The URL can be used to link to this page

Home My WebLink AboutOWTS Design33 FoUR WHEEL DRIVE ROADCARBoNDALE, CO 41623970.309.5259cARLA.OSTBERG@GMAIL.COMtil;rlTt<ì <:.():üst ;r-Tr:;GMarch 6,2020Project No. C1506Troy Trulovetru lovefarm(@qmail. comSubsurface lnvestigation and Onsite Wastewater Treatment System Design4-Bedroom Residence + 1-Bedroom Additional Dwelling Unit (ADU)1831 CR 114Garfield County, ColoradoTroyCBO lnc. performed a subsurface investigation and completed an onsite wastewater treatment system(OWTS) design for the subject residence. The 38.255-acre property is located outside of GlenwoodSprings, in an area where OWTSs are necessary.Legal Description: Section: B Township: 7 Range: 88 A TR lN LOT 12,THE SESW & NWSE SEC I38.255 ACRESParcel lD: 2393-084-00-010SITE CONDITIONSA 1-bedroom main residence and 1-bedroom additional dwelling unit (ADU) exist on the property. Theresidence is served by an existing OWTS, documented by Garfield County lndividual Sewage DisposalSystem Permit 02866. The system consists of a 1OO0-gallon, concrete septic tank followed by a soiltreatment area (STA) with a total of 9 'Standard' lnfìltrator chambers. The system received final approvalon November 4, 1997. The ADU is served by an existing OWTS, but we were not able to find a file thatdocuments this system. Both OWTSs will be abandoned.The proposed addition to the main residence will include 2 bedrooms. The 1-bedroom in the ADU willremain. The design for this system will serve the main residence, including a future bedroom, and theexisting ADU for a total of 5 potential bedrooms.The residence and ADU are served potable water from a shared well located on a neighboring property,located greater than 1O0-feet from any proposed OWTS component. The water lines enter eachstructure from the north. The water line serving the neighboring property to the south runs to the east ofan existing fence. All water lines will be greater than 25-feet from any proposed OWTS components.The proposed soil treatment area (STA) location has an approximate five percent slope to the south. Theslope shape is Linear-Linear (LL). The proposed area is located to the east of the existing STA servingthe main residence. The area is covered with sparse native grasses.The site plan was created using several documents including a minimal survey and a google earthimage. Positioning of existing structures and proposed OWTS components are approximate and done tothe best of our ability. The site plan provided is not the result of a survey. Page2There should be no traffic or staging of material over the future STA site to avoid compaction of soilsprior to construction of the STA.SUBSURFACEThe subsurface was investigated on March 4,2020 by digging two soil profile test pit excavations (Test Pits).A visual and tactile soil analysis was completed by Carla Ostberg at the time of excavation.lThe materials encountered in Test Pit #1 consisted of dark brown, moist topsoil to 6-inches, underlain bylight brown calcareous clay matrix to 6.O-feet, underlain by light brown calcareous clay matrix with somebasalt boulders to a maximum depth explored of 8"O-feet. No bedrock or groundwater was encountered.The materials encountered in Test Pit #1 consisted of dark brown, moist topsoil to 6-inches, underlain bylight