The URL can be used to link to this page

Home My WebLink AboutIMPV-2-11-15227.TIF P� - a -i( - q3( Lp - saar1 0 0.5' (1) p l0 S 1 L jC_) epL 67 \Strk(ZC �a 5�� 1'l0c) DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Shed_ of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID it: _______ ,0N -SITE WASTEWATERSECITON COUNTY SOIUSITE EVALUATION f fP� - a for ON-SITE WASTEWATER SYSTEM 11 -93110 OWNER: APPLICATION DATE • ADDRESS: DATE EVALUATED: a / / / 1 PROPOSED FACII TY: PROPOSED DESIGN FLOW (.1949): • PROPERTY ST E: LOCATION OF S 1E: PROPERTY RECORDED: WATER SUPPLY: 0 Private ,,�, /„ ublic 0 Well 0 s i :. g 0 Other EVALUATION METHOD: lY Boring 0 Pit 1 Cut • • TYPE OF WASTEWATER: l Sewage 0 'Industrial Process 0 l xod • ss.i it E ce_ it ;;;;;+ ..i r.: ::e : ::ar: _ ...i .. _ � _ •;i•• :si:: 3i%i Siiii i- . is '•7.: �. aiiii�' — «.c::. •: i�:::. ....:::»: � ; ' »� »iii3Yiiciiii�i= ^i i._...... ttt ci s :iii "i a ..... ..F.« x._ . _.z.. ii %' es:: �:s::c::::s:: »su�:::::o«:: ":241:1 _ ..... - - ii � ::s:` :niu- stti�-«s 3 wii Eiiie x Yttt� sir. _; C:tSf::ii:f.w:p:: Ei yty�� '•�11iJ. ^'� • 22: '::::: : :.^.:' .:• .............. �.. ...— . ......._ . ...i'.:i::::::::. S is iii:t::.^.r : 5::::::^ iti: isi'« :»i.':::::::::::S».L•L';: ^5:::: �� .......::ii :i ......... ........« [- -_ - "^:::ti:rna ttu.•sr«:3i'u:•a:iie Crsi .::1_ - =••w: _ »s: ^sti:: ^:xr: ciiSf: 7. C1i: iLTriC •�v:i:�siis•:�c:: _ • �::::a:::::a::c::::: __ 1tSy�••• »C« _ SH:7 S ...._:::: ::::::: : :::..... . ». »..... «... «.. ;. - — i ^t.iii ^iii::' i «i. .. — :��.�• . :t - .::: € .... iii = i -.:' c - — :: r.: • ..... = Simi ar= ..« .. _.... «...._....«. . •: ��::_m. »:......::: »_:.�i�� i�-:ss « :�::::::: - :i�� ii... T ^Esi ::: tt��ii :a i °Eii�.�iE" :� .y «..... ..._ .. a�bett!M` ....:i�.z�. °a� =i �� :::::•x.:ri:: «.... :::... : •::: .....» .... Wi t..... «.... «:: ....� f � i:11 = DS1'0}]1T - : ::t L:R �"�R . • iii:::: ^ i : . .... ^: ��•7�•� Ste• ��\ ii . «_ ... 71+0. / XY>« .�a ... «.... ..... :•:: ii.: '�{4 'i i.^ieF.Y..f.�!(f!:`ii L�• ........t:c- i= ...ii ?ii ........._.e — ..__ «...« .. i::: s.... .._ ................._........ « .: «_. S 0 'go r,- cL S� , �r • 4 , o " PS • 1 Sv /b 3 • • • • 2 . • • 3 • 4 • • DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTTER FACTORS (.1946): F5 Arai�able Space (1945) 5 SITE CLASSIFICATION (.1948): f S r' EVALUATED BY: S ` 9' S�'riem Typos) rte t OT fER(S) PRESENT: Rate LIAR , 3 cO 4JNrs: G -e' 61.