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Home My WebLink AboutPermit to Discharge Correspondence 161 L `O*IN SF4 O J fi 1 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 f�OSOR-CO TELEPHONE (860) 644-2511 PERMIT TO DISCHARGE Approval is hereby given to 161 Long Hill Road,in accordance with the Public Health Code, Section 19-13-13103e(h)to discharge to a subsurface sewage disposal system located at 161 Long Hill Road,in the town of South Windsor,CT,that will receive treated domestic sewage from a: Four(3)Bedroom Residence Permitted Volume/Design Flow=450 Gallons per day *In order to provide a sufficient factor of safety,it is recommended that the average daily discharge not exceed 2/3 of the design flow or 300 gallons per day. Operation and Maintenance: The septic tank shall be inspected regularly and cleaned as needed but not less frequently than every five years. The septic tank has an effluent filter. Effluent filters require periodic cleaning.Failure to clean the filter could result in a backup of sewage into the building or effluent breakout. Special Requirements and Restrictions: 1.Wastewater(backwash)from a water treatment system cannot discharge to the subsurface sewage disposal system. 2.Use of a kitchen garbage disposal is not recommended. 3. Signs of malfunction or failure should be addressed. Exceptions: Date of Final Inspection:November 9,2009 Inspected by: Robert De Vito,R.S.Environmental Health Officer Signature: ! Date: l 1 0 � I 18 to +o t0 � % I i Tcan� +o 3b� ►S qt� Q IQ 3 get( 1 i i � TrenC H 0 uhi�S i ,�pW N Sfq AA <` v 7-own O-P s.0-fdA ?d w� 1540 SULLIVAN AVENUE• SOUTH WINDSOR, CT 06074 f�asoR-CO TELEPHONE(860) 644-2511 Septic System As- Built Plan Street Address � � 1'01V6 rLL Date Permit Number New Septic.System�epair of Septic System Alteration of System Number-of Bedrooms_ or Design Flow of Building Type of system installed 77�S /Z ' (e.g.stone trenches,infiltrators,galleries) Square footage of system:Total length Width y . Effective Area ' Capacity of Tank New V Existing ZrgnL Length of house sewer pipe �f j' �5 9" Minimum distance between septic tank and foundation >2 Minimum distance between leaching field and foundation ? Z-S Minimum distance between sewage system and nearest well -771 72) 77141,S 100-0P' W e// Public water supply Minimum.distance between leaching system and property boundary >/i Curtain drain required? Yes No, Minimum distance from leaching field to drains > Z s (curtain drain,foundation,stormwater,etc.) Town of South Windsor Town: INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner: Date: Location: Soil Tests Observed By PERCOLATION TESTS Hole# Pit# Hole# Pit Test Pit Depth Presoak hours Presoak hours Ledge Seepage Depth Mark Depth Mark Mottling Roots Depth Observation V Rate minrn Rate minrn Test Pit Depth Test Pit Depth Ledge Seepage Ledge Seepage Mottling Roots Mottlin Roots Depth Observation Depth Observation �,� `� TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department, Town of South Windsor Fee Paid 10.0d Date f�'�`�� Permit Number 's a subsurface sewage dispos I system installer licensed in the State of Connecticut, 1 A+MQS fLl111�� Ci7 R."_-'-� de' 1/.�rNpY. ;1�SOdcIS� Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal syste� located at 1 andownedby Rc.klc_ m%/c'n. Street, Address,j Lot Number Name Address Information to be sup lied b Ap��lic t: Type of dwelling �p,5e ,'nTar . If non-residential, estimated daily flow Residential,Commercial,Etc. Number of bedrooms -2 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 (,A/11?,,1 I . If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels Percolation rate Square feet of effective leac i e requir Size of septic tank Type of system Trenches,Drywelis,Etc. Number of dry wells, trenches, etc. istance between individual leaching units. Distance from well on same property on ad0trig 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 gA,6j d f S nature of Applicant&License Number For Office Use Only r s1 Permit issued by Date System installed by Final Inspection Approval Date 0�- �JWIF IV �Q ' AM cp -7/ l ' Drys J T` s X, ays�� TO/TO 39Vd 3MO�]Hl WIr V89ZZBZ098 OT :LT 60OZ/ET/OT