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t
LUATION REPORT Page ` of J
Wisconsin Department of Commence
Division of Safety and Buildings
in accordan withRE Ws. `Adm. Codb County , 1 f
Attach complete site plan on paper not less than 8 1 x 11 inches in size. Plan must ~
r
include, but not limited to: vertical and horizontal ref ence IM#'(SM), direction and parcel I.D.
percent slope, scale or dimensions, north arrow, and ovation and distance to nearest road. C) I T
Review by Date
Please print all info atiCkh.. Cil
Personal information you provide may be used for second SNbb~y t~vV; s. -t 5.134 (1) (m))•
Property Owner Property Location
`t/ Govt. Lot 1/ 5/4 T N R E (o W
Property Owner's Mailing Address Lot # Block # Name CSM#
- I cf. ~itft
City State Zip Code Phone Number ity ❑ Village Town Nearest Road
ew Construction Use:: ❑~rResidential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement X -.Public /or commercial - Describe: - - -
Parent material ~t~Cg:~~ Flood Plain elevation if applicable 0!IZ/ ft
General comments
and recommendations: ~/P S~~ (J L t ~St
41 'n J
FV Boring # Q Boring
A Pit Ground surface elev. f-~ ft. Depth to limiting factor 1 1 in Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0') 0 NJ -7 `
n
® Boring # Boring
Pit Ground surface elev 0' ft. Depth to limiting factor Soil Akpllication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDflf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
lz-3o ~a sty s z„b~ m a' i, o
• Effluent #1 = BOD > 30:< 220 mg/L and Tr;,'-'O, >30 150 ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L
CST Name (Please Print) ture CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
4 17 2 0 ~5- 715-246-4516
1008 192nd Ave, New Richmond, WI 54;1/7'
I~
Parcel ID # Page of
Property Owner _
Boring # ❑ Boring ( r
elev. aft. Depth to limiting factor Pin.
Pit Ground surface a Soil 1'uation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
'Eft#1 'Eff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
o -fio 3j2- z ~S z ,6 r, b
3 71 rq a
n
❑ 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 GPDM
'Eft#1 'Eff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
Boring
Boring E] # Ground surface elev. R, Depth to limiting factor in.
❑ pit n*Eff#l ation Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots D/ff°
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2
• E ffluent #1 = BOD. > 30 1220 mglL and TSS >30 < 150 mgA_ ' Effluent #2 = BODS < 30 mg& and TSS 30 mglL
equal opportunity service provider and employer. If you need assistance to access services or
of Commerce is an Department
The
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (8.6(00)
Soil Test Plot Plan
Project Name Richmar Industries Shaun d
Address P.O. Box 732
Hudson Wi 54016 C #226900
Lot 18 SubdivisionHudson Business Center Date /25/05
N 1/2 S W 1/4S 27 T 29 N/R19 W Township Hudson
❑ Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron/Nail
System Elevation 96.0/95.7 *HRpSame as Benchmark
Please note: soil test was done to
satisfy zoning requirement, system
location may not be suitable for
desired building location. Verify
system location before excavating.
100' 98'
Property Line B-2
Scale is 1" = 40'
unless otherwise 4% Slope
noted
B-3
120
50
B-1
40'
30'
~k
B.M.
60' 440' Property Line
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