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HomeMy WebLinkAboutTavenner Lots Gainesboro District - Backfile� l ?si t ?. a 4 0 T'- Department of Health ROCKBRIDGE SQUARE SHOPPING CENTER 131 WALKER STREET DIVISION OF DRINKING WATER LEXINGTON, VIRGINIA24450-2431 Lexington Environmental Engineering Field Office PHONE: (540) 463-7136 FAX: (540) 463-3892 December 4, 2002 SUBJECT: Frederick County Water — Tavenner's Trailer Court Ms. Jean Rosenfeld Tavenner Trailer Courts, Inc. 3304 Edenvale Road Fairfax, Virginia 22031 Dear Ms. Rosenfeld: Enclosed you will find Commonwealth of Virginia, Department of Health, Amended Waterworks Operation Permit No. 2o69725 with an effective date of November 19, 2002. This permit is your authorization from the State Health Commissioner to operate the public waterworks serving the Tavenner's Trailer Court, located in Frederick County, in accordance with Part II of the Waterworks Regulations. You will note that the permit indicates that this water supply has a design capacity of 81 connections. This permitted design capacity is the maximum system capacity based on Part III of the Regulations and shall not be exceeded. This amended watenvorks operation permit replaces and nullifies Permit No. 2o69725 dated May 24, 1991; therefore, it is requested that Operation Permit No. 2o69725 dated May 24,1991 either be destroyed and this office advised of its destruction or returned to this office. We look forward to your continued cooperation in the maintenance and operation of this public waterworks. If you have any questions regarding this matter, do not hesitate to contact me. Very truly you jtl�a I Harold T. Eberly District Engineer HTE/bt/021204o6 cc Frederick County Health Department / County of. Frederick - Attn: John Riley VDH — Richmond Central VDHOF =HEALTH NT ftkdkg You and Your Enriwwwo WWW.VDH.STATF.VA.()S COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH DIVISION OF DRINKING WATER WATERWORKS OPERATION PERMIT TAVENNER TRAILER COURTS, INC. IS HEREBY GRANTED PERMISSION TO OPERATE A CLASS VI COMMUNITY WATERWORKS I IAVING A DESIGN CAPACITY OF 81 CONNECTIONS AT TAVENNER'S TRAILER COURT, LOCATED IN FREDERICK COUNTY, IN ACCORDANCE WITI I TIIE PROVISIONS OF TITLE 32.1, CHAPTER 6, ARTICLE 2, SECTIONS 32.1-172 AND 173, CODE OF VIRGINIA, AS AMENDED, AND 12 VAC 5-590-190 AND 12 VAC 5-590-260 OF TIIE WATERWORKS REGULATIONS OF TIIE VIRGINIA DEPARTMENT OF I IEALTH, AS AMENDED. THIS PERMIT IS ISSUED IN ACCORDANCE WITH PREVIOUSLY ISSUED PERMITS: NONE (SEE ENGINEERING DESCRIPTION SI-iF.FT DATED NOVEMBER 19, 2002); AND WITH THE UNDERSTANDING THAT TIIE OWNER WILL OPERATE TIIE WATERWORKS IN ACCORDANCE WITH PART II, "OPERATION REGULATIONS FOR WATERWORKS", OF TIIE WATERWORKS REGULATIONS OF THE VIRGINIA DEPARTMENT OF HEALTH AND ANY VARIANCES AND/OR EXEMPTIONS NOTED BELOW. VARIANCES AND/OR EXEMPTIONS GRANTED (X) NONE O SEE ATTACHED AN ENGINEERING DESCRIPTION SHEET IS ATTACHED DATED NOVEMBER 19, 2002 PERMIT NO. 2069725 EFFECTIVE DATE NOVEMBER 19, 2002 APPROVED: DIRECTOR, DIVISION OF DMNKIW WATER/ FOR THE STATE HEALTH COM IONER PURSUANT TO VA CODE § 2.2-604 EXPIRATION (REV. 03102) INSTALLATION: COUNTY: LOCATION: OWNER: OPERATOR: PERMIT NO.: DATE ISSUED: STATE DEPARTMENT OF HEALTH ENGINEERING DESCRIPTION SHEET Tavenner's Trailer Court Frederick DATE: November 19, 2002 CERTIFIED CLASS: VI TYPE: Community On State Route 679 (Indian Hollow Road) approximately 0.2 mile west of the intersection of State Route 679 and U.S. Route 522 Tavenner Trailer Courts, Inc. Tavenner Trailer Courts, Inc. John Miller, Manager TELEPHONE: 54o/662-2412 2o69725 Amended May 24,1991 and November 19, 2002 TYPE OF TREATMENT: Chlorination SOURCE: Four Drilled Wells DESIGN BASIS: 81 Existing Connections DESCRIPTION OF SYSTEM: The source of supply for this system consists of four drilled wells and two hydropneumatic tanks - one 120-gallon tank and one 422-gallon tank. Well No. i (Blockhouse) is located on the right side of the eastern or back entrance road to the