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HomeMy WebLinkAbout026-182-14-2400-SAN-2022-002 ���'� �' E`T PRIVATE ONSITE WASTE TREATMENT �ounty �'�— ;�. �oS 4\\'1�'` SYSTEMS �\(�� Ps /v��� ( POWTS) Sawyer \kU latil<`>wT�4/ INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION � � _ �j�� Petsonal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(()(m)] Permit Holder's Name: ❑City ❑ Village �Town of: State Plan Transaction ID#: �°�� �,.��,� Sa�� �a I� — Insp BM Elev: BM Description: Parcei Tax No: Oa.D 1 ���� V� e.� "`� Gi �" � av� ba6" � �eC — ��'o��� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic � �� Benchmark po.o' Dosing Aeration Bldg. Sewer Cj�, ,3 ' Holding St I Ht Inlet 9S;o ' TANK SETBACK INFORMATION St/Ht Outlet q'Y,g � TANK TO P/L WELL BLDG VENT TO ROAD Dt Inlet AI R I NTAKE Septic -1-�0` ��' �c� �� NA Dt Bottom Dosing NA Installation Contour Aeration NA Header/Man. �j'y,� ` Ho�ding Dist. Pipe PUMP I SIPHON INFORMATION Infiltrative q3, 6 ( Surface Manufacturer Demantl Final Grade Model Number GPM TDH Lift Friction Loss Sys Head TDH Ft Forcemain L Dia Dist.To Well DISPERSAL CELL INFOR ATION DIMENSIONS �N � L ys t,�S-' #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate ��� � INFORMATION P 1 L Bldg Well Waters °� GP � Chamber Model Number: ❑ EZFIow CELL TO � '1`�-�" � ti/ � ❑ Mound � Other �L 3� - DISTRIBUTION SYSTEM X Pressure Systems Only Header/Manifold I Distribution Pipe(s) X Hole Size X Hole Observation Pipes� Length Dia _ 1 Length __Dia _ Spac _ Spacing �Yes ❑ No SOIL COVER --- - -- -- -- - - ( Depth Over Depth Over Depth of Seeded/Sodded Mulched Cell Center I Cell Edges I_Topsoil �Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) � �;,s�lC� � (�-� ( �� _ Plan revision required?�Yes � No � �'j -- ___ o� t� �3 � __�'��.,. __ � .�d I� 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 NIJMBEA: �.� -0�� - :- ;___.._.__ :_. .: - -- _ , _ � � : �, . . __ _ W ; , , � ,. . .._ . � ' � � � �S , d : _ � _ _ _: __ _.___ ; _ __:_ __.:_ __ ;._. .:_ _ . _ . __ _ .__. ,_ _ . . . . � ' , , , � T �, . ; . ; : . � : ,. � ; i .. ; .:.._...... ._ ... : : . . . . . . . .. ._ � , � .._. . . . . . . .. . . .. ...�..._.. .�. ._.�.._. .;.......t ...'_..... ._.._.- �, . . . � . '. . , . i . . . . : Qa�~ � . . . �Ac . �a' / i Llo S � �,,.f , , �� � ,�1�' 0 � . i�-,a. i' �- - � �� �/� ► H C — - — '— b� .�� , �-����`"� � �G � Q �, ' �-�O ���N �a k����� �.- . � ��--- 5 -