xt7qnk361p0s_1124 https://exploreuk.uky.edu/dips/xt7qnk361p0s/data/mets.xml https://exploreuk.uky.edu/dips/xt7qnk361p0s/data/88m6.dao.xml Inland Steel Company 185 Cubic Feet archival material 88m6 English University of Kentucky Copyright has not been assigned to the University of Kentucky  Contact the Special Collections Research Center for information regarding rights and use of this collection. Wheelwright Collection Coal miners -- Housing -- Kentucky. Coal mines and mining -- Appalachian Region -- History. Company towns -- Kentucky -- Wheelwright. Community development -- Kentucky -- Wheelwright. Coal mines and mining -- Kentucky -- Wheelwright Sewer Plant text Sewer Plant 2016 https://exploreuk.uky.edu/dips/xt7qnk361p0s/data/88m6/Box_320/Folder_18/88m6_320_18__7878.pdf section false xt7qnk361p0s_1124 xt7qnk361p0s SALES
. E ORDER N0.E022938
DEL DEL CHEMICAL CORPORATION _.‘ p A
P.0. Box 280 . . . Menomonee Falls, Wis. 5305l , I x", "’
Telephone 4l4—25l—5050 .. ”-._,“er “ " * ,. ""’--r~~-u-
[4 I 4"" , ‘ " ...... ’/ ,
Viv/f” /- 7/ 2”“ ‘, /'// 7‘ / C I '
BILL TO: SHIP TO: , ‘ '
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NAME 7 , W , 7 .~ 7 NAME 5‘ 1/ 1” 'W 1' Liz/’1; W W1: _. W -:’ /
ADDRESS W - ;;; g. .- W'.‘ ADDRESS . ‘ ,
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C'TY “ARTE ZIP CIVy’J-J. first ~_ 1." ,/ STATE ,- a. y " ZIP
- ‘I I ‘ . ..’

ATTENTION ATTENTION; ‘W’ W 4’4; 5; - 4’ s 1L: fl _xpjg/

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PURCHASER g" 7 a". / "A M 7 TITLE
: ' " ‘AREFERENCEINFORMATION
Bank Address City 8. State
Suppliers l. Address City 8. State
2. Address City & State
D & B Rating: Type of Business
Parent Company Location

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T. M. REGAN. INC. . g
"‘Narvr C .,Iiicy Control Services" '
377 ALLER AVENUE A
LI‘XINGY N. KENTUCKY 40504
TERRY M. REGAN, PIE. TELEPHONE I?
PRESIDENT mom 254-303:
1
October 1, 1973 ;
Mr. Claude Anderson
Mountain Investment, Inc.
Wheelwrignt, Kentucky \
1
Subject; Upper and Lower Pnrton “teatnent Plant Renovatinrr :
‘5
Dear Sir: g
I
The following is a list of recorAen{eI lUViC‘JnS t.et are neen d 1
for the efficient operation an- prO‘er tre t ant 01 wastewatel ;
entering the Upner and Yc '* ' rtr tnc'tmtzt ‘ccilities:
' nger Burton
1. One wall needs another 1: , Of Jrjck to D: mg it up to The
level of the other thrs Tal s.
2. Replace brace between Taffle and L rthvsat w ‘. tan . This
can be undressed hardwnr .
3. Clean and creosote wood b. filtJ, Uls< f: sh w; n siteltic
paint.
A. Clean with wirv brush on. r int 5 Ji”% 'r: -3? "p? , ;
asphaltic paint.
5. Replace steel weir plete J Twent :07 *' xiv
or creel. firei‘g W‘r . tr x'
6. Remove e fluent line bxbw: n ffl.evt 3 1 ani ‘
replace with D" Cast Iron .L; .
7. It is reconneneed tna‘ tr“ ’ hdk t r '9‘ NT , ~Z‘v I»
tank be abHClOHVm 3r " 1 ‘ L. 5r - ;yfi ~ v.3
onl? the Tnhrit trek I ~ 3“ of I" ‘ ~ ‘,-,r A
water. ”4' ‘.”--
pa?l_gll,l;f 71,: ‘2“ I I
across lev;; 1:5. " , =
tineel 1E0 :ru;-. L«.~ I a l
but cover 1: ;: rr- ' ,1 ‘