trailer court. It is drilled to a depth of 220 feet, cased to a depth of 50 feet, and cement grouted to a depth of 50 feet. The extended well casing terminates approximately 8 inches above a concrete floor and is equipped with a sanitary seal, sample tap, and check valve. Water is pumped from the well by means of a 2 hp submersible pump through a 40-gallon chlorine contact tank to the 12o-gallon hydropneumatic tank, thence into the distribution system. A 15 gpd hypochlorinator injects a chlorine solution from a 30- gallon solution tank into the well discharge line. The well, hypochlorinator, and exposed piping are enclosed in an 8-foot by 8-foot cinderblock building provided with a concrete floor. The purported well yield is ioo gpm. Total water production is metered. Well No. 2 (Church) is located adjacent to the church on State Route 679 near the western or front entrance to the trailer court. This well has been disconnected from the water system and is no longer used as part of the water system having been declared surface influenced in June 1994• Well No. 3 is located in the extreme northeast corner of the trailer court. The well has been capped and is no longer used as part of the water system. Well No. 4 (Ballpark) is located 800 feet south of the intersection of the park's back entrance road and State Route 679 and approximately 250 feet southeast of Well No. 1. The well is io inches in diameter to a depth of 103 feet and 6 inches in diameter from a depth of 103 feet to 700 feet. It is drilled to a depth of 700 feet, cased to a depth of 103 feet with 6-inch steel casing and cement grouted to a depth of 103 feet. The well casing terminates approximately 12 inches above a 6-foot by 6-foot by 6-inch concrete pad and is equipped with a pitless adapter, watertight well cap, screened casing vent, sample tap, air release valve, drawdown gauge, and waste discharge (blowoff) line. Water is pumped from the well by means of a 5 hp, 12 stage, 70 gpm at 190 feet TDH submersible pump to the 422-gallon hydropneumatic tank, thence into the distribution system. A 15 gpd hypochlorinator injects a chlorine solution from a 3o-gallon solution tank into the well discharge line. The extended well casing is unprotected while the hydropneumatic tank, hypochlorinator, and exposed piping are enclosed in a 12-foot by 12-foot by 8-foot masonry well house provided with a concrete floor, heater, and 4-inch floor drain. Well pump operation is pressure switch controlled, while hypochlorinator operation is synchronized with well pump operation. Reported well yield, based on a i2o-hour yield and drawdown test, is 70 gpm. Total water production is metered. Design Basis - The design basis for this system was based on the following data: Source Capacity: Yield Pump Well No.1 10o gpm unknown Well No. 4 70 gpm 70 9Pm 170 gpm 70 gpm Source capacity will be limited by yield for Well No. 4 and unknown pump capacity for Well No. i; therefore, source capacity will be 56,000+ gpd (140 connections x 400 gpd/connection). Storage Capacity: (120 gallons + 422 gallons)(1/3) = 18o gallons @ 200 gal/connection = 1 connection Existing: 81 connections The design capacity for this system is storage limited; therefore, the design capacity will be limited to the existing 81 connections. HTE/bt TAVENNER TRAILER COURTS, INC. 3304 Edenvale Road Fairfax, VA 22031 (703) 359-4741 November 6, 1998 Mr. Ron Miller 308 Virginia Avenue Winchester, VA 22601 Dear Mr. Miller: We have received a complaint from the Building Code Inspector of Frederick County, VA that you are conducting a business out of the building at Tavenner Trailer Courts and that someone is living in the building. The building was rented to you for storage use only. If you are using it to conduct a business, please stop immediately. Also, please make sure no one is living in the building. We do not want to be cited for building code violations or assessed fines for the violations. Also, our insurance does not cover the building for a business