HomeMy WebLinkAbout781 STRATFORD RD APPLICATION FOR HOME AERATION OPERATIONAL/INSPECTIONAL PERMIT
THE DELAWARE CITY/COUNTY BOARD OF HEALTH, PURSUANT TO ITS AUTHORITY TO ENFORCE HEALTH STATUTES, REGULATIONS,
AND ORDERS, REGULATES HOUSEHOLD SEWAGE DISPOSAL SYSTEMS. UNDER SECTION 108(E) OF THE DELAWARE COUNTY
HOUSEHOLD SEWAGE DISPOSAL RULES: "THE OWNER OF ANY AERATION TYPE TREATMENT SYSTEM SHALL MAINTAIN AN
OPERATIONAL/INSPECTIONAL PERMIT FROM THE DELAWARE CITY/COUNTY BOARD OF HEALTH. FAILURE jO SECURE THIS
t
PERMIT WILL RESULT IN PR06ECUTION.
t_PO : ioua
Please indicate any changes in name or address: OENNIS & MARY LOU KNIOLA
781 STRATFORD RD •o
DELAWARE, OH 43015 •
Name of Owner:
Address:
City: State: Zip:
Phone: 3 .4 ' 7 C 1 ( Township: X'
Address of System:
For Departmental Use Only
Permit R: Receipt 0: sl tyZ
Nov 2 6 1990 APPLICATION FOR HOME AERATION OPERATIONAL/INSPECTIONAL PERMIT
THE DELAWARE CITY/COUNTY BOARD OF HEALTH, PURSUANT TO ITS AUTHORITY TO ENFORCE HEALTH STATUTES, REGULATIONS,
AND ORDERS, REGULATES HOUSEHOLD SEWAGE DISPOSAL SYSTEMS. UNDER SECTION 108(E) OF THE DELAWARE COUNTY
HOUSEHOLD SEWAGE DISPOSAL RULES: "THE OWNER OF ANY AERATION TYPE TREATMENT SYSTEM SHALL MAINTAIN AN
OPERATIONAL/IIISPECTIOIIAL PERMIT FROM THE DELAWARE CITY/COUNTY BOARD OF HEALTH. FAILURE TO SECURE THIS
PERMIT WILL RESULT IN PROSECUTION.
Please indicate any changes in name or address: If Different Than Resident:
r 1
LP#: 1306 Owner: —
Resident: - DENNIS & MARY LOU KNIOLA _ Address'
Address: _ 781 STRATFORD RD _ City:
City: DELAWARE, OH 43015 -I Phone: —
i
c
Phone: 31r� 7 Township:--_
For Departmental Use Only
.. / 067 Receipt 0:__ `SO$ I
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1 Permit Fee: NO PAYHENI REQUIRED
PLEAS SIGN AND RE IURN •YELLOW COPY JO:
UELAW•Si CI IY . )UN IY H IIEPARIHEN I qkq/ ,
caner %Operator Signature Uatei I
IU 4: 1606 nate Received
1 .
'OEC 1 5 1993
1733 ?
1
APPLICATION FOR PERMIT TO INSTALL
HOUSEHOLD SEWAGE DISPOSAL SYSTEM
•
No. mLr . - - ,-, - h
• Property owner , phone 36P- 1/477/ •
. . hereby applies for a permit st xte • or iwdify a househ 1 sge
disposal system located 179 l poi in sewage
house number street township
0/ 6 on lot number
vi age,city zip
I agree to construct, install and operate the household sewage disposal
system in accordance with regulations /701 .20 of the Delaware City-County
Department of Health. I have received an interpretation of these rules and
regulations and understand the provisions contained therein.
I further agree that I will call for the final inspection and approval
of the Delaware City-Co. Department of Health of this installation at least
twenty-,four (24) hours in advance of its being covered with earth and at
least to(enty-.fogr 2'4) hours in advance of its being placed in operation.
This perit\\ p'•res on- ort' • - e of issue.
appli,c nt Signature OFFICE USE ONLY
Permit Issued l/-/6 ba,
• house number streetdate
Fee Paid /0v
�- amount
towns p,vi lage.city zip Clerk /S�Q nrn
signature
phone date
The plot plan required by this regulation may be prepared on the reverse
side. The plan shall contain the following:
(1 ) The shape and dimensions of the lot with the location of lot lines, bodies
of water, ditches , drain tile and all easements.
