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Home My WebLink AboutPitkin.EH.264534100003 (2021)Page | 1 Pitkin County Environmental Health Department Onsite Wastewater Treatment System (OWTS) USE PERMIT Permit for Continued Use of an Existing OWTS 76 Service Center Road, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 www.aspenpitkin.com/EHNR Parcel ID #: 2645-341-00-003 OWTS Use Permit #: 0004.2020.POWU Date Issued: 1/30/20 Issued By: Bryan Daugherty Expiration Date: 1/30/21 Owner(s): Robert and Phyllis Throm Property Address: 8998 Snowmass Creek Rd (CDU) Legal Description: Licensed Inspector: Carla Ostberg Inspection Date(s): 10/23/19 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit 2 compartment concrete tank 2 compartment concrete tank 1000 gallons 1000 gallons Secondary Treatment Unit Absorption Area Mounded treatment area 470 ft2 Other System Components OWTS Use Status: In use at the time of the inspection. Not in use at the time of the inspection.* *If the OWTS was not in use at the time of the inspection, it is recommended that the system be re -evaluated when it is in use for a more accurate evaluation of the system. System Records: Permit #: 99027 Date of Issuance: 5/24/99 Date of Final Approval: 3/7/00 # of Bedrooms or fixtures served by OWTS: System is designed to serve 2 bedrooms. Operational Status: According to the inspectors observations on site, the system appeared to be functioning as designed. The tanks were in watertight condition and pumps were functioning properly. The mounded field area did not show signs of failure. Inspector Recommendations: Install an external splice box for the pump systems. Fix missing caps on field area observation ports. Department Recommendations: Continue maintenance as needed. Issuance of this OWTS Use Permit is based solely on the conditions observed and reported by the inspector to the Department on the date of the inspection(s) and on Department records at the time of permitting. The issuance of this permit does not constitute a guarantee, warranty, or representation by the Department that the system will operate properly or will not fail or that the system will not be subject to future enforcement action to correct non-compliant conditions. Estimated capacity of the system has been listed on the permit and we recommend that you monitor and/or meter water use to prevent overuse and possible failure. 1/28/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1655904640032057241&simpl=msg-f%3A16559046400…1/3 Bryan Daugherty <bryan.daugherty@pitkincounty.com> Online Form Submittal: Property Sale/Remodel Use Permit Application noreply@civicplus.com <noreply@civicplus.com>Thu, Jan 16, 2020 at 9:55 AM To: schuyler.clay@pitkincounty.com, ehapps@pitkincounty.com Property Sale/Remodel Use Permit Application Please Note: Each OWTS System must be submitted individually. If there are additional systems on the property, additional applications are required. Job Parcel ID 264534100003 Physical Address 8998 Snowamss Creek Road Residences 2 Warning!Submit a separate Use Permit Application No. of Bedrooms 1 Square Footage of each Residence 1000 Purpose of Use Permit Property Transaction Closing Date 1/21/2020 Lot Field not completed. Block Field not completed. Filing Field not completed. Subdivision Field not completed. (Section Break) Primary Contact Information Primary Contact First Name Carla Primary Contact Last Name Ostberg Primary Contact Email Address carla.ostberg@gmail.com Primary Contact Address 33 Four Wheel Drive Road Primary Contact Phone Number 9703095259 Primary Contact City Carbondale 1/28/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1655904640032057241&simpl=msg-f%3A16559046400…2/3 Primary Contact State CO Primary Contact Zip 81623 (Section Break) Owner Information Primary Contact is Owner?No Owner First Name ROBERT H & PHYLLIS A Owner Last Name THROM Owner Email Address Field not completed. Owner Mailing Address 331 Apple Drive Owner City Basalt Owner State CO Owner Zip 81621 Owner Phone Field not completed. Owner Fax Field not completed. Indicate Preferred Method of Payment Debit/Credit Card Payment Contact Email for Debit/Credit Payment carla.ostberg@gmail.com (Section Break) Licensed Inspector Information Primary Contact is Licensed Inspector? Yes (Section Break) Uploads Pitkin County Inspection Form 8998 Snowmass Creek Road Inspection Form - Guest House.pdf Site Plan 8998 Snowmass Creek Road OWTS Inspection Packet - Guest House.pdf Floor Plans Gate house.pdf Additional Reports, etc.Field not completed. Comments or additional information: Field not completed. PLEASE READ BEFORE SELECTING SUBMIT: By selecting SUBMIT, I certify that I am the owner or representative with the legal authority to agree to the conditions of this permit, the above information is complete 1/28/2020 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1655904640032057241&simpl=msg-f%3A16559046400…3/3 and accurate, and that I have provided complete and accurate information in all of the documents included in my application package. I acknowledge that this department may revoke any permit I am issued if my application is found to contain any inaccurate, false, or misleading information. Building Permit Instructions If this application is part of a building permit application, please bring a copy of this application to your building Pre-Submittal meeting. To get a copy, either enter your email address to receive a copy of your application, or select "Submit and Print" below. [Quoted text hidden] Owner's Name: Address: Parcel Number: Inspection Date: Pitkin County Systems Inspector License Number: QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION: Is the home currently occupied?YES NO If NO, how long has the home been vacant? How many bedrooms are in the home? RECORDS: Were system records available from Pitkin County?YES NO If YES:Permit number: ___________ Date of Final Approval: _________ # of bedrooms permitted: ___________ Was an as-built drawing available?YES NO Is the as-built drawing accurate? YES NO If NO: SITE CONDITIONS: Proper grading, no evidence of erosion?PASS FAIL Improper vegetative cover?NO YES Evidence of compaction such as heavy machinery or livestock?NO YES Improper discharges such as straight pipes?PASS FAIL Evidence of high ground water?NO YES Snow cover present?NO YES Any question marked FAIL will require correction before an OWTS Use permit is issued. If secondary treatment is used, who is the maintenance provider? Complete a drawing of the system on last page of this form as accurately as possible. Email: Inspector's Name: Business Name: A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by the Licensed Systems Inspector within 60 days of the inspection regardless of whether the system passes or fails. Onsite Wastewater Treatment Systems (OWTS) Use Permit Inspection Form Inspection form for continued use of an existing OWTS Website: Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Phone Number Page 1 TANK: Tank capacity gallons gallons gallons Tank material # of compartments Date of last pumping Lids/risers in good condition Risers to grade Riser height Riser condition/watertightness Inlet sanitary T/baffle Outlet sanitary T/baffle Effluent filter (if part of design) Condition of tank material Tank was pumped for inspection If YES, list the pumping company If NO, when was the last pumping Scum level (1st compartment)inches inches inches Sludge level (1st compartment)inches inches inches Scum level (2nd compartment)inches inches inches Sludge level (2nd compartment)inches inches inches Backflow (if pumped) Midtank baffle Watertightness PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present?YES NO If YES, is the pump/dosing siphon functioning properly?PASS FAIL Does the pump/wiring/dosing siphon appear to be in good condition?PASS FAIL Is the high water alarm working, both visible and audible?PASS FAIL SECONDARY TREATMENT: Is a secondary treatment unit present?YES NO UNKNOWN If YES, does the unit appear to be in good working condition?YES NO Does the owner have a current maintenance contract for the unit?YES NO UNKNOWN Maintenance Provider:_______________________________________Phone:________________________ ABSORBTION AREA: Effluent surfacing?PASS FAIL Evidence of past surfacing?NO YES Surface dampness?NO YES Excessive odors?NO YES Field location verified by observation ports or probing:Ports Probing Liquid in observation port?NO YES If YES, record depth:inches Distribution Box or ADV part of original design?YES NO UNKNOWN If YES, is it accessible from grade?YES NO Is