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GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Blake Avenue
Glenwood Springs. Colorado 816')t
PERMIT It 159A-
System Location f Ja 4
Contractor pGe9 Net 7 2- rat rti PO. 309
. Conctruotion approval for a _,,, as galtonSeptic tank
Aerated treatment unit
and abr'orottun area computed ac follows: _
t .efr,ate f lr,vhe* in 2-S nlnute* 0?3 ce ft o .
ebsorotton area Der bedtoom
�3 X a30 *a. feet (ocf 0 ea. feet minimum reautrement.
1 °uQae°t isal iS.'X /ia.' O tfdc� gt<'o/As _.itrrrfc'l
Date // - 73 Inepector #7S6
?, Final oww :oval of eyetem:
No *ystetn *hall be d@&med to be in compliance with the Sewage Disposal
Lewc until the ucwembled eyetem is approved prior to covering any Dart
thereof.
tic tank cleanout with one *eat
1 m � _.1'tsil2€t taterirtl° and assembly
l ? dequate ab erpUou Area �..
LNa._ 13f sw. oonceete Sover (dl.SY weld 41.lIYL.
lr!9l uevetiatstM"lcjne
moil 'C7�� rev Cove— *raraz- 5rrin•t 9*' a ieritt
bate_ a— rj�__Zt _ inspector S --
•* Retain with netmit react& at construction rite.
Lamo L: Kinkade, Sanitarian a
°C Cc'. Environmental Health < ❑
X201/ Blc'ke Avenue Tel. 945 -7255 '. I
Glenwood Springs, Colo. 81601 Sc a � p
NOTIFICATION OF PROPOSED DISCHARGE TO WATERS OF THE ST - !E*
INNDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
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Owner: C'/9 ?, ,4t/3^/ G/ fez/ trader- g #' z;c)
Mail Address: ,P: /. -'k* /7U City / ,CL Zip Phone 6 ?5- 23�5
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: County a;C.crr = City or town AP, AC r=
Legal descriptionAkd * - ;4 )7-Yes-M 7 e7r= /4','a4'p size / '7 f/9
2. No. of bedrooms 3 Septic tank capacity_(flfo Aeration unit capacity
3. Source of domestic water: Public (name): ,- 5AX/A/ 4.-,
•
Private: Well Depth Other Depth of first ground water table
4. Is facility within boundaries of a city /town or sanitation district? /V6
5. Distance to nearest sewer system: // -/?-
Have you attempted to arrange a connection with the system? GI/. of •
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 Sat=
7. Name, address, and telephone of person who made soil absorption tests :st_ .dc a,/7-- •
8. Name, address, and telephone of person responsible for design of the system:
4/e)
.‘-,/97 ell7 14
Date Signature of Owner
Date
Required by Article 66 -28 -12 (CR:S, 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 occur (Art. 66 -28 -8 (5), CRS) and /or areas in which there is no
local septic tank ordinance. K
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