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FLOWS AND LOADS <br /> AFFIDAVIT 374739 <br /> Legal Description: �y <br /> Gov't Lot �5 Secti\on/ 7 T Z/o N, R /S'W S <br /> IN <br /> Lot L Block_Subdivision or CSM V. a P.Sg fce'137 RECEIVED AND RECORDED <br /> Parcel ID# 0141 %07 07 00 Township ✓ceksen MAY - 6 2005 <br /> Property Owner Seven //ef.er T <br /> 9:30 A.M. <br /> Mailing Address //f Rose/4 wo, Rae w,, REGIS EEO <br /> City, State,Zip l'i oseviffe P441 Silly <br /> 1 (we) do hereby acknowledge that the use of the existing private onsite wastewater treatment <br /> system (POWTS), as installed on the above described real estate is based on the following <br /> flows and loads: <br /> gallons per day <br /> mg/L BODS mg/L TSS <30 mg/L FOG (monthly average of each) <br /> Furthermore, I (we) acknowledge that the modification to the structure served by the existing <br /> POWTS will not result in a change that affects the wastewater flow or wastewater contaminant <br /> load beyond the maximum capabilities of the existing POWTS and the following flows and loads <br /> shall not be exceeded: <br /> /SO gallons per day aX persons (maximum occupancy for structure) <br /> 2Z.0 mg/L BODS < 1570 mg/L TSS 4 30 mg/L FOG (monthly average of each) <br /> I (we) hereby state that should the flows or loads increase beyond those indicated, the POWTS <br /> shall be modified to conform to all applicable rules. 1 (we) also state that should the existing <br /> POWTS show any signs of failure in any component of the POWTS, said POWTS shall be <br /> repaired or replaced according to applicable rules. <br /> Owner Name(Print) Subscribed and swom to before me on this date: <br /> Srieven /yo er <br /> Notaril Owner Signatur Notary Signatur <br /> y mission e�i� ,v, <br /> 0 3: <br /> o s� <br /> �-,+' <br /> I'II <br /> Drafted BY_Sti'iwCn turn.. 'r,`'<., r' . <br />