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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and BuilOlpAc t(7i7X COUNTY
COMMUNITY DE1lEW&dancd with Comm 85, Wis. Adm. Code County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
/L «~L (°a r `L r✓ Govt. Lot 1 /4 1 /4 S T N R / E (o w
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
City I e , Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
[Jew Construction User, Residential /Number of bedrooms Code derived design flow rate GPD
❑ Replacement Public or commercial - Describe:
Parent material 1 Flood Plain elevation if applicable
General comments r -100'i- (r~0 C C C7 i. 15-. v~ S A
and recornimendations: o-~3
System Type S jJ System Elevation (f PS 1.J
Boring # n Boling
Pit Ground surface elev. ft. Depth to limiting factor r7~ 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
40,
r -^-I Boring # Boring 'T'f '
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#
f
"71
Effluent #1 = BOO. > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Con cted Telephone Number
1432 120th St, New Richmond, WI 54017~ 715-246-4516
Property Owner _ Parcel ID # Page of
Boring # ❑ Boring
a ® Pit Ground surface elev,/1)-4 ~ /ft. Depth to limiting factor in. Soil lication 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
z.
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 GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring # ❑ Boring
F-1 ❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon 'lepth 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 < 220 mg/L and TSS >30 < 150 mg/l- ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (8.6/00)
rSoil Test Plot Plan
Project Name Chuck Nutzmann Shaun ird
Address 1270 Cty Rd H
New Richmond Wi 54017 CSTM #226900
Lot 2 Subdivision Date 9/29/16
1/4 1/4S 2 T 31 N/R18 W Township tar Prairie
❑ Boring Q Well PL Property Line Country ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe
System Elevation TBD *HRPSame as Benchmark
County Road H
Scale is F = 40"
unless otherwise
noted
727' Property Line
180'
B-1
IL 150'
30'
B-3
Old 35'
foundation
found 30' 6% Slope
3.M.*
10'
B-2
100'
102'