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WisconsinisiofDepartmentofSafelyandProfessionalServices ORIQINil. <br /> Division Industry Services <br /> SOIL EVALUATION REPORT ge_o <br /> in accordance with SPS 383,Ws. Adm. Code c5r—H <br /> County /3'- <br /> Attach complete site plan vertical <br /> paper not less than 8 fer x 11 inches in size.Plan must <br /> include,buteslimited to:dimensions, <br /> port arrow,izontal reference point(BM) e to <br /> are parcel LD.OJ-a3?-A-41-IG-36-V o3- <br /> percentslope.scale ordimensions,north arrow,and location and distance1p nearest road. o0'6 - �/yG04 <br /> Please print all information. Reviewed by Information y.,��/� Date <br /> Poisol Informan you promay tm vied max <br /> rsecanw v�rMms tPni Law.s.is oa(1)(m)), G"/G zZf4%/� I /d-ii <br /> Property Owner Property Location <br /> L-41 -I-III p?/C"r^ Brad.Lot SW 1/4 s6 tla S36 'T I? N R' 16 �r® <br /> Property Owner's Mailing Address Lot Block S.M.Name or CSM8 <br /> t asst 5 y x/783 V 9 P. 2 . <br /> City Slate Zip Code Phone Number ity ❑Vllage Town Nearest Road 631.5- <br /> 1))A;r <br /> 316-n),v Isna 1 ) swiss .• '<}/l, Lh - <br /> El New Constmc0on Use® Residenlial/Numberofbedrooms 1 Code derived design flow,rate 300 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parentmaterial //air />,: e-y Flood Plain eleyaticndapplicable <br /> General comments [i3 <br /> and rCNmmentlalions: <br /> Bodng# Boring <br /> © Pit Ground surface elev. ` 7. 0 ft. Depth to limiting factor d P6 in. <br /> Soil Application Rate <br /> Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> ia. Munsell Ga.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 -Effd? <br /> )/ a- y 7.Jr-YRs /,�/.� / ZA I 1 < s 3m . 7 <br /> / <br /> Y- /,Y 7.JrI//Z�� /1 JMJS/L MI Gs 3T . 7 <br /> N-f0 7.SYrY'</4 f 0SG M f GS J r= . -7 /6 <br /> c/ <br /> 0-n -76 Rr/y <br /> ® Boring# Boring <br /> ❑ Pit Ground Sortace elow. g6•�it. Depth to limiting factor In. <br /> Sod Application Rata <br /> Horizon Depth Dominant Col or Redox Description Texture Structure Consistence Boundary Roots GPDIfP <br /> iLL Munsell On.Sz. Cont.Color Gr.Sz.Sh. 'EN#1 'EH#2 <br /> 71 7rYR;i -- s . ? /•6 <br /> / <br /> �a <br /> 'Eflaent#1 =BOD 1301220 mg/L and TSS 30 150 mg/L 'Efllueril#7=BOD <30 mglL antl TSS<30 mgf� <br /> CST Name(Please Print) �•� Signature �l {/' CST Number <br /> 4) ^-4 d 73-,,t d <br /> Address Date Evaluation Conducted Telephone Number <br /> 3S' w¢Esfr� .s^Y<?93 /o - d - /'/ 7i<- PGG �-N/,i 7 <br /> SBD-83301 R0"1/13) <br />