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Wisconsin Department of ConQpp Reg 4 LOI I SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
ST. CROIX COONWance with Comm 85, Wis. Adm. Code
PRF4 I'ACounty d3.30.~o. '1NoE
Attach complete s' r n'411 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. O~D
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. "
Please print all information. Revie by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 126 `7
Property Owner Property Location
Govt. Lot 141 1 /4 1 /4 S < T N R L- E (or VW
Property OwnQr's Mailing Addre Lot # Block # Subd. Name or
' Z
i
CA U
State Zip Code Phone Number El City
❑ Village 'JCTown Nearest Roa
❑ New Construction Llse$,Residential / Number of bedrooms J Code derived design flow rate GPD
Replacement /p ❑ Public. or commercial - Describe:
Parent material Flood Plain elevation if applicable ~i ft.
General comments ,C
and re xxYlimendations:
System Type System Elevation
7 I ] Boring F # ❑ Boring
-Pit Ground surface elev. _ ft. Depth to limiting factor /j~/5') 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 ' f_ A~ °/1'~ a• J
r ✓ C.i ' '1 ,y./rA~p,~. ~~i ~j c ~r ( I) F ~7 1 ff
L >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. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 1 • Effluent #2 = BOD, < 30 mg& and TSS < 30 mg/L
CST Name (Please Print) nature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Ev luation Conducted Telephone Number
1432 120th St, New Richmond, WI 54 /,V-- L//_/ ` 715-246-4516
Property Owner _ Parcel ID # Page of
F-1 ❑ Boring
Boring #
❑ pit Ground surface elev. 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
a Boring # F] 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 # Ground surface elev. ft. Depth to limiting factor in.
F-1 ❑ Pit
Soil Application Rate
Horizon 7epth 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 mgA- ' Effluent #2 = BOD, < 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
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SB0.8330 (8.6/00)
Soil Test Plot Plan j
Project Name Margaret Cloutier Shau
Address 1416 Hilltop Ridge
Houlton Wi
M #226900
Lot Subdivision Date 4/21/17
1/4 1/4S 22 T 30 N/R20 W Township St. Joseph
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of siding
System Elevation 88.5' *HRPSame as Benchmark
Property Line
Scale is 1" = 40'
40' unless otherwise
Existing 1000 gallon tank noted
20'
45' ST
Existing 3
10% Slope Bedroom
12' X 54' bed House
B
B-1 10'
Vent '11\92.0' grade