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'RECEIVED C T- r -
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Wisconsin Department of Commerce OCT
t SOIL EVALUATION REPORT Page of
~
Division of Safety and Buildings i L u I.1
ST. CR481GGM _
i~ "ith Comm 85, Wis, Adm. Code B1N0759
County
Attach complete site plan on,idrVRRc~PMhes in size. Plan must
include, but not limited ta: vertical and horizontal reference point (BM), direction and Parcel LD.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0, 41 e, - -3 G C
Please print all information. Revi ed by ;~7Z711~o
Personal Information you provida may be used for secondary purposes (Privacy Law, s: 15.04 (1) (m)). Property Owner c C ivti Ci v~ Property Location
,fit? rr7 S'-f -
(-k2CX-- 1 t" ~54-0 C Govt. Lot S c-) 1/4 JJ T J, N R / S E (or 1N
Property Qwfletzs Mailing Address u' r' Lot # Block # Subd. Na or CSNt#
r-- ~ ~ '3 S"tom
city State Zip Code Phone Number ❑ City ❑ Village own Nearest Road
,S' 5 L/ 76-1 (7 / s") -7-) ` D Y a '7 r ~t JA fi '
YNew Construction Use: Residential / Number of bedrooms Code derived design flow rate rL GP.p
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ft
General comments Cl_5r:,` 5~~r3Cs'` L G'-,;~ ~z~~~ E4fc_ e CE3l( C~. [Of~octr C;7O
and recommendations:
MO toj YA 5-
Boring
Boring #
f I ~ Ground surface elev. ) C; L , C. ft. Depth to limiting factor in. Boil A lication Rate
Horizon Depth Dominant Color. Redox Description Texture Structure Consistence Boundary Roots D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. VIM 'Eff#2
r
L ~ ~ y1 t r L ~:J ri_iCV
I ❑ Borjng
Boring # r-•1 i
L~'Pit Ground surface elev. r C ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
i~,. !hame'.t Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E02
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Effluent #1 = BQD > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BBD 5 30 mg/L and TSS 30 mg/L
CST Name (PI ase Print) Signature CST-Number
Address Date valu tiDn Conducted Telephone Number
7 c / l ,
1 / 7 ~4 7-e" ec ~c Inc LA (.P (k~ 7J3 .
Property Owner .~'1 F w~ S`tc (~`rvd (x Parcel ID#c Page c of
Boring # ❑ Bo ' g
apit Ground surface elev. ft. Depth to limiting factor _ 4 In.
Soil Application Rata
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary;: ;Roots G
in. Munsell Qu. Sz. Cont. Color Gr.:Sz. Sh. "Eff#1 "Eff#2
LF5 05--1
31-16 IMP J( 1-n I <5Z-
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I Boring # ❑ Boring
~J ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1. 'Eff#'2
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Boring
Boring # Ground surface elev. ft. Depth to limiting factor In.
F-1 ❑ Pit
Soil A Ifeation Rate:;
Horizon Depth Dominant Color Redox Description Texture Structure Cgnsistence Boundary Roots Gl?0/fg
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 "Eff#2
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Effluent #1 = BODE > 30 < 220 mgA- and TSS >30:< 150 mg/L ' Effluent #2 = BOD6 _5 30 mg/L and TSS 130 mg/L
The Department of Commerce is an equal opportunity 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: `
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