HomeMy WebLinkAbout00147A F /L
GARFIELD COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH
2014 Rieke Avenue
Glenwood Springs, Colorado 81601
PERMIT. .A
system Location &d L hwf 2 Sm :''-
Contractor 04-X / -vi no _ e 4y ),Q y�e /4-.
!. Can *truotion eporovel for a Sao. gallon Septic tank
Aerated treatment unit
and absorotton area computed es follows:
Perc rate / Inciter in /0 mtnutee- /<n.0 eq. it. o',.,,
ab *oration area per bedroom. no
4/.y /(,. -i ea. feet- 4400 eci. feet mintraures.rtirement.
I c / Lk SS'X Ar SCc eey- -
Pete (O -/- 73 Inspector
?. Final approval of *y*tem:
No system *fall be deemed to be in compliance with the Sewage Disposal
Law' until the a*Rembled Ry *tem 1* eopruved prior to covering any Dart
thereof.
L. [ P p and a *R��
i y Ademwte ab'ncotlon arse
/R Adequate ooncrete cover tdry well* only? _ _ .__..
1 71_- Covenants rigned
Date /D 7 &' - 7Ja Inspector � 7eec--
** Retain with penult second* at construction Bite.
amont L. Kinkade, Sanitarian
larfAie. Environmental Health
2014 Blak Avenue Tel. 945 -7255
Glenwooctaigs, Colo. 81601
NOTI OF PROPOSED DISCHARGE TO WATERS OF THE STATE*
INDIVIDUAL HOME SEWAGE TREATMENT SYSTEM **
Owner: tirr / J i/crt,r/
Mail Address: ,',. / City /,^wnc/ by /,4 Zip Phone
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 C Ar l-,Pia' City or town Socc //] c ncI Va//coc
Legal descript[ ✓of moo? /t'�Orr /5an /a X'�nCli Lot size 6. %rec.
2. No. of bedrooms 4 Septic tank capacity // Aeration unit capacity
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3. Source of domestic water: Public (name): hiknie�T Creek
Private: Well Depth Other Depth of first ground water table
4. Is facility within boundaries of a city /town or sanitation district? //o
5. Distance to nearest sewer system: m, ,4c.
Have you attempted to arrange a connection with the system? No
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:
3 /99 � ,satece
Date Signature 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 occur (Art. 66 -28 -8 (5), CRS) and /or areas in which there is no
/,/ local septic tank ordinance.
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Please use the following space for directions to your property site.
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