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V
« T. M. REGAN. INC. — LEXINGTON. KENTUCKY 40504
99mm _
1. Replace baffle boards with narvwooc and creosote. Be sure
and are batted tightly in “lace. Add asphaltic paint after ‘
cre sote. I
2. R? "ace weir plate at effluent box. Cover with asphalt‘n
p.int.
I
3, tug and sea_ old slud:e duaw—off line.
‘.1 ’ «
*1. 'Jhoff tank )ftiOnS of fxciiiti" should he COV‘TJO v:
pitched r001 Roof shouid be hingv. a: top so that t‘w t l
side over t: H slot can be Iifted "or inspection and c1,
out purpose . The ffx~i ride :hc11d have nryropiately pi; i
access hate as and ‘wn all- 2" ”wivinixed gas vents one-f’. 3h 3
(i) Of the stance ' 3 ~‘ "t of the roof and and EXL" €23 1
7 31x (6) I «l71’i V ' ‘ 't tit (ices snot 1
be invczrtc using; 1,,-.«.; t 7 ' rm: Vcr‘;
should be Dcated in tht stair' a“ 3.63 ;Au ,
2. Install f ~st fircof ,ard hydrunts 't bmth inc tions.
i. Sludra r Swat shou; ‘: handiad by tank trunk hafillnfl.
Suction ',se may be arnrtau through cccs’ ., ch58 in two?
of both dcilities ax? ;uwuid be locntc‘ torfingly. ~
. .‘ "V" k i
w. Renl7i Wire Chain link ;cnce. Lhe post; seem tc be in good
shap~ ard may rrmain. f
5. On end of effluent linw at headwall, install a” flap valve. 3
This will Keep water from backing up into tin». Flap valve '
shonld be ” a V 73“"0 \‘rqre =“ or fd-V-”“‘m "—‘ " 0* l
7:". , .3?“ ,1, crv‘ «.1 ”I ,w; a i ,. 1 : e
Scdywlowfi er”Iu tn CJTP'TWEJE.
* Drawinfi is en ‘osed showigfi some idua of roof plat.
Very truly ynwrs,
7‘ VI ?Wr’nr: (7
--*o 1;»-9 4w .
l I/
‘7» ’I f; ’ ,
,r' A' L T . ' ~-
“Wfl'fim'wo’ ~-_.-- '
Herb Ray“ 31: L
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cc; lr. Jordofi NTOWH «l
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 1Hgm Sc HARHfi ‘ if : XXXXHXYSXFXXKUEKX '
COMM _.x‘ousu If' H . rw:,-_;T;»,n
COMMONWEALTH OF KENTUCKY
DEPARTMENT FOR NATURALTQLDOURCES AND ENViRONMENTAL PROTECTHN:
DIVISION or WATER
FRANKFURT" KELHIUQT-{Y ’rOSOI
TELFPHF‘H‘E (soc) Eli/.rsmo
November l, l973
Wheelwright Sewer Plant
Wheelwright, Kentucky 41669
Dear Sir:

Enclosed are the revised monthly operating report forms
necessary for the sewage treatment plant, or plants, under
your jurisdiction. Since we now maintain district offices
your monthly report will be submitted to:

Kentucky Department for Natural Resources
and Environmental Protection
‘ Division of Water
P. O. Box 954
Harlan, Kentucky 40381

It is urged that the report reach the district office not

later than the 10th day of the month so that our field iersonncl

: '1 . 1 |
can promptly reView them and come to your aid where the need is
indicated.

The manner and frequency of samplings and the various tests
to he conducted will, at the present, be governed by your labora*
tory facilities and flow measurement capability.

Monitoring requirements for plant effluents and receiving
streams will require considerably more sampling and testing
output than has been performed in the past by most Cities.

 Novel’nbm: 1, 1973
Page 2.

There are {W‘if‘th/“fOUI‘ .Ecxnm’; (311c1c'155'951 for (32,411] }‘>1zmt 11715397"
your jurgLSr‘utt'Lou, winch .15: a, 0m: year‘s; ::uppiw. fake L‘sfo
copies :1” 3,137“ each 11:91:11] [371d keep one :ngiv" voviz' .m:>a**wxls:. P1«:m‘~:~,,<\
report. the 11:1»:111; 1:2 '1‘.(f>3'1=:?', of HM"; 111'111-‘1 i‘é'l Shaw! (“.1 1.1M": U?) of
Car-11 0011.311), The (,‘(i11'1‘1fi72 \a‘f1C11’13I'3 :1] 102: for 03113/ ‘L‘mcg, fjiqmjgx: no
you 111115.11 form] thaw 03117, for (\;:;::::;7>] «12:1;

