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Wisconsin Department of Safety and Professional Services <br /> Divlslan of Industry Services <br /> SOIL EVALUATION REPORT - age a of <br /> in accordance with SPS 383,Wis, Adm. Code <br /> County <br /> Attachde,but of Imple d to:on paper not less horizontal <br /> 81/2 x 11 oint(1 M),dlr.Plan must <br /> include,but not limitetl to:venicaland horizontal reference point(BM),direction and parcel l D.o7-oYbd-4/-/6_3t-Sor- <br /> percenlslope,scale ordimensions,north arrow,and location and dotanceto nearest road. Ooh- Odd000 <br /> Please print all information. - Reviewed by _I Date <br /> Personal information you Provide may be used tot secpnaary purposes griv—y law,5.150,t(11(mg V4XI IA <br /> Property Owner ' ,n1 Properly Location (/ 'lxr <br /> O<✓C AyO Govt Lotb N✓ 1/4 SL 1/4 S 33-T e// N R /( E❑(or© <br /> Property Owner's Mailing Across Lot# Black Sued. Name or GSM# <br /> 1.5-10 Ar•bo.^ G; � ' ✓ 9 /' adb <br /> City Shale Zip Code Phone Number ity ❑Village LfjTo.P Nearest Road,l9Ldb <br /> 11�<w�s/a /r Ftl /t^>N �S//.4 ( ) wrJ • 6�'l4 hfe„ [�.- <br /> N.Cmateaction Ul Residertial/Number of bedrooms .➢ Code derived design lay,rate 4J� GPD <br /> Replacement Public or commercial-Describe' <br /> Parent material Flood Plain elevation fapplicable AUM fi, <br /> General comments /<✓ 9y.0 <br /> and recommendations <br /> P Boring# 111Boring <br /> Pit Ground surface else, 9 7. 9 ft Depth to limi0ng factor ) 8y in. <br /> Soil A ,bon Rale <br /> Horizon Depth Dominant Color Redox Description Texture St--"1- Consistence Boundary Roots GPD/fe <br /> in. Munsell Qu.Sz. Cont.Color Gr.SL— 'Ef(k1 'ER#2 <br /> / o' -7.5- 'B 3/,a — lJ /—a 6/e r <br /> f Y- /f, 7Sy,Z `a/v — ' 5 st,.r6/e I G 5 3, <br /> Boring# Boring <br /> ® Pit Ground surface els¢ 97' 0 0. Depth to limiting factor �o 79 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Calor Redox Description Texture Strecture Consistence Bountlary Roots GPD/f' <br /> It. Munsell pu.Sz. Cont Color Gr.a.Sh. 'Eft91 'Eff#2 <br /> / 9- N 7SH,P 31, — cJ 3/n . 7 / 4 <br /> of Y. le <br /> 3 /o-sa 73'b/) % <br /> v re- ?s'vR S d SG f <br /> 'Effluent#1 =BOD >30 220 ari and TSS>30 1 150 mg/L 'Effluent 12=BOD <30 mg/L and TSS<30 ng/L <br /> CST Name (Please Print) i �'p' Signa aPe CST Number <br /> -1 7 3 S'! o <br /> Address - Date Evaluation Conducted Telephone Number <br /> a 7760 3S wa5'sfY� a✓s .f y657 8-d7-/y � <br /> SBD-8330(209/I31 <br />