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HomeMy WebLinkAboutpitkin.eh.264929102018 (1992)MQOFST FOR MTER AM SEMIC SYSM IlRR"B=ON USE PEnwr APPLICATIOM Date Bill Inspection Iriginal ]Report To Be Sent To CrUT of iReport To Be Sent To PEOPEFM SON: /e��G� Property OwiL Lner �!G EAN% Parcel Legal Date Septic Tank Last Pumped ./1/!Z 1 amber Subdivision RSEPS.S ILLtF it ntUiwaLL&.; - DEeAifnG= RP9M:No R,eoord2f—zf.�.?—O— ndPermit Number ©a2'C> Year IssuedTank Material Septic Tank Capacity. !/(Gallon) Septic Leach Field Size (Sq. Ft.) Leach Field Type %�11 A,' IlC_ C TION- All/ Date of Inspection Z"— Inspector Soil Conditions: Dry Saturated aw Covered other_ Septic System: Functi Satisfactorily Not Functioning Camnents: Water Supply: Public: Naane — Private: Well_j, Spring , Cistern . Surface_r Other Well Construction And Location: Approved unapproved Because Bacteriological Water Test: Lab Number Date Acceptable Other 0 Z A.P.E.H.D.:4/87