276,640 (3.01](Hug/{Luv ‘—‘— ,277 LEG?)
3,452,000 9531]101157/(1m37 ?: :5./.5 13.531)
2,768 JI:a_]/1-“3 EH77 Jag/TI .X 1,000
10,540 rug/1:: 10.5 mg/‘l. >; 1,000

The 03-;'(:»:>;»11ion to Um Hn‘cc :1:} guy; 3,1110 zrm'vlgira; to Chier’fimr:
1‘‘;:lf Mil] Ilf'iéijy (1
In: 11:33. than ‘ILCJJ. The whqu 1"11‘v.:""_,..“»:r M111" om“ <"Cw’:i111£21 (much of:

'7.] or 03) should he UFJLU 101 1:112:10 .'i_'L.a,,mz-m

11 Ytimx‘ Plant Mir; {3: rur‘Jzzr: that, 6209:» 121:»: :ia'I-z":r.r::'ij'): it, \.“iinih 171213
City or 53:11:.‘i'iin’fx (fix-,1 1:101, Mozfiw \‘73‘i‘i.c’\ the 11.3»:21’: 01' {1110 C_..'1’L_“f (v.1:
(1181117101) le'i::'r,1n.v;ib 1.12:. 1.2:,=:;::: of 1:11»; plum.

I’T'Luguio (10 1101. (‘)‘\7c’3:']_oT?;_;::J~:‘ 1i: 121:1; ‘3: an, :1:
to 1:331 Cm'm II_«;"L:,=:<‘1“,* "vudsdcrfl, :wfiflu‘un] \ sz’ 5501M. :EH fwrxf; '1
$313011] (“i 1.11"}? 1:15.;71'7'11' 1.0 E: 5,y:}.{;“:1:3:{K'IcntnL 11}n’3:."u'i:l (r? (;LI,'{Z."]’:;1I: (161“;‘31‘1'73;
to LL10 (ifludxhl‘x1'1C‘ \.cwr'f'w-‘u (w. (Shari (:1 'L":I»r~]c] 1w. ,7, (mm ;vrgiwjxc;

HF; 10 vhf; 5:12;}, 1w}! Lo show Haunm 21.43351? 1.11.112» a5; \a.u:.~]], (2:; elm} m'lwv
(pm-51.31371?) :J'wl'l may haven Ilf ym‘w }>13‘ni' <1_,:~€1 13571 11:90:: a 1(11g ‘:iww,
i‘ltu’gtrt‘: 13111;. 5:30:12; 1111031? 1111111j‘JCE] (1,~~»,,33 1,1-”(77m \c'i...‘7u:]'1 a, 1 cam 15,2“:
V‘;;V1"\(,>“,i«,:r‘ flop -V’L.1;:(,:;J'{.”. .9ij10 L110 "3,(\2‘::.7:»:'x;],:?” C:(’.x],1w:n has; Mann :3.“, 1:11] 3min],
1 F9'Ll{‘;‘_§f-‘f:11' you put any nursruxgwsz 0,1 )"Oi’jLHQULSJ {71' 1110 }_>(>'L’L(’;:n of, {he

bug-3: 5.1L]: of U113 folm.

This: form 1],] 1:10 c:>;;‘>]_a‘?nc;§d in (1:15:11 as]: our operators; ouchocfl

to be 110161 1.1} Loxmmtpm, NO‘UOHIbL‘FJ,‘ 172-‘15,. 1973.
Very tJiUJy yours ,

z) /

Ll /,:"’ I .’./K ff’2‘./m,. /
jj-Ai'vf‘fi’iljl 4‘”: 14 “““‘/3,4 (..,.{f‘rng ...
Paul K. Wood
Princugml f3am.1‘:nry Engineer
Division 01'? Waier

