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Home My WebLink About1591 Red Canyon Creek Rd - 194124402003INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT EAGLE COUNTY ENVIRONMENTAL HEALTH DIVISION P.O. Box 179 - 500 Broadway • Eagle, Colorado 81631 Telephone: 328-8755 YELLOW COPY OF PERMIT MUST BE POSTED AT INSTALLATION SITE. Please call for final inspection before covering any portion of installed system. PERMIT NO. 1225 OWNER: NJG Corporation, (Nancy & James Gibson) PHONE: 476-0742 MAILINGADDRESS: 5137 N. Main Gore Drive City: Vail Slate: CO ZIP: 81620 APPLICANT: Terry Nottingham PHONE: 949-2366 SYSTEM LOCATION: 1591 Red Canyon Road, Edwards TAX PARCEL NUMBER: 1941-244-02-003 LICENSED INSTALLER: T. Nottingham Construction LICENSE NO: 2 0 — 9 3 DESIGN ENGINEER OF SYSTEM: INSTALLATION HEREBY GRANTED FOR THE FOLLOWING: 1 7 5O_ GALLON SEPTIC TANK ABSORPTION AREA REQUIREMENTS: SQUARE FEET OF SEEPAGE BED 1 n 9O SQUARE FEET OF TRENCH BOTTOM. SPECIAL REQUIREMENTS: 340 feet of SB2 in trenches or 29 infiltrator units in "trenches. Install inspection portals at end of each trench. t7��pY (ACAYCnt� C.t�0 ENVIRONMENTAL HEALTH APPROVAL: DATE:y / /8 [73 CONDITIONS: 1. ALL INSTALLATIONS MUST COMPLY WITH ALL REQUIREMENTS OF THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS, ADOPTED PURSUANT TO AUTHORITY GRANTED IN 25- 10- 104. 1973, AS AMENDED. 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 STRUCTURE NOT APPROVED BY THE ZONING AND BUILDING DEPARTMENTS SHALL AUTOMATICALLY BE A VIOLATION OF A REQUIREMENT OF THE PERMIT AND CAUSE FOR BOTH LEGAL ACTION AND REVOCATION OF THE PERMIT. 3. .CHAPTER IV, SECTION 4.03.29 REQUIRES ANY PERSON WHO CONSTRUCTS, ALTERS OR INSTALLS AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM TO BE LICENSED. FINAL APPROVAL OF SYSTEM: (TO BE COMPLETED BY INSPECTOR): NO SYSTEM SHALL BE DEEMED TO BE IN COMPLIANCE WITH THE EAGLE COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS UNTIL THE SYSTEM IS APPROVED PRIOR TO COVERING ANY PORTION OF THE SYSTEM. INSTALLED ABSORPTION OR DISPERSAL AREA: SQUARE FEET. INSTALLED SEPTIC TANK: GALLON / DEGREES 913 FEET FROM h67t D jk ([ems W SEPTIC TANK ACCESS TO WITHIN 8" OF FINAL GRADE AND �� n PROPER MATERIAL AND ASSEMBLY YES _NO col COMPLIANCE WITH COUNTY/STATE REQUIREMENTS: '-� YES NO ANY ITEM CHECKED NO REQUIRES CORRECTION BEFORE FINAL APPROVAL OF SYSTEM IS MADE. ARRANGE A RE -INSPECTION WHEN WORK IS CORRECTED. COMMENTS: ENVIRONMENTAL HEALTH APPROVAL: 1 ! DATE: ENVIRONMENTAL HEALTH APPROVAL: DATE: (RE -INSPECTION IF NECESSARY) RETAIN WITH RECEIPT RECORDS APPLICANT / AGENT: PERMIT FEE , PERCOLATION TEST FEE _ OWNER: RECEIPT# /6C_/I-4 CHECK# ��/ ISDS Permit Building Permit # AA U c r APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT ENVIRONMENTAL HEALTH OFFICE- EAGLE COUNTY P.O. BOX 179 EAGLE, CO 81631 328-8755/927-3823(Basalt) PERMIT APPLICATION FEE $150.00 PERCOLATION TEST FEE $200.00 ************************************************************************** PROPERTY OWNER: IV,A IV L! J . i- C-_% J, 61, MAILING ADDRESS:61S'% /V<!J'Ay1 60ife bPQ.,yA%L43 9/45jPHONE• 303-476" 0-?9•, CONTACT PERSON: _�� ! `C " G ' -.� C�'� G 1►� S iti / 1 PHONE: � C 5 4') � `- APPLICANT LICENSED SYSTEMS CONTRACTOR: d L: f? /i! %! / iv ADDRESS: C C j S `0 PHONE • ******************************�********************************************* PERMIT APPLICATION IS FOR: (✓) NEW INSTALLATION ( ) ALTERATION ( ) REPAIR LOCATION OF PROPOSED INDIVIDUAL SEWAGE DISPOSAL SYSTEM: Legal Description: LCT // ' kc a (AA/ sTA?,;g7S" Parcel Number: �� j Lot size: 146-4646S Physical Address: /:5,q / 9Eb C.AN VOIJ iC04D, Eb COAP-bS; LV BUILDING TYPE: (Check (' Residential / ( ) Residential / ( ) Commercial / TYPE OF WATER SUPPLY: applicable category) Single Family Number Multi -Family* Number Industrial* Type_ of Bedrooms of Bedrooms