HomeMy WebLinkAboutpitkin.eh.273503200008 (1973)00010
PITKIN COUNTY HEALTH DEPARTMENTi C
Owner
PERMIT NUMBER RECEIPT NUM$ER !
Phone W .S - -�e b7
Address ?" -,e 1 ( -- 14SQt' l 1, L
Contractor 20.41 24 _' P cA �1Q ;A) Phone �'b 3 - .4o 4
Address�
Location of system
Lot Size Cyea'
Siganture of owner
Percolation test data""- 4' 0
minutes per inch
Minimum recommended absorption system size
Minimum recommended tank size 1000 xA .
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
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Date Sanitarian
ARADO DEPARTMENT OF HEALTH
DIVISION OF ENGINEERING AND SANITATION
ACT I V I T Y RE PORT Code 12
Section County 57
FILE REFERENCE: Frivate Sewage Disposal
INDIVIDUAL OR
ESTABLISHMENT: Ron Troxel
ADDRESS:
NARRATIVE:
On July 2, 1973, I went to Ron Troxel's construction site
at Buttermilk West and talked with the owner, Tom Anderson.
I told him the system was too samll. The leaching system they
put in was 1200 sq. feet, which I feel is too small. It should
be 1800 or 2000 sq. feet. He was very displeased at finding
this out, especailly at this time, the problem remains as is.
I went out with Ron Troxel on the initial visit. We decided
then, that he would run another series of perc. test at varying
dep-:hs to see which depth would be best.
They did indeed, again run another series of tests; the
ave, -age of those test holes was 280 minutes to the inch, which
is very slow. Where they came up with the size of the leachin
field, I don't know. I was not called upon for a consultation
for the final size. . G � J J00
T-�^A 4- 4j c -.41 # 1
LETTER TO FOLLOW: ( ) OTHER RECOMMENDATIONS:
DATE: T„ , 19 REPRESENTATIVE:
ES: 7 (Rev. 6-70-100)
PERCOLATION TEST FIELD SHEET
— r
COMPLETE IN DUPLICATE
(Check person responsible for or performing tests)
( ) NAME OF OWNER
ADDRESS PHONE 7
( ) NAME OF CONTRACTOR OR EXCAVATOR -�--anfrx ,'xccJcxT,�v�
ADDRESSI_RaX PHONE J
LEGAL DESCRIPTION OF PROPERTY
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 erformed in the 24-hour period between
®.M, and M. on the Z6 and Z ( days of
1 he actual perco ation Tests are to.be
performed at .M. and }a .M. on ����, �� ,
19-0.
At least two (2) test holes per system must be run. They
should be in the area (within 4 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.
TEST HOLE I TEST HOLE II
Reading
Drop
Time
Reading Drop
Time"
Average
percolation rate: Minutes
per inch
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3�Y6
T,•r J
9'67�
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7!6
Zl
io PERCOLATION TEST RESULTS:
HOLE I
.jo Minutes per inch
I HOLE II
32C) Minutes
per inch
Average
percolation rate: Minutes
per inch
Comments on soil and/or site:
Address:
Signature:
TEST FEE $25.00, payable in Advance
AFFIDAVIT
(Percolation est)
0
;1 n , being first duly sworn upon
his oath un er -penalty o perjury, states,avers and certifies as
follows:
1. That he is the person who performed the percolation
tests as required on the reverse hereof.
2. That the tests were performed in accordance with the
time schedules and specifications as set forth on the reverse hereof.
3. That the test results of the said percolation tests
were as set forth on the reverse hereof.
4. (In paragraph 4, affiant shall insert additional
statement(s) which may be properly and reasonably required by
the Pitkin County Control Officer or the affiant may wish to
insert.)
DATED: 19•
c
ignature bfPPerson Runnilng Test
STATE OF) SS:
COUNTY OF4!a5� )
S BSCRIBED AND SWORN to before me this �day of
, 19 73. /
My Commission Expires: Y4 . -74
Not ub is
NOTE: This affidavit must be returned to the Pitkin County
Pollution Control Department within 24 hours of the time
the percolation tests are completed (Saturdays and
Sundays excepted).
COUNTY
PROGRAM /.
LOCATION esFa +� ea
REPORTED BY
SERVICE REQUESTE
OLORADO DEPARTMENT OF HEALTH
REQUEST FOR SERVICE
0
ADDRESS TELEPHONE
ACTION REPORTi'r
,ACTION BY �„_� i` _
DISPOSITION
n "
DATE
SH—M-71 (4-71-50)
w _
COUNTY � *�,}
oonr_DAnn / '7
GOLORAfyO DEPARTMENT OF HEALTH
REQUEST FO ERVICE
RECEIVED BY
SERVICE REQUESTED.
ACTION BY
SH -M-71 (4-71-50)
ISPOSITI
DATE
COLORADO, DEPARTMENT OF HEALTH
COUNTY.% REQUEST FOR RVICE
PROGRAM RECEIVED BY
LOCATION 69E
REPORTED BY �� /'./'� ADDRESS
TE
TELEPHONE
ACTION BY DISPOSITION
TE /-Z -/Z . 11
SH -M-71 (4-71-50)