it level and in good condition?PASS FAIL If there is no maintenance contract, a contract must be in place prior to occupancy of the home. A copy of the contract must be submitted to Pitkin County Environmental Health Department. Tank 1 Tank 2 Tank 3 Page 2 Any problems with the system that were not addressed in the inspection checklist? Please list any recommendations for the continued use of the system: Were any repairs done as a result of this inspection?NO YES If YES, please describe the repairs. Licensed Systems Inspector Signature: Additional Notes: To the best of my knowledge and training, the information collected in this inspection is accurate as of __________________, 20____. Clearly label any pictures and attach them to this form. Page 3 33 Four Wheel Drive Road Carbondale, CO 81623 970.309.5259 carla.ostberg@gmail.com January 14, 2020 Margie Throm Athrom56@gmail.com Onsite Wastewater Treatment System (OWTS) Use Permit Inspection 8998 Snowmass Creek Road – Guest House Pitkin County, Colorado Margie, As requested, CBO Inc. performed an Onsite Wastewater Treatment System (OWTS) Use Permit inspection at 8998 Snowmass Creek Road, Snowmass, Colorado (Guest House) on October 23, 2019. The legal description of the 35.1-acre property is Section: 34 Township: 9 Range: 86 PARCEL OF LAND IN SECS 34 & 35-86 DESC BY M/B BK 469 PG 749. The permit and record drawing were provided by Pitkin County Environmental Health Department (Parcel ID #2645-341-00-003). The subject OWTS consists of a primary 1000-gallon concrete septic tank followed by a 1000-gallon nitrogen removal septic tank. Effluent is pumped to a mounded sand filter. Individual Sewage Disposal System Permit 99027 documents this system. The system was sized to accommodate 2 bedrooms. The permit received final approval on March 7, 2000. A 3-inch diameter clean out was observed on the west side of the house. The septic tanks are located to the west of the residence. The material of the clean out and the age of the first septic tank indicate components older than 2000. We recommend exploring the sewer line from the house to the septic tank with a camera to assure the sewer line is in good condition. Older sewer lines, such as cast iron, are prone to clogging and deterioration. A 3-inch inlet pipe enters the first septic tank. A concrete baffle was present on the inlet side. An effluent filter has been adapted to the 3-inch pipe exiting the septic tank. This filter must be cleaned annually, or as needed. Liquid levels in the septic tank appeared normal at the time of our inspection. The filter was dirty. The septic tank was pumped and filter cleaned by B&R Septic at the time of our inspection. The de-nitrification chamber is vented, but we did not dismantle the vent. The pump chamber was over- full at the time of our inspection. The chamber was also pumped so work could be conducted on the pumping systems. There is a recirculation pump in addition to a discharge pump in this compartment. Work on the pumping system was conducted by Valley Precast out of Buena Vista (see enclosed invoice). Jerry Fleck, Service Manager for Valley Precast, conducted the work and noted the S-1 control panel for the pumping system is located in a storage closet near the front door and the pumps and alarm were all functional after repairs. We recommend installing an external splice box for wiring so it is no longer located inside the riser. Effluent is pumped to a mounded sand filter which serves as the soil treatment area (STA) located on the south side of the driveway. We walked the mounded area and found several clean out caps under sprinkler boxes. We also found one clean out cap (1.5” diameter pipe) broken. We recommend this pipe be repaired. While we did not observe effluent around this broken cap, the pump was not functional at the time of our inspection AND the house may not have been occupied. This clean out cap may be connected directly to the laterals and therefore part of the pressurized system. Surfacing effluent could result when house is re-occupied and pumping system is back in use. We found no evidence of surface saturation or failure at the time of our inspection. This evaluation is not a guarantee of future system performance. This inspection is good for one year. Recommendations: • Camera