HomeMy WebLinkAbout18370 Hwy 131 - 168909300002 December 3, 2019 Paul and Brenda Worley 18370 CO Highway 131 Bond, CO 80423 wetraft@raftcolorado.com RE: Final approval of the: Septic System Installation, OWTS-016190-2019 Property location: 18370 CO Highway 131, Bond, Eagle County Mr. and Mrs. Worley, This letter is to inform you that the above-referenced permit has been inspected and finalized. This OWTS major repair permit was approved to serve a total of three (3) bedrooms for the new residence. The system installed under permit IS-0487 is active and serving the original residence at the time of this letter. If the system, IS-0487, is abandoned in the future, it must be done in accordance with ECPHA OWTS Regulation 43.9.C and the department must be notified so that permit record can be closed. Additional information about the maintenance your septic system needs can be accessed through our website links, provided on the Environmental Health Department’s septic system resource page. Be aware that changes in the use of your property or alterations of your building may require commensurate changes to, or relocation of, your septic system. Landscape features, trees with tap roots, irrigation systems and parking areas above the soil treatment area can cause premature system failure. It is equally important that you notice and immediately repair dripping faucets and hissing toilets as this will certainly cause the system to fail. If you have any questions regarding this information, please contact us at (970) 328-8755 and reference the OWTS septic permit number. Best Regards, Claire Lewandowski, REHS Environmental Health Specialist III Attachments: Certification Letter and Design – Septic System Flyer – Final Letter PUBLIC HEALTH & ENVIRONMENT (970) 328-8755 FAX: (970) 328-8788 environment@eaglecounty.us Claire Lewandowski <claire.lewandowski@eaglecounty.us> owts permit 016190-2019 - Worley's Residence 7 messages Colorado River Guides Inc <wetraft@raftcolorado.com>Mon, Dec 2, 2019 at 12:42 PM To: claire.lewandowski@eaglecounty.us, Gary Hill <garyhill@centurytel.net> Claire, Hoping this will meet your requirements. Please let me know if it's ok. Thank you, -- Brenda (970)653-1001 18-11267 Worley Residence OWTS Observations Report.pdf 1318K Claire Lewandowski <claire.lewandowski@eaglecounty.us>Tue, Dec 3, 2019 at 10:14 AM To: Colorado River Guides Inc <wetraft@raftcolorado.com> Cc: Gary Hill <garyhill@centurytel.net> Thank you! This slipped my attention earlier when scanning my emails from yesterday. Gary came in as well and dropped off a physical copy. If you have additional photos of the installation before backfilling, would you send them for review and your record? [Quoted text hidden] -- Please note that beginning July 15 the Community Development Department will have new walk-in hours. The office welcomes walk-in customers between 8 a.m. and 4 p.m. Monday through Friday, except holidays. Claire Lewandowski, REHS Environmental Health Specialist III 970-328-8755 (office) 970-328-8747 (direct) environment@eaglecounty.us www.eaglecounty.us Claire Lewandowski <claire.lewandowski@eaglecounty.us>Tue, Dec 3, 2019 at 11:53 AM To: dirthog3@gmail.com Cc: Gary Hill <garyhill@centurytel.net>, blen@nwccusa.com, ttravis@nwccusa.com, Colorado River Guides Inc <wetraft@raftcolorado.com> Hi Chris, You were the installer of the permitted OWTS at 18370 CO Highway 131. Can you confirm if, as well as how, the previous failed tank and septic system were abandoned? I attached the permit for your convenience and reference. Thank you, Claire [Quoted text hidden] OWTS Permit-016190-2019.pdf 281K Timothy Travis <ttravis@nwccusa.com>Tue, Dec 3, 