Em C 10 F; u 1:0. :4

PKW : (1113

 NAME OF SEWAGE TREATMENT PLANT fl COUNTY
MONTH OF l9
AVERAGE FLOW wee.
DESIGN DATA:
PRIMARY SETTLING TANK(S): *Based on average flow plus recrrculation where a licable
Surface Area (Sq. Ft.) ___... .___.
Volume (Gallons) ___—_ ___—__ _—
Weir Length (Feet) ___ ____ ___—___ __
Avg. Weir Overflow (CPD/Ft.)
Avg. Settling Rate (GPO/Sq. Ft.) '*
Avg. Detention Time (Hours) ’“
SECONDARY SETTLING TANKlS):
Surface Area (Sq. Ft.)
Volume (Gallons) —
Weir Length (Feet)
Avg. Weir Overflow (GPD/Ft.) i“
Avg. Settling Rate (GPD/Sq. Ft.)*
Avg. Detention Time (Hours)*‘ —
CHLORINE CONTACT TANK:
Volume (Gallons)
Avg. Detention Time (Hours)
TRICKLING FILTER(S):
Surface Area (Sq. Ft.) .__
Surface Area (Acres)
Depth of Media (Feet)
Volume of Media (Cu. Ft.)
Avg. Hydraulic Load (MGAD) * _
Avg. Organic Load (lbs. BOD/1,000 Cu. Ft.)
DIGESTER(S):
Volume (Cu. Ft.)
SLUDCE DRYING BEDSv
Area(Sq. Ft.) - ,__ ___—.___ _. ._..__. ___—___
COST DATA:
MAN DAYS FOR MAINTENANCE & REPAIR
Primary Tanks ___.
Secondary Tanks______
Digester .___
Grit Removal ___..___.
Aeration Tanks __
Other __
Sub Total ___..—
Man Days For Operation ._.._
Man Days For Laboratory Analysis ___.._—
Tofal Man Days A? Plant ______
Total Cost For Labor and Supervision $
Electricity—Avg. Cost per KWH ¢
Total Cost of Electricity $
Cost of Gas Purchased(Heating) 3
Maintenance & Repair Costs 3
Cost of Chlorine Used 3
Cost of Lime Used $
Cost of Other Chemicals Purchased $
Cost of Miscellaneous Supplies $
Other Expenses $
Total Cost of Sewage Treatment 3
Total Costs 1—Sewered Population $ per capita
Total Cost —'. Flow 3 per million gallons
Total Costs of Electricity for Pump Stations $ __
Total Costs for Maintenance 8. Repair for Pump Stations $ __
Total Costs for Maintenance 8. Repair Sewer Line $ ___
Total Miles of Sewer Lines

 NAME OF SEWAGE TREATMENT PLANT ___________’___\ MONTH Ome-,. .. ._ .-..- 19.--...._ ..-_ '
COUNTY
PLANT CAPACITY —_—_———————-‘MGD RECEIVING STREAM
.__ III—___— , r
m LE go: I_. II E z O E A > I? ’ > m g‘é DRAWN ES TOTAL
,_z w m IL p E I_ I_ I- z I_ I- I— <1 - w my M [11.1 D Om
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[D {D ..
------------ _._-.__.— . ---------------- _
...-_...— --------=- . ...-— ...-— - , ‘ _.--__ =
I'.-._- -=-- -- ___. _I ----- _._-___. _ _
_— __ -_ _--I-- -----== ;_---- ___-_._ .-
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In - .— - ._.-....— ------ I__ E:- - . _ -- - .,.-..._...-
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.— ------ ._. ----= __.- ... _— - _ -_ -._ _I_-._- —
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------------=- ..._-E _-------------- - -.-_-_- -
—----------~-------------------...-.... _
_III-III... . I-Il-I-Il I..I-I-I-I-I-III _—
TOTAL NUMBER OF SEWER CONIIECTIONS:______‘____‘ IND. WASTES POP. EQ:
SEWER CONNECTIONS:__ __X ”.__-W.,: _, SEWERED POPULATION “SW—WI“ ~.ijng—

KfI. DEPT. FOR NATURAL RESOURCES & ENVIRONMENTAL PROTECTION Dow _13 MW my
DIVISIOH of Water

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 BACTERIAL RESULTS Month ___._._—___.
I__ ”___——
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3 H331” H3181” _U H3311 H3311 '3 H331” H33"

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fl----.II-I-I-II-III-Il-I-I-I= Division of Engineering
”___-I-I-I-Il-I.III-I.I....-
==========:==============:===
“_._-.Il-I-l-Il...-I-I-I-I-I- REPORT OF OPERATION OF WATER PURIFICATION PLANT
----III-III-IIIIIIIII-I-I-II At
E_.--III-IIIIIIIIIIIIIIIIIIII
fl----III-IIII-I-I-I-IIII-I-II for the month of
fl-._-III-IIIIIIIIII-IIIIIIIII
n----...-I-I-I-I-I-I-I-I-I-I- Note: The following blanks are not to be filled out by sender. .
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=----III-IIIIIIIIIIIIIIIIIIII Rec91ved————————————————

