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Department <br /> nO s n8ulnSOIL EVALUATION <br /> REPORT ' <br /> in accordance with Comm 85.WS. Adm. Code Page/of <br /> include complete site plan on paper not less than 8 1/2 x 11 inchesin <br /> indud0.but not limited to:vertical and horizontal reference int County <br /> Percent sb size.Plan must <br /> Pe,scale or dimensions,north art (BM)•direction and <br /> ow,and IOCation and distance to nearest road. <br /> Parcel I.D. <br /> Please print ail information. <br /> Paraoral inrormaliOn you pra,nae may be usW aee000 <br /> /or Reviewed by <br /> Prop"Owner ary Purpoa*a 1Pmilcy Law,S.1 <br /> s.da(t)(mU Date <br /> �Yr i <br /> /rzZe- LV /ltCr Property Location I <br /> Property owner's Mailing ss Govt Lot <br /> 3/ E//77 Lot# 1/4 S 20 T yp N R <br /> City Block# 1/4 Subd. Name or CSM# <br /> E(or v <br /> State zip Code Phone Number <br /> t'GiI/yy/ t N "'/' <br /> N S Jb ❑City ❑VillageTown i <br /> c6 5/ ) Y6,3—767y Road <br /> fg] New Construction QNrir4� ,pp�� <br /> Use:(� Residential/Number of bedrooms._ <br /> ❑Replacement Cade derived design Sow rate <br /> ❑ Public or commercial-Describe: 'y�YY] <br /> Parent material er 2t/ r-/� <br /> GPO <br /> General comments Flood Plain I <br /> 5 eevationifapplicable <br /> and recommendations: y5 fL 8 3 <br /> © Boring# f❑I Boring <br /> 19 Pit Ground stuface elev. S ft. <br /> Horizon DepthDominant Col Depth to limiting factor Z47)RedoxDescription in. <br /> in. Munsell Texture Structure Soil Aocli <br /> ' Cu.Sz. Cont.Color Consistence Boundary Roots ration Rate <br /> h-. GPD/rft <br /> 7– 7 �y L i?i5 I `jj L Effxt I -E <br /> F 5c'S I 11,-7 - -7 <br /> Z <br /> K ��_ 3z 75%fl'✓Y�/ j/F 5`r2�/S Frj U �1 6 <br /> Y9 5 <br /> i I I <br /> u Sonno# ❑ Boring <br /> ❑ Pit Ground surface elev �S <br /> Horizon pe - Oepm to limitin �! <br /> Pth Dominant Cola r+ 5•`aror _ in <br /> Redox Des irptien <br /> in. Munsell exture Structure i Scrl Acctication Pate <br /> Qu. SZ. Cont. Color ons stence 9cunda <br /> Gr.S:. Sh. I ry cots -7 <br /> Z l y-27;7Psr� I I l5 <br /> 3 lz/-5y �sYizsr I �l�sY.esiB f5 I oS ��. <br /> Effluent X1 =BCD. > 0< 2 <br /> CST Name (Please Print) -2'�tg L and -SS >30< 150 mryL 'E(a'I�en; "2,. BCD <br /> '---- I-- <br /> = D < '0 mg/L and SS <3 —�— <br /> O d/� p� Signature C mqL <br /> Addrey CST Numr,.r <br /> Z/7�0 3LJ. Date 6iaica <br /> 5 S <br /> Conaured Talecncne;< 3 YD- 21-off Jc.cer <br />