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VV4%o Sint)Pparlment1of5atety alW PmlPasional Services Page / of
'OFiision of Irxluslry Services ,
1 q k ZO~B SOI[L EVALUATION REPORT 5
In aanrdance with SPS 385, Wis. Adm. Code County
57, C R p/ y
Allarliuompleto title pFBil.on~ than 8 112 x 11 inches in size. Plan must include,
but riot limited to: v - odzontal reference point (BM), direction and percent slope, Parcel I.D- S6 6O
scale or'dirpo , north arrow, and location and distance to nearest road. O O~ / U 70-O O U
Please print all information. - by
Personal information you provdo may be used for secondary purposes (Pri va . Law, s. 15.04(1)(in))__ - / 9
0
Property Owner ~P n(c, br Property Location
1.7 -o-r-e 11 '
G-y ~O r f Ma S GovL Lots(,} Y. S(,) Y. S S T 1 N R (Co E (or) ~V)-
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
r- Zip Code Phone Number ❑ City I ❑ Village ['mown Nearest Road
City //~7~~ State
1~J ~ I C~ V-) l N I w 1- I `S ~ U I 77_) I I IJQ I dt•iI n ) V 1 k J 'i""rT C
7rS-977 -1lb5 ~NeNLfAnslmclion Use: t.7 r<esid nbdl Numberol beetmoms _ Code derived design flow rate ~S.OGPD
07
placemont ❑ Publ c or commemal -Describe: _ O
Parer m f- o a S S ~ y r~ Flood Plan elevation if a icable R
comments and recommendations: GC ~F ' 1 S / a S : ( .i n d f ~k,. rc 5 C I I
General
L11 (C 11 O
MMBoring If ❑ ❑nng
tl Ground surface dev//1 jli. Depth to limiting fedora r in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIFtz
In. Munsell Qu. A/. Cont. Color Gr. Sz. Sh. 'Ei#t1 •Efl#2
- - . Z 61 i F r 'V E, C
c k m
YC7 , y FA7YY!? fC~-f4 6 4 -
Boning # ❑ Boring - - - J
it Ground surface elev./re), Yi. Depth to limiting factor I in,
- _ Sotl Applir:abon Rate
HHonzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Kwts _ GPD/Fe
In. Munsell Ou. Az. Cont. Color Gr. Sz. Sh. •Ef#J1 •Etf#2 • Effluent #1 = BOD, > 30 < 220 mglL and TSS > 30 1,150 mg/LL Effluent #2 = BOD, > 30 5 220 ma and
TSS > 30:5 150 mg1L
l CSTf~ame (Please Prn- Signalu~ CST Number
Ur rr tt i-r• r-~r (fir. ,~r,r. i~~f'' ~.,`)-r>>•a
Address br7E y Y /z., /.'rr ! a Date Fvalualion (,ondurted Telephone Number
l:< I/.,. LL 1. Sv76
SBD-133.30 (RO4115)
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~ ~q~~ 7 cF ~ l ci~ lC'r /~''1;.~~ e~Gtr•~<-~ ~CCU /c/n- 7c foo
Boring # ❑ Boring
(9 Pit Ground surface elev.%~n Depth to limiting factor) in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods GPD1Ft2
In. Munsell Ou. Az. Cont. Color Gr. Sz. Sh. •E##1 'E##2
01
LCI
ztn_L ~o YR
Boring # Boring ~f'• /
any ' > t.7 rn Ground surface elev. _ ft. Depth to limiting factor in.
{"5~v _ Application Rate
Horizon Depth minant Dolor Redox Description Iexlure. Structure Consistence Boundary Roots ---GP tFt'
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
3 - L;
7. 4-YtZ
y_ fan s rrt r`
Boring # ❑ Boring -
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
_ Soil lication Kalo
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft'
In. Munsell Ou. Az. Cont. Color Gr. Sz. Sh, •E##1 'EfF#2
I
Effluent #1 = BOO. > 30 5 220 mg/L and TSS > 30 5 150 mgr- ' Effluent #2 = BOD. > 305 220 m91L and TSS > 30 s 150 nayL
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