Well (✓) Spring ( ) Surface ( ) Public ( ) Name of Supplier: *These systems require design by a Registered Professional Engineer NOTE: SITE PLAN MUST BE ATTACHED TO APPLICATION MAKE ALL REMITTANCE PAYABLE TO: "EAGLE COUNTY TREASURER" �vu' ` 1 DATE: AMOUNT PAID: f Jy O RECEIPT# ` ©� DATE • / / 19-3,) CHECK # CASHIER: �Qii 1' ' ChenNorthern, Inc. Consulting Engineers and Scientists April 15, 1993 Galvin Design Attn: Rob Galvin P.o. Box 395 Avon CO 81620-0395 5080 Road 154 Glenwood Springs, Colorado 81601 303 945-7458 303 945-2363 Facsimile Subject: Subsoil Study for Foundation Design, Proposed Residence, Lot 11, Red Canyon Estates, Eagle County, Colorado Job No. 4 268 93 Dear Mr. Galvin: As requested, Chen -Northern, Inc. performed a subsoil study for design of foundations at the subject site. The study was conducted in accordance with our agreement for geotechnical engineering services to you, dated March 8, 1993. In addition, we also looked at some supplementary pits excavated in conjunction with the building excavation on April 13, 1993. The data obtained and our recommendations based on the proposed construction and subsurface conditions encountered are presented in this report. Chen and Associates (now known as Chen - Northern) previously conducted a preliminary geotechnical study for several proposed trout lakes in Red Canyon Estates under our Job No. 4 282 84, dated August 27, 1984. Proposed Construction: The proposed 5,000 square foot residence will be two stories of wood frame construction over a crawl space located in the area of Pits 1 and 2 shown on Fig. l._- Cut depths of about 4 to 6 feet are assumed. Foundation loadings for this type of construction are assumed to be relatively light. If building conditions or foundation loadings are significantly different from those described above, we should be notified to reevaluate the recommendations presented in this report. Site Conditions: The proposed building area is located in an open field near the middle of the narrow valley that is the Red Canyon Creek drainage. The site slopes gently to strongly down to the south at grades of 5% to 10%. Steep valley side slopes are located several hundred feet east and west of the site. A small creek and trout pond were observed about 150 feet east and south of the building area. The site is vegetated with grass and weeds with cottonwood trees along the creek. About 3 feet of snow covered the site at the time of our field work on March 10, 1993. Some overlot grading may have been performed at the site when the trout pond was built. This may account for the lack of topsoil at the site. Some fill may be encountered during foundation A member of the I3IH group of companies excavation. Subsurface Conditions: The subsurface conditions at the site were evaluated by excavating two exploratory pits at the locations shown on Fig. 1. The logs of the pits are presented on Fig. 2. A profile pit was excavated in the proposed leach field area. The subsoils encountered in the pits consist of interlayered silty sandy gravel and gravelly sandy silt to the maximum depth explored, 9 feet. The soils appear loose to medium dense and may be hydrocompactive. Results of a gradation analysis performed on a sample of gravelly silty sand (minus 3-inch fraction) obtained from the site are presented on Fig. 4. No free water was observed in the pits at the time of excavation. The subsoil conditions encountered in the pits are similar to those encountered in our previous borings drilled in the area. The boring locations are shown on Fig. 1 and the logs of those borings are shown on Fig. 2. Foundation Recommendations: Considering the subsoils encountered in the exploratory pits and the nature of the proposed construction, we recommend spread footings placed on the undisturbed natural soil designed for an allowable