brown calcareous clay with some angular rock to 6.0-feet, underlain by light brown calcareous claywith some basalt boulders to a maximum cepth explored of 8.0-feet. No bedrock or groundwater wasencountered.A tactile analysis of the soils was taken from Test Pit #'1 at 3-feet below grade. Soil structure grade wasmoderate. The soil formed a ball and a ribbon approximately 1-inch in length before breaking. Soilstructure shape was loose to blocky and consistence was loose to friable. Soil texture was more smooththan gritty.STA sizing is based on Soil Type 2, Silt Loam with moderate structure grade. We have opted to use aslightly more conservative long-term acceptance rate (LTAR) of 0.5 gallons per square foot will beused to design the OWTS.Sieved sampleribbor approx. '1"' Carla Ostberg holds a Certificate of Attendance and Examination fron the CPOWVisualand TactileEvaluation of Soils Training. Page 3Test Pit #1backfill from Test Pit #1Test Pit #1 looking toward ADU and residence (to left) Page 4Looking toward Test Pit #2from Test Pit #1 J Test Pit #2Test Pit #2 i nore angular rock than Test Pit #1DESIGN SPECIFICATIONSThe existing O\ÀTSs servirg the main resid=nce and ADU will be properly abandoned by pumping andeither crushing the botiom, top, anc sides o'the tank: or removing the tank structure and filling anyremainir¡ void with on-site materials. ïhe existing STAs will be abandoned in place. Page 5Desiqn Calculations:AverageDesignFlow=[T5GPDx2people/bedroomx3Bedrooms+75GPD(future4thbedroom)=$25GPDI+ [75 GPD x 2 people/bedroom x I bedroom (ADU) = 150 GPD]= 675 GPDSeptic Tank = min. '1500 gallons (5 bedrooms)LTAR = 0.5 GPD/SF675 GPD / 0.5 GPD/SF x 1.0 (gravity trenches) x 0.7 (chambers) = 945 5afhe new OWTS design is based on S-bedrooms. The main house will have 3-bedrooms + 1 futurebedroom and the ADU has 1-bedroom. An average daily wastewater flow o1675 GPD will be usedFor the purposes of this OWTS design, Benchmark Elevation has been established as 100' at theexisting sewer line existing the main residence. CBO lnc. should be notified of any discrepancies orproblems with grade elevations of proposed components during installation of the OWTS.The sewer lines exiting the residence and ADU must have a double-sweep clean out and a minimum 2%grade to the septic tank.The system installation must include a 1SOO-gallon, two-compartment Roth@ poly septic tank with aneffluent filter on the outlet tee. Risers must bring the manhole lids to grade for access. We recommendOrenco@ risers. lf more than one riser is added to the septic tank, an extension handle must be installedon the effluent filter.Effluent will gravity flow to a distribution box, and then to five gravelless chamber trenches. Thedistribution box must be accessible from grade and must have flow equalizers, or similar product,installed on each outlet pipe in the distribution box to assure equalflow to each bed.Each trench will consist of 16 'Quick 4' Standard Plus lnfiltrator@ chambers for a total of 80 chambersand 960 square feet of infiltrative area. There must be at least 4-feet of undisturbed soil between eachtrench, although we recommend at least 6-feet. lnspection ports must be installed at the beginning andend of each trench. Ports may be cut to grade and placed in sprinkler boxes for access.COMPONENT SPECIFICATIONSThe component manufacturers are typical of applications used by contractors and engineers in this area.CBO lnc. must approve alternative components prior to installation of the OWTS. Requests mustbe submitted, in writing, to our office for approval prior to installation. Component technical datasheets are available upon request.Minimum ElevationMin. 