use or if someone is living there. If you need a building to conduct a business rather than for storage, then we will no longer be able to rent to you. If you have any questions, please let me know. Yours very truly, Jean Rosenfel TAVENNER TRAILER COURTS, INC. Telephone (703) 359-4741 3304 Edenvale Road Fairfax, Virginia 22031 November 10, 1998 Mr. John Trenary Building Code Official Frederick County 107 N. Kent Street Winchester, VA 22603 Dear Mr. Trenary: Enclosed, for your information, is a copy of the letter to Ron Miller concerning the use of the building at Tavenner Trailer Courts in Winchester. We will check in a few days to make sure that Mr. Miller is no longer conducting business from the building and that no one is living in the building. If additional information is needed or if we need to take any other steps to insure that we are not in violation of the Code, please let me know. Yours very truly, i ,Jean Rosenfeld +� `fMlYll�: Er :. riti�i LEXINGTON REGIONAL OFFICE Department of Health 129 SOUTH RANDOLPH STREET C. M. G. BUTTERY, M.D. Office of Water Programs POST OFFICE BOX 915 LEXINGI ON, VIRGINIA 24450 COMMISSIONER PHONE: (703) 463-7136 NOTICE OF VIOLATION October 19, 1989 SUBJECT: Frederick County Water - Tavenner Trailer Park Mr. Frank Tavenner Tavenner Trailer Court, Inc. 6521 Arlington Blvd., Suite 20 Falls Church, VA 22042 Dear Mr. Tavenner: This notice is to inform you that the Tavenner Trailer Park public water system is in violation of the Commonwealth of Virginia Waterworks Regulations. Samples collected during the quarter of July, August, and September, 1989 indicated. the presence of coliform bacteria in 50% (5 out of 10) of the 10 ml portions examined. The maximum contaminant level for bacteriological quality is exceeded when more than 10% of the portions tested in a given reporting period show the presence of coliform bacteria. In addition, the Tavenner Trailer Park water system is in violation of the Waterworks Regulations because the required "check samples" were not collected for the errant July 25, 1989 sample. You are required to collect at least two (2) "check samples" whenever coliform bacteria are detected in three (3) or more of the 10 ml portions from a single sample. Your attention is directed to Title 32.1, Chapter 6, Article 2, Sections 32.1-169, 170, and 176 of the Code of Virginia 1950, as amended. Also, you may wish to read Sections 3.11, 3.28.01,3.28.02, 4.04.01a, 4.05.02a, 4.05,03a, 5.10.O1a, 5.10.01f, 5.10.02 and 5.10.04a of the Waterworks Regulations. State and federal regulations require that you give public notice whenever the bacteriological quality does not meet drinking water standards. This notice must be mailed to each of your customers within three months. It can be included in the water bills or sent in a separate letter. In addition, within fourteen days of the receipt of this notice you must give public notice by publishing in three consecutive issues of a newspaper of general circulation in the area served by the water supply. You also must provide, within seven days, a copy of the notice to local radio and television stations for their use, if they so desire. Mr. Frank Tavenner Page 2 October 19, 1989 SUBJECT: Frederick County Water - Tavenner Trailer Park Attached is a draft of a notice which you may use if you wish. However, any changes made to the notice must be approved prior to your use of the altered notice. Upon completion of these notification requirements, please return the attached completion report and a copy of the notice from the newspaper. If you should have any questions, please do not hesitate to contact this office. Very trul y your , Harold T. Eberly District Engineer HTE/bt Enclosures cc Frederick County Health Department Lord Fairfax Health District - Attn: J. Weiss County of Frederick - Attn: J. Ril ey VDH - Richmond Central NOTICE TO CUSTOMERS OF THE TAVENNER TRAILER PARK PUBLIC WATER SUPPLY We have been advised by state health officials that we are in violation of