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VVsconsin Department of Safety and Professional Services ORIGINAL <br />Division of Industry Services <br />SOIL EVALUATION REPORT J� _ r Page of <br />in accordance with SPS 383, Wis. Adm. Code <br />Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 8" <br />include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 07 - avo ",t `3 y` {S�-D 0 3 <br />percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Cv Oct •- o %/000 <br />Please print all information. R 'wed by Date <br />Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / j —/.�r_ ' `7 <br />Property Owner Property Location v� <br />Ike, d/ Cr -° S `% e - i f Govt. Lot 1/4 1/4 S 6 T 3'/ N R/ 9 E (or) W <br />Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# <br />:�76 e <br />City State Zip Code Phone Number City nUllage ZTown Nearest Road d 7oy� <br />/vew l?lCfimu>,c1i Z1'�" 3Yb17 ( ) we.s /%iiU,,-wca /rt <br />nNew Construction Useo Residential / Number of bedrooms 3 Code derived design flow rate y5 C GPD <br />® Replacement ri Public or commercial - Describe: <br />Parent material 6�11<CiA Flood Plain elevation if applicable <br />General comments <br />and recommendations: Sys E' v 99, r <br />Boring # U Boring <br />/ I <br />III "' Pit Ground surface elev. 96 ft. Depth to limiting factor S`! in. <br />Horizon <br />Depth <br />in. <br />Dominant Color <br />Munsell <br />Redox Description <br />Qu. Sz. Cont. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />Boundary <br />Roots <br />ouu r%ncauun mate <br />GPD/ff <br />'Eff#1 <br />'Eff#2 <br />>N It <br />f le"I O .� <br />% <br />A (� <br />Boring # Boring <br />0 Pit Ground surface elev. ��"p ft. Depth to limiting factor Sy in. <br />Horizon <br />Depth <br />in. <br />Dominant Calor <br />Munsell <br />Redox Description <br />Qu. Sz. Cont. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />Boundary <br />Roots <br />oun /ippiicauon nate <br />GPD/ff <br />'Eff#1 <br />'Eff#2 <br />% <br />A (� <br />- ••--• •• •• .•�.. - ..., - «., I I lyp al w I JJ -JU _ IOU niyL - trrwent 1;2 = BUDS < 30 mg/L and TSS < 30 mg/L <br />CST Name (Please Print) Signal CST Number <br />41 j X773 e/d o <br />Address Date Evaluation Conducted Telephone Number <br />his -'7 <br />SBD -8330 (807/13) <br />