97' (approx. horizontal distance 130' I min.2o/ofall = 32.5" drop)Min. 96.5' (approx. horizontal distance 20' I min.1o/o fall = 2.5" drop)Min. 96' (approx. horizontal distance 13' I min. 1o/ofall = 1.625")OWTS ComponentPrimary Tank lnlet lnvertDistribution Boxlnfiltrative Surface / Highest TrenchCOMMENTS2-compartment polyseptic tankDouble-walled PVC; Rrsers andLids (24" diameter)MODEL NORMT-1500MANUFACTURERRothOrenco@COMPONENTSeptic TankTank Risers and Lids Page 6The component manufacturers are typical of applications used by contractors and engineers in this area.Alternatives may be considered or recommended by contacting our office. Construction must beaccording to Garfield County On-Site Wastewarer Treatment System Regulations, the OWTS Permitprovided by Garfield County Building Department, and this design.I NSTALI.ATION CONTRACTORCBO lnc. expects that the installer be experienced and qualifìed to perform the scope of work outlined in thisdesign. The installer must review this design thoroughly and coordinate with our ofüce in advance ofinstallation. Any additional conditions in this design or county permit must be completed and documentedprior to final approval of the OWTS installation. Communication between the instalþr and this offìce isexpected throughout the installation.INSTALLATION OBSERVATIONSCBO lnc. must view the OWTS during construction. The OWTS observation should be performed beforebackfill, after placement of OWTS components. Septic tanks, distribution devices, pumps, dosingsiphons, and other plumbing, as applicable, must also be observed. CBO lnc. should be notified 48 hoursin advance to observe the installation.ln an effort to improve the accuracy of the record drawing, we request that the installer provide asketch of the installation, including path of the sewer lines, water line installation (if applicable),septic tank location, STA location, and measurements from building corners or another fixedobjects on the propefi. This sketch is most easily provided on Sheet W2.0 of the OWTS DesignPacket. Photographs of the installation and final cover are also requested to supplement our installationdocumentation.REVEGETATION REQU IREMENTSAn adequate layer of good quality topsoil capable of supporting revegetation shall be placed over the entiredisturbed area of the OWTS installation. A mixture of native grass seed that has good soil stabilizingcharacteristics (but without taproots), provides a maximum transpiration rate, and competes well withsuccessional species. No trees or shrubs, or any vegetation requiring regular irrigation shall be placed overthe STA. Until vegetation is reestablished, eroslon and sediment control measures shall be implementedand maintained on site. The owner of the OWTS shall be responsible for maintaining proper vegetationcover.OPERATION INFORMATION AND MAINTENANCEThe property owner shall be responsible for the operation and maintenance of each OWTS