2019 at 1:32 PM To: Claire Lewandowski <claire.lewandowski@eaglecounty.us>, "dirthog3@gmail.com" <dirthog3@gmail.com> Cc: Gary Hill <garyhill@centurytel.net>, Colorado River Guides Inc <wetraft@raftcolorado.com> Hi Claire, I spoke with Brenda Worley today about the exisng system. They are sll living in the exisng residence and using the exisng system unl they can get the CO for the new residence. Please let me know that you have received this message or if you need any further informaon. Regards, Tim Travis, P.E. NWCC, Inc. (970) 879-7888 ext. 103 (970) 879-7891 fax ttravis@nwccusa.com 2580 Copper Ridge Drive, Steamboat Springs, CO 80487 ****************************************************************************** PRIVILEGED AND CONFIDENTIAL: Communications sent from NWCC, Inc., may contain sensitive information. This communication, including attachments, is for the exclusive use of addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any use, copying, disclosure, dissemination or distribution is strictly prohibited. If you are not the intended recipient, please notify the sender immediately by return email, delete this communication, and destroy all copies. [Quoted text hidden] [Quoted text hidden] [Quoted text hidden] [Quoted text hidden] -- Please note that beginning July 15 the Community Development Department will have new walk-in hours. The office welcomes walk-in customers between 8 a.m. and 4 p.m. Monday through Friday, except holidays. Claire Lewandowski, REHS Environmental Health Specialist III 970-328-8755 (office) 970-328-8747 (direct) environment@eaglecounty.us www.eaglecounty.us Colorado River Guides Inc <wetraft@raftcolorado.com>Tue, Dec 3, 2019 at 2:02 PM To: Timothy Travis <ttravis@nwccusa.com> Cc: Claire Lewandowski <claire.lewandowski@eaglecounty.us>, "dirthog3@gmail.com" <dirthog3@gmail.com>, Gary Hill <garyhill@centurytel.net> Claire, Also, current system at old house did not fail and has not been abandoned. Brenda Worley [Quoted text hidden] -- Brenda Colorado River Guides Inc. www.raftcolorado.com (970)653-1001 Claire Lewandowski <claire.lewandowski@eaglecounty.us>Tue, Dec 3, 2019 at 5:04 PM To: Colorado River Guides Inc <wetraft@raftcolorado.com> Cc: Timothy Travis <ttravis@nwccusa.com>, "dirthog3@gmail.com" <dirthog3@gmail.com>, Gary Hill <garyhill@centurytel.net> Hi, thank you for the response and clarification! I can final the permit. For your existing systems record, will the system remain in place, be abandoned, or remain active? [Quoted text hidden] [Quoted text hidden] Colorado River Guides Inc <wetraft@raftcolorado.com>Tue, Dec 3, 2019 at 5:36 PM To: Claire Lewandowski <claire.lewandowski@eaglecounty.us> Cc: Timothy Travis <ttravis@nwccusa.com>, "dirthog3@gmail.com" <dirthog3@gmail.com>, Gary Hill <garyhill@centurytel.net> Claire, System will remain active. Brenda [Quoted text hidden] ' EAGLE \7UNTY DEPARTMENT OF ENVIRONI,'--�TAL HEALTH CALL FOR FINAL INSPECTION B 6th & Broadway PERMIT MUST BE POSTED ON BEFORE COVERING ANY PART Eagle, Colorado,$I.6, LOCATION OF INSTALLATION OF INSTALLED SYSTEM Box 850„, PERMIT ND 48�' (this does not constitute a building or use permit) Owner Ernest W. & Evelyn Shue / 93'70 System Location Highway 131 - 2 miles north of Bond on Hwy 131 Licensed GM&WorInstaller• * Conditional Construction approval is hereby granted for a 1,000 gallon XX; Septic Tank or Aerated treatment unit. Absorption area (or dispersal area) computed as follows: Perc rate 1 inches in 20 minutes.._ 720 sq ft. absorption area per bedroom 240 sq. ft. # of bedrooms 3 x 240 sq. ft, minimum requirement MINIMUM REQUIREMENTS: gallon septic tank (two - compartment 720 sq. ft. leach field May we