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,ETTR'EA( r� County <br /> j('i Private Onsite Wastewater Treatment os Burnett <br /> Systems ( POWTS) Inspection Report <br /> Sanitary <br /> (Attach to Permit) Permit No: <br /> Industry Services Division <br /> General Information SAN-24-69 <br /> Personal information you provide may be used for secondary u oses Privacy Law,s.15.04 1 m <br /> Permit Holder's Name: Lj City Lj Village id Town of: State Plan Transaction ID#: <br /> Voyager Village POA (DHI Holdings LLC) Jackson 658524 <br /> CST BM Elev: Insp BM Elev: BM Description: Parcel Tax No: <br /> Nail in 13" red pine 7497 <br /> Tank Information setback to: <br /> TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road <br /> Septic Infiltrator 1000 +2' NA NA N/A <br /> Dosing N/A <br /> Aeration N/A <br /> Holding <br /> Pump/Siphon Information Elevation Data <br /> Pump Manufacturer Pump Model Demand STATION BS HI FS ELEV <br /> Filter Manufacturer Filter Model GPM Benchmark 1.14 101.14 100 <br /> Tuf-Tice EF-6 <br /> TDH Lift Friction Loss Head Total Bldg.Sewer 3.6 97.54 <br /> Forcemain Length Dia Dist.To Well Tank Inlet 4.0 97.14 <br /> Tank Outlet 4.37 96.77 <br /> Dispersal Cell Information Dose Tank Inlet <br /> DIMENSIONS Width Length #of Cells Dose Tank Bottom <br /> 3' 66' 2 <br /> SETBACK FROM Prop.Line Building Well OHWM Inst.Contour <br /> +5' NA NA NA <br /> Header I Manifold <br /> Type of Cell Manufacturer: <br /> Distribution Pipe 4.32 96.82 <br /> Chambers Model Number: Infiltrative Surface 5.24 95.9 <br /> Pretreatment Unit Final Grade <br /> Manufacturer: <br /> Model Number: <br /> Distribution System X Pressure Systems Only <br /> Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes <br /> Length Dia Length Dia Spac Spacing ❑Yes ❑No <br /> Soil Cover <br /> --T Mulched <br /> Depth Over Depth Over Depth of Seeded/Sodded <br /> Cell Center Cell Edges Topsoil ❑Yes ❑No ❑Yes ❑No <br /> COMMENTS:(Include code discrepancies,persons present,etc.) <br /> 16 chambers in each row. No well or building at inspection. <br /> Plan revision required? ❑Yes I7 No O6 19 �!�2J4 1565671 <br /> Use other side for additional information. <br /> Date POWTS Inspector's Signature License Number <br /> SBD-6710(R.03/21) <br />