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� <br /> - ' SEPTIC SYSTEM INVENTOR Y <br /> --- -- --- - --- _ -- - _--- - - --_ __- - - --_ . <br /> Address: 40 Smith Ave. PID: 02-117-23 21 0002 <br /> Bui�ding Typ residence #BRs/GPD: 2 #Systems 1 Units Billed 1 <br /> Permit#: none Date of Permit: Installer: owner? <br /> System Type wide trench Experimental: no Appliances <br /> SYSTEM CONDITION <br /> Conformity: 3 Tank Condition: 6 DF condition: 12 Failure Pot: high <br /> SEPTIC TANKS <br /> Material: concrete block Capacity: 800 , <br /> Setback to Bldg: 40 Cesspool: unknown <br /> DRAINFIELD <br /> Length of Lines 200 # Lines: 1 Trench Width: 6 <br /> Treatment Area: 1000 Type of Filter rock Soil Boring: yes <br /> Tile Size: Under Tile Perc Rate: <br /> Setback DF-Bldg: 100 DF Ht above Wt: 0 <br /> Soil Type: Limitations: water table <br /> WELL DATA <br /> Setbacks - Well-Tanks: 50 Well-DF: 100 Report in File yes <br /> Pump Type: subm. Depth: 112 Diameter: 4 Method: drilled <br /> INSPECTION RECORD PUMPOUT RECORD <br /> DATE DESCRIPTION COMPLIANCE DATE GALLONS <br /> 8/13/81 no surfacing 2 5/1/86 1200 <br /> 7/30/86 no surfacing 2 4/3/92 800 <br /> 7/14/88 no surfacing 2 4/2/93 800 <br /> 9/27/90 no surfacing-need risers,pump tanks 2 6/25/96 500 <br /> 4/3/92 line cleaned between tank and drop box 2 <br /> 4/21/94 DF surfacing 3 <br /> 12/2/97 DF surfacing-pump tanks now 3 <br /> 7/13/98 non-compliant-slight surfacing,repair 12/ 3 . <br /> 7/11/00 noncompliant,connect to sewer 12/31/20 3 <br /> I/' 1/O` �(_4,�`��'�LIC1� , ll ��V.��.� <br />