HomeMy WebLinkAboutpitkin.eh.264335101001 (1992)_SEPTIC INSPECTION FORMDate Requested .
Bill To
Inspection Requested By. YY
original Report To Be Sent
Copy Of Report To Be Sent To
pIY IlTION:
Property Owner
Parcel ID Kimber
Leg A 1/4,
Lot, Block Fil:
Address -7 Sr
Building occupied
Date Septic Tank Last Pump
(g33tj? 0! 0 I
1�•i: • :r+•. 1 mv il •.
T S, R W;
livision
Age Of Building
# Bedrooms
DEPAiffi RHOS:
Permit Hmber '/` Year Issued Z� No Records F
'c Tank Capa��city (Gallons) Septic Tank Material
le LO
Leach Field Size/moi / Z (Sq- Ft-) Leach Field Type'
IIIQJ: '
Date Of Inspection inspector
Soil Conditions: Dry Saturated Snow Covered other_ _
Septic System: Functioning Satisfactorily_ NDt Functioning
Ccnrents• , i -I-- ; '
-- _q f '
.�
Water Supply: Public: Name ;
Private: Well , Spring , Cistern , Surface -r
other
Well Construction And Location: ApProved
Unapproved Because
Bacteriological Water Test: Lab Number Date
Acceptable
Other
A.P.E.H.D.:4/87