servicing theproperty. The proper'ry owner is responsible for maintaining service contracts for manufactured units,alternating STAs, and any other components needing maintenance.Geo-fabrics or plastics should not be used over the STA. No heavy equipmen:, machinery, or materialsshould be placed on the backfìlled STA- lilachines with tracks (not wheels't should be used duringChambersFlow EqualizersDistribut¡on BoxBiotube Effluent Filterlnfiltrator(Evalley PrecastOrenco@180lct-'Quick 4' Plus Standardambers3049 Equalrzer15 l-low EqualtzersD-Box 8ClCancrete distribution boxlFull stze Ellluent l-tlter andlhousingI Page 7construct¡on of the STA for better we¡ght distribution. Livestock should not graze on the STA. Plumbingfixtures should be checked to ensure that no additional water is being discharged to OWTS. For example, arunning toilet or leaky faucet can discharge hundreds of gallons of water a day and harm a STA.lf an effluent f lter or screen has been installed in the OWTS, we recommend this filter or screen be cleanedannually, or as needed. lf the OWTS consists of a pressurized pump system, we recommend the laterals beflushed annually, or as needed.The homeowner should pump the septic tank every two years, or as needed gauged by measurement ofsolids in the tank. Garbage disposal use should be minimized, and non-biodegradable materials should notbe placed into the OWTS. Grease should not be placed in household drains. Loading from a water softenershould not be discharged into the OWTS. No hazardous wastes should be directed into the OWTS.Mechanical room drains should not discharge into the OWTS. The OWTS is engineered for domestic wasteonly.ADDITIONAL CONSTRUCTION NOTESlf design includes a pump, weep holes must be installed to allow pump lines to drain to minimize risk offreezing. The pump shall have an audible and visual alarm notification in the event of excessively highwater conditions and shall be connected to a control breaker separate from the high water alarm breakerand from any other control system circuits. The pump system shall have a switch so the pump can bemanually operated.Excavation equipment must not drive in excavation of the STA due to the potential to compact soilExtensions should be placed on all septic tank components tcj allow access to them from existing gradeBackfill over the STA must be uniform and granular with no material greater than minus 3-inch.LIMITS:The design is based on information submitted. lf soil conditions encountered are different from conditionsdescribed in report, CBO lnc. should be notified. All OWTS construction must be according to the countyregulations. Requirements not specified in this report must follow applicable county regulations. Thecontractor should have documented and demonstrated knowledge of the requirements and regulations ofthe county in which they are working. Licensing of Systems Contractors may be required by countyregulation.Please call with questionsSincerely,CBO lnc{Ã}'tæWúxngCarla Ostberg, MPH, REHS w1 .0Sheet I 0F 4Date: 03/06/20Designed by: CBODrawn by: DDTrulove Residence1831 CR 114Garfeld County, ColoEdoProject Number: C1506CBO lnc.33 Four Wheel Drive RoadCaùondale, colorado 81623Phons 970.309.5259carla.ostberg@gmâll.comN0 ?5' 50'SCALE 1" = 50'LOCATIONWATER LINES-BEDROOMADU1-BRESIDENCEING