the Commonwealth of Virginia Waterworks Regulations because a water sample collected from the Tavenner Trailer Park public water system in July, 1989 has caused us to exceed the bacteriological quality level for coliform organisms in drinking water for the quarter of July, August, and September, 1989. In addition, we have been advised that we failed to collect the required "check samples" for the errant July 25, 1989 sample. Bacteriological sampling is performed on a monthly basis for the Tavenner Trailer Park water system. The coliform organism is used as an indicator of bacteriological quality. While coliform organisms themselves are no threat to health, their presence does indicate that a source of contamination might exist somewhere in the water system. We are attempting to prevent further violations of this type by using additional care in the sampling procedure and by more carefully monitoring our sample results as they are received from the State Laboratory in order that additional samples may be collected when necessary. Future violations, however minor, will be reported to you as part of federal and state waterworks regulations aimed at increasing consumer awareness of con- ditions that exist in public water systems. Sincerely, (Your signature) i COMMONWEALTH of VIRCjINIA C. M. G. BUTTERY, M.D. COMMISSIONER Mr. Frank Tavenner Tavenner Trailer Park 5105-I Backl ick Road Annandale, Virginia 22003 Dear Mr. Tavenner: Department of Health Office of Water Programs NOTICE OF VIOLATION September 15, 1989 444; �\ V Si � V Adtnin►sfra►nr4MA WOO `� Gfifi►'` L N REGIONAL OFFICE 129 SOUTH RANDOLPH STREET POST OFFICE BOX 915 LEXING1 ON, VIRGINIA 24450 PHONE: (703) 463-7136 SUB JE CT : Frederick County Water - Tavenner's Trailer Park This notice is to advise you that the Tavenner Trailer Park public water system is in violation of the Waterworks Regulations because the required water sample for bacteriological examination was not collected from the distribution system during the month of August, 1989. One satisfactory sample must be collected each month. Your attention is directed to Title 32.1, Chapter 6, Article 2, Sections 32.1-169, 170 and 176 of the Code of Virginia, as amended. Also, you may wish to read Sections 3.28.02, 4.04.01a, 5.10.01f, 5.10.02 and 5.10.04a of the Commonwealth of Virginia Waterworks Regulations. State and federal regulations require that you notify your customers whenever you fail to collect the required water samples. This notice must be sent to each of your customers within the next three months. It can be i ncl uded with the water bills or sent as a separate letter. Attached is a draft notice which you may use. If you change the notice in any way, please obtain approval from us before mailing it to your customers. After the notice has been mailed to your customers, please complete the enclosed form and return it to this office. Mr. Frank Tavenner Pa ge 2 September 15, 1989 SUBJECT: Frederick County Water - Tavenner Trailer Park If you have any questions, please do not hesitate to contact me. S i nce r el y, tek Harold T . Eberly District Engineer HTE/bt cc Frederick County Health Department Lord Fairfax Health District - Attn: J. Weiss County of Frederick - Attn: J. Riley VDH - Richmond Central i EE r�FP20� t 4 NOTICE TO CUS TOME RS OF THE TAVENNER TRAILER PARK PUBLIC WATER SYSTEM We have been advised by State health officials that we are in violation of the Virginia Waterworks Regulations. This violation occurred because we did not collect the required water sample from the distribution system during the month of August, 1989. One sample is needed each month to determine the bacteriological quality of the water being served to you. We are attempting to prevent further violations of this type by collecting the required number of water samples each month. Future violations, however minor, will be reported to you as required by federal and state regulations. These regulations are aimed at increasing your awareness of the