HomeMy WebLinkAboutApplication-Permit11
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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 81601
PERMIT # S 055
Owner V O_,r i\ a 4. Le An rr T. A rb,-,:),TIviit
C1(10
System Location �rIvei of TT�r N < <V
Licensed Contractor aeptper-----
* Conditional Construction approval is hereby granted for a 05 5 Q gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate inches in /0 minutes ,f sq. ft. c- ri '� 7 aewot- r.7 - l
GyRF/ etrz o 0(9 a47...rri)
absorption area per bedroom �Cali.P_
# of bedrooms 4 x /dr'5 sq. ft. minimum requirement = Gv CoG7 5Q -; re -yr -et -f_
11-7 . ewe ri7 teon
(this does not constitute
a building or use permit)
May we suggest / .' -k $ . r X 3's3'*64012
Date e?— / 7
Inspector
uFINAL APPROVAL OF SYSTEM:
No system shall be deemed to be in compliance with the Sewage Disposal Laws until the assembled system
is approved prior to covering any part.
Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
Proper materials and assembly.
Adequate absorption (or dispersal) area.
-Adequate compliance with permit requirements.
Adequate compliance with County and State regulations/requirements
Date
71/
Inspector
t/;?<
RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE
*CONDITIONS:
1. All installation must comply with all requirements of the County Individual Sewage Disposal Regulations,
adopted pursuant to authority granted in 66.44.4, CRS .1963, amended 66-3-14, CRS 1963.
2. This permit is valid only for connection to structures which have fully complied with County Zoning and
building requirements. Connection to or use with any dwelling or structures not approved by the building
and Zoning office shall automatically be a violation of a requirement of the permit and cause for both
legal action and revocation of the permit.
3. Section III, 3.24 requires any person who constructs, alters, or installs an individual sewage disposal
system in a manner which involves a knowing and material variation from the terms or specifications con-
tained in the application of permit commits a Class I, Petty Offense (8500.00 fine - 6 months in jail or
both.
.) CQLP RADO DEPARTMENT OF HEALTH
. Water Pollution Control Division
4210 East Ilth Avenue
Denver, Colorado 80220
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE',
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM**
Owner: /ERN ..41.cg7- Aga
Mai i Address: 2,11,Ulla4 /35, city CAR6,04V it Z 1 p ff/623 Phones 23-3
A. INFORMATION REGARDING PROJECT.SUBMITTED .FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of Greg, .habitable buildings, lceaLion of potable water w.11s,
soli percolation test holes, soil profiles In test holes.
1. Location of facility: CountyG/,BFILO .. _ .CI ty or town POU.,$ /4, CAgEk_
TRACT /7 (Hew&Y se8DIa/siw
Legal descrlptlonM ofyoLia7/ V3 7iup7 Lot size 42,3
4.9 F9(2) of G-0'-P,m
2. No. of bedrooms ¢ Septic tank capacity Aeration unit capacity
3. Source of domestic water: Public (name):
Private: Well,( Depth Other Depth to first ground water table f e
4. Is facility within boundaries of a city/town or sanitation district?
5. Distance to nearest sewer system: iv 1EE11 7 2 O FT,
Have you attempted to arrange a connection 'with the system? 4/1 (wok 5Erfi .
5 )4574.i m f6R ON€ AO 0?E)
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location map, in minutes per inch
of drop in water level after holes have been soaked for 24 hours
7. Name, address, and telephone of person who made soil absorption tests:
Ao&72
8. Name, address, and telephone of person responsible for design of the system:
-- /v -- 7 Ci
Date
*Required by Article 66-28-12(CRS, 1963, 1967 Perm. Sum. Supp.)
**Required in areas which have been identified as areas in which danger of pol!u:ion
of waters of the State may occur (Art. 66-28-8(5), CRS) and/or areas iii which there
is no local septic tank ordinance.
B. SIGNATURES OF LOCAL OFFICIALS: The undersigned have reviewed the notification
described on the front of this sheet and recommend approval or disapproval of
the discharge as shown-
below:
Date
Comments:
Approval Disapproval
Signature for Local Health Department
Signature for City/Town Official (Title)
Signature for County Official (Title)
Signature and Title
Note: The Notifier (front of this sheet) must obtain comments and signature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer:
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP -33(10-72-2)
A-cce4Q. trzA4441,ilic h 4 mae4L "04-t
CAA -4W 7IC) I /0,4, 74-.?
prom
(.CurtiMuu
•
COLORADO DEPARTMENT OF HEALTH
GENERAL SANITATION SURVEY REPORT
FOOD AND DRUG
FIRM NAME
LOCATION
OWER
ADDRESS
MANAGER
COUNTY
INSPECTION OF YOUR AT THE ABOVE LOCATION REVEALED THE FOLLOWING
ESTABLISHMENT TYPE
DEFICIENCIES:
1. PREMISES: DUST CLEAN OTHER
2. WATER SUPPLY: ADEQUATE SAFE TYPE
3. TOILET -LAVATORY: FACILITIES GOOD REPAIR CLEAN
4. WASTE DISPOSAL: SEWAGE TYPE REFUSE PRODUCT WASTE
5. VECTOR CONTROL: RODENTS INSECTS VERMIN PROOF
b. BUILDING: CONSTRUCTION MAINTENANCE CLEAN
7. EQUIPMENT: ADEQUATE GOOD REPAIR CLEAN STORAGE
B. CONTAINERS -UTENSILS: CLEAN SANITIZED STORAGE
9. REFRIGERATION: CLEAN TEMPERATURE THERMOMETER STORAGE DRAINAGE
10. FOOD: OPERATION STORAGE TRANSPORTING NON-FOOD HANDLING
OTHER
11. MISCELLANEOUS: ANIMALS DRESSING ROOM PERSONNEL HAZARDS OTHER
(✓) UNSATISFACTORY - EXPLAIN IN REMARKS SECTION
REMARKS:
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...,404.44, -0.44146 -04040i
DATE: RECEIVED BY: SANITARIAN:
ES:MFD 55 (1-71-50)