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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 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 Canty Qk r n'e f f <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Paroel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0j IT— q IDd- Opt 0 00 <br /> Please print all information. Reviewed b Z 1,+F. Date 1l I <br /> Personal information you provide may be used for secondary purposes(Privacy law,s.15.00(1)(m)). M...L t'4 <br /> Property Owner T Property Location /// ���"'���••• <br /> M is k LZA,,So h Govt.Lot 6 NW1/4 NR/1/4 S 9 T q0 N R /y E(ta <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> .(319 ll;dden (/a lle Ln. <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> S7C /"/V I Ss-O91. (/0s/ )430-9d36 Scoff Lon 1-4 /?j <br /> j I New Construction Use:O Residential/Number of bedrooms 3 Code derived design flow rate z/r0 GPD <br /> Replacement ❑ Public or commercial-Describe: <br /> Parent material erlac1w. Flood Plain elevation if applicable ft. <br /> General continents / 93. S For 'Ve w Oe A."r1 Fr e%Q <br /> and recommendations: $/-.f• E 'e <br /> GXisF�nS syr'• e%v. 910.9 <br /> 1-71 Boring# ❑ Boring Q <br /> ® Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil 'cation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Effn <br /> / 0-13 7.SrR3/,t /S /ms64 ml cs 3F _7 <br /> /-4-As 7,srl24/y /s /Ms6k „.l! rrS 3s< 7 <br /> IT- 91 7,5W `//N — S OS-3 m G S — • 7 <br /> Ll N/-80 1 7.9YA %y s14 OS 3 rn 1 GS - . 7 <br /> ® Boring# ❑ Boring <br /> ® Pit Ground surface elev. ft. Depth to limiting factor > 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. 'Eff#1 'Eff#2 <br /> / <br /> o- 6 7-s-m -'/,L - /S /ms6 k ,,t / c s 3r .7 /. A <br /> A 6.39 7S4R "At - /s //hsbk mI GS 5>` . 7 %, A <br /> 3 38—YS- 7-S 7R Y/`1 S O s G ,,, 1 65 .7 <br /> Y yr- sr� `'/4 — Ifs Annsdk i,"r, GS <br /> S ss-cid 7•9YR %/ <br /> Effluent#1 =BOD >30:E 220 mg/L and TSS>30:5 150 mg/L •Effluent#2=BOD,:5 30 mglL and TSS<30 mg/l.CST Name(Please Print) — — Signature CST Number <br /> JAm E•s •S DAf'1/6/s S 1�2vw�7 73 <br /> Address Date Evaluation Conducted Telephone Number <br /> 7760 ffu, 3s" webstc, wr 51r/ e93 7 <br /> nl.n n1•.n,,.n�,Mn. <br />