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Wisconsin Department of Safety and Professional Services <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT Page_of_ <br /> in accordance with SPS 383,Wis. Adm. Code �-7 <br /> L4. r#1 <br /> �s I (�-a <br /> e t/ <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must L7 <br /> County <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. I s jd-S!S gas-- 0 34000 <br /> ercent slope,scale or dimensions,north arrow,and location and distance to nearest road.p -ptA-1-N0- cz3S os o <br /> Please print all information. Reviev,�d by 036000 <br /> Personal Information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). (�j� <br /> 61 <br /> Property Owner/' ' Property Location 7 CR <br /> Gar we wer44 Govt.Lot 1/4 1/4 S T <br /> ad 4Yo N R/S' E(or)® <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> dd 38 !►lol7gwk lye S <br /> City State Zip Code Phone Number []City []Village [OTown Nearest Road <br /> Al S+. ?A w.f Al n/ SS-/00 (GSl ) $Ir--Oa(o l <br /> Jw�lcson 1. fk11 6t /7d <br /> New Construction Use> Residential/Number of bedrooms� Code derived design flow rate 3 pU GPD <br /> Replacement 0 Public or commercial-Describe: <br /> Parent material l/A c r a1 ,`< Flood Plain elevation if applicable N11q ft, <br /> General comments 5 ys, B/e✓• 9S. o a fi. • 41 <br /> and recommendations: <br /> Boring# 11 Boring 97, S <br /> PPit Ground surface elev._ _ft. Depth to limiting factor > 80 in. <br /> Soil Applicaflon Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 Eff##2 <br /> 7.SyR3/A — /S �lmsd/c , vh / CS sm 7 el6 <br /> 3 dg-yo <br /> ! CS 3e <br /> N ya-Sd SyIZ �%y - -r/t;r D s , , / — I /_ . -7 16 <br /> witA Syz `7/.ti/ 1✓6S rJ � �,�h s <br /> Boring# Boring <br /> 0 Pit Ground surface elev. cl 7 7 ft. Depth to limiting factor 9y in. <br /> Soil Apolicatnon 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 /> J o - S 7.3'`I/2afd (S d» s6A, <br /> at 7.s'%rZ S/y r,s4le I 4 S <br /> 3 3Y) 6- 7e? v/y 1FS�<✓ ,Zms6/e- r., I C 5 eco . S- /• O <br /> N yA - 7Q 7.5•11R 1 -z/ Gr CSG ,., I — l/` -7 <br /> /ZY/Y — Iv FS /a1fo / 6a..rp <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) ignature CST Number <br /> Oi� ,173�1of <br /> Address ODate Evaluation Conducted Telephone Number <br /> 7-7(;-O 3� W�6s><:°, u/ 55893 CJI' (o 7/S- Gob- WS-7 <br /> SBD-8330(R07/13) <br />