HomeMy WebLinkAbout00135 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
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2014 Blake Avenue
Glenwood Springs, Colorado 61601
REPAIR PERMIT N S 1' (this does not constitute
a building or use permit)
Owner Thome Panrnan i,ragg
System Location Snuth Glnnwnnd
Licensed Contractor Hr":kloiWkaK : Se rhnndala
* Conditional Construction approval is hereby granted for a /rnOr7 gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as follows:
Pere rate / inches in . minutes /-. 5 sq, ft.
absorption area per bedroom
N of bedrooms 5 x /..-As` sq. ft. minimum requirement w %-' —rrfe, f"' " -Y.f . -7r. 'nee,,.
May we suggest / ix 3. / ,k i � 'c` s: /�T .c' f..-?ccW
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Date _ ;:. r, Inspector
FINAL APPROVAL OF SYSTEM:
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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.
4 Proper materials and assembly.
Adequate'absorption (or dispersal) area.
Adequate compliance with permit requirements.
S _Adequate compliance with County and tate regulations /requirements.
CleUe /9--)rlOG fii tl6 5 y7 'CC)
Cr.'- a rV lt'c S et a9,* 'C= a I
Date N Inspector
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 66.8.14, 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.
8. Section III, 8.24 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 aClass I, Petty Offense ($500.00 fine • 6 months in jail or
both. v .- - --
COLOR.'iDO DEPARTMENT OF HEALTH � 7 / P � �1
Water PoLlution Control Division /
421(1 East J 1 th Avenue S Yi
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Denver, Colorado 80220 sl° —f
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NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE M MENT SYSTEM
O wner: ,.��, .. - - - ' 2A .—......t...../
// Zi Po G2 4 P
Mall Address: en' 111 City ; i_ _... �_. P
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: -
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography cZ ari.::, haLitable Li;;, iL y aLion of potable water wells,
soil percolation test holes, soil profiles in test holes.
1. Location of facility:. County .City or town �
Legal description Lot size 2 cc,"
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2. No. of bedrooms 3 Septic tank capacity Aeration unit capacity -
3. Source of domestic water: Public (name): a
/ i
Private: Wel14Depthl Other Depth to first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /Ara
5. Distance to-nearest sewer system: ` j
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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:
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Date Signature o Ow
*Required by Article 66- 28- 12(CRS, 1963, 1967 Perm. Sum. Supp.) A
* *Required in areas which have been identified as areas in which danger of pcllutioi
of waters of the State may occur (Art. 66- 28 -8(5), CRS) and /or areas in .r::ic", then:
is no local septic tank ordinance.
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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 Approval Disapproval •
Signature for Local Health Department
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Signature for City /Town Official Title?
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Signature for County Official (Title)
Conmments :
Signature and Title
Note: The Notifier (front of this sheet) must obtain comments and si ,nature of at
least one of the above.
C. FOLLOWING FOR STATE HEALTE DEPARTMENT USE: Recommendations of the District Engineer:
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D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
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V -33(10 -?2 -2)