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Wisconsin Department of Safety and Professional Services V 1a Page 1 of 3
Division of Industry *Wes 1
SOIL EVALUATION REPO 96H7FVEF40AM8
T. G i t:
j~ In accordance with SPS 385, Wis. Adm. CRde C;oumy
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, St Croix ti A
but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road. A &W 19 1Z (0 , 51
Please print all information. Revie d by Dat
Personal information you provide may be used for secondary purposes Priva Law, s. 15.04 1)(m))- 27
Property Owner Property Location ❑
Dave Coyer Govt. Lot NW NW % S 2 T 29 N 18 E (or) W
Property Owner's Mailing Address Lot # Block # Subd. Name car CSM# 1
1122 76 th Av 1 ~3ZG
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
Roberts WI 54023 (651) 399-4023 Warren 80d'Av
® New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material sandstone Flood Plan elevation if applicable A ft. n
General comments and recommendations: ' J
1❑ Boring # ❑ Boring
® Pit Ground surface elev. 100 ft. Depth to limiting factor 70 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff#2
1 0-4 10YR3/3 SL 3 M BK MVFI C S 2 M 0.6 1.0
2 4-36 10YR5/6 SL 2 M BK MFI C S 1 F 0.6 1.0
3 36-70 10YR 4/6 S 0 SG MFR 0.7 1.6
Boring # ❑ Boring
® Pit Ground surface elev. 98 ft. Depth to limiting factor 72 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Fe
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff#2
1 0-5 10YR2/2 SL 3 M BK MVFI C S 2 F 0.6 1.0
2 5-36 10YR5/8 COSL 2 M BK MFI C S 1 F 0.6 1.0
3 36-72 7.5YR5/6 COS 0 SG MVFR 0.7 1.6
* Effluent #1 = BOD, > 30 5 220 m /L and TSS > 30:5 150 > 30!5 220 m /L and TSS > 30!5 150 m /L
CST Name (Please Print) Signature CST Number
Dale R. Stewart 220879
Address Date Evaluation Conducted Telephone Number
757 107" Roberts, WI 54023 11./01/2016 715 497-9996
SBD-8330 (R04/15)
i
F7iBoring # F] Boring
® Pit Ground surface elev. 104 ft. Depth to limiting factor 70 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff#2
1 0-7 10YR4/3 SL 2 M BK MFR C S 2 F 0.6 1.0
2 7-24 7.5YR4/6 COSL 2 M BK MFR C S 1 F 0.6 1.0
3 27-70 7.5YR4/6 COS 0 SG ML 0.7 1.6
❑ 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/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff#2
1 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/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff#2
* Effluent #1 = BOD, > 30:5 220 mg/L and TSS > 30 5 150 mg/L * Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L
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