HomeMy WebLinkAboutSeptic Repair 585 Griffin Road .: SOUTH
LNPWIGAT,:w ?'QR SE;AGE DZS?MAL SYSM14
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PE CDUTIO� TE"a'I9: (Record all to rta) d` 97 SOIL MOISTURE:
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TEST .4EADIMS
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Tint Readlag Time Reading Time '"Mat ?eedi�
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WULATION CV T.g'Q? °F5 M S
Dept pr"!soaY Miaimua •pescalstioa °e�
Hoye 1;oaatioa (*�nch�es) Ess. (Dian./Zach)
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, F344ATZOI� FIT'': (gecord all pits) Ground ',later Table.Date ,ear MIX , e ov Max.,
son
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PIT A PIT D C I PIT D
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TAaViA".'IOR CF 01iS!'R'JA'!'IQR PZ"'S
Ground eMc'."-*Sal;
LcmtA� Fy L"d water At
Pit
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pGM4 A SOUTH W I N D S O R HEALTH -2- lave ou for .;.-W&GO
DEPARTMENT
Sy�ZAL Coi�DITIORS
System design 1ar8er than 2,000 g.p.d* water supply latarshed
glgh ,gz'vund voter (less than 41 ft. ) Possible seasonal hiah
VVund water
�,,;atarccurse, aarsh ar pond Possible seasonal flooding
tad suitable axes Slope over ISZ•-
Marginal soil (30 - 60 miss./inch) Sha l?.ov ledge (loss tbaa T ft.)
Underlying tight soil (.6ess tbaa '+ ft)__ other
CO11C'Lt,1 cw
Suitsbla for sewage disposal
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s ��Unsuitable for wage disposal
ti Additional iavestigatiom required
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�Ce Retest during vet season
.near's plan required .
I DESICA R20t�t'DPlTI0P5
Investigated by Title
Coati=ed/Witnessed by Ti`
Comments:
Hench.awk location r^levatioa
TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new/repair subsurface age di posal system. To the Health Department,
Town of SQut Windsor.
Fee Paid J Otaf Date � r
w
.� Permit Number
�s--- subsurface ewage disposa !M�U'_pj,571/V_
installer cense in the State of Connecticut, I
Name, Address, Telephone Number, License Number
hereby ap ly�or, ermit tq construct/,repai a subsurface sewage di, sal system
alated/ �t
r, }���' - C� Lr/ ��Gb�. and owned by
Street, dress, Lot umber Name
Address
Information to be supp ' by A{?plicar
Type of dwelling j2� Q If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms Size of lot
Number of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any _ ,
Pumped or gravity flow,
Type of water supply 'r) If private, type of well
bl ic-Private
Information to be supplied by Health Department:
Soil type at various levels
Percolation rate Square feet of effective leaching area required
Size of septic tank Type of system
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. Distance between individual leaching
units. Distance from well on same property on adjoining property
Curtain drain required
Yes,No
Height of system above ground water maximum ground water ,
ledge , impervious soil layer
If automatic closing is required,description
A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM-
BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED
FINISHED GRADE;5MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED.
THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE.
NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE
SANITARIAN.
SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST
BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN.
THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS
THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT.
Permit Received by Date
l �
S' n ure of Applicant&Li se Number
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval Date
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STATE OF CONNECTICUT
DEPARTMENT OF PUBLIC HEALTH
NOTICE OF EXCEPTION
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An Exception is hereby granted to the requirements of Technical Standards IIA of
Regulation 19-13-13 103 of the Public Health Code of the State of Connecticut for the
REPA%A. of a subsurface sewage disposal system on the
Brcoos pigay-e rI — Sias "%FF%N yZoAo in the Town of
50 VT11 W%NdsoR ,Connecticut. It has been found that the well
located at THE sgmlac•T 'PI2-*MRT`( %5
unlikely to be polluted in such a manner as
to cause a health hazard,provided:
1. THE RE Pk-A,C.F W1ENT Sy(3S jfkFACre SEWAGE -b1SPoSA%- S`(IreyA aE
LOCATED NOT LESS T'�k6N 50 FEET FAQVA 1-k-1E 6PMST%WG WELL
L,oc.ATED oN TttE Sv t3jEcT -r oPEe-T*4.
2. THE EX%ST%NG WIEU— StAAll- SAE -^ESTED Fort BACYENOLO`olCAI —
C4rIrAM%r4AT%oy4 T, 'SrJSrAL;AT%oa OF V&F.PIA%'R SYSTEM.
3, gleeA%yt SNAV.. 09- ZNSPECTsD AND AffgoVED Y34
-r+W SovTN WINDSoA %AEA%,Y" 'bEeAyETvn6jv'i
Recorded at the Department of Public Health, Hartford, CT.
7:rvNE 10, ton-f
Date
Arthur J. Castell zo
Sanitary Engineer III
Environmental Engineering Section
noticeex.doc /
Phone: 0160) 02-70(o
Telephone Device for the Deaf (860) 509-7191
410 Capitol Avenue -MS# S 1 SEW
P.O. Box 340308 Hartford, CT 06134
An Equal Opportunity Employer