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HomeMy WebLinkAboutSeptic Repair 90 Ident Road TOWN OF SOUTH WIN DSOR LTH DEPARTMENT Application for permit to install a new r p i subsurface sewage disposal system. To the Health Department, Town of South Wind r. Fee Paid !fj —&" A6 V Date Permit Number As a subsurfM.Sco, sewage disposal system installer licensed in the State of Connecticut, I o i a i e T clo ad- asb Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at . Ci0 =CL.-At 11,4, andowned byMornioicr �= x5'ccx. -i2 Street, Address, Lot Number Name Cl 0 Address Information to be supplied by Applicant: Type of dwelling I�esFc�.e�.t-rix.l If non-residential, estimated daily flow Residential,Commercial,Etc. Number of bedrooms Size of lot Number of fixtures above basement 3 a kwcnr1s %I_ -t-,Jb j- =0'. le--* Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any , Pumped or gravity flow, Type of water supply ��t�(,t-�-t° If private,type of well M d,lea, Public-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 I A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM- BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST 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 Signature of Applicant&Li Anse Number For Office Use Only Permit issued by J Date System installed by Cxt 0(A_-0k_w) Final Inspection Approval Date TPOC7RAP44`j O� _ qO- ya�CN'�' ZY 6FP• 140C,6F EXlST/NG 140CJ5t t0O.00 ZZ/------� ►NV, our 95.50 PRoPEcrt`t 10� 9(°,7y 9�•g� 97,11 gq,25 i 9 ,57 91.41 97,5Z q'7,5% g7.17o 26' 95.90 ��"�?— 97,5co , 9 .72- =5.zo — g5.a5 95,65 95.76 gy, cI`i.y`i -I S2 g4,G8 9y,�8 9`I,S`{ g5,13 95.3° eo yq��9 -== --�'�y�- -�� 1� 9 q.07 �' 93 39 r._-3.7Z 93,79 93551 `13,19 93,92 gq,6G 9N.11 gy.so ?o' i5•SI g13.71 13,U 93,`70 Sv 93,50 131,15 93.35 '_ ;g3.y09b,8`j 10 20 30 Ho' 50 Go 70 go q0' i4� 6� ip �r c to oFF r4s_ 3 GRAIN SIZE DISTRIBUTION TEST REPORT 100 - ~ = y N ,� ry State Septic Und TI J ga ' 1 — so \ 70 ' 60 �\ z 50 LlJ :\ w 40 N as 0 200 100 10.0 1 .0 0. 1 0,01 0.001 GRAIN SIZE - mm Tess: a +3" 7. GRAVEL a SAND % SILT n CLAY • 5 0.0 0.0 97. 1 2.9 I.L PS D85 060 D50 030 01 S D10 Cc Cu 0 N/A N/A 1 .57 0.841 0. 576 0.420 0.258 0.20.3 1 .03 4. 1 MATERIAL DESCRIPTION USCS AASHTO 0 Brown Sand Tracy Pines N/A N/A Project No. : 1582 Remarks: Project: In Hausa Tcating ASTM C 136,C 117 a Location: Barrow (Pit 8 3 Cast Windsor,07) . Septic sand Retained on #4 Sieve Datc: 2.68% CRASN SIZE DISTRIBUTION TEST REPORT `i'R —STATE MATERIALS TESTING Tcc�,n i a an x. E00/EOO 'd SElt 6V6 E02(Xd3) Steta84pw a4e4S-?al 90 :21 (3nl)9002-12-NON PRIMUS & WELT•I ENGINEERS Glastonbury, Conn. r� Y v", T Tit Q. ,E�t� 5 La- s' t `43 T des , Q Q N p 14' ` 4Z' .