• (2) The size, location and construction of the household sewage disposal
system.
(3) The location of all water supplies within 100 feet of any component of
the household sewage disposal system on this or adjacent lots.
(4) The location and number of dwelling units and bedrooms served by this
system.
(5) The percentage slope and general drainage pattern of the lot.
(6) Soils limitation evaluation. /
Site Approved //hag Disapproved
9�'� re date
Sanitarian �C/ Z`e s�tutste �� ' .
Final Inspection Approved •2, : GT Disapproved
date . date
Sanitarian -,�,.,f-'`;cc, .---- ' s
'signature
, .v " i
`:"2 - - & ce" ahtStri
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DELAWARE CITY-COUNTY HEALTH DEPARTMENT
109 N Sandusky St - Delaware, Ohio 43015 - 368-1700 or 548-7055
RESIDENTIAL AEROBIC SEWAGE SYSTEM
ASSESSMENT REPORT
NAME: ADDRESS: 7' i S)/TA-7 TO/Lb
DATE: I6-.Ic' ics TIME:
OFF-LOT PERMIT e: /IOC. () JET (] AQUA-CLEAR
TOWNSHIP: [1 MULTI-FLO () NORWECO
ROUTINE INSPECTION (1 () OLDHAM [1 OTHER
RE-INSPECTION ()
COMPLAINT ()
AN ASSESSMENT WAS MADE TODAY OF YOUR AEROBIC SEWAGE SYSTEM. THE FOLLOWING OBSERVATIONS WERE
FOUND:
Effluent Orality: $atisfactory Unsatisfactory
(- 1 Clear ( 1 No Odor ( 1 Colorless [ ] Light Solids [ ) Musty ( ) Grey
[ ) Cloudy ( ) No Odor [ ] .fight Grey [ ] Solids ( ) Septic Odor [ ] Oma/Blad<
[ ] Heavy Solids [ ] Offensive Odor ( ] Black
Effluent 00: I 1 3-7wg/1 [ ] <3sg/1
( ] >7mg/1
Maintenance: ( ] Motor Present [ ] Missing Motor
( ] Motor Operating Properly [ ] Motor not Operating
[ 1 Air Shaft Clear [ ] Air Shaft Obstructed
( ] Air Line/Defuser Clear [ ] Air Line/Defuser Obstructed
[ ] Chlorine Present (April to October) ( ] Chlorine Absent
[ ] Filter Clean [ ] Filter Obstructed
[ ) Electrical Connection Intact [ 1 Electrical Connection Interrupted
( ) Timer Set to Specs [ ] Timer not set to Specs
[ ] Other [ ] Other
REMARKS:
Observation By: v I s .tCe.1 e Jta,i A7-
SHOULD THE SYSTEM FALL INTO THE UNSATISFACTORY OPERATION RANGE, AN INSPECTION WILL BE MADE BY
A REGISTERED SANITARIAN WITHIN 20 DAYS TO DETERMINE COMPLIANCE OR NEED OF FURTHER ACTION.
Reinspection Date:
REMINDER
The following liquids or solid materials, commonly used in households, must not be placed in household plumbing fixtures
and flushed into the aerobic systems:
Plastic in any form Cooking oils or greases (Excess)
Wet strength paper towels (Kleenex) Solvents (Paint Thinners Dry Cleaning Fluid)
Cloth of any kind Caustic Drain Cleaners (Excessive)
Rubber Products Acid Drain Cleaners (Excessive)
Throw-Away baby diapers (No part) Kerosene-Gasoline-Motor Oil
Cigarette stubs Paints (Oil or water base)
Sand-Grit Floor Waxes
Coffee Grounds Garbage (Excess through disposal)
Fabric Softener (Excess) Bleach, liquid (Excess)
It is recommended that a bio-degradable detergent be used for laundering purposes.
This department reodrnde arabic tanks be pimped and clewed at least every three years.