soil bearing pressure of 2000 psf for support of the proposed residence. Settlements up to 1 inch should be expected and may occur over a long period of time. Additional settlements could occur if the bearing soils were to become wet. Precautions should be taken not to cause wetting below the building such as from roof runoff and landscape irrigation. Footings should be a minimum width of 16 inches for continuous walls and 2 feet for columns. Loose and disturbed soils and existing fill encountered at the foundation bearing level within the excavation should be removed and the footings extended down to the natural soils. The exposed subgrade should be moistened to optimum and compacted to at least 95 % of standard Proctor density. Exterior footings should be provided with adequate cover above their bearing elevations for frost protection. Placement of footings at least 42 inches below the exterior grade is typically used in this area. Continuous foundation walls should be reinforced top and bottom to span local anomalies such as by assuming an unsupported length of at least 10 feet. Foundation walls acting as retaining structures should be designed to resist a lateral earth pressure based on an equivalent fluid unit weight of 45 pcf. Floor Slabs: The natural on -site soils, exclusive of topsoil or old fill, are suitable to support lightly to moderately loaded slab -on -grade construction. To reduce the effects of some differential movement, floor slabs should be separated from all bearing walls and columns with expansion joints which allow unrestrained vertical movement. Floor slab control joints should be used to reduce damage due to shrinkage cracking. The requirements for joint spacing and slab reinforcement should be established by the designer based on experience and the intended slab use. A minimum 4-inch layer of free -draining gravel should be placed beneath basement level slabs to facilitate drainage. This material should consist of minus 2-inch aggregate with less than 50% passing the No. 4 sieve and less than 2% passing the No. 200 sieve. All fill materials for support of floor slabs should be compacted to at least 95 % of maximum standard Proctor density at a moisture content near optimum. Required fill can consist of the on -site soils devoid of vegetation, topsoil and oversized rock. Chen @Northern, Inc. Consulting Engineers and Scientists Galvin Design April 15,1993 Page 3 Underdrain System: Although free water was not encountered during our exploration, it has been our experience in mountainous areas that local perched groundwater may develop during times of heavy precipitation or seasonal runoff. Frozen ground during spring runoff can create a perched condition. We recommend below grade construction, such as retaining walls, crawl space and basement areas, be protected from wetting and hydrostatic pressure buildup by an underdrain system. An underdrain is probably not necessary for the relatively shallow crawl space that is proposed provided that good surface drainage around the residence is maintained. If drains are provided they should consist of drainpipe placed in the bottom of the wall backfill surrounded above the invert level with free -draining granular material. The drain should be placed at each level of excavation and at least 1 foot below lowest adjacent finish grade and sloped at a minimum 1 % to a suitable gravity outlet. Free -draining granular material used in the underdrain system should contain less than 2% passing the No. 200 sieve, less than 50% passing the No. 4 sieve and have a maximum size of 2 inches. The drain gravel backfill should be at least 2 feet deep. An impermeable membrane such as 20 mil PVC should be placed under the drain gravel in a trough shape and attached to the footing with mastic to prevent drain water from wetting the bearing soils. Surface Drainage: The following drainage precautions should be observed during construction and maintained at all times after the residence has been completed: 1) Inundation of the foundation excavations and underslab areas should be avoided during construction. 