suggest Date March 9, 1981 n�' ctor Erik W. Edeen FINAL APPROVAL OF SYSTEM: CF +� No system shall be deemed to be in compliane with the Sewage Disposal Laws Mil the assembled system is approved prior to covering any part. Septic Tank cleanout to within " of final grade or aerated access ports above grade. Proper materials and assembl / Or 1W Adequate absorption (or dispersal) area. l �S � /"'�'ct Adequate compliance with permit requirements. ( —7 It`f cc �l Adequate compliance with County and State regulations/requirements.vU{�,1 Date JJ� Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE 3/24/81: Erik Edeen advised that conditional final approval *CONDITIONS: givenfor the above installation as pei 1. All .installation must comply with all requirements of the County Individual Sewage Disposal Regulations,abo` adopted pursuant to authority granted in 25-10-104, CRS 1973 amended 25-1-614, CRS 1973 2. This permit is valid only for connection to structures which have fully complied with County Zoning and building requirements. Connection to or use with any dwelling or structures not approved by the building and Zoning office shall automatically be a violation of a requirement of the permit and cause for both legal action and revocation of the permit. 3.28 3. Section III, 11requires any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material variation from the terms or specifications con- tained in the application of permit commits a Class I, Petty Offense ($500.00 fine - 6 months in jail or hnth PLEASE RETURN THIS PORTION WITH YOUR SITE PLAN AND FEES ° 3'�8--7311 - 949-5257 927-3823 ENVIRONMENTAL HEALTH BOX 850 EAGLE, COLORADO 81631 PERMIT FEE = $75 PERCOLATION TEST FEE = $50 APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. Z— 7 NAME OF OWNER: C 1.), Z ADDRESS: e=a fdHONE: NAME OF APPLICANT (IF DIFFERENT FROM OWNER): ADDRESS: DESIGN ENGINEER OF SYSTEM (IF APPLICABLE): ADDRESS: PERSON RESPONSIBLE FOR INSTALLATION OF SYSTEM: PHONE: PHONE: ADDRESS: PHONE: PERMIT APPLICATION IS FOR: (. New Installation ( ) Alteration ( ) Repair LOCATION OF PROPOSED FACILITY: County Lot Size e�* �D < City or Town, LEGAL DESCRIPTION: if within City or Town Limits — — STREET (RURAL) ADDRESS: IS SYSTEM DESIGNED FOR BUILDING OR SERVICE TYPE: (Check applicable category) ( t4- Residential - Single-family dwelling ( ) Residential - Triplex ( ) Residential - Duplex ( ) Residential - Quadplex ( ) Commercial - State usage # Persons # Bedrooms WASTE TYPES: (Check all applicable) Commercial or Institutional ( Dwelling ( ) Non -domestic wastes ( ) Transient Use ( ) Other SOURCE AND TYPE OF WATER SUPPLY: ( Well ( ) Spring Give depth of all wells within 200 feet of the system: If supplied by community water, give name of supplier: TYPE OF IfV,9IVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: ( V Septic Tank ( ) Aeration Plant ( ) ( ) Vault Privy ( ) Composting Toilet ( ) ( ) Pit Privy ( ) Incineration Toilet ( ) ( ) Greywater ( ) Other ( Garbage Grinder ( Dishwasher ( ✓)' Automatic Masher ( ) Creek or Stream O Chemical Toilet Recycling, Potable Use Recycling, Other Use WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? ( ) Yes ( v'j"' No Signature Date c-_� /11 /� /F/ INFORMATION BELOW TO BE FILLED OUT BY ENVIRONMENTAL HEALTH OFFICER GROUND CONDITIONS: Percent Ground Slope: Depth to Bedrock (per 8' Profile Hole): SOIL PERCOLATION TEST RESULTS: FINAL DISPOSAL BY: ( ) ( Depth to Groundwater Table: Minutes per inch in Hole No. 1 ,z Minutes per inch in Hole No. 2 Minutes per inch in Hole No. 3 Absorption Trench, Bed or Pit ( ) Evapotranspiration Above Ground Dispersal ( ) Sand Filter Underground Dispersal ( ) 'Wastewater Pond Other -�/� PLAT OF TRACT 49 T 2 S, R 83 W of the 6th P.M. TR. 48 4 S 890 50'02 E 2 WITNESS CORNER 1324.74' SET 19.80 FEET SOUTH TRUE COR. TR. 47 TRACT 49 w 3 O O O - o 0 40.029 ACRES Q i° PC) ° M) f 0 0 — i z cn w a m cD z cc W { m i 6 3 N 89055'32"W 4 131 9.31' T R . 