conditions of the water system which provides your water. (Your signature) COMMONWEALTH ©f VIRCjINIA k Ci'J � 1 'r FRvu'ER.tuK rn00 Department of Health L EXINGTON REGIONAL OFFICE 129SOUTH RANDOLPH STREET C. M. G. BUTTERY, M.D. Office of Water Programs POST OFFICE BOX 915 COMMISSIONER LEXINGI ON, VIRGINIA 24450 NOTICE OF VIOLATION PHONE: (703) 463-7136 January 18, 1989 SUBJECT: Frederick County Water - Tavenner's Trailer Park Mr. Frank Tavenner Tavenner Trailer Park 5105-I Backlick Road Annandale, Virginia 22003 Dear Mr. Tavenner: This notice is to advise you that the Tavenner Trailer Park public water system is in violation of the Waterworks Regulations because the required water sample for bacteriological examination was not collected from the distribution system during the month of December, 1988. The December 12, 1988 sample was too old when it arrived at the laboratory and the December 27, 1988 sample leaked in transit to the laboratory. One satisfactory sample must be collected each month. Your attention is directed to Title 32.1, Chapter 6, Article 2, Sections 32.1-169, 170 and 176 of the Code of Vier i n�i a, as amended. Also, you may wish to read Sections 3.28.02, 4.0T6Ia, �1O.O1f, 5.10.02 and 5.10.04a of the Commonwealth of Virginia Waterworks Regulations. State and federal regulations require that you notify your customers whenever you fail to collect the required water samples. This notice must be sent to each of your customers within the next three months. It can be included with the water bills or sent as a separate letter. Attached is a draft notice which you may use. If you change the notice in any way, please obtain approval from us before mailing it to your customers. After the notice has been mailed to your customers, please complete the enclosed form and return it to this office. Mr. Frank B. Tavenner Page 2 January 18, 1989 SUBJECT: Frederick County Water - Tavenner Trailer Park If you have any questions, please do not hesitate to contact me. Sincerely, C�L Harold T. Eberly HTE/b District Engineer Enclosure cc: Frederick County Health Department Lord Fairfax Health District - Attn: M. Tenney County of Frederick - Attn: J. Riley ✓ VDH - Richmond Central NOTICE TO CUSTOMERS OF THE TAVENNER TRAILER PARK PUBLIC WATER SYSTEM We have been advised by State Health officials that we are in violation of the Virginia Waterworks Regulations. This violation occurred because we did not collect the requiF—ewater sample from the distribution system during the month of December, 1988. Our December 12, 1988 sample was too old to analyze when it arrived at the laboratory and our December 27, 1988 sample leaked in transit to the laboratory. One sample is needed each month to determine the bacteriological quality of the water being served to you. We are attempting to prevent further violations of this type by collecting the required number of water samples each month. Future violations, however minor, will be reported to you as required by Federal and State Regulations. These Regulations are aimed at increasing your awareness of the conditions of the water system which provides your water. (Your signature) A?PLZCATION FOR TRAI" OR TRAILcEN R COURT it1CATICI :.N'ame of' Applicant L. '.', ���rn z ;.ar: t r; z'.'� Viy9nneic -j AddresG of Applicants. 15,)-0 Colu3 a ?:. r>ail.-w' ^:prods, Va. t l Name of Operator cr 1,.7'^?nn,:tr and ?'+.an'X. B. S ayl annex i Address of Operator: y.i;'}ii '.:..^.' s _—Pik Dzn. l,? - s Cro8sreadat Nunber of Trailers Proposed: R-`C"nansion if � r:': . 'v t -oaark to 70 P.rt33ent park has 210 trai.i�ars. Y xpansi. n 1970 would be 10 P.enalni.nt j 20 in tf'a "L.:i.tA�¢�, 'Plat OF trailer (COUrt)P lay nut 77 tea% facilltlew t j i As @joining property owner to the above named applicac��t, I do hereby agree to his (operating a trailer (court) in the ( having above proper, y. j Signed { } Sionatura of Applicant i Approval of Comrrtissiener of the Rcvenuazrc'.,,�--�''��'( f Approval or Poard of Supery sons: _ ;i:, y� �, t Es;`�t l3 1971, B0AIRD 0fUpE Date o; Approval: V�:OS 1 i i 0 :Z1 1-a it Ko 937 n ri P .... . . . ...... . +•fi/•-.