2) Exterior backfill should be adjusted to near optimum moisture and compacted to at least 95 % of the maximum standard Proctor density in pavement and slab areas and to at least 90 % of the maximum standard Proctor density in landscape areas. Free -draining wall backfill should be capped with about 2 feet of the on -site, finer graded soils to reduce surface water infiltration. 3) The ground surface surrounding the exterior of the building should be sloped to drain away from the foundation in all directions. We recommend a minimum slope of 12 inches in the first 10 feet in unpaved areas and a minimum slope of 3 inches in the first 10 feet in pavement and walkway areas. A swale may be needed uphill to direct surface runoff around the residence. 4) Roof downspouts and drains should discharge well beyond the limits of all backfill 5) Landscaping within 5 feet of the building should not require regular heavy irrigation. Chen@Northern, 11 c. Consulting Engineers and Scientists Galvin Design April 15,1993 Page 4 Percolation Tests: Three percolation tests were performed on March 11, 1993 at the locations indicated on Fig. 1. The test results are shown on Table I. The percolation rates varied from 11 to 16 minutes per inch. We recommend that a rate of 15 minutes per inch be used for sizing of the leach field. Based on the subsurface profiles identified at the site and the test results, an individual septic disposal system should be feasible at the site. Observation of Supplementary Pits: We visited the site on April 13, 1993 to observe several pits excavated to determine the depth of old fill encountered when excavation for foundations was begun. The old fill included organics and oversized rock but was similar to the natural on - .site soils. The fill was encountered in the building area to the east of Pits 1 and 2 shown on Fig. 1. Three pits were excavated which revealed that the fill was 2 to 5 feet deep and appeared deeper to the east. It was decided by the contractor and owner to move the house further west and if more fill was encountered, to extend the footing down to the natural soils. Limitations: This report has been prepared in accordance with generally accepted geotechnical engineering principles and practices in this area at this time. We make no other warranty either expressed or implied. The conclusions and recommendations submitted in this report are based upon the data obtained from the exploratory pits excavated at the locations indicated on Fig. 1, the proposed type of construction and our experience in the area. Our findings include interpolation and extrapolation of the subsurface conditions identified at the exploratory pits and variations in the subsurface conditions may not become evident until excavation is performed. If conditions encountered during construction appear to be different from those described in this report, we should be notified at once so re-evaluation of the recommendations may be made. This report has been prepared for the exclusive use by our client for design purposes. We are not responsible for technical interpretations by others of our exploratory information which has not been described or documented in this report. As the project evolves, we should provide continued consultation and field services during construction to review and monitor the implementation of our recommendations, and to verify that the recommendations have been appropriately interpreted. Significant design changes may require additional analysis or modifications of the recommendations presented