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Home My WebLink AboutSeptic Repair 696 Main Street c'0 V`tki WINDSOR K Th t «: rw.-.id .:,.: _ i. ATJO.,1b G •j nfVES=GATTCX FOR SMGE DISPCSAL SYSTEM n 1 a PPMOTATION TESTS: (Record all. testa) 41-23 xis SOIL MOISTURE: (Date), med., low, etc TEST RFADIMS 1 HOLE #1 1= #2 -CLE #3 Ht7LF. Time Reading Time Reading Time Reading Time Readins J-7 OIL r+� �3 / ?°/Z 5/ TABULATIOR OF Tom..--T RIM s-TLTS Depth Presoak Minimum .Percolation Rsate Hole Location (?'nch:s} rse ) (Mina./Inch) 2 3 4 C3.-cER4ATION PM: (Record all pits) �r`��-3'� Ground Water T-sblel. Date ;dear ;fax. Below Max.;�c OIL DErCRIPT'IM-10 PIT A Pr." B PT-T C O-)a j J� TaLTLATTOR OF OBSERVAnOR FITS Ground Soil Pit Location Depth Ledge At Water At Met'.2 ng A C —.---- D F : ir` SOUTH 6 - Iavestigstioa_tor Sewage D spoe". DEPARTMENT SPECIAL CONDITIONS system, design, larger than, 2,000 g.p.d. Water supply watershed Eigh ground water (less than 4+ ft. ) Possible seasonal, high ground water Watercourse, marsh or pared Possible seasonal flooding Limited suitable area Slope over ISM'' Marginal soil (30 - 60 mins./inch) Shallow ledge (less thaa 7 ft.) Underlying tight soil (less than '+ ft) other CONCLUSION Suitable for sewage disposal Unsuitable for sewage disposal Additional investigation required Retest during wet season mad veer's plan required DESIGN RMWI-00ATIONS Investigated by �.��L��I�i.�iti.. Title Confirmed/Witnessed by Title Comments: Rench.mark location Elevation SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION No. CHECK LIST REVIEW OF PLAN INSPtCTION r SE54AGE DISPOSAL SYSTEM uumer _knC102-ZLi 6 96 N1 � Date Location Rec'�. ?laa prepared by '�— Title Address Site Investigation y.23-93 Investigated by Q (Date) Bench mark location Elevation -�esiga Percolation Rate 3 Mins./inch at hole(s) 3 If residential, number of bedrooms IF non-residential, estimated daily flow HOUSE SEWER (INVERT LEVELS) Depth at foundation wall Depth at septic tank SEPTIC TANK . st-r- QS 6vi cleanout located ft. From and ft. from g�l Manufacturer Size U gals. Depth to cleanout n i3 ere LEACHING SYSTEM Description_ e y)j v a•9 c.i 5-t Effective area Sl6 sq. ft. Required effective area rop sq. ft. ;pacing between units l2, ft. 10CW p reserve area provided -- Bottom of leaching system 18 inches above maximum water table Bottom of leaching system 4feet above ledge rock 11 Bottom of leaching system 30 f inches below final grade. 'Pumping required 110 Curtain drain required ;aerial distribution tin bevel system f SEPARATING DISTANCES Nell located ft. from — �V b d � ft. From Distance sewage system to well on property ft, To water service ft. To well ou adjacent property ft. To property line/49 ft. To house served ft. To dwelling adjacent property 7 abo ft. To nearest watercourse 7 jcu ft. To nearest ground or surface water drain ��'� ft. nevieWcd/Inspected by �, Title ew-, PIAN/INSTALLATION APPROVED DATE �=3 -g 3 INSPECTION FEE PAID �l avVan r.aa.lJ.�vn t1L:nLan LL'rnntniDl\t r APPLICATION FOR PERMIT TO COST OR REPAIR A SEWAGE DISPOSAL SYSTEM • (Office -Use Only) APPLICATION NO. TO THE DIRECTOR OF HEALTH TOWN CF 66uTu w.,Na sQp_ DATE 13 -9 3 Application is hereby made for permit to construct a savage disposal system for a Res e, Store, Re 8to. Located at f l 04/AI c3 T (Street Address,, Lot Number, Subdivision Name; Map, Block, Lot, c• New System Addition Repair Other Owner JON 19,4NO'dZ z / Address /W /?/1/41ti1 57- Tel-No. Installer Sk(PS S;L!::-P77 C Ski v rcr--Address `) rR a DOy I-t ook— 7t A Tel.No. g17 5'o?33g- Installer License No. 00.1, 7 In accordance with detailed information stated below Sigaed, (Owner or authorized repres ntative) Application fee paid t/ GENERAL IWORMATION Subdivision Approved Date Lot size Sq. rt. On public Water Supply Watershed On Designated Wetland SCS Soil Classification Public Sever Scheduled - Date if residential, number of bedrooms_-- Flood zone If non-residential, design criteria; (Sanitary Facilities, No. of anployees, Meals Served, Eta.) Basement Fixtures Foundation Drains Special Equipment ENGINEER'S PLAN REQUIRED TEST DURING WET SEAS ON Water Supply 1_L_,&C Type Well e Well Location Approved Yield Satisfactory Sample —----- (Date) Well Driller's Name AAArPas rWATER SUPPLY APPROVED r' 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 Vi=-W Fee Paid LDS Date Permit Number As a subsurface sewage disposal system installer licensed in the State of Connecticut, I Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at Ora IV41AJ 57- and owned by JdAl FAA),Doz-7 Street, Address, Lot Number Name 6 9& Al191AI 5 T .57e u TI-1 4J,(Alm d7Z Address Information to be supplied by Applicant: Type of dwellin If non-residential, estimated daily flow Residential, ommercial,Etc. Number of bedrooms 4— 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 If private,type of well Publi rivate Information to be supplied by Health Depa ment: Soil type at various Levels .Sctn Percolation rate �J Square feet of effective leaching area required J�V Size of septic tank /00 2�1 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 kilo Yes,No Height of system above ground water y maximum ground water '> �g , 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 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. Oo.2-247 Permit Received by Date s ¢ 3 Signa*Applicanticense Number For Office Use Only Permit issued by Date System installed by i .:F Final Inspection Approval Q Date sn3-9 3 yv\ a� �U / - I^ I _I r I r I � I i HEALTH DEPARTMENT NOTES SOUTH WINDSOR LOCATION 696 /1/lGc h S7R OWNER Z . TYPE OF WORK i 1r DATE PERMIT PIPE INSTALLER INSPECTOR DRAWN BY 4 QUC r F 'Pry (2