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RECEIVES CSfi-c ~ 1-3
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Wis. Dept of Safety and Profess iQN IU SOIL EVALUATION REPC 7GOW26Y3HPK6 geOf
Division of Safety and Buildings
ST. CROIX Qnce with SPS 385, Wis. Adm. Code
02 F County
Attach complete site p[annon pape no ssQygN;C 11 inches in size. Plan must ~r
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 30 ^ G ~Q ~Q,134G
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. tJ
Please Print all information. Revi by Date C7
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z' , ( 1
Prope Owner Property Location
Govt Lot Sb+/ 1/4SGv114 S T 30 N R t(or)®
Property Owner's Mailing Address L Lot # Block # Subd. Name or CSM#
~7 COPS' 'C CQ~Q ~r• JKf Khr7ll
C' State, Zip Code Phone Number ❑ City ❑ Village [3Town Nearest Road
Qf I/P as Y O ( ) Sf ~6 A 1 ~J 6"-r O 0. ~G L4r"~
New Construction Ose: Q Residential / Number of bedrooms Code derived design flow rate 6o o GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable /Y ft.
General comments Srsa ter, F~ • Y 2 ~a
and recommendations:~ 5~ f
1
Boring Q u`
Boring # ~ Pit Ground surface elev. v' ft. Depth to limiting factor Z in. Soil Application Rate '
Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPD/ft Z
in. MunsellQu. Sz. Cont Color Gr. Sz. Sh. ff#1 ff#2
0-7 lUv ~2. /V/+ f% PIU14- y ki Z G 0 r0/ 0,00
3 W Y3 -Yof ` b 114- s~ //rrs~k M 7-4,- c c~ 14 car y 0, -7
y3-/ 7s'rj►Z M5 Os ~'yi G O~ 7 I r b
® Boring # Boring y
® Ground surface elev. • 96r Oft. Depth to limiting factor/ in. Soil Application Rate
Pit
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPDt t Z
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ff#1 ` ff#2
b
1 o-9 G. 21-" r R.. w 2 C 0 6 0,
Z e-21 /oYR S/~ N~ .S 2 m-4& C- O, 6 0, 8
3 29- y6 SCR % L -11n-f4i6 M4- w l G- V 0, 7
y Y6- 7SY/~~8 S OS m L I a4- Or 7 A 6
' Effluent #1 = BOD > 30:S 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) _ Sign ~?/G
131-1 6A 1clAell Date Evaluation Conducted Telephone Number
Add a a e SOm~'5-
SBD-83-10 (R] 1/11)
Property Owner 8 e ~O4't Oe/- C/ Parcel ID # 7~ 4 Page Z of r
1-71 Boring # ❑ Boring
® pit Ground surface elev. Aao• ft. Depth to limiting factor 7 Z 7 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure nsistence oundary Roots GPDfft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2
o-$ 1414- Z, z/h . "F, y~. 2 o,,/, o,,
3 2g-Y~ syof 6 IVX c w ~rI 7
Boring # ❑ 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 2
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ff#1 0#2
❑ Boring
❑ Boring # Ground surface elev. ft. Depth to limiting factor
El pit in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2
* Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L
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.
saD-8330(Rr vi1 )
OWNER Page 3 of 3
Name ~rOSPP Brian Parnell
Address 7VY cc- t Gn St
~ CST 231314
Las y' as /YU / z ?
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® Benchmark 1 TOP j'9 vc a
S Benchmark 2 T0P ~y Lae ln' P` ,e5.1. 9S : 3
❑ Sail Boring
Suitable Area
l 40' Scale
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