The URL can be used to link to this page

Home My WebLink About026-938-14-5101-SAN-2022-010 �=� ' `` PRIVATE ONSITE WASTE TREATMENT county �/o"*µ�„\\^'� SYSTEMS � $ , y '�� ;! ( POWTS) Saw er �ry�T-'S1—"`�`' INSPECTION REPORT Sanitary Permit No: Safety and Buiidings Division (ATTACH TO PERMIT) GENERAL INFORMATION 2� � 6,� Personal infonnation you provide may be used for seconda urposes[Privacy Law,s. 15.04(1)(m)] Permit Holder's Name: 5�,�,p�,,,� � ❑City ❑ Village I� Town of: State Plan Transaction ID#� �� J��nv�5o��•�Gc . S ,.�,� Sa� �.-4� ��-01��o�3a-- L Insp BM Elev: BM Description: Parcel Tax No: �o�.b` N�q�l �w 2�" �� _ 0�6 -�38-�Y-S�� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic w� S��' Benchmark �vp�or Dosing _ Co�'4j,o c�� Aeration Bldg. Sewer -- Holding St/Ht Inlet qp,o3 � TANK SETBACK INFORMATION St I Ht Outlet g ,$' TANK TO PIL WELL BLDG vENr ro ROAD Dt Inlet AIRINTAKE Septic ' �}lc�` .�.ta,' ,�oo' NA Dt Bottom $Sg"7� Dosing a « « ,� NA Installation Contour Aeration NA Header/Man. �� . Holding Dist.Pipe PUMP 1 SIPHON INFORMATION Infiltrative q6f� c Surface Manufacturer rb� Demand Final Grade Model Number L�S GPM TDH�� Lift Friction Loss Sys Head TDH Ft Forcemain L � Dia " Dist.To Well DISP SAL CELL INFORMATION DIMENSIONS W 3 � pt�' #of Cells Type of System Distribution Media Manufacturer: SETBACK OHWM of Nav � Conv ❑ Aggregate c � , INFORMATION P/L Bldg Well Waters � AG !� Chamber Model Number: ❑ EZFIow CELL TO }�bo �l0 � �Oo� �'l do� o- Mound ❑ Other ��,f - 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 ❑ No COMMENTS: (Include code discrepancies, persons present,etc.) ��.S�l(� sl i31�� -v . �a� k S7S� �-� � Plan revision required?❑ Yes❑ No �n' �o �� >�_ � �j�� / � � - - � - - � Use other side for atlditional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) A��ITIONAL COMMENTS ANO SKETCH SANITAAY PERMIT NUMBEA: � --O(� ��{k _ -: -- �_ . _ _ �so> _- - - -_ . : - ; - - - --- - - , .. _. � ,_ _ ; - --- � -- . . ♦ . : . . . : - _ -- : _ ; $;� ; _ . _ : . -- -:- - --- �-- - - - - - -- - . . . �+� ~"- �1 . ... . .:._ , _._.y . ._. . ..:. .. . � - - . . .. ! . % .... . .. . .. ._ .._._ _.__._� , ..._.. __. ..: ..___. ,._.. ♦ ._.__.-... _i...._._.. _y.._ ...t_. : : � , ,, ., , , � . i : ; . ; i : ' � . , : ., _ . ' . . �. ,: . . j , . i . �, I . . i . �4 . �. , . : : . : _.. . _. � . .... .. . , . . ...._._'__ ."' _ _� _ _;....._. _ . ,-. .. ._ . ._ . . ._ _ ..._ __ ... _ _ .._ . �� , , � � � � . . . : . . �. . �So'�:�►�C�-h� �` �' - . � wi�' ,sgs�s��P ,��I� ��,�i . - A-,�- ,� ��