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010-941-24-4406-CST-2024-056
�1��I���V�� o��� � V�\� WsconsinDepaRmentofSafetyandProfessionalServices Page_of �� \ Division of Industry Services � �'�~_� �� SOIL EVALUATION REPORT ��"�������`` In accorCance with SPS 385,Ws.Adm.Code County SAWYER � Attach complete site plan on paper not less than 8 1!2 x 11 inches in size.Plan must include, - but not limited to:vertical and honzontal reference point(BM),direction and percent slope, Parcei I.D. 1 srale or dimensions,north arrow,and location and tlis[ance to nearest road. Q��_Q I,zy_ y y o� Please print all information. Review by Date [n� Personal infortnation you provide may be usetl for secontlary purposes(Privacy Law,s.15.04(�)(m))_ � IS'a, ,Z Y O Property Own1e'r Property Locatinn ❑ ❑ S l YL f-�■1[7 e � �� e�� `L�' Gov[.Lot '/. '/. 5 �y T �I N R �q E(Or)JV Property Owner's Mailing Address Site Address or CSM antl Lot#: I 3 5�S w Pen� �l 4 R-- �o-E- L Cs r-� 3S g �gz�l� -�,o c 4c. Ciry State Zip Code � Phone Number ❑City ❑Village �Town Nearest Road Wa�-c� W( 5�{�8 ( ) }{� ar iy�OS�-�) W �NewConstruction Use:❑Residential/Numberofbedrooms Codederiveddesignflowrete GPD ❑ReplaCement [�Public or wmmercial-Describe: �!�D arnuv�� Flood Plan elevation if applicable ft. a\S� Parentmatenal S4�1.� , 4�QVe��v nu'�'�aJ4S � s �y `1,-�--�— � n'�ain��nanc_e_ $(�5 w� h4�-�=,s ou�cv- 7° General comments and recommendations: `1 Sv IS s�_�e( �,R � -��-'!,- 2- �� Bonng# ❑Baring G uv J �Pit Ground surface elev.C1��. Depth to limiting factor�OD in./elev.$��t tt. �f' C��� TO ihSTw�� Zb� S SK�'V/ SoilApplication Rate Horizon Depth Dominant Color Redox Descnption Tezture Structure Consistence Boundary Roots GPD/F!� In. Munsell Qu.Az.CorL Color Gr.Sz.Sh. 'EH#1 'Eft#2 � -S 1.S r 3L _ S Q_5 Z.J-� .� 1.` Z- $_3Z �� 4 Y — Y'S �� i� 17�� (. 3Z-Il� S r �f y — r5 �i �i ���- •`] ��6 �.orjz � Z 3 i $ Irc�7 Go roc � QBoring L I Bonng# �qp�� Ground surtace elev.R3•3 ft. Depth to limiting factor I D y in.�e�ev.$`I3 ft. —J yo. Soii Application Rate Honzon Depth Dominant Color Redox Descriptior, Tezture Structure Consistence Bountlary Roots GPDlFt� In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. 'Eff#1 'EffN2 � o-N �,s � 3 z � — / o- n� � �`t 6. Z _ Y v y Y - S �� �i ,� ��� ,Z l•lo Z7 ' y�3 S � `� '! l� •�[ I.�. `f 7-10 s r `+N — s �, �� � -- .-1 �,(� ac-,z Z � l °o Go C' L csT Name MERTON MAKI Signature 224901 K�— �i CST Number .P tiW� Address 10869N SMITH COURT Date Evaluation Conducted P (715)634-8719 Tele hone Number HAYWARD,WI 54843 � EfFluent#1=BOD>30<-220 mg/L and TSS>30_<150 mg/L 'EfFluent#2=BOD,_<30 mg/L and TSS<-30 mg/L SBD-8330(R04l21) Page of � Boring � 3 Boring # Pit Ground surface elev. R � �ft. Depth to limiting factor �� in. / elev. � � � Soil Appiication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 � - `7.4 r " — � S 6 -s � 2 v� ,`� ( , d 2- _ 2.(, << y — r i, �, i� � �E� •"1 . 6 �. 5' ,� � y � ('S l � I l� l( � u 1' '� I ,�e � _� � � 4 Y .� cf I� �- -� ��j � . b pY' � � � s f4 (� Go 6 G �L � ❑ Boring # ❑ Boring � ❑ Pit Ground surfa�e elev. ft. Depth to limiting factor in. i elev. ft. Soil Application —T--- Rate iorizon Depth Dominant Color Redox Description j Texture Structure I Consistence Boundary Roots GPD/Ft� � In. Munsell Qu. Az. Cont. Color j Gr. Sz. Sh. � _ -+-- 'Eff#1 'Eff#2 � � S� I 5 n r ►'v1 R� v1 e✓! t C c�c- r' ^E- u.'� � S�D G`� � �I —� t- O �� � � Se � S I ' � � SZ"> = 3��� .�So��—Z�i r ' � `-t�i = 4-= Z2�t� (�c � � T � I l e. s - . S `I o 6 U�4 � � ��.���-e�� ��i Boring # ❑ Boring _J ❑ Pit Ground surface elev. ft. Depth to limiting factor in. I elev. ft. I S io I Application __ _ Rate� Horizon Depth Dominant Color Reclox Description Texture Structure �, Consistence � Boundary � Roots GPD/Ft� In. Munseli � Qu. Az_Conk. Cclor j i �r. Sz. Sh. � � I 'Eff#1 'Eff#2 — -�---- ' �-- _i— _ --_ ��-.-----f__----t--=-� _ i i —�-- � �_-I -- � � _ � � � , , �_ � � --- � __. --�- �- ___� ___ � � ' EfFluent#1 = BOD > 30 _< 220 mg/L and TSS > 30 <_ 150 mg/L ' Effluent .#2 = BO�. s 30 mg/L an � ,r�l�.-�. _ _ . , � .� , ,. � : "" } ��1'.��`'• ;•,.� : _ . _1 ._.�:.`.�_.t__.r_:__.. _ � NO REFUND6AFTER s�?�1,_�.,�,.,._ ; ISSUE OF PERMIT v�� q � � ��;� � Z ���,� � f .t`:7t __ ; ---------� � f 36 "1 � SA�rY�� C�U'��:�;•�< , _.� ,�w.�_.�.,,_....� - 2C)NING ADMINI51"R�l"iC.`rJ a� n���• �eqa.� S,v�.k(no(� �v�ues�wt e..�,�s �.�.0 S�.w�.e..- C�o� �-}-0.�wQr-� ��P f 3�p�ts w �en..�w� �4 6t—t� Ar►.� o�b _ a�r_ Z� , �r�,�a� L-�-�.,�w Q.�-�� w I S��ti3 5�/s� � z� �r' �t c� 2 0�w s� : �4-TD54a S� �w� -T� Lo�- Z CSVI 3 S��(o tf. 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