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n-I-IIll-Illlnlllllllllllllll Filed
fl----III-.II-IIIII-I-I-IIIIII __._—________
u----...-...I-I-I-I-II-I-I-I- Reports Must Be Sent in Monthly
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Hypo-Chlorlte on Hand in Pounds _.___—_.___... Fluoride Compound used ___—m Respectfully Submitted: Name ___—___—_____

cmmiL-m on Hand _.___—___— Municipality or Company ——————-——————————
Percent Solution _______________________ Date __.—.__. SE-WS-IQ

 REPORT OF OPERATION OF WATER TREATNHENT PLANT AT ._ ._____ _,KENTUCKY
FILTER OPERATION
OF
GALLONS a Wash 5 Wash 5 Wash g Wash 5 Wash Wash Wash
Sga‘Wgaagfig 553% W33.
s. u - .»‘ L4 ' "‘ m '4 I.. t. u - km 0 h h a.
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Percent Wash Water Used During Month _.___—___— Date semmg Basin Last Cleaned ___—___..— Chiorine Remaining in Cylinder _—
Rate of Filtration in Gallons Per Sq. Ft. Per Minute _ Number of Extra Cylinders on Hand ___——
STATE DEPARTMENT OF HEALTH OF KENTUCKY—DIVISION OF ENGINEERING

 . DEPARTMENTFORNATURALRESOURCESANDENVIRONMENTALPROTECHON
Permit No. _ _
Bureau of Envnronmental Protection
Plan No. D'VISION OF PLUMBING
Frankfort, Kentucky 40601
Cerfificate No, APPLICATION TO DO PLUMBING Date 19.........
The undersigned hereby applies for permit to install plumbing work according to the
State Plumbing Code covering such work.
Location Cost of permit
Owner‘s name "nuuun_uununnuuuunuflunn”nuluunnnunuuu" Address uuannnunnunuuunuwnuuunnufluuunnn
W...— '
Building, new or old? "”0"“ Used for what purpose?unnluu““uuulununn Number of stories "nnn”
Where does the house drain empty? ”nu"""""”luununu”ulnnuulunvHun""lulu“"luau““"”“""“"uuunuu
How are water closet apartments to be ventilated? "Hun"""nnnnnnunnnn “unuununuuunun"”unu n"
What is size of main soil pipe?hwnnn Wasteuunnn No. vertical lines“"0nn Soiluuuuu Wasteunu"
(For charges for permits see State Plumbing Law and Code)
0 P E N I N G S
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TYPE I NO. I TYPE | NO. I TYPE I NO. I TYPE | NO.
I I I I l I I
“aim CI‘ISL'ZS I-——---—---- 5111be I..“.WI Laundry Trays I I Ann) Washers
Bath Tubs I_________I Sprvm (sinkw I_..____._.,_I Floor Drains I‘..........I Open Rweptaclos
LLU'LIIUIX'S ------------I Drinkina Fullntnins I~——----~-~-I Min. Floor Drains WI Roda Fountains ...........
Simwrs I B:1r\\LLSU' I I Sump Pumps I Snw‘ile Fixtures
UTIIILIIF I............ I DISH \‘y‘ds‘hflrrx’ l””””““ I Garage DHUHS |............ I "._......"
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Water Heaters I I Sewer Connection | I Water Service I I
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Posted Permit: Date Inspector
___.__“__:=:====::=:::E2::3:=:=:=::_____.l___fl.____.________._______________________
INSPECTIONS
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TYPE DATE INSPECTOR REMARKS
Lateral.................. I I
Pit I I _
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Water Testuunnun "nunununuunuul"nuuuuununnqu"annulununuuunuunnuuu"no""uuunuuuuunuuaununuuu
Final Testuuunuu ”ufiununuuuuull"nunnununnunul"“hunnnnu“nnu"n”n"u”u”an"uuuuunuuuuuunuunnnuuu
Water Service" ”Iunfluuuuuuuunu nflnulnufluuuqu"n””U”nnn"u"a"unuun"nun“ununuunnnuu"nuunnuuunu
Sewer ConnectionInnunnuunnnuuu ""0"“"nuunnunl.an“”unnUUUHH"nuununuuunun""""“”"""””“"""""uun
Master Plumber on“"annuuu”unuununu“unfinuunfluunnuunun. License Number " "nunuunu"unnnnun
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 WHEELWRIGHT FILTRATION PLANT REPORT FOR MONTH 0F , 19m_
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NOTE: A day of operation runs from 7:30 A.M. to 7:30 .

