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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 7 <br /> Division of Safety and Buildings <br /> in accordance with.Comm 85,Wis. Adm. Code <br /> Attach complete site dam on paper not less than 81/2 x 11 inch"in size.Plan must county <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. p/o( - "1 $'Q _ 0/gpQ <br /> Please print all information. Reviewed by Date <br /> Personal information you Provide may be used for secondary purposes(Privacy Law,a.15.01(1)(m)). <br /> p U9 04 <br /> Properly Owner Property Location <br /> /t pet 6rAeA Govt.Lot va 1/4 S !$"T 1/0 N R /$- (or <br /> Property Owners Mailing Address Lot# Block# ISubd.Name or CSMA <br /> Mal OrGAdrD( fir. g I 7'rr,a.7-S .;4AoU r'o ✓1 <br /> City State Zip Code Phone Number ❑city ❑Village ®Town Nearest Road d 8xrD <br /> (3urnJv%//� 07N i 6.x306 I ( ) jek�kSon 7-•ru+ S r.„ r. <br /> ❑ New Construction Use:[3 Residents]/Number of bedrooms dA Code derived design flow rate__ „�Od GPD <br /> ©Replacement ❑ Pudic or commercial-Describe: <br /> Parent material Flood Plain elevation if applicable /V/ ft <br /> General comments <br /> andrecommendations: .5)0• e/! <br /> �Wfvt as G; yYC61 "—./Nene], a <br /> Boring# ❑ Boring <br /> Pit Ground surface elev. 46.0 ft. Depth to limiting factor 8y in. Soft tiration Rate <br /> Horizon Depth Dominant Color Redox Description Texture StructureConsistence Boundary Roots GPDW <br /> in. Munsel Ou.Sz. Cont Color Gr.Sz Sh. •Eff#1 I •Eff#2 <br /> -y 7XVi,7-&fid ^- /-$ /M adK ,,, / Gtr am . 7 /. 6 <br /> d y- 76 7-fR- IV? — !Fs deradK ! 4S Sao 15- <br /> /10 <br /> 7 31, 7•Stl? Y/y — /FS 'dmd4 K <br /> . ;rti Sr211/ — t/a <br /> / c/adAnt <br /> 41 IrR fn 1.6 <br /> 1 syn>Y <br /> Boring# ❑ Boring <br /> ® Pit Ground surface elev. °Ib'Q ft. Depth to limiting factor > 9b in. <br /> Sal ADDlication 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 /> / O- to 7.SyR '3/d — /t /,,,sd/e .n ! cJ 3M . 7 <br /> A t—41o; 7dv�' y/�/ — /FJ nsd e <br /> +-n 1 6 S 3c <br /> 3 1-60 7.SYi?y/4 — / �S a7 +r 1b/e G5 /n S- <br /> ...„<hI Pif"AA111 7,S4i?H/J <br /> ZI t0o- d6i 7rv/z9y '7 /, 6 <br /> •Effluent#1 =BOD >30<220 mg/l.and TSS>30<150 mg/L •Effluent#2=BOD <30 mglL and TSS<30 mg& <br /> CST Name (Please Print) - Signature CST Number <br /> Jame-s S 73zldo <br /> Address Date Evaluation Conducted Teleptxxle Number <br /> 7760/. 3s lUe-6s If,-, wr v15-7 <br />