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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 /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County pjj_ <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 7 <br /> a �2 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0/9 02� 07 <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Lew,s.15,04(1)(m)). <br /> Property Owner Property Location �p <br /> Govt.Lot 1/4 1/4 S 3 T // N R /(0 E(or)W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 2248 r. d. 0 <br /> City State Zip Code Phone Number ❑City []Village Town Ngarest Road <br /> New Construction User Residential/Number of bedrooms_� Code derived design flow rate _GPD <br /> ❑Replacement ❑'Public or commercial-Describe: <br /> Parent material Alms s W Flood Plain elevation if applicable IY/J ft. <br /> General comiments <br /> and recommendations: <br /> Boring# ❑ Boring <br /> 5Pit Ground surface elev. �r• ft. Depth to limiting factor 1 76 in. <br /> Soil Appilication Rate <br /> Horizon I Depth Dondnant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl? <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. `Eff#1 'Eff#2 <br /> S - 7 AZ <br /> .7 /.7- <br /> a �# Bonn <br /> ❑ pit Ground surface elev. ft. Depth to limiting factor in. <br /> Sal 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 /> / 0 2 <br /> 2 M <br /> Effluent#1 =BOD >30< <220 mg(L and TSS>30 150 mg1L `Effluent#2= D <30 mg1L and TSS 130 mglL <br /> CST (Please Print) — — — CST Number <br /> ;KCJ4AAQ <br /> Date Evaluation Conducted Telephone Number <br /> 27760 W► -gam 5 •2z-o) Its- g"- S <br />