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Wisconsin Department of Safety and Professional Services
Pi vision of Industry Services
SOIL EVALUATION REPORT
M IS
JUN ') 'L 'i 025
In accordance with SPS 385, Wis. Adm. Code
Attach complete site plary;»a4iapfer not less than 81/2x11 inches in size. Plan must include,
but not limited to: vertical and horizontal reference point (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)).
Countyayndd co.^oninu !,"pi
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son TEST
Parcel I.D.
lelcTCu toning ^"p;r7-^>^Z/" n-3r5-\
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Date^>//z;w? \^/vr\
property Owner
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[Property Owner's Mailing Address
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Property Location
,Govt. Lot S(^ y< ^^r 1/4 S} ^ T ^S~~ N R Z? ^ E (or) W
Site Address or CSM and Lot #:'-?<$^r-^^/</
Citv
.ft>Llff&/0 State/w Zip Code
\rr3l3
Phone Number
( )
Village 0 Town
^»-\. "tx. ^^-t^l
Nearest Road
//t^/A/
^ New Construction Use:j(3 Residential/Numberof bedrooms __^
D Replacement D Public or commercial - Describe:
Parent material 6-/^^'A / /^u^u/^sL
Code derived designflow \3\s-9f^0 GPD
Flood Plan elevation if applicable_ft.
Genera] comments and recommendationsns^ . fl^ ~^>. ^^S. ^ y/ ^- <L<y^u£<f^^^ s, 1 /^s. c<5K^», e.-^/^^/y/'^ Ths^^
Boring #D Boring
0 Pit Ground surface ele',J^?,Depth to limiting factor ^ in. / elev<^^ • "ft.
Horizon
J_"z
Depth
In.~^~
Dominant Color
Munsell
?.5rY^
" ^s
Redox Description
Qu. Az. Cont. Color
-^cT^^^ wSt^^
Texture
S L
y^l
Structure
Gr. Sz. Sh.
-?^<^/r
/<^<^/:
Consistence
^n^^-f
^/^^
Boundary
^r i^
Roots
<e^u^
/u^
Soil Application Rate
GPD/Ft2
*Eff#1
•- •6'
,2
*EfW2
/'o
_^_
Boring #QBoring
DPit Ground surface elev._Depth to limiting factor.Jn. / elev.__ft.
Horizon Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture Structure
Gr.Sz. Sh.
Consistence Boundary Roots
Soil Application Rate
GPD/Ft2
*Eff»1 *Eff#2
CST Name (Please Print)
Address /t 3^ t3e*^fe <,^u^ O^fQ^l^ i^/ /^^t
Signature
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Date Evaluation Conducted^~-^-2S~
CST Number
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Telephone Number7/^-^^f -//^
* Effluent #1 = BOD > 30 S 220 mg/L and TSS > 30 S 150 mg/L Effluent #2 = BOD, <. 30 mg/L and TSS < 30 mg/L
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Bayfield Cu. Zoning Dept.
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