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#- -7 -1 3S <br /> EEC -EWE <br /> J <br /> Wisconsin Department of Safety and Professional Services (I OCT 1 7 2023 Page of <br /> /'►G�?,, <br /> Division of Industry Services n?-1'9g <br /> SOIL EVALUATION REPORT Burnett County <br /> In accordance with SPS 385,Wis. Adm. L nsjo*yicIA Department <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, LY 4q v✓� l�-- <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. <br /> scale or dimensions,north arrow,and location and distance to nearest road. 07- 0/6-.1-31-17-d(-4 03-.O pe_01 3 6 U•0 <br /> Please print all information. v' w b Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). "S! 0/02103 <br /> Property Owner Property Location 02 <br /> J 0 ii v, /3 t,k 1,---dA-e-M-e Govt.Lot I% % S f T 3 N R / 7 E (or) W <br /> Property Owner's Mailing Address - <br /> Lot# Block# Subd.Name or CSM# l j�., <br /> iI) 's fitimii.,, i31 d NW U,� .t ) 03 -3 V. Iy Pit�3 Lcoo_ <br /> City State Zip Code Phone Number ❑City El Village al Town Nearest Road ,).7c 3D <br /> .'ov1.1 Ri-pilh Jmnl Iscy33, I ( I i L /,, cAl I Ce /7of Fi7103 <br /> Ug New Construction Use:0 Residential/Numberofbedrooms �,0 <br /> ,� Code derived design flow rate ..3 GPD <br /> ❑ Replacement // 0 Public or commercial-Describe: <br /> Parent material l -/I 4(1!- / D.-•4- Flood Plan elevation If applicable /"il4ft. <br /> General comments and recommendations: <br /> iBoring# 0 Boring J <br /> �J Pit Ground surface elev. • ''eft. Depth to limiting factor 6 in. <br /> • Soil Application Rate <br /> Horizon DeIn.pth Dominant Colorll Qu.Redox Description <br /> ' Texture StructureSz.Sh. Consistence Boundary Roots GPD/Ft? <br /> Munse / Az.Cont.C Gr. <br /> © - Cc 7 3`l� 3} < Al / *EfF#1 *Eff#2 <br /> : : l.)::,ii.,.4//t . i'l I <:. 3 * /11 ' ---2 /' 6 <br /> I d I Boring# 0 Boring ‘. Cl <br /> Cf Pit Ground surface elev. ft. Depth to limiting factor 3. 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 /> S`1/2 <br /> C)~ (u 67, /,)-- *Eff#1 �,`Eff#2 <br /> /S /m_b/( , '3 I c.5 w. 7 / 6 <br /> 6- a 17,s-L7/? y/y C d5kiiz1/4 / ,l s4 fe. , ► 3c0 . 7 /. E <br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30 5 150 mg/L *Effluent#2=BOD,>30 5 220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Please Print) Signat re CST Number <br /> Address ,A.-7 76�' i`'�'�•% ?S Date valuation Conducted Telephone Number <br /> wY�s�r� ��� - ' 3 /� -y- 3 "7/ 4 —Li 7 <br /> SBD-8330(R04/15) <br />