sewer line from house to septic tank. • Clean effluent filter annually, or as needed. • Install external splice box for pump wiring. • Repair broken clean out cap. A completed OWTS Use Permit Application must be submitted to the Pitkin County Environmental Health Department. Applications must be submitted to Pitkin County Environmental Health Department electronically. The following is the link to the required OWTS Use Permit Application: https://pitkincounty.com/FormCenter/Environmental-Health-18/Property-SaleRemodel-Use-Permit-Applicat- 70 Within the application, you must attach the Inspection Form where “Pitkin County Inspection Form” is requested, the OWTS Inspection Packet where “Site Plan” is requested, and Floor Plans where “Floor Plans” are requested. Floor plans may be hand drawn and must represent number of bedrooms or potential bedrooms in the residence. All questions regarding permit submission can be directed to Pitkin County Environmental Health Department, 970-920-5070. Disclaimer: This inspection is intended only as an evaluation of the present condition of the OWTS based upon what was observed and the Licensed Inspector’s expertise in onsite wastewater technology. The Inspector has not been retained to warrant or guarantee the proper functioning of the system for any period of time in the future. Because of numerous factors which may affect the operation of an OWTS, as well as the inability of the Inspector to supervise or monitor the use or maintenance of this OWTS, this report shall not be construed as a warranty by the Inspector that the system will function properly for any particular prospective buyer, and the Inspector disclaims any warranty, either expressed or implied, arising from the inspection of the OWTS or this report. The evaluation does not ascertain the impact the system is having on groundwater. Please call with questions. Sincerely, Carla Ostberg, MPH, REHS NAWT Certified Inspector Certification # 11044ITC Exp. April 2020 Clean out view of septic tank lids Inlet and outlet lids to first septic tank de-nitrification chamber 3-inch pipe entering septic tank (concrete baffle) Outlet side of septic tank with effluent filer De-nitrification access pump chamber / over-full Mounded STA Clean out caps Clean out caps in sprinkler boxes View of mounded sand filter dirty effluent filter Pump chamber after pumping (internal splice box) View of pump lines Note effluent filter connected to 3-inch with fernco in first septic tank 8998 Sno w mass Creek Road - G u est Ho use Legend 8998 Snowm as s Creek Rd 90 ft N ➤➤ N As /Pitkin Environmental Health Depart t Permit for an Individual Sewage Disposal Sybcam 130 S. Galena St. Aspen, Colorado 81611 Phone 970-920-5070 / FAX 970-920-5197 Permit # 99027 Parcel ID # 2645-341-00-003 Re Addition to House( ) New guest house Type of permit New(X) p air ( ) Name of Owner Robert Throm Street Address 8998 Snowmass Creek Rd, Snowmass Property legal description Total square footage of the house 700 Size of lot 35 acres Water source Well of bedrooms in house 1 # of offices, lofts &similar sized rooms in house Caretaker unit Total soquarefootageofthecaretakerunit Ca # of offices, bedrooms in caretaker unit ffilofts & similar sized rooms in caretaker unitr but design is for 2 bedrooms Designed for what # rooms (list) 1 Bedroom guest house, Permit information Designed by Eagle Eye Engineering Mailing Address 10144 E. Jewell Ave, #2, Denver, CO 80231 *< 5-1/2 ft Perc rate 20 mpi Profile hole depth 5-1/2" Depth to groundwater or bedrock Absorption area see design Septic tank capacity 1,000 gallon Comments Septic permit approved per compliance with the Mineer design and bellow grade cations teBefore any work i e design is for a sand mound with the assumption of high water at one foot started under this permit, the engineer designandhthe o a was noto dug durdwater ing period 'lofh gh ground watery the engineer and by this department since the profile The engineer design will be re-evaluated for the following concerns: necessity of the second tank using plastic, not concrete for 2nd and 3rd tanks design formula used for sand mound no anchoring in design of the septic tank and dosing chamberredesign mound if ground water is determined to be more than one foot below grade. J Date: a Permit