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RECEIVED
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t Wisconsin Department ommerce SOiL L-V /-%L M 1 lUlN KtPORT Page of
Division of Safety ar?~Pr tX COUNTY
COMMUNITY DEVELOM,"Ipance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. L
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 01~ 1617- CPO 0+
Please print all information. Revi ed by Date
Personal information you provide may be used for seco dary purposes (Privacy Law, s. 15.04 (1) (m)). 9
Property Owner Property Location
J GLt(v ( Govt. Lot1~ 1/4 1/4 S T N Rn E(o W
Property Owners Mailing Address PP Lot # Block # Subd. Name or CSM# r
t a _ 7 `7ld~
aL 1~' r
City y State Zip Code Phone Number ❑ city ❑ Vi ge Town Ne rest Roads
12--New Construction Use:;g-Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material I Flood Plain elevation if applicable
General comments
and reoomimendations:
System Type ~ i t) c System Elevation f t
Boring # ❑ Boring r%
a pit Ground surface elevL ' ft. Depth to limiting factor o in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
2- 10 r51-- h~ ✓Y' r~~+ 1 l
` JJ l' l'A''~
Boring # ❑n 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/f `
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
c J ✓ E r,/~, G~/~ i
I A
Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 ' Effluent $Q = BOD, < 30 mg/L and TSS < 30 nxyL
CST Name (Please Print) CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Dale Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54 7~~-/ 715-246-4516
r
Property Owner _ Parcel ID # / Page of
Boring # ❑ Boring
01 gPit Ground surface elev. 7 2 1 1 ft. Depth to limiting factor 2 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
.20
FY-1 ❑ Boring
Boring # n I~
U~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
(~q ✓ A ~
L
L
o.
E] Boring
F-1 Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit
Soil Application Rate
Horizon ')epth 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 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOOS < 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.
S813-8330 (8.6/00)
Soil Test Plot Plan
,Project Name Shaun Bird Sha ird
Address 1432 120th St.
New Richmond Wi 54017 &~(rM #226900
Lot 3 Subdivision Date 8/25/16
S W 1/4 S W 1/4S 13 T 29 N/R19 W Township Hudson
r-J Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of survey iron
System Elevation TBD *HRPSame as Benchmark
Scale is 1" = 40'
unless otherwise
noted
B.M.* 240'
Property Line 20'
B-2 50'
-3
9% Slope
40'
B-4 10' 30 B 8
Chippewa Path
97'