herein. We recommend on -site observation of excavations and foundation bearing strata and testing of structural fill by a representative of the soil engineer. ChenONorthern, Inc. Consc' Engineers and Scientists Galvin Design April 15,1993 Page 5 If you have any questions or if we may be of further assistance, please call our office. Sincerely, CHEN -NORTHERN, R .. Al� J- Daniel E. Hardin, P. E. Reviewed By Steven L. Pawlak, P. E. DEH/lr Attachments ChenONorthern, Inc. Consulting Engineers and Scientists Legend: Topsoil Gravel and Silt (GM-ML); interlayered silty sandy gravel and gravelly sandy silt, loose to medium dense, slightly moist, reddish brown. Sand and Gravel (SM-ML); silty to very silty with silty sand zones and slightly clayey zones, cobbles and boulders of sandstone fragments, loose to medium dense, slightly moist to moist, reddish brown, stratified. Relatively undisturbed drive sample; 2-inch I.D. California liner sample. Drive sample; standard penetration test (SPT), 1 3/8-inch I.D. split spoon sample, ASTM D-1586. M Disturbed bulk sample. 7/12 Drive sample blow count; indicates that 7 blows of a 140-pound hammer falling 30 inches were required to drive the California or SPT sampler 12 inches. Notes: 1. Exp.loratory pits were excavated on March 10, 1993 with a Case 580 rubber -tired backhoe. 2. Exploratory borings were drilled in August 1984 as part of the subsoil study for the trout lakes, Job No. 4 282 84. 3. Locations of exploratory borings and pits are approximate. 4. Elevations -of exploratory borings and pits were obtained by interpolation between contours on the site plan provided to us during our previous. work at the site. 5. The exploratory boring and pit locations and elevations should be considered accurate only to the degree implied by the method used. 6. The lines between materials shown on the exploratory boring logs represent the approximate boundaries between material types and transitions may be gradual. 7. No free water was encountered in the borings at the time of drilling or in the pits when excavated. Fluctuations in water level may occur with time. 8. Laboratory -Test Res.ul.ts. WC = Water Content (%) -200 = Percent passing No. 200 sieve DD = Dry Density (pcf) LL = Liquid Limit (%) +4 Percent retained on No. 4 sieve PI = Plasticity Index (%) 4 268 93 ChenONOrtherh, Inc. Legend and Notes Fig. 3 t i O t0 O N N MO Y o_ N O1 O Yr tip = d � ' II O Y w m L O > L 0) O 2 n w w v- o ol 0 o J Lo lo to n N 'OOao Y a > v w v M II N C, O M 1 CD N l0 } 1 1 n i 1 Y N �0, d W LO M M O 0 N > N M t0 .•-� •-+ 3 I M O r- 11 _> W N I'O CO N W (t N N C14�� II II ��o \ It II O \ l0 \ LO I- CID�+ V U O 3 0 N U O N O M :m I N N N to n v o > v w o In o o LO o N N m laa� - 41dap m V V r APPROXIMATE SCj I".= 100 ,767e HOLE 18 -700 PROFILE AP 1 `PIT 2 PIT O 0 ■ O HOLE 19 'G'y HOLE 17 P 3 PIT I HOLE 16� % O 01f EXISTING POND INS THIS AREA LEGEND: ■ EXPLORATORY PIT FOR THIS STUDY. Zp PERCOLATION TEST HOLE FOR THIS STUDY. 0 EXPLORATORY HOLE DRILLED FOR JOB NO. 4 282 84 , DATED AUGUST, 1984. NOTE: CONTOURS TAKEN FROM PLAN PROVIDED FOR JOB NO. 4 282 84 LOCATION OF EXPLORATORY PITS 4 268 93 ChenNorthern,Inc. AND PERCOLATION TEST HOLES Fig. I Job No. 4 268 93 TABLE I PERCOLATION TEST RESULTS WATER WATER LENGTH DEPTH AT DEPTH AT DROP IN AVERAGE HOLE OF START OF END OF WATER PERCOLATION HOLE DEPTH INTERVAL INTERVAL INTERVAL LEVEL RATE NO. (In.) (Min.) (Inches) (Inches) (Inches) (Min./Inch) P-1 67 10 8 6 1/2 1 1/2 6 1/2 5 1 1/2 5 4 1 water added 9 1/4 7 1/4 2 7 1/4 5 3/4 1 1/2 5 3/4 4 3/4 1 4 3/4 3 3/4 1 3 3/4 3 3/4 3 2 1/4 3/4 12 P-2 63 1/2 10 9 7 3/4 1 1/4 7 3/4 6 3/4 1 6 3/4 6 3/4 water added 9 8 1/4 3/4 8 1/4 7 1/2 3/4 7 1/2 7 1/2 7 6 1/4 3/4 6 1/4 5 3/4 1/2 5 3/4 5 3/4 16 P-3 50 10 water added 9 1/4 8 1 1/4 8 6 1/2 1 1/2 6 1/2 5 1/2 1 10 1/2 9 1 1/2 9 8 1 8 7 1 7 6 1 6 5 1 5 4 1/4 3/4 11 FEP CAW ON t��7A\TF—Asl / | / / � | National Association of Wastewater Tra nsporters, Inc. do �94 Onsite Wastewater Treatment System Inspection Report ii pni 5j .1CM! ('00Y LO: Addrc- tkMOV AU& I'f Phone: . ..... General Information: (Obtakit�. 