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s t 1 GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs, Colorado 51601
PERMIT 116 326 (this does not constitute
a building or use permit)
Owner Gaylen K. Rees
System Location 0286 - 236 Road - Silt
Licensed Contractor owner
"* Conditional Construction approval is hereby granted for a /0 gallon
Septic Tank or Aerated treatment unit.
Absorption area (or dispersal area) computed as Iollows:
Pere rate 1 inches in a0 minutes . oZ sq. ft.
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absorption area per bedroom rAtR C'e"'
41 of bedrooms -3 x c sq. ft. minimum requirement =^ 6(3 Srz •,cr; or 4,,7r;44 ptla
May we suggest /a S.
/ X.?' X 33/ 6 &e72 esd,er + a3
°�'- 9 7 Inspector
¢ � ' - 74 Date I ns
FINAL 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.
test Septic Tank cleanout to within 12" of final grade or aerated access ports above grade.
O - Proper materials and assembly.
Ott— Adequate absorption (or dispersal) area.
O W- . Adequate compliance with permit requirements.
—t&--Adequate compliance with County and State regulations /requirements.
Date S —;gyp • 7S Inspector 1 074
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 66.444, CRS 1968, amended 66.8.14, CRS 1968.
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 permirand cause for both
legal action and revocation of the permit.
8. Section 1I1, 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 a Class I, Petty Offense ($500.00 fine • 6 months in jail or
both.
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COLORADO DEPARTMENT OF HEALTH .
Water Pollution Control Division
4210 East llth Avenue .
Denver, Colorado 80220 .
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREAiMENT SYSTEM **
Owner: f P 1 —
Mall Address:6 ,,86- 2-3L,C City ,i zipf /d4 one_ —
A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW:
Attach separate sheets or report showing entire area with respect to surrounding
areas, topography of area, habit blu buildins, location of potable w;atcr wells,
soil percolation test holes, soil profies test holes. J(
1. Location of facility: CountyS zL "City or town _ - --
Legal description Lot size /Q Qeb =e
2. No. of bedrooms Septic tank capacl / 6fl Aeration unit capacity
3. Source of domestic ater: Pu is (name): ((
Private: Well Depth Other Depth to first ground water table __
4. Is facility within boundaries of a city/ '.an or sanit ion district? ° --
5. Distance to nearest sewer system: 2 /
Have you attempted to arrange a connection with the system? e it 0 ._
If rejected, what was the reason?
6. Rate of absorption in test holes shown on the location neap, 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:_ _
. (seF pCJ2_i ;2,
8. Name, address, and telephone of .person responsible for desist) of the system:
AO
Air /r /k� ,
12_ iT nature Irw: er
*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 pcitutioo
of waters of the State may occur (Art. 66 28 - 8(5), CRS) and /or areas in e: theta
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 Disappro4al
Signature for Local Health Department
Signature for City /Town Official title)
Signature for County Official (Titre) —
Comments: — ---
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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:
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D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
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WP- 33(10 -72 -2)