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Wiscon n Department of Commerce JAN Q ,35~~ V EPORT Page ~ of~
Division of Safety and Buildings
in' ~ with Comm 85, is. Adm. Code CO tIN County Is
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Attach complete site plan on paper no q ss 1, ~s in si e. Plan must
include, but not limited to: vertical and horizontal re a BM), irection and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and dis nce to nearest road. Z D J -
Please print all information. viewed Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ( (0
Property Owner Property Location
Govt. Lot 1/ S 1/4 S pc 0~ T_,)o N R J 8 E
Property Owner's Mailing Addr ss lot # Block # jC9N'd.,,Name CSM#
City State Zip Code Phone Number City ❑ Village Towre Nearest Road
New Construction Us Residential / Number of bedroomsT Code derived design flow rate '56-22 Z,4 ~Q GPD
~ .Y7
❑ Replacement ❑ Public or commerce Describe:
Parent material 201/ -Z Flood Plain elevation if applicable /f/~ - - fL
General comments
and recommendations:
Boring # Boring j~
F-/1 ~ Pit Ground surface elev. % , U 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
"I V
s
Boring # ❑ Boring /i
a Pit Ground surface elev/ 5 I ail ft. Depth to limiting factor in.
Soil Application 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
.b
Q~iZ Y-3/z- - c s (a
Z 12-- 36 I ti s V-) r
3 -105 r y t% F r - - i , L
• Effluent #1 = BOD > 30 1220 mg/L and TSS >30 1150 m9A- vent #2 = BOD < 30 mg/L and TSS < 30 mg/-
CST Name (Please Print) Signature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conduc ed Telephone Number
1008 192nd Ave, New Richmond, WI 54017 /17 ~l 715-246-4516
r
Property Owner _ Parcel ID # Page of
Boring # ❑ onng
pit Ground surface elev. ft. Depth to limiting factor in. Soll Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
2- V-n V- rl-
-y 1 o
ry I r-7 I'
F-1 Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sa'I Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
❑ Boring # ° Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
' Sal ication 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 = BOD, > 30 1220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS 130 mg/L and TSS 130 mg/L
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need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SB48330 (8.6/00)
Soil Test Plot Pla
Environmental Holdin9s LLP S
Project Name Bird
Address 706 19th St.
Hudson Wi 54016 CSTM #226900
Lot 7 Subdivision Lundy's North Date 12/1/04
S 1/2 SE 1/4S 22 T 30 N/R18 W Township Richmond
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe
System Elevation 97.1 *HRPSame as Benchmark
Alternate Benchmark Top of 1/2" Pipe @ 103.3' Scale is 1" = 40'
unless otherwise
Please note: soil test noted
may not be suitable for
owners desired
building location, Soil Property Line
test was done to
satisfy zoning
requirements, please
verify system location
before excavating.
5% Slope B-2
A1t.B
10' 25'
* B-1
40'
96' 15'
97, B-3
164' Property Line
274' Property Line