HomeMy WebLinkAbout020-1491-04-000 (3)ti//�rarnr�n+
✓�i! �r�. �Visconsln Department of SafEYy& Professional Services
/ Division of Industry Services
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SP J I MAY 02 2023 SOIL EVALUATION REPORT
In Accordance with SPS 385, Wis. Adm. Code
Attach complete jite plan on paper not less than 8 1�2 x 11 inches in size. Plan must include,
but not limited to Vertical and horizontal reference p6int (BM), direction and percent slope,
scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)).
Page ( of20
County
5 T,
Parcel I. D.
OZ ra .. /5/ S/ - OS/- 136 o
RevieweA by 4)) f,
Property Owner
Property Location
❑
H, S G
ge ke /%2e H'
Govt. Lot N G h 'A S /3 T
S N R J 5 E (or) W
Property Owner's Mailing Ad ress
�
Site Address or CSM and Lot #:
GvY 6"-n-
I1Pn
S fe qilrel-1
gi
/1,//
City State, Zip
Phone Number
El city El Village 9 Town
Nearest Road
j4vjSar?
fit, .0 s-o -,7
77 044--e
J4 New Construction Use: ❑ Residential/Numberof bedrooms Code derived designflowrate 5/ GPD
❑ Replacement ❑ Public or commercial — Describe; Flood Plan elevation if applicable ft.
Parent material Td
General comments and recommendations:
Boring #
❑Boring c '/
® Pit Ground surface elev./(20, Vft. Depth to limiting factor 7ZZ in. I elev.7 y r ft.
Soil Aoplication Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
'Eff#1
"Eff#2
a�
/0 tK z_L
—
sc
IAjS&,r
mI-
C.r
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Iv
, y
3
y
r 5
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7z-7q
l6
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4,64
L-
L
CS'
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7
>.
I
_
IV] Boring #
Boring p
®Pit Ground surface elevVp ft. Depth to limiting facts - A in. / elev., l�j Sr7D
ft.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Cu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
'Eff#1
'Eff#2
1
018
10 Y, Z/7.
—
SZ
/nrs9,<
aMSV,
L
"W t--
1C S
2/r7
Z
0 36
16YK 3/y
SL
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3 t -
7, S Yif5 /y
F> � s'YRS/%(o
a m5-9X
-In /-
CST Name (Please Pri t)
i� 7 n%S ;!
Signa re
CST Number
2z/ /
Address
3sz 5I 9mrr LwI s-YOG
Date Evaluation Conducted
,Z/-Z3
Telephone Number
a 3 7
* Effluent #1 = BOD > 30:5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 ni
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