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Wisconsin Department of Commerce SOIL EVALUATION REPORT _ . <br /> Division of Safety and Buildings Page of_l <br /> in accordance with Comm B5,Wis, Adm. Code — <br /> Attach complete site plan on paper not less than B 1/2 x 11 inches in size.Plan must County jd/ . <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and <br /> percent slope,scale or dimensions,north show,and location and distance to nearest road. Parcel I.D.a.27:�o2;j�-/4 jQ 03•o00•O/ZOOD <br /> � .�CX� <br /> Please Print all information. Reviewed by Date <br /> Parsonal Information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner /1 RlL IdID <br /> Property Location�c. <br /> /C e r (-/S,$ Govt.Lot SA)' <br /> 1/4.S Gc�1/4 S�I T N R {C E (orJ�j <br /> Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# <br /> 699 ;�f <br /> city --State Zip Code Phone Number ❑City ❑Village }-Town Nearest Road <br /> ❑ New Construction Use:;3�Residential/Number of bedrooms_s Z-- Code derived design flow rate GPD <br /> �-Replacement ❑ Public or com ercial-Describe: -" <br /> Parent material lT//4 C /f1-1 /'/f� r� <br /> Flood Plain elevation ifapplicable —Lti _ it, <br /> General comments <br /> and recommendations: ,5V5& JE�suaf-r 9f:. /7 6 9G. 70 efei <br /> M000r( ds 43-13 - 6m " -r4�tla�iea Lo.,,�/ticf Ao(daC -r. 3f4 t? 8 - Gyedu., �el+ly 51� <br /> Boring# ❑ Boring qq <br /> Pit Ground surface elev._I�L7_ft. Depth to limiting factor �_�_—in. <br /> Soil Application Rata <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft' <br /> in. Munsell Qu.Sz. Cont. Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> ; <br /> 1 17Boring# bN Boring pp <br /> Z ❑ Pit Ground surface elev. ft. Depth to limiting lacto __—in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/re <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> C -L 7,S 3/ — 5 <br /> •Effluent#1 is BOD s,30<220;;;;L and TSS>30< 150 mg/L 'Effluent#2=801 <30 mg/L and TSS 130 mg/L <br /> CST Name (Please Print) Sig at CST Number <br /> Address Date Evaluation Conducted Telephone Number <br /> ,deX .3-/ y SiZ :5-VS'7_2 /d - _0 -/;zFG <br />