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Wisconsin Department of Safety and Professional Services
<br /> Division of Industry Services .
<br /> SOIL EVALUATION REPORT Page of
<br /> in accordance with SPS 383,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 L`�''�
<br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.C - cd S` " 4j -/q`0-s'-7 45'
<br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. S' o.S'- 0 3/d c O
<br /> Please print all information. Reviewed by Date
<br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). I
<br /> Property Owner ry,/ Property Location El
<br /> 1 i v,y- +c-/1 /e v' Govt.Lot 1/4 4 S ) T 4/0 N R j� E(or)W
<br /> Property Owner's Mailing Address Lot# Block# Subd. lame or CSM# —
<br /> s'6 C/ n-t.s Tr, d 7
<br /> City State Zip Code Phone Number
<br /> City ElVIII.ge x®Town Nearest Road
<br /> Atd36 vt IWY I5V 016 I ( ) 5C0 ht I Heil ker doIliiv /zP
<br /> ElNew Construction Use° Residential/Number of bedrooms of Coded: ived design flow rate 3o GPD
<br /> flReplacement 0 Public or commercial-Describe:
<br /> Parent material t'/4c'/c / ON/Is/ Flood P ain elevation if applicable A//',Q ft.
<br /> General comments
<br /> and recommendations: 57j. e/Zv,/ c y, /
<br /> l 0 Boring
<br /> Boring# 9
<br /> 6
<br /> El pit Ground surface elev. . Depth to limiting factor ,r� E 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.Col. Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> / ( _ '-1 7 S'i 34 - /s I i,-)s,.6 A ,,,-, 1 S 3 m 7 / 6
<br /> 'i-d s'',? `'/y — /J d i, _56 ie r-, ! a s 3 c e , .S' /. 0
<br /> 3 AY- y6 7,S`/i? tel.
<br /> y /y S dS ,n ) � s , �m ,
<br /> G 7 / 6
<br /> `16-.�8 7.s-.7x %y ,--- /FS 6 5 l ,,,., I - - 3- / 0
<br /> s s--4,6 7,5"`►1z/-/y — S o-)-G ,/,�,. 1 — . '7 ! 6
<br /> wlfll s i /'/ .2 �I I, P". 6e r., s
<br /> Boring# Boring
<br /> E] Pit Graund surface elev. 9b `f ft. Depth to limiting factor ) 6 6 in.
<br /> Soil Application Rate
<br /> Horizon Depth Dominant f olor Redox Description Texture Structure Consistence Boundary Roots GPD/ff
<br /> in. Muns' I Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
<br /> I 0- q 7.5-7 - J./d -- / s /),,),5 b lk ;M / c s 3 A-, 7 A 6
<br /> q-3 c 7, `-ii? '/ /FS
<br /> dM 3 P r-, / G j 3 c c: , S / D
<br /> 3 36 vol .,."'717 17/ / 5 0l mS,b/C ,-, 1 S ,,1 h7 , -7 /. 6
<br /> L/ y,i- 6,, 7s'1i2 75, . /fS dms>S%< r, / — — ,3— ,/• 0
<br /> *Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L
<br /> CST Name (Please Print) CST Number
<br /> .�aiK� 3 5 /)ci?,�)t/S /.442i:n_astureo
<br /> L 734/,17e)
<br /> Address Date Evaluation Conducted Telephone Number
<br /> 017-7/e 4y ,mss Zwe!.s><r, Li _ y8'v? /l.- /t—/ 745 g'6e,- yis--7
<br /> SBD-8330(R07/13)
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