approved by: ' considered Plans and specifications of the p posed individual sewage disposal system have been reviewed and are satisfactory. Permission is hereby granted to the owner This becomesinval d 6 monthshe agent to perfrm the work ) faom the datetlhat the ted in accorance wipermth wlasin County tlSDS Regulation in effect at the time of issue. issued unless system construction has commenced or an extension has been approved in writing by the Department. As -built drawings must be included with this permit before the final approval will be issued. Installer: Date: D L% Final inspection approval: Agle eye engineering 10144 a ,}ewes( Av-, #2, Denver, Co. 80231 303-755-4374 eagleye@ecentvc I`Om Nancy Mckenzie, Aspen -Pitkin County Environmental Health 130 S. Galena Street Aspen, Colorado 81611 Dear Ms. McKenzie: December 13, 1999 Ref: Robert Throm Cabin 8998 Snowmass Cr. Road Pitkin County, Colo. ISDS As -Built Report This letter, together with the attached drawings, will serve as confirmation that The above -referenced system has been installed to my satisfaction, as design engineer. Site Plan: Attached drawing illustrates the relative positions of system components. Measurements not specifically included may be scaled from the drawing. imary Tanks: Tanks are illustrated in a cross a second 000 gallon tank which removes nitrogen , showing internal details. The rfrom 1000 gallon septic tank is followed by g the water, and lifts the final effluent to the disposal mound. A re -circulation pump ensuresthorough contact of the water with microbial colonies on the gravel surfaces in the first chamber. An activated -carbon filter on this tank removes odors from air discharged during tank re -filling. The carbon granules may be replaced if odors become noticeable. Disposal Mound: Effluent from the lift station is distributed over the absorptive surface of the mound by a branched system of 1.5" pipes with flow restriction holes. Each branch is providedwithacleanoutcap, through which the lines may be cleaned, if necessary, with a steam probe. Inlieuofthenormallyrequired3:1 slope on the side adjoining the road, the slope is reinforced with heavy rock. Mound surface plantings should be exclusively native species providing slope stabilization, and normally requiring no supplemental water. Operations & Maintenance: To comply with Pitkin County regulations, of such leaning to the rimary septic tank nmustbepumpedeverytwoyears. Property owner proof Aspen/Pitkin Environmental Health Department. Annually, the effluent filter in the first tank should be cleaned with a water hose. ng. However, at the of tank 1, Tank 2 will not require regular laccaccumulation of solids, and or any potengthe pump ial problems with the chamber should be inspected for pump assembly. It is anticipated that this tank will not require pumping more often than ten years, if ever. The resident in this cabin must be aware of certain necessary use patterns, in order to ensureproperoperationandservicelifeofthe system. The only product to be disposed in the toilet is toilet paper. Any brand is acceptable. Chlorine based toilet tank additives (tablets, bottles, etc.) are not to be used, but chlorine containing cleansers, such as Comet, are acceptable. Chlorine bleach is not to be used in laundry. If bleach is needed, an oxygen bleach, or other non -chlorine type must be chosen. The use of anti -bacterial cleaning products should be minimized. Otherwise, any soap or detergent is acceptable. Food wastes must be scraped into a container. Only incidental amounts of food should be rinsed down the drain from dish and utensil cleaning. A garbage grinder, if installed, must be used only to clear the drain of these incidental materials. Additional maintenance and cleaning requirements, per article 9 of the County ISDS regulation, may be imposed by the Aspen/Pitkin Environmental Health Department. Sincerely, D F. P. Fitzgerald Colorado Registered Professional Engineer #19656 copies: Robert Throm, Owner AS—BUILT Dec 13, 1999 " " Flotation anchoring by very targe boulders on lid from four half—inch ho/es in /eve/ 2" pvc pipe loop, at 45 degrees approx. fIOW off bottom, to enlarged section distribute flow. of distribution 32 inches from pipe, showing 1/2 inch tank 1 hale of 45 deg. 4" diameter