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Wis. Wt of Safety aW f SOIL EVALUATION REPORT
Safety B •
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Of
Division of and s
in accordance with SPS 385, Wls. Adm. Cie
County
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Attach complete site not less than 81 /2 x 1 I fr��ch�es in ♦■■ size.
•••gypaper
.PPlan must
-+ plan on
y �� {�+�.., y� ■may',
Include, but riot limited to: ver0c l � ho�Y• �ryal ref point (BM), direction and • �YMI I.D. I
' `
punt slope, scale or dtrrtensk�ns, north a►row, and location and distance to nearest road.
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Please print all lnfonnatiorr. Revie
by
gate
Pemonw ink you pmvWe may be used for teary pwpow (Pnv Lew, s. 15.04 (1) (m)).
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Property Property WmHoYn
✓ Govt. Lot 1±` 19 S / T N R
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Property Owner's Mailing Aftm Lot # 9kX* # Subd.
`7
or
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X4
City State Zp Code Phone Number
0 City [� Wage
MTown Nearest Road
1New Cc3nstnx ion Use: Residential l Nuu ber of bedrooms Cade Cade derived design flaw rate GPD
0Replamywt Public or commercial - Describe:
Parent Flood Pion elevation if applicable .__ L _. _ tt.
8i'1d 1"+�3C�1111'Y1�6�On&: .
t
Jr ri
[j BMng
Bodng
pit Ground surface elev. Depth to fimifing factor In. -SoN
AppomtIon Rate
WAWA
Pit Ground surface elev. ft. Depth to hmrting factor n. SoIA Apoicadw Rate
Horizon Depth Dominant Color Redox Description Texture Stnuicture sistence Roots GPD1, R
in. Munsell Qu. Sz. {wont. color Gr. Sz. Sly.
r
�7 2� 1�
--
v r
Gj q
Zz
* Effluent #1 r BCD 5 > 30 < 220 m91L. and TSS >30 < 150 mgJ'L Effluent #2 = 800 < 30 mg1L and TSS < 30 MgIL
CST leaserite CST Number
A Date Evaluation Conducted Ted Humber
-2 Zw'Z
I
I
Property Owner ,--<//,/. Parcel ID #
BmIng # ❑ Boring
pit Ground surface elev. Depth toVmMng factor—,_-, -An.
0
Page of
I 467;j A - I
INN9:11
Redox Dma"on
Qu. Sz. Cont Color
Strucbre
Gr. Sz. Sh.
!PanrAten'�*
ila
U;
MWA A
AgA
*,J&
A
A X
1:1 Boring # Bot*V
E] pit Ground surface elev. ft. Depth to firm " factor in. QM
Redox Description
Qu. Sz. Cont. Color
Structure
Gr. Sz. Sh.
oundary
oil
Boring # 0 BoM9 Ground surface elev. ft. Depth to limifing factor in.
0 pit
Soil Antftabon Rate
Redox Description
Qu. Sz. Cont. Color
Effluent #1 = BCD > 30 < 220 mg/L and TSS >30 < 150 mg& Effluent #2 = BOD 5:5 30 nxYL and TSS 5 30 mgA-
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or M through Relay.
SOD-8330(R11111)
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