50 O Denotes a U.S.G.L.0). brass cap set in place. f I, B. James Burk, being a duly registered (land surveyor in the State of Colorado, do hereby certify that this plat is a correct :representation of a survey made by me durin March of 1980, to the best of my knowledge p�j,[� LAND SURVEYING CO. and belief., pEJRK ,•, .�a4 .%„:.f ..............3;s/80. GYPSUM, COLORADO B: James Burk R.L.S. 11204 date DATE OF SURVEY DRAWN 8Y MARCH 27,1980 SCALE FILE NO. 1 IN. = 300 FT. ------ IMPROVEMENT LOCATION CERTIFICATE \ \,—POWER LINES —243.1 -'- 0 SATELLITE DISH -_- --__10- OPEN �=="= DECK «=="POLE SCALE: ,.� / '-_---' ACCESS ROAD ^5') � '~° ^^''~—~~~' '^~'—''�"'~° s�xoo� c�wu ..�~�~._ � -'~�=^...~,,~,,. _,~^~' or i.prn—m-1 . �~='~,^^~^'^~~"~ SCALE:.��� upon^~ "~ ..^'~~~` .. _� ,^`~.^� ~ °~~ .°' ��~�~. u.. 1 STATE HIGHWAY NO. �. . '~�� .~ . *~~.-^~ ' ,-~. on ^~^°. . '..` .,� =­ ~.~.... ^,~�~`° , described pi. _~.~~� .~`, � ^�.... ^^^v+ cross— � ��—_ept as —P�1' C4 LEGAL DESCRIPTION ..~, °. ~~`.~ , �~^.,/~=^� ~~, °_`u ,~°^~.~.�. �,u� �^."~,.^^~~. - - | ��������­`�—����~~— �'a.." .. -- . 67- EAULE COUNTY ENVIRONMENTAL HEALTH ROUTE FORM ot NAME ------------ SATE REFERRED APPLICATION NO. OCATI0N i 'lease review the attached ap icationn"d return it and this completed form =o the Environmental Health Office.. MLMNINC_ Complies with: Yes N Subdivision Regulationsi Zo ing Regulations Recommend Approval 3omments :��� 31,TILDING: Set Backs tl/ Site Ass Other Recommend A- ,omments: %NGINEER Roads Grading Drainage Recommend ApprovaLk ,omments: ----......,. l- Lvty 1 ZO 1 FEE: $50 APPLICATION NO. 9171 0[A'ER: LEGAL DESCRIPTION: l < y� RURAL ADDRESS : TYPE OF DWELLING: OF BEDROOMS DATE OF TEST: �-- � `—1 TYPE OF SOIL: TEST HOLES PRESOAKED: YES N0 TIME WATER DEPTH INCHES OF FALL RATE 1 Z 3 1 2 3 1 2 3 1 2 PERCOLATION RATE: /��— '�w" � TANK SIZE: '7 SQUARE FOOTAGE PER BEDROOM: _LEACH FIELD SI E: Site has been reviewed and tested for pe 1ation rate. We recommend: APPROVAL DISAPPROVAL DATE: w EAGLE COUN ENVIRONMENTAL HEALTH OFFICER 1� M91'')-Rrv. Application must be complete where applicable. Type or print in BLACK I N K. No overstri kes or erasures unless initialed. COLORADO DIVISION OF 1^JATER RESOURCES 818 Contenniul bldg., 1313 Sherman St., Denver, Colorado 80203 ,{. m e, ,., -' PERMIT APPLICATION FORM ( ) A PERMIT TO USE GROUNDWATER (i<) A PERMIT TO CONSTRUCT A WELL FOR:( ) A PERMIT TO INSTALL A PUMP t 1) HrrLIUAI\1 I - mailing address cy c• �/ NAME l 0 ( ) REPLACEMENT FOR NO. ( ) OTHER WATER COURT CASE NO, STREET- CITYO D / �_ � l t _r-u' ✓j :1 % l es-L>,/_ (State) (Lip) .�. TELEPHONE NO.G- (2) LOCATION OF PROPOSED WELL c• County(4, 'i- J L '/< of the 5 �k %, Section 9 C —, Twp. c� Rng. G P.M. M.S) (E,W) , (3) WATER USE AND WELL DATA Proposed maximum pumping rate (gpm) Average annual amount of ground water 4- to be appropriated (acre -feet): — Number of acres to be irrigated: Proposed total depth (feet) : / 0 L-1' Aquifer ground water is to be obtained from: Owner's well designation GROUND VVATER TO BE USED FOR: ( ) HOUSEHOLD USE ONLY - no irrigation (0) (}<) DOMESTIC (1) ( ) INDUSTRIAL (5) LIVESTOCK (2) ( ) IRRIGATION (6) ( ) COMMERCIAL.(4) ( ) MUNICIPAL (8) ( ) OTHER (9) DETAIL THE USE ON BACK IN (11) (4) DRILLER Name Street City (State) (Zip) Telephone No. Lit:. No. �EGEI V ED FED! 7 1s8' WATER ItE�CJURCES SUITE ENGUIE98 0..04 FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN Receipt No.