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ORIGINAL <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County tp(A r n e7Y" <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. d 3.1 90/0 011 G 0 <br /> Please print all information. Reviewed b Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). U©� <br /> Property Owner Property Location <br /> p k n 6 r,..s fa,Fsovn Govt.Lot 1/4 1/4 S /S T et N R /5" E(or)( <br /> Property Owner's Mailing Address Lot# I Block# Subd.Name or CSM# /� <br /> PO 0-09 y7d S LD� res <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> er es60 Ng' 1600/"7 (10A ) 66S- SO°?l SWISS Bass Lit /icf <br /> ® New Construction Use:® Residential!Number of bedrooms Code derived design flow rate 3019 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material ,-I"i. I /7r/lei Flood Plain elevation if applicable /✓//� ft. <br /> General comments y3, y �, <br /> and recommendations: S/ Cl `^PP 0 9�i•ab 93.33 Lowest 6cw„-hr►•1 <br /> lew�r 9.t,70 .E,. 9.}•.7a <br /> l 060 AS 6AvLA-G- C439 Apo (5;�4 L"SAMO 399 <br /> Ft <br /> Boring# ❑ Boring© Pit Ground surface elev. 97 0 ft. Depth to limiting factor > Y-0 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I •Eff#2 <br /> / -,I 7s- q/Z 7// 415 6"S6 h o"I C s <br /> A Y- YJ 7.s osd� wr l 65 3eo . '7 /. 6 <br /> 3 ?A-s'0 7.S'y!?y/y os4 ,,,.r / G S 'd.' ? 1. 6 <br /> `l 0-9-0 7.S-7/Z %y — s oSG I — . 7 46 <br /> D Boring# Boring <br /> 0 Pit Ground surface elev. 97.0 ft. Depth to limiting factor�_in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> l 0 - 4 7.SyR aIA /-T /,.asA ,,,/ C.5 3�"� (o <br /> �!- 3 ib 7.s Y/?yl — s osloe A" / 65 3co . 7 1. 6 <br /> 3 zb-st 75"7/?9/1, s os rr ,..� / G s .� . 7 A 6 <br /> 'Effluent#1 =BOD >30<220 mg1L and TSS>30<150 mg1L •Effluent#2=BOD 130 mg/L and TSS<30 mg1L <br /> CST Name(Please Print) - - ' CST Number <br /> ►..es Snature.5 . t.�a��•e/.r d73tie0 <br /> Address VDate Evaluation Conducted Telephone Number <br /> A776o Hr.-r 3r we6-0e- fv3" Sgs9.? `?, a7- 06 7is 9'd6-yis> <br />