HomeMy WebLinkAboutpitkin.eh.264316400051 (1974-85);Z(a9 3 -- /6 �-Do DSI �//y(\/.
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TKIN OUNTY HEALTH D ART /
PERMIT NUMBER 720184 RECEIPT NUMBER
Phone #
Owner tTh�f�e R Z13—,2 6e,?
Address
Contractor Phone #
Address
Location of system wI -6d q r.,p IQ Lot size o?cu e�
pp �- P5 W,, - k a
Legal description �t,d» /d-�%�.a��' O �t 30�,
J
7,3
Number of bedrooms Dateci
V_ l
Signature of owner
Percolation test data
Minimum recommended absorption system size
Minimum recommended tank size
minutes per inch
Permit application valid one year from date. Application to become permit and final
only after lower portion is completed and signed. Retain this form at the construction
site.
DRAWING OF SYSTEM
/0
3e
Date Sanitarian
• • • IN b' �t° LAMONT KINKADE
` • COLORADO DEPARTMENT OF HtALTH �, ti�,> ENVIRONMENTAL HEALTH
Water Pollution Control Division �� `� sox V
4210 East 11th Avenue 6 Aspen, Colorado 81611
Denver, Colorado 80220
/ � &,'e�,; 6J
APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS
Applicant (Owner) :
Mail Address: 1�'a//� City: 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 City or Town
Legal Description /1/a-rl�� � �w� Lot Size: _
2. Type of area and facility - Number of persons served:
Subdivision Motel Restaurant Trailer Court
Other:
3. Source of domestic water: Public (name):
Private: Well Depth Other Depth to first ground water table
4. Is facility within boundaries of City or Sanitation District:
If so name:
5. Distance to dearest sewer system:
Have negotiations been artempted with owner to connect:
If rejected, give reason:
6. Rate of absorption in test holes 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:
9. Est. bid opening date:
Date:
Est. Completion Date: Est. Project Cost:
Signature of Owner
B. SIGNATURES FOR LOCAL u.,JERNMENT OFFICIALS: The unders""-4ed have reviewed the
proposal for the location of the above-described septic tank system and
RECOMMEND APPROVAL or DISAPPROVAL to the space provided below:
DATE APPROVAL DISAPPROVAL
/—% /-7
Signature for Local Health Department
Signature for Mayor or City Manager
Signature for County Commissioners
Comments: -
Signature and Title
Note: The applicant must obtain the comments and signature of at least one of the above.
C. FOLLOWING FOR STATE HEALTH DEPARTMENT USE: Recommendations of the District Engineer
D. ACTION BY THE COLORADO WATER POLLUTION CONTROL COMMISSION:
WP -10 (Rev. 5-70-100)
COLORADO DEPARTMENT OF HEALTH
COUNTY �� / REQU T R SERV E `
PROGRAM i �. RECEIVED BY DATE
LOCATION NAME / _ '_ _Q
REPORTED BY "A 9- ADDRESS Lyg� `tel TELEPHONE
s_—
SERVICE
SERVICE REQUES
ACTION REPORT
ACTION BY
DISPOSITION
DATE
SH—M-7i (4-71-50)
4
COUNTY C-3
PROGRAM
LOC ATI ON
REPORTEDBY
COLORADO DEPARTMENT OF HEALTH
REQUESTIFORSERVICE
TE_
TE LE PHONE
ACTION BY
DISPOSITION
DATE
SH -M-71 (4-71-50)
PERCOLATION TEST FIELD SHEET
COMPLETE IN DUPLICATE
(Check person responsible for or performing tests)
( ) NAME OF OWNER -i't t_c G fe►e�
ADDRESS 13, 7 p�PHONE 9,,-)3
( ) NAME OF CONTRACTOR OR EXCAVATOR
ADDRESS 4 PHONE
LEGAL DESCRIPTION OF PROPERTY
8 5 - lv.0'4t.
General Information & Instructions
In addition to compliance with all other rules and regula-
--tions for sewage systems as promulgated by the County of Pitkin
and State of Colorado, it shall be the responsibility of every
property owner/installer/contractor/excavator (the person running
the tests) installing a sewage system to conduct percolation tests
in accordance with the specifications hereinafter set forth.
Subsequent to the performance of the required test, it .
will be necessary for the person responsible for/or person perform-
ing the tests to file, complete and under oath and penalty of
perjury, the affidavit form contained on the reverse hereof.
Warning is hereby given that spot checks and inspections will be
performed by the Pitkin County Pollution Control Officer and his
authorized agents with or without the knowledge of person perform-
ing or responsible for the tests to insure compliance with the
requiements hereof.
Soaking is to be performed in the 24-hour period between
_ OQ_.M. andM. on the �� and ,e days of
1 e actual percolation tests are to be
pbrTarmed at M. and ,.M. on
19_'ZJ .
At least two (2) test holes per system must be run. They
should be in the area (within feet) of the proposed leach-
ing system and dug to the depth of the proposed system, generally
2.5 to 3 feet deep and 12 to 16 inches in diameter.
The holes are to be soaked for a 24-hour period prior to
running the test.
DEPARTMENT OF ENVIRONMENTAL HEALTH
AND POLLUTION CONTROL
COUNTY OF PITKIN
P. O. BOX I 0125
ASPEN, COLORADO 81611
:'ebruary 11, 197+
John 11.1brris
Royalty Water Service
PO Box 446
Basalt, Colorado
81621
Dear John:
On February 4, 1974, two members of this department made
a field visit to the Boyd's -property on goody Creek. Our purpose
of the visit was to inspect the septic tank which your company
installed.
After viewing the septic tank, it was determined that several
corrections are needed to be made before a final approval can be
given. Cast iron pipe should extend from the inlet and outlet
to span the excavation. The inlet pipe needs to be placed at the
opposit end of the tank from the outlet pipe. 'njis will prevent
possible "short cirauitins," later.
Until the Fround becomes pliable enou;il for these corrections
to be made, you have the permission of this office to utilize the
septic tank in its present condition.
We look forevard to hearing from you in t'i.e spring for the
final inspection.
Sincerely yours,
,,J vina i t . Tracy
Sanitary Assistant