HomeMy WebLinkAboutpitkin.eh.264322203002 (1976)o2(o43- l-i%NiTs 6-7
PITKIN COUNTY HEALTH DEPARTMENT r
76074 ~ ��
PERMIT NUMBER RECEIPT NUMBER%
OwnerI'��' 'y,o .%�.�'.�2� Phone No.
Owner's Mailing Address 7`76 S ---
Contractor ��� Phone No.
Address
System's Contractor's Name
Address
•/vX1Z_
Legal Description Com/ iAx-ld (11117 5 �n /4Nl> 7
Lot Size Type of Building by Use '/� ��,� 4,?
Number of Bedrooms Type f Water Supply
f ,4 Date �' ��'�'C'
Owner's Signature
PLOT PLAN: ATTACHED AS REQUIRED
PTi Type of Individual Sewage Disposal System
�� ti�� Lk9l1U)& L &
Type of Soil or Soil Classification �� A��� c"el cL
Proximal Location of Bedrock �_'/��-TAl F�
Proximal Location of Ground Water Table( 1611_72Se /!E�
Percolation Test Date / Minutes Per Inch
Minimum Recommended Absorption System Size
Minimum Recommended Tank Size 125-6
Special Conditions of Issue: NOTICE
7 When properly signed for issuance, this application
becomes your permit. Application valid one year from
date. If an individual sewage disposal permit is issued
for propertyon which no building permit has been
issued, the individual sewage disposal permit shall
expire 120 days after its issuance if construction has
not been commenced. Any change in plans or speci-
fications after the permit has been issued invalidates
the permit, unless approval is secured from the Health
Officerfor s h chan 's.
Approved for Issuance By Date
; 71
FINAL INSPECTION APPROVAL Date
(Drawing of System on Back)
IP/
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1
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COLORADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
A C T I V I T Y R E P O R T
Section
FILE REFERENCE:
INDIVIDUAL OR
ESTABLISHMENT:
ADDRESS:
NARRATIVE:
Private Sewage Disposal
W/J Ranch
Units 6 and 7
Code
County
12
49
I received a complaint from Helen Hines concerning the
discharge of sewage on the surface of the ground at the last unit
west on the upper bench. Investigation with the manager, George
Koch, revealed that an effluent line had separated at a joint and
was ponding directly below. Verbal notice was given to make repairs
and notify this office when completed. Koch said that he would
contact Frank Hodges immediately to do the work.
LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:
DATE: May 1
ES: 7 (Rev. 6-70-:100)
19 76 REPRESENTATIVE:
■ .
PITKIN COUNTY ENVIRONMENTAL HEALTH
1 Field Test Data Sheet on Percolation Test
PROPERTY OWNER w , PHONE
MAILING ADDRESS _
!!
LEGAL DESCRIPTION OF PROPERTY
LOCATION OF TEST HOLES
Three (3) test holes required per system
Test Hole Depths (24" minimum)
Diameter of Test Holes
Water remaining after 24 hour soak
TEST HOLE N ,1
TEST HOLE No. 2
TEST HOLE No. 3
Drop Time
Drop Time
Drop Time
S�
3 2.
.3S
Percolation Rate Each Hole
Average Rate _ 7
Comments on soil or site: n
' Signature
1
Date