SEPTIC TANKSPROPOSEDADDITION OF 2.BEDROOMs+ I FUTURE BEDROOM =TO BE ABANDONEDTOTAL 4 POTENTIAL BEDROOMSTP2+STATP1THE LOCATION OF EXISIING AND PROPOSED IMPROVEMENTSSHOWN ARE NOT THE RESULT OF A PROPERTY SURVEY. THEEXISTING STA TOBE ABANDONEDé=--ãLOCATIONS ARE APPROXIMATE. lT lS THE HOMEOWNERS'DUTYITO ENSURE ALL CONSTRUCTTON AND TMPROVEMENTS ILOCATIONS ARE ACCURATE. PROPERW LINES AND SETBACK \DISTANCES SHOULD BE CONFIRMED PRIOR TO EXCAVATION.SHEETS SCALED FOR PRINTING ON 1'I" X 17' PAPERLINEDRAWINGS MUST BE USED INCONJUNCTION WITH DESIGNLETTER DATED 03/06/20!|/2.0 N DRIVEWAY 4' DIA SDR-35 SEWER PIPE WITH CLEANOUT (MIN 2% FALL TO TANK) 0 10' 20' SCALE 1'' = 20' WYE WYE WITH CLEANOUT TWO.COMPARTMENT POLY SEPTIC TANK WITH EFFLUENT SCREEN MtN.25' FROM STA TO WATER LINE 4" D¡A SOR-35 PVC SEWER LINE (MrN. 1% FALL TO D-BOX) 4" DIA SDR-35 SEWER PIPE WITH CLEANOUTS (MtN 2olo FALL TO TANK) +rP2 DISTRIBUTION BOX WITH ACCESS AT GRADE TP1+ 4' DIA SDR-35 SEWER LINE TO EACH (MtN. 1 70 SLOPE TO TRENCH) 4" DIA SDR-35 INSPECT¡ON PORT AT BEGINNING AND END OF EACH TRENCH 'QUICK.4' CHAMBER TRENCHES. 5 TRENCHES WITH 16 CHAMBERS PER TRENCH FOR A TOTAL OF 80 CHAMBERS AND 960 SF. CBO lnc. 33 Four Whee¡ Drive Road Carbondale, Colorado 8'f 623 Phone 970.309.5259 cârla.oslberg@gmail.com Trulove Residence 1831 CR '114 Garfield County, ColoEdo Prciecl Number: C1506 Date: 03/06/20 Deslgned by; CBO Drawn by: DD w2.0 Sheet 2 0F 4 w3.0Sheet 3 0F 4Trulove Residence1831 CR 1'14Garfield County, ColoradoProiect Numbêr: C1506lDate: 03/06/20loesisneo uy: ceolora*n ov, ooCBO lnc.33 Four Wh6el Drive RoadCarbondåle, Colorado 81623Phone 970.309.5259carla.ostberg@gmail.com(recommend 6')4' min.16 CHAMBERS PER TRENCHEND PUTE,QUICK4'4" DIASDR-35 StrERLINETO üCH TRENCH(MrN.1%SLOPElOTRENCH)CHAMBER (4'x 3')DìASDR-35DIA SDR-35EFFLUENT PIPE FROMSEPTICTNKINSPECTIÒNPORTDISTRIBUTION BOXWtrHATGilDEsotL4' mln.PIPES PUCEO INTOP PORI OFCHAMBER ENDPUTESLIMIfilCAVATIONCHAMBER f4'x3')OIA SDR-35 INSPECTION PORTAT BEGINNINGAND END OF ACH TRENCH/^CHAMBER TRENCI{ SËcTloN/ICHAMBER 'IRENCH PLAN\r--AÍACH CAP OR THRUDEDCLANOUTASSEMBLYSMÀLL VALVÊ COVERBOX OR IRRIGATIONVALVE BOX AT GWEFINISHED GRADEBOX AND COVER BROUGHTTO GRADE24',CONCRETE4" DIA SDR.35 SEWERFINSHËDGRADESASEIO SUPPORTBOX4'FVC PIPE CUITOFIT(M¡N 27O SLOPE TO TANK,MlN. 'l'lo TO SIA)USE HOLE SAWTOCUT THRUTOPOFSCREENEDOR SAND FORBEDDING3" MtN.BAFFLE ORANGLED PIPETO BE USEDEND8" MìN.AT INLET/ãDISTRIBUIION BoX\,,--ffi/:\.TRENCH DEIAILÆ\DISTRIBUTION BOX DETAIL\9reOUTLETSoooo DESIGN 4.BEDROOM RESIDENCE + 1-BEDROOM ADU MAIN HOUSE = 75 GPD x 2 PERSONS/BEDROOM x 3 BEDROOMS + 1 FUTURE BEDROOM (75 GPD) = 525 GPD ADU ='1 BEDROOM = 75 GPD X 2 PERSONS/BEDROOM X I BEDROOM = 150 GPD WASTEWATER FLOW = 675 GPD SLIP-ON PVC DO NO'T GLUE INSULATED TRACERWRE FINISHED GRADE TANK: 5 BEDROOMS = MlN. 15oo-GALLONS 4'DIA SEWER LINE SOIL TREATMENT AREA (STA): LONG TERM ACCEPTANCE RATE (LTAR) = 0.5 GAU SF CALCULATED STA = CüLTAR = 675 / 0.5 = 1350 SF GRAVIïY, TRENCHES = 1350 SF X 1.0 = 1350 SF CHAMBERS = 1350 SF X 0.7 = 945 SF / 12 SF / CHAMBER = 79 CHAMBERS FIVE GRAVELLESS CHAMBER TRENCHES 16'QUICK 4'CHAMBERS IN EACH TRENCH TOTAL 80 'QUICK 4' CHAMBERS TO TANK HOUSE /I CLEAN OUT DETAIL\i/ SOIL PROFILE TÊSÏ PII NO. ,1 SOIL PROFILE TEST PIT NO.2 LEGEND Fl topsoil [!:1 celecreous clav malrixlil