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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ I of _
Division of Safety and Buildings
in accordan , with Comm 85, Wis. Adm. Code
County LYC~ i
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent siop 7 Z U r 2 Q
e, scale or dimensions, north arrow, and location and distance to nearest road. ~
Please print all Information. Reviewed by Date
Personal information you provide m cy Law, s. 15.04(1) (m)).
Property Owner Property Location
Govt Lot 1/4, )w 1/4 S J0 I T Z N R E (or)O+
Property Owners MallingAAddress 2 3 20p4 Lut # 81ock Subd. Name or CSM#
11 _ 25 e
City State p ociic` Ml' 4' ` ❑ City ❑ V' ge own Nearest Road
(WI ' ING 0 FlCE Hudson C-6 r
® New Construction Use: 5a Residential / Number of bedrooms 3- Code derived design flow rate -0 O GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ___L----_--- ft.
General comments ~L/
and recommendations. y T
® Boring # Boring ~U
V1 Ground surface elev. ft. Depth to limiting factor
p~ pit in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
d-~ IO 3J3 SL i m5ral CS I v+ y
2 1~-r~ 1® l SL 2msbK m cs - 5
3 i8 Q t 4dto - S 05 ml
Boring # Boring
Z 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/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-(P 'I3 - !SL- 1- k r CS ) \n • ~f
Z U-26 14 - SL 2m nor c. - 5 .9
3 r 111n - S m I - '~-7 - Z
Effluent #1 = BOD > 30:5 220 mg/L and T88 >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
T Name (Please Wit)., i ature CST Number
Address Date Evaluation Conducted Telephone Number
tj-
J..
Parcel ID # Page _ of _
Property Owner
❑ Boring
FS-1 Boring # g.E- ?-C) ft. Depth to limiting factor in.
~ Pit Ground surface elev. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtf?
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 `Eff#2
I --7 10 - `3 L Inn
-
2, _ - SZ 2m n4r CS
S Q m~
3 II-(ZI ( f `tJCo
❑ 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/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
❑ Boring
F-1 Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD, > 30 <220 mg/L and TSS >30 < 150 mglL " Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal oprarlunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD.8330 (R.07100)
PAGE_ OF 3
NAME: e ( LOTP, LEGAL DESCRIPTION:S!= 114tW 114,5 !t TZ,N,R,Lq E(or)&V
SCALE: 1"=
m ELEVATION: I O U- 0 i
BM 1 DESCRIPTION: i_ ~1 D e
BM 2 ELEVATION: U I
BM 2 DESCRIPTION: o
SYSTEM ELEVATION: q3,8-0
SYSTEM TYPE: ~G n u e V-, +,'c3 ti0.1
, oj (y- 3
SIGNATURE: DATE: 7