Laserfiche WebLink
Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPO T Page_of_ <br /> in accordance with SPS 383,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 112 x 11 inches in size.Plan must LK v N t 0 <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. C 7- 0Q-,Z-140-I.S-IN-3'0S <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. d- oil f ec <br /> Please print all information. R iewe by �Dgate <br /> Personal information you provide maybe used for secondary purposes(Privacy Law,s.15.04(1)(m)). X-4 —I 1 <br /> rty Prope Owner Property Location U <br /> T <br /> G h / r d,& Govt.Lot 114 114 S 14 T 416+ N R ZS- E(or)W <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSM# <br /> J a v„-es Aite N <br /> City State Zip Code Phone Number City 17 Village WTown Nearest Road <br /> ,✓Yl /j All f::-411j kecr utn J-rw <br /> New Construction Use Residential/Number of bedrooms_� Code derived design flow rate S f4.(r GPD <br /> misplacement rl Public/oar commercial-Describe: <br /> Parent material �}t'a e j 4 /J N t 1r1F Flood Plain elevation if applicable <br /> General comments �/ <br /> and recommendations: -<YJ. C/-e L.pp - <br /> /swY V `73, e' <br /> ❑ Boring# (� <br /> El Boring Gr <br /> Pit Ground surface elev. 90J ft. Depth to limiting factor_ �> 7j_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 /> o- 7.5-y21/ 1 .5 /wrs6/,- 1 C sr '101 . 7 16 <br /> A '-f-" 7s-Nf?s7"9f Mis dM 56/c f G 5 146 <br /> 3 4*--7a --7J-In? <br /> �� <br /> ® Boring# n Boring <br /> 12 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 Or.Sz.Sh. *Eft#1 I *Eff#2 <br /> r: 0-14 sye / /'S Xwslle `" cs 301 .7 <br /> -9- 113 7,s yl?� /FS sSX Gj 3ee " <br /> 7.S1U7 -- /ems d.+»s6/e- ?„ ( G S -4 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD,<30 mg/L and TSS<30 mg/L <br /> CST Name(Please Print) Signature I CST Number <br /> ;!e,w1-c s -� �a e? +�e fS S J 73 44(A0 <br /> Address V Date Evaluation Conducted Telephone Number <br /> )774,0 A,.. 3 r �- d G 17 7<s=JY4 - v/s-7 <br /> SBD-8330(1107/13) <br />