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HomeMy WebLinkAbout010-941-21-2128-SAN-2021-369 /,`" � `` PRIVATE ONSITE WASTE TREATMENT county ,.-,,,:\,y� (">j?�SPs<\��� SYSTEMS Sawyer �L���/� ( POWTS) ��'='�=-°v^''' INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION a 1 _ 3 6� Personal infonnation you provide may be used for secondary purposes[Privacy La�v,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village �Town of: State Pian Transaction ID#: S(b�-~ i- �a{.� (/1/I���� �q a�'� —. Insp BM Elev: BM Description: Parcel Tax No: l lc�.o a,` �-�� 3b ,� K �s�'s��c �6<< ��o _ �r�l.—�..( ..�r�-8 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic p Benchmark 3,� � o �� �oo�O' Dosing Aeration Bldg. Sewer "7,O(, � �i��(q� Holding St I Ht Inlet g�6 � 9 Y � , TANKSETBACK INFORMATION St/HtOutlet .�'� 4y,3S` TANK TO P/L WELL BLDG vENr ro ROAD Dt Inlet AIR WTAKE Septic .{-(p� �(�` �..a r NA Dt Bottom Dosing NA Installation Contour Aeration NA Header I Man. q,7,�'� �73•S"� Holding Dist. Pipe PUMP 151PHON INFORMATION Surface e �°'7S � �a�S � Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFORMATION DIMENSIONS �N L Y' #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav 6L Conv ❑ Aggregate � � INFORMATION P/L Bldg Well Waters � IGP p� Chamber Model Number: ❑ AG ❑ EZFIow CELL TO �� �.p� N ❑ Mound � Other - ��� _— — --- -- DISTRIBUTION SYSTEM X Pressure Systems Only — -- Heatler/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 Cell Center Cell Edges Topsoil ❑Yes ❑ No ❑Yes ❑ N� COMMENTS: (Inclutle code discrepancies, persons present,etc.) ��,s�I(� os t r I��a � � Plan revision required?0 Yes ❑ No � � �3 � e � /�� '� _ O � Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A�OITI�NAt COMMENTS ANO SKETCH SANITAAY PEAMIT NUMBEA: �I �.3C�� � �1� . . 1 : �� 5� rb���" _ _ _: _ ,__ . _ _.,._ Q�.� . - - - - -. __ _ . _ � _. � . � : : ' ' . . . s - �- - __ _ . . ' ; . _. _ ' : : --- . . _ . ; .. . ` ��(ljm� - - . � 2-O , ,_. . t . _ ,__ , , . . -�- . � ; - - _ ,_ � ._ , , _ _ _ _-- , , , - , __ --- : : � . . __. . : :_ ` �,�h�, . , , _ _ , � ��° � ����o �'� 1$� � . —� ��o ��. � C`�,,{•� � 3�'Ac ��, 9 � - o-� � � C Vv � \b�ba � �— � � �.�- � a �—