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Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page�_of 3 <br /> Division of Safety and Buildings Cj� —I 4 <br /> in accordance with SPS 385,Wrs. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions, north arrow,and location and distance to nearest road. <br /> P/ease print all information. Review <br /> edt Date '. <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 14 3'0v1G,2a5 <br /> Property Owner l �j 'TGM� ell's Property Location <br /> V t*i Fart�i�! - >` ,PO A?�,*-.{ ,&,r� Govt.Lot 114 114 S T * N <br /> Property Owners MalwAdd Subd. orCSKWeS <br /> G <br /> Stalie Zip Code 'Phortd umber .❑City pvfllage RTown ' ` flea st Road" <br /> 4 5:5066< 5l )ns=106 ac o.J Ghar S <br /> New Construction Use:Q9 Residential/Number of bedrooms Z Code derived design How rate GPD <br /> ❑Replacement /❑ Publico co at-Describe: <br /> Parent material [�/NL4C/�/ �ft Flood Plain elevation if applicable H. <br /> Generalcomments <br /> and recommendations: /'tS /O C 95' /a) <br /> P Ped as ag3g : MaAtof+let; /OaSrla( <br /> Boring Boring <br /> # 76 <br /> ® pit Ground Ground surface elev. 7 H. Depth to limiting tactor r in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure >nsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. H#1 ff#2 <br /> m k I�� G5 M . 2 <br /> -/ 7SY Lfi /II 65 !r� •5 <br /> Boring# F1 Boring <br /> © Pit Ground surface elev.�H. Depth to limHing factor 7 —70( <br /> in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure istence oundary Roots GPD/ft <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> Z 3 L Z •5 5 <br /> Effluent#1=BOD >30:<220 mglL and TSS>30 <150 mg/L `Effluent#2=BOD <30 mg/L and TSS <30 mg/L <br /> CST Name(P Princ�r ' / tur T Number <br /> os� /ol�C� � S/95H <br /> Address Date Evaluation Conducted Telephone Number <br /> SBD-8330(RI 1/l 1) <br />