Revised 1/95
DELAWARE CITY-COUNTY HEALTH DEPARTMENT
109 N Sandusky St - Delaware, Ohio 43015 - 368-1700 or 548-7055
RESIDENTIAL AEROBIC SEWAGE SYSTEM
ASSESSMENT REPORT
NAME: I t(Tics-s- Kn I C:J IL. ADDRESS: 1) I 51i(L.4#o(nt n
DATE: - 1C TIME:
OFF-LOT PERMIT 0: I )I (n O JET [1 AQUA-CLEAR
TOWNSHIP: aZ n O MULTI-FLO [] NORWECO • I , '
ROUTINE INSPECTION a [1 OLDHAM 14 OTHER \'r ': I (r i
RE-INSPECTION (1
COMPLAINT (1
AN ASSESSMENT WAS MADE TODAY OF YOUR AEROBIC SEWAGE SYSTEM. THE FOLLOWING OBSERVATIONS WERE
FOUND:
Effluent Quality: 5atisfactory Unsstisfactory
[ 1 Clear [ ] No Odor ( ) Colorless [ ] Light Solids ( ) Musty ( 1 Grey
[ ] Cloudy [ 1 No Odor ( ] Light Grey [ 1 Solids [ ] Septic Odor [ ] (hey Block
[ ] Heavy Solids ( ] Offensive Odor ( 1 Black
Effluent DO: ( 1 3-1.9/1 [ ] <3eg/1
[ 1 )159/1
Maintenance: ( 1 Motor Present ( 1 Missing Motor
,1 Motor Operating Properly [ ] Motor not Operating
[ ) Air Shaft Clear [ 1 Air Shaft Obstructed
( ) Air Line/Defuser Clear [ ] Air Line/Defuser Obstructed
[ ) Chlorine Present (April to October) [ ] Chlorine Absent
[ ] Filter Clean [ ] Filter Obstructed
[ ) Electrical Connection Intact [ 1 Electrical Connection Interrupted
[ 1 Timer Set to Specs [ ] Timor not set to Specs
[ ] Other [ ) Other
MARK,: +Vvp+nr c r_14,14 L14- 41 a C4 i t1 aFer—hm. Nc .s I r y ,L r114 1kJ/c ti M .
Observation By: 61 n.4904z L /Q
.T.
SHOULD THE SYSTEM FALL INTO THE UNSATISFACTORY OPERATION RANGE, AN INSPECTION WILL BE MADE BY
A REGISTERED SANITARIAN WITHIN 20 DAYS TO DETERMINE COMPLIANCE OR NEED OF FURTHER ACTION.
Reinspection Date:
REMINDER
The following liquids or solid materials, commonly used in households, must not be placed in household plumbing fixtures
and flushed into the aerobic systems:
Plastic in any form Cooking oils or greases (Excess)
Wet strength paper towels (Kleenex) Solvents (Paint Thinners Dry Cleaning Fluid)
Cloth of any kind Caustic Drain Cleaners (Excessive)
Rubber Products Acid Drain Cleaners (Excessive)
Throw-Away baby diapers (No part) Kerosene-Gasoline-Motor Oil
Cigarette stubs Paints (Oil or water base)
Sand-Grit Floor Waxes
Coffee Grounds Garbage (Excess through disposal)
Fabric Softener (Excess) Bleach, liquid (Excess)
It is recommended that a bio-degradable detergent be used for laundering purposes.
This department recommends aerobic tanks be pugged and cleaned at least every three years.
Revised 1/95
•
DELAWARE CITY-COUNTY HEALTH DEPARTMENT
109 N Sandusky St - Delaware, Ohio 43015 - 368-1700 or 548-7055
RESIDENTIAL AEROBIC SEWAGE SYSTEM
INSPECTION REPORT
DATE -4 - I - 9rr ,2- TIME I ' ! -?^
OFF-LOT PERMIT •: t I () JET [] AQUA-CLEAR
TOWNSHIP: [ t [] MULTI-FLO [] NORWECO
ROUTINE INSPECTION j [] OLDHAM [). OTHER !(G
RE-INSPECTION [)
OWNER: ADDRESS:
s- Kin i rin _._ _ 751 51-rA+ -Ford 12 d .
