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Home My WebLink About014-942-34-2105-SAN-2020-168 - °'""'"�� PRIVATE ONSITE WASTE TREATMENT co��ry .'', -�'� •$ � SYSTEMS Sawyer ;�� P$ ( POWTS) ;�,, �--.�� =x°»��'' INSPECTION REPORT Sanitary Permit No: - Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION ' Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)] �� Permit Holder's Name: ❑City ❑ Village Town of: State Plan Transaction ID#: � \C,.ve��C. �—,w�e7��\ �`G.Jc�� Insp BM Elev: BM Description: Parcel Tax No: �G�;. UC_� `..�� UL ��:��\�� \ U�`` -�y�-�"` - 0�1�;� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark °� �,(� 1c5.�, Dosin9 �-.��, `75� Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St I Ht Outlet TANK TO P/L WELL BLDG AIR NTA�KE ROAD Dt Inlet �1. G6 Septic ��'� 3y� �.�' NA Dt Bottom ��.i�`1 Dosing NA Installation Contour Aeration NA Header I Man. ' \�, Holding Dist. Pipe PUMP 1 SIPHON INFORMATION Infiltrative - Surface � Manufacturer �Z�;\�� Demand Final Grade Model Number ��; GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS W L #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ❑ Conv ❑ Aggregate P/L Bldg Well ❑ IGP ❑ Chamber Model Number: INFORMATION Waters ❑ EZFIow ❑ AG CELL TO ❑ Mound o Other DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold Distribution Pipe(s) �X Hole Size X Hole Observation Pipes i Length Dia _ILength Dia _ Spac I _ Spacing �Yes ❑ No � SOIL COVER Depth Over Depth Over Depth of Seeded/Sodded Mulched Cell Center Cell Edges Topsoil _ ❑Yes ❑ No � ❑Yes � No 1 COMMENTS: (Include code discrepancies, persons present,etc.) �I r�I ��-��-i1 �t_.�A�`r1 1`i^v\ c.�� '�v��.��,v�� e�'C C�.�i�{��s'� �_�— ' C��.i .-•`�'�d��c Z. c-� �'r;^-e� dr' �n��.-.a•c J" �\.,..��i a ��..o--�.�.� �c:.y��1- i„j�� yJ��,�✓ ��7�C%�, �,, \ Plan revision required?0 Yes❑ No li '� ��, A �aa ; ;' � � �i � ' �_ � ',�,� L' i; _ � ��-�� `� Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) . ADOITIONAL COMMENTS ANO SKETCH '�- �ANITAPY PERMIT N'JMBER �.�-�C-�� ' I�_�� ,��(--�� /------�� .\ - _ - -- -- - ---,, _ .�,,,`.' �� ' ,��',- ` i� ��-� i -� i �� , i� �� /\ � � �� \L .� 1� H" �,�w'� � c� � ��`�" : nl� .�G � . � �� >� ! _ " ` � � i � i �� <,� G�<�/�j�� -{� ��,��, � �r,:< � 1�c-a�1� , ' _ ---�. �� ,U�\��. ��- �-� .`��J� .�� - - -----------� ---- - - _---- - -- _------ b F ----- --_�_-1 � �,1 �`� ti � y �c, L__-� � , , /S.S � J\�` � � _ ��1, ��,� � � �� ''�� -°�� "� ,l � � p�, 1 � � --- - _-J � l � � � � � � • �� ; ', ��d '� � �, ,,� _r ,, _ � � � --��. a �� s- � �� •� ��( �, �, ., � �i�C� i � n�`' t�\��1-� �c° � �� 4`-- - !,.,,....�� -1►N � �� ` v�� 1 Ii . J. � /' '�� /� � I ' �