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Wisconsin Department of Safety and Professional Services Page of <br /> Division of Industry Services <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County �3 <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, '" L 1^n e1q, <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. yL,/bQ._S cC <br /> scale or dimensions,north arrow,and location and distance to nearest road. .37-Cbdo---)r /J`S�o <br /> Please print all information. vie d by - D e Q <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)m). <br /> Property Owner Property Location <br /> /Z 6it 30 i,L P- $I Govt.Lot '/< '/ S �(� T idC3 N R E (or) W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> City State Zip Code Phone Number ❑cit <br /> y ❑Village (2f Town Nearest Road '76A 3 <br /> ,FK] New Construction Use:[�]Residential/Numberof bedrooms J-7 Code derived design flow rate `/SZbPD <br /> ❑ Replacement ❑Public or commercial—Describe: <br /> Parent material /CL C I c, Flood Plan elevation,if applicable <br /> General comments and recommendations: 5 f e-to i, q3} 7 <br /> 1❑ El Boring Boring# 9? of �U <br /> (�Pit Ground surface elev. ft. 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. *Eff#1 *Eff#2 <br /> S`/ 5'/ lS v� b /c wi I 5 3 <br /> ❑Boring c <br /> � 7 P-1 <br /> Boring# 97 0 T <br /> ®Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/FC <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> y- 7-5-Y l? '5- to <br /> *Effluent#1 =BOD,>30 s 220 m /L and TSS>30<—150 mg/L *Effluent#2=BOD,>30<_220 mg/L and TSS>30<_150 mg/L <br /> CST Name(Please Pr1nU Sign ture CST Number <br /> t� f < r-�3 S <br /> Address at 72 i-G 16+,,Y y DsWe Evaluation C d e Number <br /> 1710 <br /> U/e�u fY, u/r "57 <br /> SBD-8330(R04/15) <br /> JUL 3 1 2019 i�����i�7��f <br /> Burnett County <br /> Land Services Department <br />