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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 7 <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 12 x 11 inches in size.Plan must Country -e 7'/ <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I D o7 OJ1 d W/ / I7 S' <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. &*jr O/4 o e0 o32 5217 63"O <br /> Please print all information. Revi by y Date fN <br /> Personal information you provide my be used for secondary purposes(Privacy Low,s.15.04(1)(m)). 4 ..'O/0 <br /> Property Owner / Property Location <br /> J % LAX rl i 1 ce _50t IV CS001 Govt Lot s' 'K 1r4 S 17 T y( N R /s R(or)W <br /> Property Owner's Mailing Address Lot# I Bleck# I Subd.Name or CSM# <br /> d/8 13454O. & Rd. .'r V.I'i F -1) <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road $o 5"9/ <br /> WO-Y aa+a 1 Ptn)V I rS391 I ( ) >wfu j A.6erL/c 0, <br /> ❑ New Construction Use:® Residential/Number of bedrooms J Code derived design flow rate 4.S"O GPD <br /> ®Replacement ❑ Public or commercial-Describe: <br /> Parent material _ G/acre./ 0--f-"' Flood Plain elevation if applicable y//9 ft. <br /> Genera(comments s S. e/ g✓. 9{00 <br /> and recommendations: Y ) e�2i <br /> /#won 90.00 (89.(.74-0 91.00 <br /> Mapped as 399 Gf 1J - Gre If� Sanc( <br /> a Boring# Boring <br /> © Pit Ground surface elev. 93. O ft. Depth to limiting factor 7 7g in. <br /> Soil cation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz Sh. •Eff#1 I •Eff#2 <br /> 1 # <br /> -q 7.6Y R 1/y — /S /h .%61e , l c jr .1 . 7 /, G <br /> cZ If >S'Y•?Vj, /J .1mt614 . 7 /. 4 <br /> /r- y8 7,$-Y/r W/& — s ms G ,., / G s ,i,n 7 44 <br /> �l <br /> ,Pit- 79 rs•hR %9 — S o« ,., I — — . 7 /, 6 <br /> Boring# ❑ Boring <br /> pit Ground surface elev. `t 3' O ft. Depth to limiting factor Y 74 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 I 'Eff#2 <br /> / #, H 7.avRA/� — S ,„ s6k , / cs 'Y + . 7 <br /> 01 /Y-/4/ 7•SY/?4 -- S j» s6/C /. ! Gs Tc# -7 /, 6 <br /> 3 Y- so -/r'f/7 s m s s ,., / G s d -7 b <br /> 74 7.SYR�Y f DS4 r. 1 — — - 7 /. 6 <br /> Effluent#1=BOD >30<220 mg&and TSS>301150 rrg/L •Effluent#2=BOD <30 mg&and TSS 130 mg& <br /> CST Name(Please Prim) - Signature / CST Ntxrber <br /> Groes San/e /s 734)0 <br /> Address V Date Evaluation Conducted Telephone Number <br /> d477(oDf/s 3� W�S)�r w2 S48s3 h-ot9-/O lis- X66- 4/s7 <br />