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WisconsinDepartmentofCom me QPR 2noMLaEVALUATION REPORT Page 1 of 3
Division of Safety and Buildings
m accordance with Comnl 85, Wis. Adm. Code V~ county
Attach complete site plan on r ncW6 si l1N inches n size. Plan must St. Croix
include, but not limited to: verti and hi{ M), direction and Parcel I.D.
percent slope, scale or dimensi ertll~novlr. and location and distance to nearest road. , Gl~ v
Please print all information. Revi ad by Date p
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). C~ Y✓~ -70 D5--
Property Owner Property Location, f
Steve Derrick Govt. Lot 1/4 SE 1/4 S 15 T 30 N R 18 E( W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1438 County Rd G 19 - Cherry Knolls 1st Addition
City State Zip Code Phone Number 00ity Village ■ own Nearest Road
New Richmond Wl 54017 ( ) County Rd G
El New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD
0 Replacement a Public or commercial - Describe:
Parent material loess over glacial outwash Flood Plain elevation if applicable ;'A ft.
General comments This site is suitable for a conventional below grade system
and recommendations:
❑ Boring # Boring
El Pit Ground surface elev. 100.40 ft. Depth to limiting factor >90 in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EfW
1 0-16 10yr3/2 - sil lmpl mfr as 2f .4 .6
2 16-30 1 3/3 - sil lmsbk mfr cw if .4 .6
3 30-36 1Oyr4/3 sil 2msbk mfr cw if .6 .8
4 36-46 7.5yr4/4 ifs Osg mvfr cw - .5 1.0
5 4 90 7yr5/6 - s Osg ml - - .7 1.6 I/ V 27 Boring # ® Boring 101.40 >90
■ pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *E1f#2
1 0-9 10yr3/2 sil lmsbk mfr as 2f .4 .6
2 9-18 1 3/3 sil lmsbk mfr cw if .4 .8
3 18-27 7.5yr4/4 - is Osg mvfr cw _ .7 1.6
4 27-90 7.5yr5/6 - s Osg ml - - .7 1.6
* Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 rrg& * Effluent #2 :,500r,:< 30 mg& and TSS < 30 mg/L
CST Name (Please Print) - - Signature - r 4 CST Number
Thomas C Nelson 227387
Address Date Evaluation Conducted Telephone Number
1432 120th Street, New Richmond, Wl 4/1/04 715-246-2454
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Property Owner Derrick Parcel ID # Pending Page 2 of 3
11 El 3 Boring # 11 Boring
Pit Ground surface elev. 100.20 ft. Depth to limiting factor >90 in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 'Eff#2
1 0-15 10yr3/2 - sil 1mp1 mfr as 2f .4 .6
2 15-33 1 3/3 - sil Imsbk mfr cw if .4 .6
3 33-43 7.5yr4/4 Os mvfr cw _ .7 1.6
4 43-53 7.5yr4/4 - sl Om mfr cw - .2 .6
5 53-90 7.5yr5/6 - s Osg ml - - .7 1.6
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 GPDAF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
F-i
❑ 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/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD5 > 30:5 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD, < 30 mg/l. and TSS < 30 mglL
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need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330Tat (8.07/00)
Cherry Knolls 1st Addition
Lot 19
f
NW lot corner
BM
20'
24' 36'
i B1
B 2
94'
159'
107'- 10.
B2
2%
slope Scale 1" _
BM1 Top of ' n pipe 100.00'
BM2 Top of c duit pipe 100.40'
B1 100.45'
36' B2 IOI.40'
B3 B3 100.20'
10T
100'
Thomas Nelson
227387 ~ r