—/ t�— //5/ Basin Dist CONDITIONS OF APPROVAL This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of the permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. APPROVED PURSUANT TO CRS 1.973, 37-92-602 (3)(b)(II) AS THE ONLY WELL 017 A TRACT OF 35 ACRES OR MORE DESIGNATED AS y0 ACRES IN SC- % X5. �. Sec �F T APPROVED FOR DOMESTIC USE, INCLUDING THE IRRIGATION OF NOT OVER Ott ACRE OF HOME GARDENS AND LAWNS. APPLICATION APPROVED PERMIT NUMBER 118743 DATE ISSUED I.D. S _6 3 COUNTY hJR-26-77 ,-�•� •`' \' COLORADO DIVISION OF WATER RESOURCES ' THIS FORM M ST BE SUBMITTED 1313 Sherman' Street - Room 818 VITHIN 60 DA S OF COMPLETION Denver, Colorado 80203 OF THE WORK DESCRIBED HERE- N. TYPE OR PRINT IN BLACK WELL COMPLETION AND PUMP INSTALLATION REPORT NK. PERMIT NUMBER 11^lk3 WELLOWNER :..:.e, a _�>70 3/. , 3 'i , /. of the /. of Sec. , ADDRESS -". .. .:G]: ^gib ;Cs.`Oy' �,.0=c,:? T. 5 R. P.M. DATE COMPLETED ,,tine ?' 19` 1 HOLE DIAMETER r � WELL LOG — in. from to �� ft. ; �Q Water From To Type and Color of Material Loc. in. from to ft. in. from to ft. :• �� hits .andzt,;ne DRILLING METHOD J�• �:�� ?�:1 .a�g�GTI`3 CASING RECORD: Plain Casing 1.00• -'Zed .`+. 3ankda; ,one Steel 0 20 Size & kind from to ft. l Size4" & kind ='lactic from IQ to IN, ft. 1COw 1301 dray 32azdstane Size .& kind from to ft. Perforated Casing Size liN & kind='Z2S4C from 90• to no ft. Size & kind from to ft. Size & kind from to ft. GROUTING RECORD Material Cement Intervals Q to 200 . 3 Placement Method Poured I IiGRAVEL PACK: Size 1 � Interval TEST DATA Date Tested 6/3/$1 19 • Static Water Level Prior to Test SQ ft. AIX >� :. _ . Y ,:, .:>;Type ATest Pump Length of Test L, Sustained Yield (Metered) TOTAL DEPTH la Use additional pages necessary to complete log.: Final Pumping Water Level 13o :. _ _ PUMP INSTALLATION REPORT P Imp Make , roe 3-)wered by HP Pump Serial No. *.rotor Serial No. ,ate Installea ?ump Intake Depth ,'remarks +:'ELL TEST DATA WITH PERMANENT PUMP Nate Tested `static Water Level Prior to Test F ength of Test Sustained yield (Metered) Pumping Water Level Remarks Hours GPM W AI 3 WATER J W v TABLE W J Q J .4 ry w J a I d coN E Of F' DEPRESSION CONTRACTORSSTATEMENT The undersigned, being duly sworn upon oath, deposes and says that he is the ccntractor of the well or pump installation described hereon; that he has read the statement made hereon; knows the content thereof, and that the same is true of his own knowledge. 7 Signature License NO. State of Colorado, County of `` �� SS Subscribed and sworn to betore me tFTs '"`�Uayaof�Aires OciobM 2te119_ My Commission expires: , 19 Notary Public FORM TO BE MADE OUT Iry UUAURUFLIUAlt:: WHITE FORM must be an original copy on both sides and signed. I WHITE AND GREEN copies must be filed with the State Engineer. PINK COPY is for the Owner and YELLOW COPY is for the Driller. % THE LOCATION OF THE PROPOSED WELL and the area on, which the water will be w-ed niteu be indicated on the diagram below. Use the CENTER SECTION (1 section, 640 acres) for the well location. + - I- -.1 -- I- . -.. I - . I-- --._ -+ --- -I- -- + - 1 MILE, 5280 FEET yl -�- i- + + + + + + I I l — —t- — I �NORTHL f- I 4- - + I -I-- -I— I -I- - -+- - (10) _— II + _ The scale ofthediagram is 2 inches = 1 mile Each small square represents 40 acres. WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep --- - 1 cubic foot per second (cfs) ... 449 gallons per minute (gpm) A family of 5 will require approximately 1 acre-foot of water per year. 1 acre-foot ... 43,560 cubic feet ... 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. 1AfAi'GR IA/Ill QC t ict=n. (6) THE WELL MUST BE LOCATED BELOW by distances from section lines. U ' .' ft. from �i ��v� sec. line north or South) L<? 