activated— carbon fitter for odor control of tank venting. Fitter is in roser, rather than above grade, to prevent freezing of moisture within the carbon granules. Top v/EW, TANK 2 distribution loop SECTION THROUGH TANKS scale 1/4" = 1 ft screened vent NO HIGH WATER FLOTATION above grade Q ANCHORING NEEDED, due to rock. PLUGGED tee high water alarm handle (vent) on effluent 2" influent filter distribution 1,5 inch pipe sloped back from disposal to chamber to Orenco effluent filter 0 0 o°0°0° 0°0000000 on" wtr leve/ 1 inch below tank 2 inlet 0°00000000000000 bottom of o° o°0°°°°00°°°°° 0000000000000000 off" water level o0o0000000o0°Oo00000000000000 0 0 0 0 0 0 as low as proctico% 0°0°0° 0° 0° 0°0° 0° 0 0 0 0 0 Effluent pump controlled by 0 0 0 float switches, app roximote 1000 gol concrete 4 ft drawdown, 580 gol%yc%. Robert Throm On—Site Sewage ]Eagle lye Engineering Residence Cabin Tank Details 10144E Jewell Av, *2 Denver, Colorado 30231 8998 Snowmass Cr. Rd. 303-755-4371 Pitkin County, Colo. System Design: FPF, p.e• filled to insto%led 3" capped pipe with 9 pairs of 1" holes 30 watt circulation pump discharges through chamber max wtr level at "4 and 8 o'clock". 1/4" air hose, introduced INTO distributor at top of Primary Septic Tank rock and first comportment. 1000 gol concrete emarble De—Nitrification Tank 2—chamber tank and lift Stat/On w/ inlet & transfer 1000 gcl concrete baffles Plus 2—chamber, no baffles, effluent filter only partition wall Robert Throm On—Site Sewage ]Eagle lye Engineering Residence Cabin Tank Details 10144E Jewell Av, *2 Denver, Colorado 30231 8998 Snowmass Cr. Rd. 303-755-4371 Pitkin County, Colo. System Design: FPF, p.e• MOUND DETAIL S'{e' Sco%: >" = 2 ft kith talo it m x{Ure 3: . e ego geotextile covering OV9 not over gravel \ n shededed With o and se 6 inch bed of ' 1.5 inch gravel. Grade 1 foot AS—BUILT D c 13 1999 groundwater 1.5 inch distribution T pipe in top of gravel Total of 19 Minimum soil cover 3/8 in. holes 18 inches as in plan view OOO00000000000000000000 O_ O..O„O,,O„o,O,On00o0000 4 ft of Filter Sand screen size 9' passing 1/4 inch 1009 j 40 109' to 409 100 less than 29 200 less than 1/2% Finished soil may be 1.5 inch distribution pipes contoured by landscape gravel bed Overall mound section designer, as long os vent scale: 1" = 10 ft MIN. COVER OF 18 INCHES /rol1e I,- maintained. 1 vPr 9e f;7 s, so Sxo hed siooe , A 2Ograde grade Filter Sond x Assumed Max. groundwater AO level 1 ft below grade On NW edge of mound, heavy rock in lieu of 3: > slope X33 r 1.5 inch toe of a / distribution effluent from slope \ / P/Pes w/ \ pump. 1.5 in. / 3/8" ho/es sloped on bottom, dlineP one end of each one per bock to line is screw— 25 sq ft pump basin copped, broughtAO of gravel up w/45 's, and covered by an 01) access box, for possible steaming. cleonouts i vent edge of gravel Plan View of Mound scale: I" = 20 ft Robert Throm On—Site Sewage Eagle Eye Engineering Residence Cabin Mound Disposal 10144 E. Jewell Av, *2 8998 Snowmass Cr. Rd. Details of Mound Denver, Colorado 80231 Pitkin County, Colo. System Design: FPF, p.e. Valley Precast 28005 CR 317 Buena Vista, CO 81211 vallayprecant.aorn Phone: 719-395-6764 slpreceas.aaak Fax: 719-395-3727 INVOICE c03510 SOLD TO: SHIP TO: CARLA OSTBFRG DOUG THROM 33 FOUR WHEEL DRIVE ROAD 8998 SNOWMASS CREED RD CARBONDALE CO 81623 SNOWMASS CO 81654 ACCT #: CV05125 ORDER DATE: 01/14/20 INVOICE DATE: 01/14/20 ORDER #: c03602 PO #: 8998 SNOWMASS TERMS: DUE ON CREEK RD RECEIPT 1 5% PER MONTH FINANCE CHARGE SALES REP: 124 ON PAST DUE BALANCES t Qy Whse/ltcm# Description Unit Price Discount Extended Order Shy Amount Price 1 I CV 560200 GOULD PUMA 246.77 0.00 246.77 1 1 CV 731282 EFFLUENT PUMP; .4HP, 115V, 476.17 0.00 476.17 60HZ, 20' LEAD - REV B 1 1 CV 730460 4" CAST IRON RING 136.99 0.00 136.99 1 1 CV 730469 24" SEWER CAST IRON LID 131.84 0.00 131.84 3 3 CV 731239 SIGNAL FLOAT WITH COLLAR 46.32 0.00 138.96 W/ 20' CORD 2.00 2.00 CV 730114 SERVICE TECH -LABOR 90.00 0.00 180.00 SERVICE COMPLETED 12/22/2019 DUE ON RECEIPT 01/14/20 AFEATHERKILE Sales Amount 1310.73 Tax Rate: 6.90 Sales Tax: 78.02 Total: 1388.75 By accepting our product(s), you are agreeing to pay the full amount owed as well as any legal fees and finances charges that may be assessed. Signature: THANK YOU 832‐R‐13‐002