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Wisconsin Department of Safety and Professional Services Page of
<br /> Division of Industry Services Cyr–2D -54
<br /> SOIL EVALUATION REPORT
<br /> In accordance with SPS 385,Wis. Adm. Code County
<br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, �iu It11
<br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel 1.0.07-Cla-ot-.1/0-11/-0-s'3"-/S.--
<br /> scale
<br /> Sscale or dimensions,north arrow,and location and distance to nearest road. ,5-76- C,//U00
<br /> Please print all information. evi wed fly Dal
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). I 4/11P)8
<br /> Property Owner Property Location ❑ E
<br /> J?livi o,.+<n 4,-. Pe//4'C.-K Govt.Lot 'IA h S 3 e/0 N R /y E (or)
<br /> Property Owner's Mailing Address Lot# Block# Subd.Name o CSM#
<br /> 10-0 ti res l 3 V' `-1 P /95-
<br /> City State Zip Code Phone Number 0 City 0 Village m Town Nearest Road a 64
<br /> L4..i1-,v r ((e I mW 1-5-'57°1/11 I (G;L& )i�fj I I5"77' I pare /<<,cta LAk
<br /> ❑ New Construction Use:(l Residential/Numberof bedrooms , Code derived design flow rate)00 GPD
<br /> 51 Replacement 0 Public or commercial-Describe:
<br /> Parent material 6 AL',/a /)) -it/' Flood Plan elevation if applicable 40�.
<br /> General comments and recommendations:
<br /> 57j. .1e1,' c 3:d
<br /> Boring# ❑Boring cit./''L4 X 7
<br /> 2 Pit Ground surface elev. ft. Depth to limiting factor in.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> / 0--ti 75'`7134 -- /S /, h/ y,, ! c S 3 m . -7 /,6
<br /> 01 y —aS -7,5,-/i? 947, — /S ,{.,N S 6 it ,vi l C 5 ,k tr, , 7 / 6
<br /> 3 )1"---`1F 7,J-vi/? `'/c — /3 )/1-,..<4/t py, / G 5 -- . -7 / 6
<br /> el `13-'75 7Y-1i? /y 5 c?5 6 in, I -- , -7 /, 6
<br /> Borin # a Boring G ,N 7y
<br /> 0 Pit Ground surface elev. ft. Depth to limiting factor in.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
<br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Efy#1 *Eff#2
<br /> i Ln . L/ 7S`1Z34 — lJl • 7 /i 6
<br /> ii- 3 0 7 5``//T y/Li — / j
<br /> 7 JO-- 1{5- 7,5-‘71? _ i s /, 6
<br /> '1 /is- 7y 7,c II? 47.1 — dS . 7 /, 6
<br /> *Effluent#1 =BOD,>30 s 220 mg/L and TSS>30 s 150 mg/L *Effluent#2=BOD,>30<220 mg/L and TSS>30<150 mg/L
<br /> CST Name(Please Print,ThSignat a CST Number
<br /> Jet. •C,.3S Uct(,),.e_ is S�c- ,)73 91,
<br /> Address i 776 0 "' V ?-f— Date val Conducted Telephone Number
<br /> L' w f?Lel' G .S7/fr 3 ._ `" (1— .).0 lis- f66-- W.5.'"7
<br /> SBD-8330(R04/15)
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