Loading...
HomeMy WebLinkAbout014-941-04-5802-SAN-2021-331 � � �"T"%� PRIVATE ONSITE WASTE TREATMENT counry ��y� X�i o;$P , \1�1 SYSTEMS SaW er \�� s /~� ( POWTS) Y k'`L ._y�"� �i��"N^' INSPECTION REPOR7 sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION � l — �3 ( Personal infonnation you provide may be used for secondary purposes(P�ivacy law,s. 15.04(1)(ul)] Permit Holder's Name: �City ❑ Village Town of: State Plan Transaction ID#: ��1H��2 Gf1CG Ga�e�,..�� (X�ryn� T�"T� )Oa ��s2��q Insp BM Elev: BM Description: Parcel Tax No: ���a �� o� w�2.�' DIY _`�Y( —OY -�8oa TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACI7Y STATION BS HI FS ELEV Septic �; ��, �� ��pd Benchmark ,��,45� � (0?.9�` (v�.o ' Dosing — co•�•.,b a ��\O o Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL BLDG VENTTO ROAD Dt Inlet AIR INTAKE Septic �o` ��� �o` k3d NA Dt Bottom �.S � 9 3.YS� Dosing �� �� .. ., NA Installation Contour Aeration NA Header/Man. Holding Dist. Pipe �� p � (oo q�r PUMP 1�IPHON INFORMATION Infltrative , ' Surtace �+Pc 3 �.3Y �o��6i � Manufacturer (�a„`� Demand Final Grade Model Number P��( ( GPM f �� � `� 9, bl � TDH Lift Friction Loss Sys Head TDH Ft Forcemain L k,Z,s` Dia �' " Dist.To Well �60' DISPERSAL CELL INFORMATION DIMENSIONS W 3,,'ZS� L �j Z� #of Cells a Type of System Distribution Media Manufacturer' SETBACK OHWM of Nav ° Conv ❑ Aggregate G,� r'�R'� INFORMATION P I L Bldg Well Waters o GP ❑ Chamber Model Number: a EZFIow CELL TO -I-� -f-� �-,(�a �(oo _ �r Mound � Other — DISTRIBUTION SYSTEM X Pressure Systems only Header/Manifold �„ Distribution Pipe(s) „ , X Hole Size X Hole �D� Observation Pipes Length 7 Al Dia (•2� Length 31 , Dia �•�S Spac �•�� D�I�� Spacing �,Yes ❑ No SOiL COVER Depth Over „ Depth Over �, Depth of �� Seeded/Sodded � Mulched � _ Cell Center �a'__ _ Cell Edges ��' Topsoii � f�ti'es ❑ No L�Y Yes � No COMMENTS: (Include code discrepancies, persons present,etc.) ��,�((� �o( iq ����1 �o �;� —��.e�-� w.o��d� Plan revision required?�Yes❑ No 03 �g�2� ` � — — — � �GS�� � Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITIONAL COMMENTS ANO SKETCH SANITAAY PERMIT Nl1MBEA: a ) � �3 � �— - �"S�i r�'�, �.a�ti ' � ._ . , Y � �° � f_ , _ :_ . ,._ ..; 1 , - -- , � . , . ....._. . .---._ �_. ,_.. . : ._ , ., � , , , , _:a��, : ; - � , - : - . ,_ _ _.- ---; � . /� _ .� . . ..__ ._ ____....: _ ., . _. ..__ .. . ;-.'_'_� ._ ` _ '._ . '_._'_..._' ' v ' ' � . . � : . ! �` { . . . , . .���.. ...._..... -:..._....i._ . . ...._ . i._ _� . .'i-.. ._._ ..._ . { , __ i _ . . . .. ,. ...� _ i..__.._ � ..._..�.... r._ __ . .. � ' � : ; . : ' ��. . � . . ..I ' - . _i _'�.. .' _"__.... -. . ._. L-_. .; .. : . . _.. ,._ �: . � , : . . � . � I '�_- .. . _ . ._ ' _..�.. ....... .._._.. .._ ' . . , . . � �. � i , . �1 : � � . : �: ; � . . 7 " . ` � � . . b� �� . __ . _ . . : _ _ � r � - � . � . . . , I . . . _ .. . . . .. ._ . _ �_ . . . . . _. i .. .. . . . . � . . . . . . ... .. . _ _... , \ �• . . � '�7b . ��q,�� . .. ` ¢�c� \ \M�-�'`[��� ' • CC�"''•- , fi k S ! ,,5�. r . �� , �o �� �„��� o� ,- �L ` o-.� �� ,����� �� ��� �°( .� �. � �- �C I .` G;nn, �. �`�" ` ( k/�� .1 . � , � � �or �.�� L . �\���' ° �-5--s, �l �-- � � � � • ( �°� 1 \ �,w� ,�� �� _ - ,x�.. 1 � c� \ b�G�v��� �a �----- �� ��3.aS .�� ��- ���