•f V\/• f r, wa,w/ ..a a+.n ..m .-+'GL•wYe •fir Lf'0f i i%h - (1) Void after (12) twelve months. (2) Automatically ccncei'iad when site conditions are changed from those shown on permit. (3) Automatically cancelled should facts later become known that a potential hazard woul be c C. eated by continuing installation. / FHA/VA Yes �❑(No Date 2 Case No. Owner (1—�� f' / ' xJ C Address / 6' 416 Phone r, (Mailifn�g A(Ydress}j Occupant '2 Address r�2 J %('� Phone 7 (Mafl"i g Add— r�' Exact Location of premises r f, f°- 1 _ '2"Ir! � 7 ( Subdivision, Street or Road Name, Section or Lot No.) STALL ❑ REPAIR ❑ WATER SUPPLY SYSTEM gwjSEWAGE DISPOSAL SYSTEM FOf ❑.,T elling ❑ Other Actual or potential Bedrooms Automatic Washing Machine a[�-res [:]No Act lloI or estimated Water Consum lion `� p—gal. per day j� Go age D^isposay�Unit Yes [�No' Addjtional wastes ✓ «' Signature`'-9�✓j✓t�� �' ./ .%2��/C�'^.7�-t% Owner or Representati DETAILS OF SYSTEM r I Yes No (4) DETAILS OF CONSTRUCTION (1) � ATER SUPPLY (Existi Class Approved [:I[:] Watertight S®pt'c Tank of Other _ /" ?4,1 f n Inside Dimensions Length feet. (KQ of Material) 1 (Location & Class to be approved by Sanitarian.) L " Width ,c 4 _feet. Liquid Depth � r feet. Depth of Class Cased ft. to be grouted ft. Air Space __feet. Liquid Capacity�/GC ,..gallons. (Unless supported by positive evidence Class III is to be considered as to be installed.) (5) SUBSURFACE ABSORPTION FIELD Distribution Box re - A /2 n quired. Ditches of equal len gth re wired. (2) SOIL STUDY Naturally drained, 0 it'ble by sight [j 'es []No -) G , .. Technical Classification Number of square feet required Type aggregate required [J oken Stone ❑ Gravel Slag. Size range Rough Classification [-]Son dy 5�4edium Clay [:]Pipe from %2 inches to 2%2 inches. Dept of aggregate from base Clay. Percolation Test Required Yes El No. Rate - of tile to bottom of ditches a__inches. Allowable Minutes per inch. Depth of Water Table - feet fall 5-- to inches. Total aggregate must equal ���-' (Estimated) minimum depth of inches or more. Depth of drainfield Surface drainage required [] E� Yes I` Area Drainage not to exceed _'L—inches from surface of original ground. by Lowering Ground Water Table required 7yes E-T-14o Distance from well to septic tanker ` feet; distance from (3) HOUSE SEWER LINE Size inches. Type of material re- well to droinfieldfeet. quire d ��. Distance from Water Supply` -_feet. ✓. Rough Sketch of Premises (including adjacent properties if pertinent, Showing Trees; and Other Possible Sources of Contamination of Water Supplies, by Indic M of Lot Line, Buildings, Water Supplies, Sewage Disposal Systems, nice and Slope with regard to one another. Note: Owoer or his agent m st not �'' "� Health Department, Phan ,` ) when installation is ready for inspection. If a y Sew ge Disposal System, or part thereof, is covered before being inspected by the Health De, rtment, it shall be uncovered at the direction of the Health Director or his agent. CONDITIONS DISCOVERED DURING INSTALLATION MAY REQUIRE ADJUSTMENTS OF SYSTEM DESIGN. Changes from above specifications require Health Department approval before being made. Based on the above information, the undersigned recommends that this permit be issued. Date Approved g P Dote , � ,S gned / �� - I KY' fj�lll I. `. -, E V, 3;'7 t (Reviewing Authority) (Sanitarian or Health Director) V,;;-1 z,e Department of Health DUIPLIC ATE } (1) Void after 02) twelve months. (2) Automatically cancelled when site conditions are changed from those shown on permit. (3) Automatically cancelled should facts later become known that a potential hazard wLo Ie Bated by continuing installation. j I FHA/VA ❑ Yes j� No Date �' Case No. r r ( ,/ / / G Owner `-•-�^' .ti•" '"� -"'� �J�° Address ��� � Phone � '.,art , (MG, I* 1 dress) Occupant, ' ' Address `r /� 'a/ Phone r (Mciff ing Addr ss) Exact Location �„ J ' // of premises (.. l rJ i'Lr�.. ✓ 4 - 3 _ ( Subdivision Street or Rood Name, Sacty nor Lot No.) [_ ;STALL [] REPAIR ❑ WATER SUPPLY SYSTEM Li.