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HomeMy WebLinkAbout008-938-34-5401-SAN-2021-343 �/`-'''�'-''f":%;�. PRIVATE ONSITE WASTE TREATMENT county i��� ''�� SYSTEMS Sawyer f ' $ `����PS�j�� ( POWTS) /�UFT_)SI \�P` INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION �1 .,. �`f 3 Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(l)(m)] Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: 50�V1 ��`,- ( h �'�'i4 t'd l I��GC `^/� - Insp BM Elev: BM Description: Parcel Tax No: ��� ,D ' �► -�„��,d o � dso�- � .� �B --��--3�r-- sYd/ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic ,,,� - �rp Benchmark (oo.p� Dosing --co,,,,.,�oo �� b ( �Dy��J � Aeration Bldg. Sewer qS 3r'� Holding St/Ht Inlet ��^1� TANK SETBACK INFORMATION St/Ht Outlet q �q � TANK TO P/L WELL BLDG vEr,rro ROAD Dt Inlet AIRINTAKE Septic •h,2s` ��' 1�"` ,{., � NA DtBottom Q'f,3 � Instaliation Dosing �� `' � �� NA Contour Aeration NA Header/Man, Holding Dist. Pipe PUMP/SIPHON INFORMATION Infiltrative Surface � �'� Manufacturer Demand Final Gratle Model Number GPM ���, � `j, � TDH Lift Friction Loss Sys Head TDH Ft ,2 �-j,g ' Forcemain L � Dia ��� Dist.To Well , � DISPERSAL CELL INFOR ATION DIMENSIONS N1 ` L � #of Cells Type of System Distribution Media Manufacturer: -��I SETBACK OHWM of Nav � Conv ❑ Aggregate , INFORMATION P I L Bldg Well Waters � IGP � Chamber ❑ AG ❑ EZFIow Model Number: CELL TO .��' .y-��j �--(av ❑ Mound � Other QY � - --- - ------ --- DISTRIBUTION SYSTEM X Pressure Systems Only --- ---- Header/Manifold Distribution Pipe(s) � X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac � _ Spacing ❑Yes ❑ No � - --- — ---- SOIL COVER - -- — --- Depth Over Depth Over Depth of Seeded/Sodded Mulched Ceil Center Cell Edges Topsoil _ � ❑Yes ❑ No � ❑Yes ❑ N� COMMENTS: (Include code discrepancies, persons present,etc.) ��►s}�fl� ��16�a°a� ---- -- -- - Plan revision required?�Yes❑ No p� �� �3 � ! l ��, � 1 � -— �(/ ----� I Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) AOOITt�NAI COMMENTS ANO SKETCH SANITAAY PEAMIT NUMBEA: z���Y3 � ��2. C�¢.�2iL �� _ . ___._. , � --._ : �._ ,_.. .- _ _. , . . . _.. . \,`��rr E , . 7\\0���� � 3�'` ' � ' ; _. ��� ;w�- ;. _.___ � �---�51 . , �G ��_� �/`- . ._ � . _ . ._. .. . . . . � .. j . .. .._ _ L I, � Z � ; . : . _. a _ _ __. ; : ._ c�` ----� � � . . � ' � , _ __ : �� � 5^s°�� � � : � � , � s% �Yk . <<� �� , � , ,�, +s � �� �°'L c � ��� ��� . ���5� �_ �o s =