HomeMy WebLinkAboutSDP199200004 Sewage Disposal System Construction Permit 1991-11-21 . S
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Sewage Disposal System Construction Permit PAGE OF
Commonwealth of Virginia � Health Department • 101-91-0491
Department of Health •
Identification Number o'—cq — f 21
ALBEMARLE CO. Health Department •
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Map Reference
General Information
New ❑ Repair ❑ Expanded ❑ Conditional ❑ FHA ❑ VA ❑ Case No.
Based on the application for a sewage disposal system construction permit filed in accordance with Section
3.13.01, a construction permit is hereby issued to:
Owner EAST °I!''4NA FIRE CQ Telephone
Address p r1 pqx 157, CHARLOTTESVILLE, VA 22901
For a Type Sewage disposal system which is to...be—constructed on/at
SOUTH OF RT. 250 1 . 5 MILES tASi ubb �it.I .
Subdivision Section/Block Lot
Actual or estimated water use
DESIGN
NOTE: INSPECTION RESULTS
Water supply; existing: (describe) Water supply location: Satisfactory yes ❑ no ❑
comments
To be installed: class T To G.W. 2 Received: yes ❑ no ❑ not applicable ❑
cased -T grouted r
Building sewer: Building sewer:
I.D. PVC 40, or equivalent. Y ❑ no ❑ comments
q Satisfactory
Slope 1.25" per 10' (minimum).
❑ Other
Septic tank: Capacity gals. (minimum). Pretreatment unit:
❑ Other yes ❑ no 0 comments
Satisfactory
Inlet-outlet structure: Inlet-outlet structure: yes
PVC 40, 4" tees or equivalent. ❑ no ❑ comments
❑
Satisfactory
Other
Pump and pump station: Pump&pump station: yes
g ❑ no ❑ comments
No ❑ Yes
❑ describe and show design. Satisfactory
if yes:
Gravity mains: 3" or larger I.D., minimum 6" fall per Conveyance method:
100', 1500 lb. crush strength or equivalent. Satisfactory yes ❑ no ❑ comments
❑ Other
Distribution box: Distribution box: yes
Precast concrete with ❑ no ❑ comments
ports. Satisfactory
❑ Other
Header lines: Header lines:
Material: 4" I.D. 1500 lb. crush strength plastic or equiva- Satisfactory yes ❑ no ❑ comments
lent from distribution box to 2' into absorption trench.
Slope 2" minimum.
rl Other
Percolation lines: Percolation lines: yes
❑ no ❑ comments
Gravity 4" plastic 1000 lb.
per foot bearing load or Satisfactory
equivalent, slope 2" 4" (min. max.) per 100'.
❑ Other
Absorption trenches: Absorption trenches: es
Square ft. required : depth from ground surface Satisfactory y El no ❑ comments
to bottom of trench ; aggregate size
Trench bottom slope •
center to center spacing ; trench width I
Depth of aggregate Date Inspected and approved by:
Trench length ; Number of trenches
Sanitarian
C.H S.202A Revised 6/84
11-2
FILE COPY
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Health Department Identification Number 10 1_91_ '1 f
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Schematic drawing of sewage disposal system and topographic features. SAGE OF
Show the lot lines of the building lot and building site, sketch of property showing any topographic features which may impact on the design of
the system, all existing and/or proposed structures including sewage disposal systems and wells within 100 feet of sewage disposal system and
reserve area. The schematic drawing of the sewage disposal system shall show sewer lines, pretreatment unit, pump station, conveyance sys-
tem, and subsurface soil absorption system, reserve area, etc. When a nonpublic drinking water supply is to be located on the same lot show all
sources of pollution within 100 feet.
❑ The information required above has been drawn on the attached copy of the sketch submitted with the application.
Attach additional sheets as necessary to illustrate the design. .
6 A.CRES
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Pru:,I_,r,E,I-.I_i Parktri l
Fir N t iitiorl P.r Efa
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50, Prop Used
Class IIIB Well
6 0'
11
Stnetmri
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The sewage disposal system is to be constructed as specified by the permit ❑ or attached plans and specifications ❑ .
This sewage disposal system construction permit is null and void if (a) conditions are changed from those shown on the application (b) condi-
tions are changed from those shown on the construction permit.
No part of any installation shall be covered or used until inspected, corrections made if necessary, and approved, by the local health department
or unless expressly authorized by the local health dept. Any part of any installation which has been covered prior to approval shall be uncov-
�,,.„ ,. ;,»ered,if necessary, upon the direction of the Department. - . , . _
Date: Issued by: - This Construction
/ Sa 'ariaann/ Permit Valid until
Date: z /eviewed by: ' ✓',c w c//c--— 0 et_.-
Supervisory Sanitarian
If FHA or VA financing
Reviewed by Date Date
Supervisory Sanitarian Regional Sanitarian
C.H.S.2028 Revised 684 ll-2A
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