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y <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT V R I G I i y AL_of_ <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 112 x t 1 inches in size.Plan must 9UfZkWM <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> 06 percent slope,scale or dimensions,north arrow,and location and distance to nearest road. z- o i 2-m <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> Govt.Lot � 111/4 S 2-9 T 40 N R l� E(o W <br /> Property Owner's Mailin ddress Lot# Block# Subd.Name or CSW <br /> Ht4FP 1 21516RC RRMLS <br /> City State Zip Code Phone Number ❑City ❑Village own Nearest Road <br /> ICIAIUWa M ( 1Z ) ! uT <br /> 81 New Construction User Residential/Number of bedrooms _ Code derived design flow rate GPD <br /> ❑Replacement ❑ Public or commercial-Describe: _ <br /> Parent material fj(f 11 Flood Plain elevation if applicable �J 'ft. <br /> General comments <br /> and recommendations: <br /> Boring# u Boring �'7� <br /> Pit Ground surface elev._ _ft. Depth to limiting factor >76 in. <br /> Soil Application Rate <br /> jHorizonepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 -Eff#2 <br /> �� S DS �t� e- I d 7 /.Z r� Ms IDS <br /> FilBoring# / <br /> Boring <br /> Pit Ground surface elev. s•(a ft. Depth to limiting factor t 3—in. <br /> Soil Application Rate <br /> Horizon pth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP <br /> Nn. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> o-1 <br /> Z 7- 1Z 7 1,Z- <br /> -71-1 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30:5 150 mg/L •Effluent#2=BOD <30 mg/L and TSS 130 mg/L <br /> CST Please Print) — — Ra re — CST Number <br /> z sl <br /> Address Date Evaluation Conducted Telephone Number <br /> z7-160 X W sgn W1.S48 9-1( • oo -1 <br />