�. I �� Ip�.'•G�J Via. - +,•fin '' O S" ',C. k£ 4 � PLOT OF s SOUTH-! VV tr3U50i. cOtori t r FOUNDATION CHECKED DATE SCALE I• = 5-0 CERTIFIED SU13STANTIA RECT SIGNED DAT 51CY f � 6k° HoUS DVTLCT ELL"VATIOn 95,50 25 LF — -_ y„ SC4 40 25 Con ours R3. " 1� � �,r -fnFSo+°ice -rANK INLET ! � ��'" ILTe(-fAeAc €LE, 9 5,00 z" ! OUTLET r c , 9y.15 a2 � L.F 5y. LF ! OF SCH 15 i GL C. D-Q�ox GlGda'�ioo 42.00 � \ GAfler'y 0E, iWV ! 91.10 yo LF GAllefie-S _L 18 LF of GAllertes ? BOX PRiMLjS & WEl,7'i ENGINEERS Glastonbury, Corm. ti Lai t7 54� 0 - —,_ O t7 N p N 1 e IS • i 14' dZ' PLOT PLA\ Q OP j 4 0 L.7 E© P—:-,is G Q L D i"i^t`.� •. ra GY- c P' -", t r FOUNDATION CHECKED DATE SCALE i` = .50 — CERTIFIED SUBSTANTIA RECT tIlk jIGNEDDATE 9ff.. G', �• -. -- i --_._ � ► � 1 9' � ff M .4 - _. ---__ - 1 -- -- --- - s--Z'-11 ---- --- -- --- - - - -- - __- -- - -- -_. -_ _ -_-- - ---- - -- - 7 � r_ IMPORTANT MESSAGE FOR a DATE_ 7�1_/ TIME M one Co' OF PHONE ?/�/6 Z 0 ❑ FAX AREA CODE NUMBER EXTENSION Cl MOBILE AREA CODE NUMBER TIME TO CALL TELEI'HONEQ PLEASE'CALL CAME'TO SEE y WILL CALL AGAIN WANTS TO SEE YOU Rl1SH i�'EMltRNEO YEUFI CALL WILL SAX Tb YOl1 MESSAGE ip SIGNED g� FORM 4005 MADE IN U.S A, RM#2 State of Connecticut Department of Public Health APPLICA1lU1v NU. INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner r Location 9,6 PERCOLATION TESTS:(Record all Tests) /1-2 2..-06 SOIL MOISTURE: (Date) (high,med.,low,etc.) TEST READINGS . .HOLE HOLE Tune ea g fine. -HOLE HOLE �.® g „' une ea g Tune Rea g 2. 2 /o`l y t TABULATION OF TEST RESULTS Hole Locana. Depth Presoak Time Percolation Rate ------------- OBSERVATION PITS:(Record all pits) Groundwater Table (Date) (Neat'max.,Below max:,etc.)` SOIL DESCRIPTTONS PTF. PIT . Z PITPIT 0-- a� � �t L lU _ TO f 4 r�ci 9 �v� Fill t z--yx- nnr d 3 �k n�a�l� z� ►����� ` 2� Pit Location TABULATION OF TEST RESULTS . Depth Ledge Ground Water Mottling 1/1/00 i 49 FORM#2 Con'd State of Connecticut Department of Public Health Investigation for Sewage Disposal System ✓Vl of f 62 � ► 6 �v AN LOCATION DRAWING SPECIAL CONDITIONS CONCLUSIONS System design larger than 2;000 g.p.d Suitable for sewage disposal (� or Water supply watershed Possible seasonal high groundwater Unsuitable.for sewage disposal. . �u ,ri Watercourse,marsh or pond a r Possible seasonal flooding Additional investigation required t h� Limited suitable area Excessive Slope(over 250/6) Retest during wet season Marginal soil(30-60mins/inch) Shallow ledge.(less than 5 ft.) Monitor groundwater thm wet season Underlying tight soil(less than 4 R.) Other Engineer's plan required DESIGN RECOMMENDATIONS Investigated by Title Confirmed/witnessed by Title Comments: 1/l/00