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ORIGINAL <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_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 1/2 x 11 inches in size.Plan must <br /> Include.but not limited to:vertical and horizontal reference point(BM),direction and Pym 1.157 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. Reviewed by Date �J <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> TED wog- F-C Govt.Lot 1/4 1/4 SN T 4 N R E(or <br /> Property Owner's Mail' Address Lot# Block# Subd.Name or CSM# ' <br /> !b o 1�.►1��- SU I-t� 400.. ._. s-_. - <br /> city State Zip Code Phonll e Number ❑City ❑village -OTown Nearest Road <br /> i 1 6E ( S2.) &= - U�) <br /> New Construction Usei'lg Residential/Number of bedrooms_ Code derived design flow rate GPD <br /> ❑Replacement /1 ❑ Public or commercial-Describe: <br /> Parent material �7wiAL POPE Flood Plain elevation if applicable <br /> General comments <br /> and recommendations: <br /> gs-Z- <br /> Boring# Boring <br /> 1 pit Ground surface elev. ft. Depth to limiting factor >78 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f! <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> r .s it z s MI 15 24 .-7 /-Z <br /> -S a3Z A MI s 2 ca .7 z <br /> 3 4% 6 AUSa mr), Cf 44K •7 /.2 <br /> 4 46 1 Sq /P -7 AI- <br /> a Boring# 1❑� Boring — <br /> �►I pit Ground surface elev. 7 ft. Depth to limiting factor-*7y in. <br /> Soil kation 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 /> #5f . ? e.a <br /> z 5-28 7,SUA12 µl A$ Aa • #7 z <br /> 3 2$- 7jue g A41 <br /> hoelzopi 4*3 w 4�S R 41611 <br /> /f <br /> r <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <;0 m9n a`'TSS 130 mglL <br /> CST (Please Print) - - ignature - --r^ST Number <br /> lil I 'l.rSSSI <br /> Addrest Date Evaluation Condur3ed Yehiphone Number <br /> 2760 Wer W S6-4+s-7 <br />