11111cl, as pnsIji[)Je when inspection orderc,d ;tee of "asti:�Jater LrC"ItHIC111 systell): --. 2l I .- --- years. Questionnaire C.0111I)ICIC(I'! 0-jarbage CIISVOSad tOW111i 1pool hath `)Cleaning service In -home business: type Jye; V.No Flow Ineter: `).Yes �Swo TeMl jjjjltv.,, of, peciple ocetipying dwelling: CLI). V' If CtIJ-1-critIV U11OCCUPiCd, fOr IIOW long hius, it been "'acant?- ninnifis n ch Xurnbe, ;f ivelling: of )YO, )"o UUKML Y'llm%ut repairs made In OIL, "'v"Wi1v I I las I hc system receiiLly been inspected by offit, If so, who? .----..--.—.did it Fail? -')NNo i 1� there asel-vice contract for system components` ColnPaTIV7 Dai 4Nc\ cr ' - the treatment tank last pmnped� to my kjw�,� le -de At �r�hat trequency'! Comparly: )The above information is true t -st)of m'), knowledue. Dme: A"I"11tionA Conluien.'s National Association of Wastewater Transporters, Inc A. :1:6 - 17 z 15 i NAWT Inspector Training/Certification Program 63 B. System Type . ; Components of Wastewater Treatment System - complete as necessary ® Pretreatment Unit l: V1,N-b'C'\C_ 5\-p1Z% gal ons )r 4aI per day (gpd)) Purnp: Pump tank l :i gpm/ tdh [ ] [ allons) ® Pretreatment Unit 2: �Pt,A��e« -cwy w�P • [ i o00 F6.LIMIO' or gal per day (gpd)] =) Pump: Purnp tank 2: ! gpnv tdh ( ) f gallons] Sail Treatment Unit: _ 5� t '�_r_� [) [square feet] ® Additional Components: 3.�t) Ciray water discharge'? ® ONone OSurface OSubsurface discharge 3.b. i Foundation drainage system? ;7None OSurface OSubnurface dischargc ® .J Comments: ® C. Evaluation Procedures: Check the appropriate boxes. Locate, access, and open the septic tank cover. 0 yes O No ® I C at grade, is the cover "secure`'" O Yes 0 No Ci1S c_.AL 6,ti,-;e l $ Can surface water infiltrate into the tank? O yeNo :fin\ indicators of previous failure? O Yes 0 No ® Inspect lid, inspect level, measure sludge and scum, check effluent screen. O Yes O No Run ari operation test 0 Yes O No ! Gallons added in the test: Z�;b _ _ gallons 11 .applicable, pump out primary treatment tank, # Yes ,O No I-.,isten and observe for backflow into the tank from the outlet pipe. (: onunents:._'�-qQ..._.__t:1L%,�?lxT.� ----- - --- _ __ C'crr-rtion: L?o reot Purnp treatment tank: if there: is evidence o/'u m,,, fAnction in any portion o/'thc> systcrrr. Inspect the condition of the primary treatment tank 0 Yes O No .,or cracks, infiltration, deterioration, or damage) Md the integrity of the inlet and outlet baffles (for deterioration or damage) 0 Yes O No r NEVER enter a tank unless proper confined space entry procedures are followed! S Does the system contain a dosing or pump tank, ejector or grinder purnp? O Yes 0 No I Did you check integrity ofthe tank (cracks, infiltration, etc.)`, 0 yes ;',7 No . Is the pump elevated off the bottom ol'the chamber'? 0 Ycs O \t7 A Does the pump work'.) - l'c: 7 No Vi/A i National Association of Wastewater Transporters. All rights reserved. Not for reproduction. 64 Inspection Manual for Onsite Wastewater Treatment Systems II•there is a check valve, is a purge hole present? 0 Yes 7 N( MA Is there a high water alarm? O Yes 0 No (UA Does the alarm work? 0 Yes '7 No A 14 Do electrical connections appear satisfactory) C) Yes `D No W/A Did you clean the pump tank? O Yes :-) \o IIJA Probe the soil treatment area to determine its location Yes J No and to check tax• excessive moisture, odor, and/ or etfiucnt. rope of distribution: - ObGravity C) Pressure Is There: Any indication of a previous failure? 0 Yes 0 No Seepage visible oil the lawn? 0 Yes *No Lush vegetation present? 