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-dweliing or eetabtiahment� - .l u • � u •,� <br />Any "M" answer above lndieatm the system is <br />an Imminent Threat to Public Health and Salary. <br />OammentsfF�rplertaiiort: <br />2. Tank Integrity - Compliance component #2 of 5 <br />Campfiance criteria:.-� T �_ <br />System consists of a seepage pit, ❑ Yes E No <br />cesspool, drywell, vrleaching pit. <br />Saepaga PfLs rneering 70802W May ae <br />nvn ant ii alfowwf`r1_ zca-1-j anae._ <br />Sewage tank(s) leak below they ❑ Yes 0 No <br />cleslgnedoperaUdepih. _ <br />If yes, wN0h aewego tank(s) leaks:_� -___. <br />r4nY `yes" answer above indicates the <br />system Is Failing_to Protecf Groundwater. <br />Comments tExplanafion <br />On VIM, Elmer J. Peterson Co, pumped tanks. <br />❑ System requires -emergency' pumping <br />Q Performed dye test <br />Cl Unab;e to verity i&o CemmerrfsrExparatian) <br />❑ other methods not fisted (See Canrmert+cxB:anat. .^.,1 <br />Verification method(s); <br />© Probed lank(s) bonom <br />Examined construction records <br />Examined Tank Integrity Form (dreaJ,) <br />Observed liquid level belaN operating depth <br />E -mined empty {pumped) tanks(s) <br />'! Probed outside tank(-) for'blar-tr so&' <br />t-matw to Verify (See Co.�isrn:slEa¢ienc,Up' n% <br />C-1 011ier methods not listed (See comrrantarExpbnaGo,�r <br />3. Other Compliance Conditions- compliance component 93 of -S <br />a. Maaztteltance hate covers are damaged, pocked, unsecured or appear to structurally unsound. tom' Yes' ❑ Na p UNmw.n <br />b. Other issues (OW& ralhaxnals, etc.) to immediately and adversely impact publiaheatth or safety. C] Yes' []NO rj tmknarvn <br />°System is an'MRW nt threat to PuWk haafth and satsiy <br />Explain: <br />9ystom is non-pmWctive of gm-ed;vator for other condikns as detemllned by Inspector L-1 Ycs' Ll Nn: <br />'System Is ffi lug to Protectgrnundwater <br />Explain: <br />vrww.gca.sW[e.mn.tyg - A5t-296.53gq - e0o•rb7MA T - 37Y 6511-282.5332 or 90-6573264„vn;.aS:W r, alcrrnarive fari�ars <br />coq--wis64.3t TIZ4112 Pogo 2 u1 3 <br />