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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_L of 3 <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 inches in size.Plan must County 3&tr.1 e7 - <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print aii information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ''f /_ <br /> Property Owner v Z& a'r' <br /> Properly Location <br /> t f/es Ste//recht Govt.Lot Sk✓ 1/4 1'414 S 7 T 39 N R MY E(or <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSW <br /> s720 J.44-k A re Ln 1 esm v. aC) 30 <br /> City State Zip Code Phone Number ❑City ❑Village Town Nearest Road <br /> S wr s4�oi ( W5-)6,�s=P69� ewe h7W <br /> New Construction Use:(8 Residential/Number of bedrooms � Code derived design flow rate .300 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material //GG/ix / Ur%Fy Flood Plain elevation if applicable X1/`7 ft <br /> General comments <br /> and recommendations: <br /> P Boring# ❑ Boring <br /> © pit Ground surface elev. 9S ft. Depth to limiting factor ,�' 7A in. <br /> Soil ADDlication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. I •Etf#1 'Eff#2 <br /> o- K sy/? — /S a ,+f 1 7 /. 6 <br /> / (53r 3 rvr 7 1146 <br /> 7 /. G <br /> 4f 36-S'6 7.S` 1i"I'ey S o ,,r/ GS — . 7 <br /> / 6 <br /> 71 Boring# ® Boring <br /> 1 Pit Ground surface elev.�S�fL Depth to limiting factor 7 77 in. <br /> MuADDIiCatiOn 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 /> 6- q 7.SYef;)�- e — s <br /> t� . 7 /6 <br /> err-36 7.'5�(Z% /1 .7 1, 6 <br /> 3 -sy -7sYR7 /. <br /> Sit- 7v i751-/?JPq <br /> 7 15 <br /> •Effluent#1 =BOD >30:E 220 mglL and TSS>30:5 150 mg/L •Effluent#2=BOD <30 mg/L and TSS<30 mgll- <br /> CST Name(Please Print) Signature CST N <br /> SWM�S S• h/Elf f 73 <br /> Address Date Evaluation Conducted Telephone Number <br /> 35- We Plow, url-578!.3r /L -�s-6 -mss= SSG- Ws7 <br />