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PAGE 1 OF 4 <br />Holding Tank Plan <br />Index & Cover Sheet <br />Component Manual Design References: <br />Version 2.0, SBD -10855-P (N. 03/07; R 01/12) <br />Pg 1 of 4 Index & Cover Sheet <br />Pg 2 of 4 Plot Plan <br />Pg 3 of 4 Holding Tank Specifications <br />Pg 4 of 4 Management Plan <br />Attachments: <br />Enclosures: <br />66WR 5 L <br />POWTS Application for Review <br />Soil Evaluation Report & Site Map (if ap <br />Holding Tank Pumping Contract if appii <br />Holding Tank Agreement if applicable) <br />Project Name / Description <br />OwnerName(s): bAV10 L � Cwurt+�A ,A. ANbeZSQAJ Phone: - - <br />plicable) <br />cable) <br />Owner Address: 13X3 (3o -A iz 0- A v (- , PW L- 1 A/W Zip: t5--"5, 1 /0 <br />Project Address: lo3gZ- '5-TH . 70 <br />Govt. Lot: 3 � �/ AtvJ 1/4 of 1 /4, Section 3 , T 3q N -R i E -� or W <br />Township: Al 9�L-NQA County: 13 U -PA &--tT <br />Project ParcellD#: 07-61�-z-3�-i� -3s-S ps-0o�f-d3s�oop <br />Designer Information <br />Designer Name: A Aoy4 a Phone: -711,S-- LIA6 - t ??S <br />Designer Address: ;ZS4q 1 Kt/vyo <br />E-mail: b It cie�Wg 1)U41 QW'. Co rn This <br />License Number: I95I-007 <br />Remarks: <br />Zip' S�3D <br />Signature: D Date: <br />eaCh 9"aW Copy. <br />aces +pct (br'VPNpvai stamp. <br />7 j:P1�',ir. <br />.,.... <br />• ra.a s <br />b : p� <br />