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HomeMy WebLinkAbout00143A d GAARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 2014 Slake Avenue Glenwood Springs. Colorado 816 11 PERMIT # 1 4i 1- System Lpoatipn 54077 �i97VC-M Contractor - s. Qe 1,. Construction apwrovai for a _Sap _., gallon 0 Septic tank Aerated treatment unit and abaorptton area computed as follows: Para rate / inches in /0 etin stgfnt 'S ' so, ft. of absarntton twee per b, clue zas u„_ X / r ea. feet- .. '30 sq. feet minimum reautremejt. I swum 'Jra?8'x ,3 Seasomsbe 'rs4e? Date 9 "73 Inspector ?. Pint eDProval of systems No system shall be deemed to be in compliance with the Sewage Disposal Lew* onttl the assembled system is approved prior to covering arty part thereof. V septic tank clement with nag seed i —' Msatll�.iib°a1'Dtiari a 9uveuents stoned ' :t' i �r >� . r ! .E? ,zi,(. 't) .- /Ale_ - ter 69ir-- / n' gC.9C/ (n f/ // cf7 C/a /4&tY Dope. ©'e7L ,se' i'1a-sp {�� w2/ - 73 ** Pstaiq with permit records at construction site. mont L. Kinkade, Sanitarian 1 f. Co. Environmental Health i ' ' P/9 /� ) / 2014 Blake Avenue Tel. 945 -7255 !;. Ir Glenwood Springs, Colo. 81601 NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE* INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM ** Owner: %S% ea. �,.j Mail Address: (3 //? � p City yn,,., %� a 7it-' Phon ` I363 A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, soil profiles in test holes. 1. Location of facility: CountyCity or town Legal description stare Lot size 2. No. of bedrooms Septic tank capacity Aeration unit capacity 3. Source of domestic water: Public (name): Private: Well 7/ Depth Other Depth of first ground water table 4. Is facility within boundaries of a city /town or sanitation district? 5. Distance to nearest sewer system: ,ze A Have you attempted to arrange a connection with the system? 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: 8. Name, address, and telephone of person responsible for design of the system: -! . i 9 //- 7 3__ Date or Sig . ure of Owner *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 pollution of waters of the State may ogcur (Art. 66 -28 -8 (5), CRS) and /or areas in which there is no local septic tank ordinance. . i Please use the following space for directions to your property site. i 1 t --D a /• VI