AN INSPECTION WAS MADE TODAY OF YOUR AEROBIC SEWAGE SYSTEM. THE CONDITION OF THE
SYSTEM WAS FOUND TO BE AS FOLLOWS:
( ) Missing Motor ( ) Filter Needs Cleaning
( ) Motor Not Operating ( ) Electrical Problem
( ) Air Shaft Needs Cleaned ( ) Timer May Need Reset
( ) Air Line/Defuser Needs Cleaned
( ) Missing Chlorine (Seasonal April to October)
( ) Other:
REMARKS: 14E( -ft (ArrR-h ], , - :11'0C lI iroy -,rrl. E4lUC([-F i . ear•
-
[ ] Your system is not operating properly and is causing a public health
nuisance. This is a violation of Section 108-E of the Delaware County
Household Sewage Disposal Rules. You are hereby ordered to have your
aerobic sewage system operating properly and contact this department upon
completion of said work with proof of service by a registered service
contractor or proof of repair using manufacturer's original parts within
days. Failure to comply with a public health order is a violation
of 3709.21 of the Ohio Revised Code.
REINSPECTION DATE:
[ ] Your system is operating satisfactorr4,ly At pis time.
t17hr417 KJ / :T . ..
Sanitarian
REMINDER
The following liquids or solid materials, commonly used in households, must not be placed in
household plumbing fixtures and flushed into the aerobic systems:
Plastic in any form Cooking oils or greases (Excess)
Wet strength paper towels (Kleenex) Solvents (Paint Thinners Dry Cleaning Fluid)
Cloth of any kind Caustic Drain Cleaners (Excessive)
Rubber Products Acid Drain Clearers (Excessive)
Throw-Away baby diapers (No part) Kerosene-Gasoline-Motor Oil
Cigarette stubs Paints (Oil or water base)
Sand-Grit Floor Waxes
Coffee Grounds Garbage (Excess through disposal)
Fabric Softener (Excess) Bleach, liquid (Excess)
It is recommended that a bio-degradable detergent be used for laundering purposes.
This department recoands aerobic tanks be pumped and cleared at least every three years.
1/S1
•
•
•
•
•
DELAWARE CITY-COUNTY HEALTH DEPARTMENT
115 N . Sandusky Street
Delaware, Ohio 43015 363-6330/545-7055
RESIDENTIAL AEROBIC SEWAGE SYSTEM .
INSPECTION REPORT '
DATE: I-17-c
TIME: 1 .00
•
OFF-LCT PERMIT 3: 130(D [].•, ET •
•
TCa:SHIP: C'• 11uM(v I, (tl S1/4, • -111 (] Multi-Flo
•
RCUTINE INSPECTION lc () Olohah
RE-ItLSPEC;ZC:1 •
(] Rcua-C1,;r
[] Norweeo
Other
OWNER: ADDRESS:
• .
*` -- rlri : Vim1L )1 `' �%•' • 'tt<l Ali .
AN INSPECTION WAS MADE TODAY OF YOUR AEROBIC SEWAGE SYSTEM. THE
CONDITION OF THE SYSTEM WAS FOUND TO BE AS FOLLOWS:
{ ) . Missing Motor - ( ) Filter Needs Cleaned
( ) Motor Not Operating ( ) Electrical Problem
( ) Air Shaft Needs Cleaned ( ) Timer May Need Reset
( ) Air Line/Defuser Needs Cleaned
( ) Other:
REMARKS: 1'i' / , , `ljr/ 1 , ‘'Ni' 5/3E, 1 Lcun i-Hii ` / 4 ;1v i
•
( ] Ycur system is not operating properly and is causing a public
health nuisance . This is a violation of Section 108-E of the
Delaware County Household Sewage Disposal Rules . You are
hereby ordered to have your aerobic sewage system operating
properly within days. Failure to comply with a public
health order is a violation of 3709 .21 of the Ohio Revised
Code.
] Your system is operating satisfactory at this time . No cause
for action .
Ci-'1 . , S_ • /, 01 /.C /
Reinspection Date : Sanitarian
Conditions Found : ( ] System operating Satisfactory - No cause
for legal action
( ] No improvements have been made - Case to
. be referred to prosecutor
RCCh?R. , r
• DELAWARE GENERAL HEALTH DISTRICT
1 W WINTER ST., PO BOX 570
DELAWARE, OH 43015-0570
(740) 368-1720
MONTHLY REPORTING FORM FOGJR�SEPTAGF. HAULERS IN DELAWARE COUNTY
NAME OF COMPANY: A -4-71-
1`) PN NATIO t•-3
ADDRESS: .
