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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page--L of <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 81/2 x 11 inches in sae.Plan must Courdy Aril r N e ff' <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel J.D. o 7 e JA A Y1 r S-A 7 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 9476 oy d ODt7 <br /> Please print all information. Reviewed by Date <br /> Personal information you provide my be used for secondary purposes(Privacy Law,s.15.04(1)(m)). fi JrnG 2olb <br /> Property Owner Property Location <br /> / e rS 'f o n n C.t.Lt. Govt.Lot 1/4 1/4 S OL 7 T /// N R /S E(or <br /> Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSM# <br /> J81OQ Jac � of P.r # �{rnnewsaKex a5S2SSorY ha{, <br /> City State of <br /> Code Phone Number ❑City ❑Village ®Town - Nearest Road 3 e o e y <br /> L</d. v;//e I m v ss-oNN ( ) Swrss I /-Ale es 'oe <br /> ❑ New Construction Use:® Residential/Number of bedrooms H Code derived design flow rate GPD <br /> E Replacement ❑ Public or commercial-Describe: <br /> Parent material G/zu 4 i w / o r/1C{. Flood Plain elevation if applicable N/'/Y ft. <br /> General comments /. OD <br /> and recommendations: Sr1• e/ev. (( 9 . <br /> 00) <br /> mapeed as 399 D- Grayl(-a S.L,d <br /> F1 <br /> Boring# El Boring <br /> © pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate <br /> Horizon Depth Dorninant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell ou.Sz. Cont Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> 41/p _ /3 at—s6 le -7 A e� <br /> 3 /s- y 7.SyR1/y S SG / G s d • 7 /. 4 <br /> 1. 6 <br /> Boring# © Boring <br /> ❑ Pit Ground surface eiev. gs' r ft. Depth to limiting factor > 90 in, <br /> Soil Applicafion Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eft#2 <br /> v–.t> 74-1fRW/X/ s > 116— <br /> AA- <br /> . 6 x- r.% 7.59/?'r — s 7 /• 6 <br /> 41 d- 90 Iry/7 7% <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BOD <30 mg1L and TSS<30 w4pt <br /> CST Name(Please Print) S' natu ,/ Number <br /> - <br /> jc%h18s S02,71e%s g f 73 Q)0 <br /> Address Date Evaluation Conduced Telephone Number <br /> 77�p/fr. 3s Gc/e bs f� rtir S98s3 - />— /D lir- ddb- 4/r7 <br />