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�Wscere in Department of Safety and Professional Services oR ' I� <br /> Division of Industry Se 'G'N <br /> rvices I ` <br /> SOIL EVALUATION REPORT n �ge_of_ <br /> in accordance with SPS 383,Wis. Adm. Code -1 _ <br /> County P Y f'/� <br /> Attach complete site plan ea paper not less than 8 fer x 11 inches in size.Plan must <br /> Y7- <br /> include slope,but limited to: ensio s.port arrow, <br /> reference point(BM),distance <br /> toare parcel LD.p7-o3A-d '.0-)S-Sos- <br /> percentslope,scale or tlimensions,north arrow,and location and tlistanceto nearest road. 006- 0"000 <br /> Please print all information. Reviewed by Date <br /> Persnarintormatloo you peude may be used for secondary Purposes ermavv Law.s.15.04(1)(m)). <br /> Property Owner ' ,n1 Property Location (/ <br /> Q<✓C A)ro Gavt.Lotti N✓ 1/4 $G 114 S 3f T H/ N E❑(or)W <br /> Property Owner's Mailing Address . Lot# Block#' Subd.Nameor CSM#[ : <br /> 1-5-10 Aoebee Gt I )/. 9 T ddb <br /> City State Zip Code Phone Number ity ❑tillage Town - Nearest Road.fgadb <br /> �i{a A6t1 I IW/Y -1CS/KJ I ( 1, ill <br /> ® New Construction OseE• Residential/Number of bedrooms .3 Code derived design flow rate 4J'0 GPD <br /> Replacement n Public or commercial-Describe'. <br /> Parent material /ae c / Jr rt"Y Flood Plain elevation if applicable /U1A ft. <br /> General comments S , ,e 7r✓ `'/H,0 <br /> and recommendations: <br /> Boring# [] Boring o 7 <br /> Pit Ground surface elev, / 9 ft. Depth to limiting factor ) 8Y in. <br /> Soil A IiraGon Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIK <br /> in. Munsell On,So, Cont.Color Gr.Sz.Sh. <br /> -7.Sv Is /–a 6/e .-. I I < S Y, -7 L6 <br /> 7J f.,,ars so r,., 1 e- 5 Y, -] 1.6 <br /> 3 U-S47s w'? — J s3G ... 1 G5 A . ? /, 6 <br /> /W SY- Sy ZJ"+F JIY — S o S 4 µ, l - - . 7 <br /> Boring# Boring <br /> ® Pit Ground sudaceelev. 97' O ft. Depth to limiting factor 7tr 09 <br /> in, Soil lication Rate <br /> Horizon Depth Dominant Color Redox Description Texture SWcture Consistence Boundary Roots GPDItP <br /> in. Munsell Co.Sz. Cont.Color Gr,Sz.Sh. 'Eff#1 'EH#2 <br /> / e• or 7S-Ad S/ — /s /04& r., / c S Sin , -7 /. G <br /> 7.d'S•P+/ir / r fir..,S</c .,/ 6 / J n-, . 7 /. L <br /> 3 /o-SO 7J-vA % S r + ac / 6s <nr <br /> 'Effluent#1 =SOD,X30 1220 mg/L and TSS>30<-150 mg/L 'Effluent#2=BOD,<30 mg/L and TSS<_30 mi <br /> CST Name(Please Print) 1 `I .yi r�� �, rI Signature CST Number <br /> Adtlress 1q f Date Evaluation Cooducted Telephone Number <br /> 77 ' _,� <br /> 6,..d7-7q <br /> AN 8330(R07113) <br />