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028-1017-10-000 (2)
Wis.Dept of Safety and Plb�ssional Servion 4 SOIL EVAL twin i Page 1 of 4 Division of safety and Buildings L"1 ' ��G in ac�nfce SPS 385,Wis. Adm. Code GO P ME ��y St.Croix Attach complete site plan on p ie 1T2 x 11 inches in size.Plan must include,but not limited to: ontal reference pant(BM),direction and parcel ID. 028-1017-10-000 percent slope,scale oral' ns,north arrow,and location and distance to nearest road. J Please print all information. Re ' Date, Personal informadon you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 'O / Property Owner Property Location ❑ El Kristen S Miller Trst Govt Lot SW 1/4 NW1/4 S 12T 28N R 17E(or)W Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSW 471 200th St. 1 CSM Vol,13,Pg.3736 City State Zip Code Phone Number EP4 []Village ■ own Nearest Road Baldwin Wisc.1 54002 ( 71?5-684-5102 200th St.-R-41sh.River ® New Construction UseCj Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD ElReplacement © Public or commercial-Describe: Parent material Sandy Out wash Flood Plain elevation if applicable NhA ft General comments and recommendations: Mound system contour 100.00 Existing 1000/600 gal,combo tank used for septic add 1000 gal.pump tank a Boring# 13 Boring Q pit Ground surface elev. 100.00 R Depth to limiting factor >120" in. Sob Amlication Rate Horizon Depth Dominant Color Redox Description Texture Structure nsistence Boundary Roots GPD/tt 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. IM Im 1 0-6 10YR3/3 — 1 lfgr dsh as 3 0.4 0.6 2 6-15 10YR3/5 — sl ltbk dh cw 2 0.4 0.6 3 15-32 7.5YR3/3 — scl 2mbk dh cw 1 0.4 0.6 4 32-120 7.5YR5/6 — s osgr ml cw — 0.7a 1.0 ❑2 Boring# ® Boring 95.7 32 E) Pit Ground surface elev. ft Depth to limiting factor_ in. Soil AnAcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Rods GPD/It 2 in. Munsel Qu.Sz. Cont.Color Gr.Sz.Sh. 1 0-6 10YR3/3 — 1 lfgr dsh as 3 1 0.4 0.6 2 6-19 10YR3/5 — sl ltbk dh cw 2 0.4 0.6 3 19-32 7.5YR3/3 — scl 2mbk dh cw 1 0.4 0.6 4 32-60 7.5YR5/6 fld2.5YR4/6 scl lfpl mvf cw - 0.0 0.2 *Effluent#1=BOD >30<220 mgJ1 and TSS>3o <15o rngA- *E #2= <_30 mgA-and TSS 5 30 niWL CST Name(Please Print) Signature CST Number Thomas W.Gedatus 962178 Address de Evaluation Conducted Telephone Number Stang Plumbing&Electric P.O.Box 263 Woodville,Wisc.54028 8/11/2014 715-684-5166 SBD-8330(811/11) Property Owner Kristen S Miller Trst Parcel ID# 028-1017-10-000 Page 2 of 4 Boring# 11 Boring 100 24 El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft : in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 I (#2 1 0-6 10YR3/3 --- 1 Ifgr dsh as 3 0.4 0.6 2 6-15 10YR3/5 --- sl Ifbk dh cw 2 0.4 0.6 3 15-24 7.5YR3/3 --- scl 2mbk dh cw 1 0.4 0.6 4 24-60 7.5YR5/6 fld2.5YR4/6 scl Ifpl mvf cw - 0.0 0.2 ❑ Boring# 0 Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 3 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ` ff#1 ff#2 Boring ❑ Boring# Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft ' in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 02 * Effluent#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS<30 mgll_ r. The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8337re5t(RI 1/11) K r�s �e� s m����,�Y --C•'�5� was,-, �yo2,g Yq, s1a, T29 N , R IkW f)lD'* 02'9- 1017- /0- ood { Jc r ,OV IW 5 /4cres i� 1 . S u q $.7 U b i S cST 50 0 I u r 1, �E c N _ f � 9 y LO t t $ y. gEn y C F , i o0 1400 f} � N Pr I � e coi?N ER y . Post pages 30� t ( t i z i R t ' LU _,_.__.._..... ....__.___. _ _....._.,_._: .. .. .......... ... _..........._ ... ...... ...................._..._.__._...._....___a_.___ ,.. i _....._.._.._.... .._ ........ .... . e ��v 1 tl5 tt .. n,. 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