 A (Ivan/mW/QL) , . -
~ VALVE RECORD Valve No.
Location
Nearest House No.
Date Installed __ 19____ Date Located 19___
Location Feet Inches of Line of
. Feet Inches of Line of
\ s'ize __ Depth to Top__________ Feet Inches
Style of Valve Reqaires .. Turns to to Open
Size and Type of Operating Nut
Remarks: _
OeeggééL—o'ggfi Remarks: As to Condition and Repair
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CI” v’A.-.I‘~:~' Mi.”~"l'/"§«’«’Jfi// ,

 INSTRUCTIONS FOR SUBMITTING PLANS

1. Check Regulation SAN—A—Z. Submission and approval of Plumbing, Sewerage, and Water
Supply System Plans for Construction, Alteration or Modification of Public Buildings.

2. PLANS:

(a) Plans shall be submitted in triplicate, with 3 copies of Survey Sheet and 3
copies of Percolation Test if required.

(b) Plans shall be not less than II x 17 inches, blueprints or white. Scale
drawings are preferable.

3. THE LAYOUT SHALL INCLUDE:

(a) Site and topographic plan showing size of entire plot of ground, buildings and
parking area, with information showing ground elevation.

(b) Floor plan layout of the establishment showing overall dimensions; size of
various rooms; location of outside doors and windows; toilet rooms; partitions
and door openings; location of equipment, machinery, wash vats, stoves, hoods,
lavatories, etc.

4. SPECIFICATIONS: Sepcifications shall include material and finish of floors, walls,
ceilings; height of ceiling, location of lighting fixtures and proposed illumination,
screening and rat proofing if required.

5. WATER SUPPLY AND WASTE DISPOSAL:

(a) If city water and sewer are available, so state on plans and show where they
abut the property.

(b) If water supply is other than a municipal supply, indicate type and location on
plan. All hospitals, schools, motels and tourist camps not served by a munici—
pal wnter supply shall submit to the Engineering Program at the time plans are
submitted, a gallon of water proposed as the supply for the chemical analysis
and such other samples as required by the Bureau for Health Services.

(c) If u sub—soil disposal system is to be used indicate the location on the plans
showing the size of the septic tank and the length of the drainage field. A
Percolation Test as referred to in 2 is required.

(d) If some other type of sewage disposal system than (c), separate plans must be
submitted.

(8) If a privy is used, the location and type of privy must be noted on the plans.

6. PLUMBING: Plumbing installations must be made in conformity with the requirements of
State Plumbing Code. The plumbing system shall be shown in plan and in elevation, in—
cluding location of all fixtures, soil and waste pipe, floor drains, vents (Riser
Diagram). The size and kind of material used for soil, waste and vent piping must be
stated on the plans.

7. HEATING, VENTILATION, AIR CONDITIONING: Indicate on the plan type of heating facilities,
gas, hot air, etc., and show method of venting gas appliances, including water heaters.
Location of ventilation and exhaust system including any process exhaust system and its
capacity shall be shown on the plan.

Air conditioning equipment when used shall be shown on the plan, including type and size.

8. REMODELING: If an existing establishment is being remodeled, plans shall show new par—
titions, plumbing, etc., with full lines, showing the partitions, plumbing etc., that
are not to be changed, by broken lines.

9. PLANS SUBMITTED FOR APPROVAL: Three copies of all plans shall be submitted to the
local health department prior to the time of construction. The plans and survey sheets
must be checked for completeness of required information by the local health department
and then forwarded immediately to the Plumbing Program with a statement of approval,
disapproval or comment on the Survey Sheet.

 SUBMISSION OF PLANS -- SURVEY SHEET
Name of Owner Date
Address _____________._______—_——————————————————————————---
Street City
Name and Type of Establishment
Products Handled or Manufactured
Location
Street City
No. of People Employees Male Female
No. of People Served (Students, Patrons, Customers, etc.,) Male______ Female
WATER SUPPLY - Source _ ._u-
Method of Protection
Type of Treatment
Distance from Water Source to Possible Source of Contamination
Volume of Water to be used Monthly
SEWAGE DISPOSAL (Domestic)
Type
SEWAGE DISPOSAL (Plant Waste)
What Waste Products are Expected?
Method of Disposal to be used
______________________________________________________________.______________________._
Possible Waste Load Per Day___________________________________________________________
PERCOLATION TEST MADE? Yes . No . Date______________________________
Percolation Test conducted by
Results of test attached (in triplicate) Yes . No .
Submitted by
Date Approved Not Appr0ved
Comment .-____________________
' ___—m
(Instructions on Back)
Department for Human Resources E.S. 151 (Rev. 1/74)