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sconsin Department of afety and Professional Services CIS 3 e Page I of /
Division of Industry Servi MAY 01 2020 5f5 ��5 SO L EVALUATION REPORT I
''' '-'°'z 4R rdance 'th SPS 385,Wis. Adm. Code County C I , C R U 1 y
Attach complete site plan on in size.Plan must include,
but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel 1.020
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scale or dimensions,north arrow,and location and distance to nearest road. G v lJ J /(J r (a
Please print all Information. Revygwed by//ik / Drat/q/
Personal information you provide may be used for secondary purposes(Privacy Law,S.15.04(1xm)). VI / 71 Z z
Pr�o.D{p Owner
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/ '� r`I I T 1 ti DE�44t�� ) ,j Go otL5 YJJ % S 011 T 2.1 N R 1 q / E (or) W
Properly Cnvf� Mallyy Ades r ^ /O� Lot#4 Block# Subd.Nafne orA / �]Ktr+sA q
City 7Y K State /Zio Code Phone Number ❑City 0 Village fa TownV NearestC Road
NU,L2‘0" I�1 15 -/O/g I ( ) I INCIr d I He Pal Fs k0
gpNew Construction Use:❑ Residential/Number of bedrooms Code derived design flow rate _ GPD
0 Replacement Q 1 ',Public r commercial—Describe: 6 As S-,-fr'/a'/ CIS
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Parent material PI l 1D} sill- (i�p`.,t Flood Plan elevation if applicable_ft. r C J 1 C /�
General comments and recommendations: L )T 2
0 Boring �'7 �y
/ Boring#
E Pit Ground surface eiev//3 ft. Depth to limiting fact/W in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft'
In. Munsell Ou.Az.Cont.Color Gr.Sz.Sh. •Eff#1 E 2
1 0 -8 /byR3IZ- - SI I f� rt1 I C s l-P NJJA NIA
„28'30 ley 514 - S 0 n't r" I G 5 — N/A N/A -
.30-35 iajle3h- Sc I 2 r�,coir M-;. r[ S - r N . G
35 yL ,v y c y/c - c Am K , Walr, A S - . 2 .3
L/ f ) ioyey/y — -S ,nms5 rn ! — . 7 1,6
HoP )2oNS I end Z sire - If
2 Boring# ❑Boring �`
WI Pit Ground surface elevJ7 3 ft. Depth to limiting facto Main.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft'
In. Munsell Ou.Az.Cont.Color Gr.Sz.Sh. E+fr1 'Efftf2
I e -8 ,•yR/17- — S/ . I fi> ) Al l c�' ► N/Q A
2 -a6 45/4. — 5 nosy Al 4 s - AlA r/A
3 30-033 , dya IZ - .ScI _,,20)<.k rn-r,' cs - • '/ . G ,
41 33-Via r o✓/L y!` ,- C" A rr. r o� v11 v'; q s - , 2 3
S -/) /ayR 'f/y — s ✓Jr- S al I — — - 7 /, 6
61 X 20/Xs /qr) 4r 4AL /-
•Effluent#1 =BOD,>30 s 220 mg >30 s 150 mg/L
CS ame(Please nnt) Signature CST Number
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Address / Date Eva u Conduc ed Telephone Number
1 zc N; a /Pcl, s1 oscr� � K ���ao 7/5-yyO -37V0
SBD-8330(R04/15)
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❑Boring �/77
Boring# ®Pit Ground surface elev. 0 ft. Depth to limiting fact d6in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. •E 1 E 2
0 33 /I,/f'; " S ; j f rr Mf. C,5 f F kl A ijv
/Z 33 -44'5 /Q- 1/ CZdiOy2c /I C 2__Lnwbv. Yrj- qS ,
3 ys-Hs lay _Dry, W� � — - . 7 i. G
. /ODT7Lcs eyPMP4- S F- Z
f-ic-) P1Z aN `P I t
o Boring
Boring#
❑Pit Ground surface elev._ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Cu.Az.Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2
B El Boring
Boring#
❑Pit Ground surface elev._ft. Depth to limiting factor In.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. •Eff#1 'EIf#2
•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 5150 mg/L
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