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Wisconsin Department of Safety and Professional Services Page of
<br /> Division of Industry Services C s(- ,/98'
<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, N
<br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. s -°
<br /> scale or dimensions,north arrow,and location and distance to nearest road. d?-c*a-�_Lio -lie aty-Sc "1
<br /> O 3//©DO
<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)). W ki I !D'14'11'/b*Z,p
<br /> Property Owner Property Location 0 El
<br /> --sd n j0. f ae-k o vL' Govt.Lot Ll % '/ S d l� T 1/0 N R /et E (or) W
<br /> Property Owner's Mailing Address Lot#.2, I Block# Subd.Name or CSM#
<br /> 9/-5"Eh e,a,✓tt. Lh .,( U- ,k b P .s&?
<br /> City State /Zip Code Phone Number 0 City El Village ®Town Nearest Road //71_
<br /> Le-i P/&lrlNs / . 0/:� ( ) I 1.5-e.,,* /
<br /> c',* C.-C,,,tfy /2,( E
<br /> ❑ New Construction Use:©Residential/Numberof bedrooms '/ Code derived design flow rate Com" GPD
<br /> ® Replacement 0 PublicF..'or commercial-Describe:
<br /> Parent material C(a a a! (� f '
<br /> Flood Plan elevation if applicable /eft.
<br /> General comments and recommendations:
<br /> S>-s- f-ev 87.O/ 6'q,. 90/o go. .S
<br /> , /
<br /> Boring# ❑Boring
<br /> ©Pit Ground surface elev.y ,3,Oft. Depth to limiting factor fin.
<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.
<br /> *Eff#1 *Eff#2
<br /> 0-Lt 7,x`91234- /S /w,s6/C m/ e:5- /?" , 7 /6
<br /> d. y-y4 7 3-ii? % — /FS )4n 5 6/e_ rn / G. S /F , - /,o
<br /> 3 36-7? 7,511k '41 — /F-5 vl w/sbk ;--, i 6 t 1 u,= J. 5— /, O
<br /> 11 7 3-Pt -7.5- -11•711/.1 5 o 5 6
<br /> d I Boring# ❑Boring
<br /> Pit Ground surface elev. '1ft. 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.
<br /> j O /D 7,S`9,�;/J *Eff#1 *Eff#2 -
<br /> /s l>~,_//e oil C s , >/- , 7 46
<br /> 01 it -yo --7,s'72 `1/y /Fs d0-3.5K
<br /> A, /r5 „10.5.5 k I d 5' a6F , 5- /, e-
<br /> ll 65- FJC -45-7?-7/9 — /FS ),....5,6k- --
<br /> *Effluent#1 =BOD,>30<_220 mg/L and TSS>30 s 150 mg/L *Effluent#2=BOD,>30 s 220 mg/L and TSS>30 5 150 mg/L
<br /> CST Name(Please Print) Signatu CST Number
<br /> .J,tW,,rs -51.),..l,-e/s s !),#,.....---4- -73ttAU
<br /> Address77 G e /'-Y '
<br /> � Date valuation Conducted
<br /> (4/ 263>er, Gv_r- S�-8 ? �_,1 sr—'d Telephone Number
<br /> 7/s= 3'wG--yiS7
<br /> SBD-8330(R04/15)
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