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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> �� ✓ ((- <br /> Attach complete site plan on paper not less than 8 1/2 z 11 inches in size.Plan must County <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcef I.D. D 7 vol 9 d 40 /Y /9 S percent slope,scale ordimensions,north arrow,and location and distance to nearest road. 0e3 od/000 <br /> Please print all information. Reviewed by Date <br /> Personal inforrnation you provide may be used for secondary purposes(Privacy Law,s.15.06(1)(m)). <br /> Property Owner Property location <br /> /nQ r /< L etn of f,s Govt.Lot .3 1/4 1/4 S /9 T 4/0 N R /e/ E(or <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSM# <br /> 7-f yy<a Sf. N. 3j V. // P 13-1-- <br /> city <br /> 3sCity State Zip Code Phone Number ❑City []Village ®Town Nearest Road <br /> D<LKdale M/V I SS7.t8 I ( ) Scoff I <br /> ® New Construction Use:® Residential/Number of bedrooms -? Code derived design flow rate 4/. 19 GPD <br /> ❑Replacement / ❑ Pu�blilic or commercial-Describe: <br /> Parent material (r&e/4/ yr/S'` Flood Plain elevation if applicable R <br /> General comments <br /> and recommendations: SyS - e/Cd- 97- 3 <br /> Baring# ❑ Boring <br /> ®'pit Ground surface elev. 94.8 ft. Depth to limiting factor 345 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 10#2 <br /> I o — v,....7.SXR'7/4 S6 At M l C-S 3F <br /> 7 /•6 <br /> J v- 36 7Svti' /q — /FS ,7H S6 <br /> 3 3b 60 3y� ;�13 F/vsv/� % c ,tmadu <br /> Boring# Boring <br /> Pit Ground surface elev. `/4' R. Depth to limiting factor YY in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Colorl Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I 'Eff#2 <br /> }"It <br /> 75-1//2 �y /FS J,5,6 Ic .� / GS 't.,c . S /. O <br /> 3 vs-s6 s ri7 `'/a /f <br /> No sf/. O(�S-eco-ed�- <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30 1150 mg/L •Effluent#2=BOD <30 rngit and TSS 130 mgL <br /> CST Name (Please Print) ignature CST Number <br /> J�m�s S11n 6 /'S S Jai 734x0 <br /> Address Date Evaluation Conducted Telephone Number <br /> 7760/f~ 3S Lue'63)/w✓ wt 548%3 S-d 3— /oj 7iS- X66- 4/5--7 <br />