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Home My WebLink About151-26Wisconsin Department of Safety& Professional Services SOIL TEST #/ ' S Page�of Division of Industry Services . 2 SOIL EVALUATION REPORT 5ay In accordance with SPS 385, Ws. Adm. Code County ; s�-oo ac plate site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, ga �el i d to vertical and horizontal reference point (SM), direction and percent slope, LD. s ensions, north arrow, and location and distance to nearest road. TAX ,53 6 Q Please print all information. Revi w z /7 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(l)(m)). �J 7/ I Property Owner � / Property Location W ❑ 2 M /V e� O Govt. Lot S r_ % S C- '% S T L{, N R -7 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 164g FaerTor.S-reecT 14010 F R Li O A City, State, Zip I Phone Number ❑ City ❑ Village (Z Town Nearest Road S -t- A. MA) _r_rt3O ((ola) 3S2-0302. Pt tsev',. IrRHaoA New Construction Use: R]Residential/Numberofbedrooms Code derived designflow rate 60OGPD ❑ Replacement ❑ Public or commercial — Describe: Flood Plan elevation if applicable ft. Parent material So.nd.y Gic c octuylos( ptpos i-rs General comments and recommendations: Boring # Boring ®Pit Ground surface elev.-IJ.Oft. Depth to limiting factor 95 in. I elev0 / • I ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 *Eff#2 0-t IoYR 3/ - Is I f r a5 C .7 Z -36 3/ - is Osp aS .7 '9C SY - 1 . i.G RECEIV !D OCT 06 2)26 Bayfield Co. ❑Boring Planning and Zoning Agency oo Boring # ❑pit Ground surface elev.Cis. ft. Depth to limiting factor?in. / elevfl'7. I t. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 *Eff#2 I O- '7.s 3// Ic I$ f a CS 3wN .7 I. 2 7 SYR 3 - LS a -91. S5RtI/9— 1 1 CST Name (Ple se Print) Signature , /� �%�� CST Number Ton P0Ikoski 5 IIn6$-ST Address $tLc Gevvlt.( N 1511 W4.' g Date Evaluation Conducted Telephone Number =ro.- (Ziv r L.t)T S4StrH 9-7--t6'Zl -3ql -7O$ Effluent #1 = BOD > 30 S 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, s 30 mg/L and TSS S 30 mg/L SBD-8330 (R03/22) Page of Boring # fl Boring Q� ® Pit Ground surface elev. rt9. 1 11 Depth to limiting factor in. / elev. 77. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Or. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 'Eff#2 O -S . Y 3/ - ►5 Os as c 3 •-7 I. Z -36 y.svkyg0s d I S 0 s CU 7 I______ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. R. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 Eff#2 0 2026 Planning and Z ning Agency ❑❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 Effluent #1 = BOD > 30 5 220 mg/L and TSS > 305150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L Combined Soil Evaluation Plot Plan - System Plot Plan Component Manual Design References: In -Ground Soil Absorption for POWTS Version 2.1 Owner: Andrew P & Wendy M Nelson Site Address: 14810 FR 420A, Mason, WI 54856 Tax ID: 18556 Legal Description: The Southeast Quarter of the Southeast Quarter (SE 1/4 SE 1/4), Section Eight (8), Township Forty-seven (47) North, Range Seven (7) West, Town of Pilsen, Bayfield County, Wisconsin; LESS the Easterly 460 feet of the Southeast Quarter of the Southeast Quarter (SE 1/4 of SE 1/4), Section Eight (8), Township Forty-seven (47) North, Range Seven (7) West, Town of Pilsen, Bayfield County, Wisconsin, Lying South of Forest Road 420A; AND LESS the Southeast Quarter of the Southeast Quarter (SE 1/4 SE 1/4) Section Eight (8), Township Forty-seven (47) North, Range Seven (7) West, Town of Pilsen, Bayfield County, Wisconsin, Lying North of Forest Road 420A. Soil Evaluated By: Tony Polkoski - 11068 -ST Plumber: Allan Polkoski - PMRS 220090 0 50 100 ft [All piping shall conform to i SPS Table 384.30-3 and SPS Table 384.30-5 Fe i No existing wells on Propert F Page 2 of 4 --- Approximate Property Line o Soil Test Pits: 1 - Elevation - 95' 2- Elevation - 95.1' 3 -Elevation -96.1' A Benchmark - Screw in Maple Tree Elevation - 100' slope OP 0) 30 3 Trenches Quick 4 Plus �I� A: Standard Chambers zo Garage Tank- Wieser W1250 -MR Filter- PolyLoc PL -525 Proposed 4 Bedroom Home RECEIVED OCT 062026 sayfield co. Planning and Zoning Agency 1 13 LYFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: NELSON,ANDREW P & WENDY M SR -00524 1649 EDGERTON ST ST PAUL, MN 55130 Transaction Number: SR -00524-57A99 Description Certified Soil Tests - Review & Filing Fee Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 2517 Paid by: Polkoski Soil 2 Septic, 5115 County Highway B, Iron River WI 54847 Payment Type: Check Transaction Date: 10/12/ 2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.