} -SEWAGE DISPOSAL SYSTEM j FOR I ❑(.Dwelling ❑ Other Actual or potential Bedrooms Automatic Washing Machine [ZY.es []No Actual or estimated Water Consumption 4 gal. per day 1 Garbage Di sal•Un t ]Yes [;_Wo Additional wastes l/1- !� '' Signature "1_ t' ✓�, � ,� � �r ;41 Yes No (1) W/1TERr SUPPLY (E;i ' ) Class - Approved ❑❑ Other (Location & Class to be approved by Sanitarian.) Class Cased ft. to be grouted ft. (Unless supported by positive evidence Class III is to be considered as to be installed.) (2) SOIL STUDY Naturally drained, suiIt bfie by, sight [&eis ❑ No Technical Classification— 0"" Rough Classification ❑ Sandy []1� dium OClay Lj Pipe Clay. Percolation Test Required 7yes ]No. Rate Minutes per inch. Depth of Water Table f eet (Estimated) Surface drainage required ]Yes [yLWP Area Drainage by Lowering Ground Water Table required Yes �o G (3) HOUSE SEWER LINE Size inches. Type of material re- quired t . Distance from Water Supply__$_"feet. YSTEM (4) DETAILS OF JtONSTRUCTION Watertight Septic Tank of /'tf.vy '7 Inside Dimensions i Length _feet. (Kind of Material) �'"''�". , Width __feet. Liquid Depth L 7_"feet. Death of Air Space _feet. Liquid Capacity�'6%gallons•. (5) SUBSURFACE ABSORPTION FIELD Distribution Box re- - quired. Ditches of equal length required. Number of square feet required 40 C t' Type aggregate required [t]-$Token Stone Gravel' ❑ Slag. Size range - from Yz inches to 2Y2 inches. Depth of aggregate from base of tile to bottom of ditches inches. Allowable fall -2- to �_ inches. Total aggregate must equal minimum depth of �aLinches or more. Depth of drainfield not to exceed 3 -a inches from surface of original ground. Distance from well to septic tank feet; distance from well to drainfield feet. j Rywgh Sketch of rRremises (including adjacent properties if pertinent, Showing Location f Lot Line, Buildings, Water Supplies, Sewage Disposal Systems, -trees, and er�sible Sources of Contamination of Water Supplies, by Indicating pis ces and SVd e with regard to one another. 00 - ✓� /17 j 7^ �^ to f r Note: Owoer or his agent must n ify v ' 4 Health Department, Phone n ? ' when installation is ready for inspection. if any Sewage Disposal System, or Part t reof, is co Bred before being inspected by the Health Department, it sha I be uncovered at the direction of the Health Director or his agent. CONDITIONS DISCOVERED DURING INSTALLATION MAY REQUIRE ADJUSTMENTS OF SYSTEM DESIGN. Changes from above specifications require Health Department approval before being made. Based on the above information, the undersigned recommends that this permit be issued. - 1 Date Approved Date j! 6:gned REV. $17 i (Reviewing Authority) DUPLICATE, �a � r� � (Sanitarian or Health Director) 6,z?e Department of Health - 1J V 9��..�li�6Y�1G Z.,4Nd !''�CLE� 50 8 3 O/Ac. �s �o v GA Z74 00 7 Co i o/AC. kl J /052 t� J ' � W 0. 46 eAG . D. 874 • }- 0 14. 0 DO 97A rc f Pk�G�M/,vaky PLAT TrEUAVE,e LoTS f�e�dE,ex',��Co. YQ /Iduly /9GF3 LEE ,Q• E6E xT C.L.S. li L,4^'d Z,o N .7 ; fa { /. 0 /Ac . - 3 i �o• r W q �:�G A�. 4.87Ac. Ot O Q z i �o [ Q - i� i 7';q Y•C f fR�L�M/u�� y PLAT Tr.r,a,vE,e LoTs 6,44,,Nx J£Q aco QIJ`T �;��d,6, ,O 4 00. ✓a. //'�-/ao• /7✓li _�'" LEA A. Eitw7- C.L.S. tLER ot d 504. $4 d - LAo Z7o Qo tt 3 i t ' J ..J 0 14 Q i 0 { a i %;0 rG t T(EAiA)4z Go7s 6'.41 ,Asf ox p�sT J14 . LEE /Q . EL e P7- C . G, • S. WA C/ v a$ Z� �P i o � cv � 4 � >-- i 1 • L G, ?9 97A re t /40_ GO.d9 oa►u 7,vrru�vA e Lo- —s v � � .�c,��-- ��i�t6 s� ore o lJ•s 7"' /I✓� Ey lf4R U • Q, LEE A• Eder �. L.S 4TH,,e L 4 G 1600, I* G 4,4d r 3 0 / Rc. , 0 3 1 N J Age O i� ��� goo ";t� i� V a u•> ice` e � tD 17�{ o ;o '99 arc ,� .• Ro UTF' ' Co 7 °9 , f'R�L�N/AI.�Ry )GAT �` r��►t!!�c�i.Tfi'E,�sc�£K.. TrrLivt e Lo73 i,4',6 $U OR 0[/1V� 7'•�2,acT LQ / =/r�Q' /7,u1� /O a /10 i9r'B U N LEE %1. E6�-�;rT C•L.S. L,4,,v,2,1 • Tavenner Lots 0 Gainesboro District ROVk;D SUBD