so¡ltypez¡ 0 1 2 3 4 b 7 B 10 DARK BROWN, MOISTTOPSOIL DARK BROWN, I/I|OIST TOPSOIL LIGHÏ BROWN CALCARIOUS CLAY MATRIX LIGHT BROWN CALCARIOUS CIAY MATRIX (MORE ANGULAR ROCK THAN TPr) LIGHT BROWN CALCARIOUS CLAY |\¡ATRTX (SO|L TYPE 2A) W|TH SOME BASALT BOULDERS LIGHT BROWN CALCARIOUS CLAY MATRTX (SO|L TYPE 2A) W|TH SOME BASALT BOULDERS NO GROUNDWATER OR BEDROCK ENCOUNTERED DURING EXCAVATION .:SOILS LOG\r¡-ffi CBO lnc. 33 Four Wheel Drive Road Carbondale, Colorado 81623 Phone 970.309.5259 cârlâ.ostberg@gmall.com Trulove Residence 1831 CR 1 14 Garfield County, Colorado PrcjectNumber: C1506 Date: 03/06/20 Designed by: CBO Drawn by: DD w4.0 Sheet 4 0F 4 lcooC.C¡¡Èù.9¡é.iofMÈ xiP|l¡bqg¡-ãråsú.rye9'sd x Grsräetd(@:yi3¡d:ãpg* x + - O X+ ' e ô @hl,ctm¡elgis4Èrffêld-cd$ty¡m¡1¿rdtryt¡¡g¡'indqhlml â Ê |' i'*: Àpp * a*at t! €oôçÈecÂren€r 3 C.cogk l,l .i€¡g 3 Sdêob!Í I lws Ô tu3*rce: ç'åatstPe6l&... l¡ Fá(tuk US8Þr q âdÈk{6ñüo.. F€51È :r -øëd,*ótT+k#YÉS"4ñ?ædAdAð'83ì ¡ 4c:tÀllPtc.æþrÐêsslæ3flo-¡g Àdb g¡i*O N .\dE-C"--Ë trl¿¿ÐCflsDtrÆffiæilVÅH -{.g3IShffi,OIt F by ¡é-æ94t å¡deiúdub@ æ:r-o:-z:'æ-:r.p.qE o¡s:=l$ø.d X Yq[ r t¡Ì i'Legendf re¡r co Rd 114I,,'.1{4 I Perrnlt2866GARFIELD COUNTY BUTLDING AND SAI,IITATION DEPARTMENT109 8th Slroet Sulte 303Glenwood SPrlng,l, Colorado 818üPhone (3031 945'8n2f''INDIVIDT'AL SEI]I'AGE DISPOSAL PERMITPROPERTYOwnor'ÊSyslemLegal Descrþtlon ol Assessor's Parcel No.SYSTÊM DESIGNAgtotSor'g Parcel No.This doss not conglilulêa building or usè pormlt.Qoe¡<- c€rtce - ß€Ði: c rra z.a O*"f ""1Nemesteve &.Dcbbf¡ l{ecÈboff Fresenl¡66¡s6-1830 CR 114' G'3'l pnone-9-åå:-Z-!-ZÉ-.-o"r,,on l&. cR tl4. cl"otood s*f p --s(L-ì.q2 4r6cé-ç I v6 {rr r 3oeFT)S€Ptic Tank CâPac¡tY (gallon)t,I -7 tu ' ^l Percolation Rate (minutes/¡nch)Required Absorplion Area' 9ee Atttch€dSpecial Selback Roqu¡r€ments:(dpr)ù'Number of Bedrooms (or othor)IDgtelo- 9)lnspoctor6l ¡.FINAL SYSTÊi¡lINSPECTION AND APPBOVÂL (âs install3d)call lor lnspection (24 hours noticel Before Govering lnstallationSylgtem IsepficTsnkcepacity,o o oSeptio lank Manufecturer or Träde NamêsSâpt¡c Tånk Accss withln 8" ol ¡urfaceYv3x€,rr)Absorption A¡eaAbsorption Area lype end/or Manulactur€r or,ruo" *""'" I l¡ f, f (' ? fL '4î C> ( SAdequate complience w¡th County and State regOther1lnspector/L^r{DatèRETAIN W]TH RECEIPT RECORDS AT CONSTRUCÌION SITETGONDITþI{S:1. Âll inBtallstion must comply wilh ail roquirements of tiìô Colorado SlalÊ Board of H€alth lndividual Sewage Disposal Syst€ms Chapter25, Arllclo'lo c.R.s. 1973, R€v¡sed 19&4'2. Thlsp6rmlilsy¿lidonlyforconneclionto6rructuÌ€6whlchhavefullycompliedwithcountyzon¡ngandbulldingfsquirem6ntt' cor}noot¡on toor us€ with anydwelting or"r-"trio;oi+prve¿ ¡v tne euining andzonlng.off ice Ehill automal¡callybô avlolatlon or arequirement oíìiä à"inñ¡ianà cãuJa tor ooth legat äbtion Ênd r€vocât¡on of lha permlt.3. Anypereonwhoconstruct.,attors,orinstâllsan¡ndlvitualsowsg€digposalsysteminamannerwhichinvolvosaknow¡ngandmator¡¡lvar¡arion rrom rhe rorms or specìticer¡ons "äîiáiirîà'iñit'áìipÏi'ðãiión oi pórnlt commits a cta¡s I' Pottv ofl€ns€ ($500-@ linE * 6monthB !n Jâll or both)'' Whils - APPLIC-ANT Yêllory - DEPAFTIIIENT r N DI V.rgUA!" S E.WAG E pr S POSA r- SY S TEM AITLI CATIONADDRESs P.O. Box 23L7 GLenwood Sprinss, Co PI{oNF. 945-7502PERMTT REQUEST FOR e{ ) NEW INSTALLATION ( ) ALTERATTON ( ) REPAIRAttach separate sheets or lepoil showing entire area witlr respect to surrounding areas, topography of area,habitable builcling, location of potatrle water wells, soil percolation test holes, soil profiles hr test holes (See page 4),I-OCATION OF PROPQSED FACJ!