MONTH REPORTING A g C O '
I" 1
(Due by the 10th of following month)
Truck # DATE ADDRESS PLACE OF COMMENTS:(Note any
PUMPED ' PUMPED DISPOSAL problems with system)
)c C6y?4 3 -S-o , B3oo 3'pErjv f1'1i dnw c 1-rW DS . rLt.(A .C<,
73t c 4,1,9i 3 -/o-c6 /0 v99 t ri e cLw 'le T GU. a S
&?EUHaze) 3- iti-o(o 3213 M1Ltkc ?AU I-.. RA "rtiv
%-.' 1 1`t863 3.2�-205 578 rPL.t rr t a►.) L-"t > S `.
'7? vLe283-22 ( 3SLI CHt ST !� TwD S
04?-6,o-18ze 3.2z-ero 52 5 HA�rh r m D c-I `T w D S
X &� %.2 (.-c-Co 'SNS CiJO�'T({l y j om t_oi J✓lI 1D S 11 v
X'f5LA€26' '3 .23.OIP (0452 e(�o -riil Ncni-o N) P-or- I-v 0 S
t 4Y8I 3 -aY-o6 751 s`rkarroAd lid J TWD c
0
DELAWARE CITY-COUNTY HEALTH DEPARTMENT
109 N Sandusky St - Delaware, Ohio 43015 - 36d-1 (00 or 548-1055
RESIDENIIAL AEROBIC SEWAGE SYSTEM
ASSESSMENT REPORT
DATE TIME �r 2i4
OFF-LOT PERMIT O. 'T/j - O JET O AQUA-CLEAR
TOWNSHIP: 11J1(c, (] MULTI-FLO () NORWECO /�A
ROUTINE INSPECTION ./k../k. () OLDHAM (] OTHER 'v Q.1/ULA I ^V
RE-INSPECTION ()
REALTY INSPECTION O
COMPLAINT (]
AN ASSESSMENT WAS MADE TODAY OF YOUR AEROBIC SEWAGE SYSTEM. THE FOLLOWING OBSERVATIONS WERE
FOUND:
Effluent Quality: Satisfactory Unsatisfactory
] Clear [ ] No Odor [ ] Colorless [ ] Light Solids ( ) Musty [ ) Grey
[ ] Cloudy [ ] No Odor ( ) Light Grey [ ] Solids [ ] Septic Odor [ [ Grey Black
[ ) Heavy Solids [ ] Offensive Odor [ ] Black
Effluent 00: ( ] 3-7m9/1 [ ) (3m9/1
[ 1 >7eg/1
Maintenance: [ ] Motor Present [ ] Missing Motor
[ ) Motor Operating Properly ( ] Motor not Operating
[ ) Air Shaft Clear [ ] Air Shaft Obstructed
( ] Air Line/Defuser Clear [ ] Air Line/Osfuser Obstructed
[ ] Chlorine Present (April to October) ( ) Chlorine Absent
[ ] Filter Clean [ ) Filter Obstructed
( ] Electrical Connection Intact ( ) Electrical Connection Interrupted
[ ) Timer Set to Specs [ ] Timer not set to Specs
[ ] Other [ ] Other
Observation By: � '
SHOULD THE SYSTEM FALL INTO THE UNSATISFACTORY OPERATION RANGE, AN INSPECTION WILL BE MADE BY
A REGISTERED SANITARIAN WITHIN 2U DAYS TO DETERMINE COMPLIANCE OR NEED OF FURTHER ACTION.
REMINDER
The following liquids or solid materials, commonly used in households, must not be placed in household plumbing fixtures
and flushed into the aerobic systems:
Plastic in any form Cooking oils or greases (Excess)
Wet strength paper towels (Kleenex) Solvents (Paint Thinners Dry Cleaning Fluid)
Cloth of any kind Caustic Drain Cleaners (Excessive)
Rubber Products Acid Drain Cleaners (Excessive)
Throw-Away baby diapers (No part) Kerosene-Gasoline-Motor Oil
Cigarette stubs Paints (Oil or water base)
Sand-Grit Floor Waxes
Coffee Grounds Garbage (Excess through disposal)
Fabric Softener (Excess) Bleach, liquid (Excess)
It is recommended that a bio-degradable detergent be used for laundering purposes.
This department recommends aerobic tanks be pumped and cleaned at least every three years.
REMARKS: .(-1-(n •
Revised 6/91