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'VisconsinDepartment of%Wen 20,1,i, SOIL EVALUATION K&ORT~ Page of
Division of Safety and Bull Ir b%
in accordance with Comm 85, Wis. Adm. Code
County _r t
Attach complete site QIacN~t►i apei-W6~ i 16n8112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel W. (
percent slope, scale or dimensions north arrow, and location and distance to nearest road. n
Please print all information. Reviewed by Date
Personal information you provide may are used for secondary purposes (Privacy law, s. 15.04 (1) (m)).
Property Owner Property Location
Govt. Lot /r 1/4/1, 14 E (o S Tz N R rwl
Property Owner's Mailing Address Lot # Block # Subd. Name CSM#
4/ ` / ZV A
City State Zip Code Phone Number ❑ City ❑ Village MTown Nearest oad
1 6 '
ew Construction Use:%Resdentiai I Number of bedrooms Code derived design flow rate GPD
❑ Replacement ~L ❑ Put,lic commercial -Describe:
Parent material r~! ✓ _ _ Flood Plain elevation if applicable -Z r~ ft.
General comments
and recorrunerdations:
System Typet/wSystem Elevation--T~~L0
# Boring
Pit Grouid surface elev.671 ' ft. Depth to limiting factor / in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
Eff#1 Etf#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
-IL -3Cz &j- - Y
-
I
70
3 os I V).4 "
i
i
Boling # ❑ Boring
IF- it Ground surface elev. ft. Depth to limiting factor_.- in. Soil Application Rate
0 P
a
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, 'Eff#1 •Eff#2
0-13 i0 3 2 r FY CS
A/M
1141
Effluent #1 = BOD5 > 30 < 220 mg1L and TSS >30 < flluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address ate Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, 54017 ~-j 715-246-4516
Property Owner - Parcel 10 # Page of
Boring # ❑ Boring
Pit Grow id surface elev. J_ ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
'31, r21-
061
4fj
4W PL/A-
F-1 Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary
Roots GPD/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eft#1 'Eff#2
❑ a Boring # Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Application Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD, < 30 mg1L and TSS < 30 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 aitemate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
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• Soil Test Plot Plan 1
Project Name Travis Waldschmidt Shaun B`
Address 476 Cty Road A
Hudson Wi 54016 C #226900
Lot 4 Subdivision Date 8/31/12
NE 1/4 N W 1/4S 16 T 29 N/1419 W
Township Hudson
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of survey iron
System Elevation TBD *HRPSame as Benchmark
260' Property Line 120' B.M.*
5'
B-2
'
7% Slope 35
B-1 35'
50'
15' 96'
1' P.L.
B-3
40' 94'
Scale is 1" = 40'
unless otherwise Property Line
Area of poor soils
noted
235' Property Line
McCutcheon Road