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EMuent #1 = BOO. > 30 < 220 mWL and TSS >30 < 150 T2l ' Effluent #2 = 500, < 30 mgrL and 1 a5 < 3u mgrL
CST Name (Please Print) Sign CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Teiephom Number
1432 120th St. New Richmond. WI 54017 3 - Z Z — Z / 715-246-4516
Property Owner Parcel ID # / / \ Page —Of
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Effluent #1 = BOD, > 30 < 220 mgrL and TSS >30 < 150 nglL ' Effluent #2 = BODY 130 mg& and TSS < 30 mglL
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Soil Test Plot PI
Project Name Mauritz Kool
Address 834 220th St.
Baldwin Wi 54002
Lot 8 Subdivision
NE 1/4 SE 1/4S 19 T 29 N/R16 W
r-lBoring Q Well PL Property Line
BM or VRP Assume Elevation 100 ft
System Elevation TBD
Bird
5TM #226900
3/22/21
Township Baldwin
County ST. CROIX
Top of survey iron
*HRPSame as Benchmark
Certified Survey Map
Mauritz Koo/ and Lifiane Dos Santos
Part of the Northeast !/ of the Southeast I/ of Section 19, Township
29 North, Range 16 West, Town of Baldwin, St. CMIx County,
Wisconsin, being all of Lot 6 of that Cerh6ed Survey Map recorded inVolume 26, Page 6008, Document No 994759
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Dated March 6, 2021
Owner's Address:
834 220n' St
Baldwin, Wf 54002
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APR 05 2021
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ORIGINAL
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Sheet 9 of 2 Sheets