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HomeMy WebLinkAbout032-539-18-4102-SAN-2021-312 ��� "`"'E^ PRIVATE ONSITE WASTE TREATMENT �ounty ,�_�� � ` ``` SYSTEMS ,�,'�� �, Sawyer � , , s p � r�, `'�\��s ��' � POWTS) ��H�fT__// �'���=' INSPECTION REPORT sanitary Permit rvo: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION p� 1 - 3 �a Personal infonnation you provide may be used for secondary pucposes[Privacy Law,s. 15.04(l)(m)J Permit Holder's Name: ❑City ❑ Village IQ�Town of: State Plan Transaction ID#: ��►� �}-(a�� �•�tis w�,n, ��'�`��i p��Q$-C. Insp BM Elev: BM Description: Parcel Tax No: 1���� Ma;� n`��ti ���. S•s��v m� \3���ia �� C�a,r o32 - g39'- l�-�lfol TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic — 1ppp Benchmark �pp,� ` Dosing � M�rjo (�00 Aeration Bldg. Sewer $3 D�r Holding St I Ht Iniet g ,� � TANKSETBACK INFORMATION StlHtOutlet �,�{-�` TANK TO PIL WELL BLDG vENr ro ROAD Dt Inlet AIR INTAKE Septic �D' �' a. ` .��` NA Dt Bottom "7�,$�,� Dosing „ .< <• a NA Installation Contour Aeration NA Header/Man. qq,$f' Holding Dist. Pipe PUMP 1 SIPHON INFORMATION Infiltrative � Surface lG�. Manufacturer ��Q Demand Final Grade Model Number P� �� GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L ��` Dia " Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS �N ` L �� � #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav ° Conv ❑ Aggregate INFORMATION P(L Bldg Weli Waters � IGP ❑ Chamber ❑ AG � EZFIow Model Number: CELL TO �}-{pa` ` -�5'a` ,}.-c�o ` Mound � Other -- .�_--_ �— _ � __ DISTRIBUTION SYSTEM X Pressure Systems Only - - Header/Man�foid i �l Distribution P�pe(s) �� � X Hole Size X Hole �� Observation Pipes Length_� Dia� Length �a= Dia� Spac.�_ 5 3 Spacing'�' Yes ❑ No SOIL COVER - - — Depth Over << Depth Over �� Depth of /„ Seeded!Sodded Mulched Cell Center t2 Cell Edges �� Topsoil_ b ___ � �'Yes ❑ No��Yes ❑ N� COMMENTS: (Include code discrepancies, persons present,etc.j �— .� s�t-(,P 1 !��!ti� �� (t�(�1 [r'� 1 � Wt� �s���� (o� 6 (a.2 [PcQ� Plan revision required?❑Yes❑ No �� �$ �� � � . ��-_� � �� 1� � Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A��ITIONAL COMMENTS ANO SKETCH SANITAAY PEAMIT NUMBEA: � � �3� '___. ._.. _�'"..__"..L._._ :.__ _.__._.�_i_. . :. . �. ' - ' �. F : . . ., . . . .. . . . .. . . .. . . . _... . . , . _ ; — — — — �o�`6'� n� � . _ . I T, � ,�o , ,,. e�� ,� , . I 1 I S �3 O 3. , - , , , '� \ � _ : . _ .. _ _. � � ._ � /� � I��-�$ ---t � � , -- - ; .� ' / � 1 ... , . - . . . � ...... __....� � . ,. . . ... .._._.... . . . �. . ! . . , ._.... ... .... `. i. . . . . I � � � � � � , . � \ i � . . I . , , ` . , . . . . . . .. . . ' . �� __ ' .___ . . '. \ - - -+f ' . � , � a� � '� O� , ��� .� � � �s� , � �v- ,r�°� 6` �%�'�ow �, � ��� � � s � �. r �.�`c�` �PI� --� ��SS �.�� �� N SCALE 1"=