent#2=SOD,<30 rni and TSS<30 mg1L <br /> CST Name(Please Print, Signature d -s . J . til,r S <br /> Address Date Evaluation Conducted Telephone Number <br /> d 776x, f! 3.f GVcbjf-.� wt .r/S9J //- //—iY 7/3='966-4/,3- 7 <br /> SOD8330(Rag/13) <br />