Laserfiche WebLink
Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT Page_of_ <br /> in accordance with SPS 383,Wis. Adm. Code CS <br /> County H�r n-e�� <br /> Attach complete site plan on paper not less than 8 112 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.O-)� <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. —voir —0/4 a iyv <br /> Please print all information. R ed y Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). r ,�_'1 J_ <br /> Property Owner Property Location <br /> l?A 44 CR 9k i Govt.Lot 114 1/4 S d y T 11'10 N R /y E(or)W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> (b7 74 in 4-co- S7' d'Y <br /> City State Zip Code Phone Number City Village X Town Nearest Road /Jd y <br /> F] New Construction Use[Z Residential/Number of bedrooms el Code derived design flow rate 300 GPD <br /> fj Replacement rl Public or commercial-Describe: <br /> Parent material 1,/1AG10. yr4 Flood Plain elevation if applicable <br /> General comments <br /> and recommendations: sys t✓/-rv. 9 7„3 / <br /> ❑ Boring# <br /> n Boring <br /> 12 Pit Ground surface elev. ft. Depth to limiting factor 7 7'D in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 "Eff#2 <br /> 0 - 4 7.5-ti1? �/ 15 4. j6/l Aw e- 5 -X *1 7 /•6 <br /> 9- i 9 7 S y R `'/ /S ,., s b A 3 e v . -7- <br /> 3 <br /> -73 1*- d) 7.sy/? v/k S oSG <br /> k G A- 77V s'I Z y/.1 -- 1 e.4 le <br /> ® Boring# 17 Boring <br /> Pit Ground surface elev. �1�/, ft. Depth to limiting factor > 7.? in. <br /> Soil Application 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. I 'Eff#1 I 'Eff#2 <br /> 1 0 -24 7S`IR Il /S Jim 541e I es 3'-p? ' 7 /.6 <br /> y-d.d 75-1i7*9 1 / S dl�MS6Ae 1 GS ace , -7 /, 6 <br /> 3 )a-Lk 7-s-'1R /c s &S6- , 7 /•6 <br /> -7 /. <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD,<30 mg/L and TSS<30 mg/L <br /> CST Name Please Print) Signature CST Number <br /> tis e,h <br /> Address Date Evaluation Conducted Telephone Number <br /> � 7760 SYFr53 •7- /-1 -7/s- 6 z11-5--7 <br /> SRD-8390(R07/13) <br />