-ITY:COUNryGarf i ¡rl ¿lNeal whar ciry or Towr Gl9nwo?d.-9P-tln9? , . co *- size qf t-oJ ã5 ¿9¿ ,..- .l.egal Description orA zl,l'"a¡¡WASTI]S TYI)II:(x) DWELLING ( )TRANSIENTUSE( ) COMMERCTAL OR INDUSTRIAI- ( ) NON-DOMESTIC WASTES( ) OTHER-DESCRÍBRTJII,DING OI{ SERVICE TYPE:raa ì Äan*,i ¡'lNunlber of Beclroone (1)Nurnber of Person. two (2)ft^tnQcf(ou.Nr) coNplTIoNsDc¡rlh to l¡cclrock:OWNE,S& Debbie westhoffADDIì ÊQQCountRd 1I4 GlenwoodSr¡crs rrl{r.rNtr I45-7I?6CONl'RACTOD.M. Neuman Construction CompanyDepth to first Ground Water TaklaPelcent GroutclD|S]'ANCE TO NEARESTCOMMLJNITY SEVúER SYSTEM: - . . , -Wns arr effort nrade to .onudct to cotnmunity system? ( ) YES'|YPII OF INDIVIDUAL SEWACE DISPOSAI- SYSTEM PROPOSED:()No( ) Garbage Grinder (x ) At¡tornatic Washer (x ) DislrwasherSOIJRCE.AND. TYPE QF WA'I_Eß..$I.JPPLY: ( ) WELI.. ( ) SPRING ( ) STREAM OR CREEKGil,edePtlrofallwellswithinl80feetofsystem:lf supplied by Cotttmuuity Water, give ttanre of su¡r¡rlx ) SEPTIC TANK) VAUI-T PRIVY) PIT PRrVYIìINAL DISPOSAI- BY:(x ) ABSORPTION'|RDNCH, BED OR PIT) CHEMTCAL TOILET ( ) OTHER - DESCRIBil AERATION PLANT( ) coMPosrlNc TOILET( ) TNCINERATION TOILETFVAULTRECYCLTNG, POTABLE USERECYCLING, OTHER USEEVAPOTRANSPIRATIONSAND FTLTERWASTEWATER POND((((()()()()()()) UNDERGROUND DISPEI(SAI-) ABOVE GROUND DISPERSAL) OTHER-DESCRIBtrWII-I- I]FTTLUI]NT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE(((2?no I)ERCCII.A'l'lON TFST RESULTS: ('l'o be completecl by Registererl Professio¡ral Engirreer)Minutesper inclr in hole No. IMiuutes er inch in lrole No. 3Minutes per inch in hole No. 2 Mint¡tesper inch in hole No.Nanre, acldress and tele¡llrone of RPE who lnatle soilabsor¡rtionNanre, address antl tele¡rltolre of RPE res¡ronsitrle for desiglr of the systenrApplicarrt acknowledges that fhe cornpleteness of the ap¡rlication is conditìonal upotr such firnher mandatory andadclitional tests alrcl reports as may be required by the local healtl¡ department to be made ancl furnished by theap¡tlictut ol by the local lrealth rle¡lartment for puqroses of tlre evaluntion of the a¡lplication; and the issuance of the¡rerrrrir is srrbiect to suclr tenns alrd couclilions as rteemed Decessary to insure com¡rliance with rules and regulationsadopted uncler Article 10, Title 25, C.R.S. 1973, as a¡nencled. The undersigned hereby certiñes that all statementsIr¡ade, irrfonnation and repoÉs submitted herewith and required to be submitted by the applioant are or will berc¡lreseuted to be true a¡¡d oo¡r'ect to the best of rny knowledge and belief and are desigtred to be relied on by thelocal departnre¡rt of health ir evaluating the same for lruryoses of issufug the pennit applied for herein. I ñlrtherrrnrlerstRncl tlrat any falsilication or rnisrepresentatiorr may result iu the cle¡rial of the application or revooation of anyperlrit grartterl based upon said application arrd in Iegol aotion for perjury as provided by lawSig:rn¡f c g-L6-97DPI.I]ASI] DIIAW 4ìg.AÇÇURATE MAP TO YOUR PßOPERTY!ISee attachedNE3