20 ft. from //��1� sec. line (east or west) LOT BLOCK FILING SUBDIVISION (7) TRACT ON WHICH WELL WILL BE LOCATED Owner: No. of acres Will this be the only well on this tract? (8) PROPOSED CASING POOGRAM Plain Casing in. from �' 17 ft. to '5 ft. .... � rcm ft. to-ft.. Perforated casing in. from ft. to 16�—� ft. in. from ft, to ft. (9) FOR REPLACEMENT WELLSgivedistance and direction from old well and plans for plugging it: Owner(s): ���'�✓� S% l� % /�� .S_ G< No. of acres: - Legal description: �—} F _ i /u% o•f (11) DETAILED DESCRIPTION of the use of ground water: Household use and do stic wells must indicate type of disposal sys m to be_useq. g (12) OTHER WATER RIGHTS used on this land, 6cluding wells. Give Registration and Water Court Case Numbers. Type or right Used for (purpose) Description of land on which used Al a//Z= (13) THE APPLI.CANT(S)� STATES) THAT THE INFORMATION SET FORTH HEREON IS TRUE TO THE BEST OF -IIIS KNOWLEDGE. SIGNATURE OF APPLICANTM i Use additional sheets of paper if more space is required. Policy No. A 25983 GRUN®FOS- 5 Year %s through 1 '/2 HP Submersible Pump Protection Application Dear Grundfos Dealer: To make certain your customer's Grundfos submersible pump is fully covered under the supplemental Performance PLUS protection program, READ AND FOLLOW THESE _ INSTRUCTIONS CAREFULLY. Please type or print clearly. Complete this policy application in full. Then sign and date the application. Your customer should keep the top white copy of the application. Keep the yellow copy for your records and send the two remaining copies (pink and goldenrod) to your Grundfos distributor. Should the pump fail due to any of the conditions specified under Performance PLUS prior to the expiration of the 5-year term of the policy, your customer should contact you. You then pull the pump and determine if the cause of failure is within the terms of the Performance PLUS policy. If it is, Grundfos will repair or replace the pump at no charge through your distributor. Performance PLUS does not cover the labor charges involved in pulling and reinstalling the pump. The Performance PLUS protection policy covers all Grundfos domestic submersible pumps up through 11/2 HP. It is limited to the original owner of the pump and is non -transferable. Customer Name Address City -- _� c- � -1� � l�, i) State ��- Zip Grundfos Dealer Name 71�! y^�/r Jr✓ !;k% yt r Address ? �T'' IY/- i_,. (� . ✓'!', �`_' 1 Cityr'� State (, 0'- Zip Pump Model: Serial Number: Phase & Volts: Horsepower: Date Installed: Application: Pumping/Water Level: Pump Setting: SO` 0 Well Inside Diameter: Depth: Flow (GPM): Lightning Arrestor Type: New Installation or Brand of Pump Replaced: Replacement: I certify that a proper lightning arrestor has been installed with this Grundfos submersible, and that the unit has been installed in accor- dance with the Grundfos I allation and Operating Instructions. Dealer Signature: Date: SP-SL-007 1 1/26/85 PRINTED IN U.S.A. V �T IS Cfsv JOB NAME PL i Ds ' �) 0�3_ oo -aGa /93 7d `7 I JOB NO. .,. JOB LOCATION BILL TO DATE STARTED TE COMPLETED DATE BILLED JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL --------- ---------------- --------- TOTAL LABOR INSURANCE PERMIT # 487 - SALES TAX OWNER: Evelyn Shue (q *k MISC.COSTS LOCATION: 18370 - Highway 131 - 2 miles north of Bond INSTALLER: James Matlock SIZE OF TANK: 1,000 gallons DWELLING: residential - 3 bedrooms x 240 sq.ft. TOTAL JOB COST PERC RATE: one inch/20minutes (720 sq.ft.) GROSS PROFIT LESS OVERHEAD COSTS % OF SELLING PRICE Finalized: 3-20-81 By: Erik Edeen NET PROFIT ILDER Pdnted in USA -3 0 o .