46 Yes 0 No Ponding water in the DistribUtion media? O Yes *No Even distribution of effluent in, the field? 0 Yes C) No Determine distance between water well and soil treatment area. Distance is feet. Explain answers as necessary: --n4i. t-i ►x v 3� �ty� i A � a � gv.' i ;� '1':v'ti iti i✓-i f-t.V', ��rCb� •,A«,..�`.� tac:i tL- k��Ns� � t"��i D. Sketch of System For reproducible results, show dimensions from structures that will not change, such as corners or the house - S how details, such as the road, in relation to the house to y(yct the correct orientation_ hr�tu 'All 11,111, I.,,r .,.,,, NAWT Inspector Training/Certification Program E. Checklist Summary Pretreatment Unit 1 is in Acceptable O Unacceptable condition. Pretreatment Unit Z is in Acceptable; O Unacceptable coiufition. O N/A Comments: i Pump and pump tank I is in O Acceptable O Unacceptable condition. ®NSA Pump and pump tank I is in O Acceptable O Unacceptable condition. N/ A Comments: i Soil Treatment area is in #,Acceptable Con-ments: F. Company Disclaimer O Unacceptabic condition. B;i ed on what we were able to observe and our experience with onsite wastewater technology, we submit this Ci,tsitc Wastewater Treatment System Inspection Report based on the present condition of the onsite wastewater u e fitment system. �^, :i 4. _:�;,las not been retained to warrant, guarantee, or certify the proper ili,ictioning of the system for any period of time in the future. Because oi'the numerous factors (usacle, soil characteristics, previous failures, etc.) which may effect the proper operation of a wastewater treatment sys- trrn. this report shall t be construed as a warranty by our company that the system will function properly for anti particular buyer. DISCLAIMS ANY WARRANTY, either expressed or implied. aiJiily from the inspection of the wastewater treatment system oi• this report. We are also not ascertaining the impact the system is having on the environment. Inspecting Company ` 61 I'hone:(`M) ) s_ 127_3cl National Association of Wastewater Transporters. All rights reserved. Not for reproduction. ' ty Systems Cleaners Reporting Form (Please Print) game of Systems Cleaner 16--Pi i QC - dame of Service Person \ )A_Q:X'�S r 2� c Date of Service (f- 7_4 = OA Date of Installation '7i t1�iiJ �`{ � , Property Owner j?)jNiJi_- 0vJ O`e-0 - UN et\ NIA- -- Telephone # 6k6 -7a,;, Phvsical Address �5 `� 1 Rid �N`YbtJ UZI�- CCJvv�lt Lot x Subdivision _— Estimated Tank Size 1 NO WOO Ci -Rz c S Material of Tank �r-I V ## of Manholes 4 _ Depth to Manhole Covers Estimated Volume Pumped _21. -C_' # of Compartments Sludoe Thickness `2-�A inches Scum Thickness _ �_ inches Baffle or Sanitary Tee in Place' Inlet_ Outlet UNK Effluent Filter in Place? Y N (,Required after 6/2000) DosinL,� Mechanism Pump Siphon _ None Dosing Mechanism / Alarm Functioning Properly Y N Previous Pumping Date, if known Location of Septage Disposal General Comments (include any signs of failure and all work in addition to pumping) Sketch (Location of Tank) I G< _ 0 tu, -:11der section I63,0 .0? (l)) of the Summit Count) ISUS Reeulations, holders of Systems Cleaner Licea se nntst report to the Fnvi enutl health Department eac t ISDti ahi h s cic;uiai. eet 11:ed m inspected rot more than thirty (30) days after such service is performed. cerOtA th:.tt to the hem of nt)knoxN ledge the above information is true and correct,. - - Date 6 � Z� \ 4 1225, Tax Parcel #1941-244-02-003, Lot 11 JOB r Red Canyon Estates, 1591 Red Canyon Road Gibson JOB NO. /1AJ B LACATtON BILL TO DATE STARTED DATE COMPLETED DATE BILLED t c G� �- JOB COST SUMMARY TOTAL SELLING PRICE TOTAL MATERIAL TOTAL LABOR INSURANCE SALES TAX MISC. COSTS TOTAL JOB COST GROSS PROFIT LESS OVERHEAD COSTS OF SELLING PRICE NET PROFIT JOB FOLDER Product 278 ®p NEW ENGLAND BUSINESS SERVICE, INC., GROTON, MASS- 01471 JOB FOLDER Printed in US.A.