HomeMy WebLinkAboutSeptic Repair 878 Strong Road WK .42 SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION NO.
' 1XVW=GAT1Cff f OR SEWAGE DTS?OSAL SYSTT,94
owner 91/1 4m e", LOCAMN w,-54 Pd
PERCOIATION TESTS: (Record all. tests) -gam SOIL MOISTUTRE:
Date , med., f lov. eta.
TEST READINGS
HOLE #1 3= #2 RCLE #3 HOLE ,#4
Time Reading Time Reading Time Reading Time Reading
if/, ya -7/ ,
!v
1Pe+�7!/ cif
to �Y�Z
r
TABULATION OF 'PST RL-LILTS
Depth Presoak Minimum .Percolation sate
Hole Location (Iachss) Ers. ) (Mins./Inch)
2
3
4
OBSERVATION FITS: (Record all pits) 7 7 Ground Water Table- w
?Date ;?ear mmx., Below Max*, NNE
OTL DEZCRIP 0' 140
F= ! PIT Pam+ 03 PIT AD `l
C?-8 "�l`,� So;l C2- S" -to �01� fi",i1a` f� 2 r
' �� d Iiff gI,yv •� Fiue-S fay fiW ��.tt��
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36 w Z yo-S/s- fiPy s C ue� _,_ �' i Xil.'L
%L 7 c9 r r7
TABUTAR,70TT OF OBSERVAmIC17 PI'"S
Ground So
Pit Location Depth L_dgp At dater At Mottl
A
B SCE x oil
C beC.16 side,
D
r i1z tt= 5 U U TH W 1 N U 5 U R HEALTH -.;d- Investigation,_for Sewage,- Disposal.Syste
DEPARTMENT
SPECIAL CONDITIONS -
System design larger than 2,000 g.p.d. Water supply watershed
Sigh ground water (less than, 14 ft. ) possible seasonal high
ground water
Watercourse, marsh or pond Possible seasonal flooding
Limited suitable area Slope over 15 '
Marginal soil (30 - 60 mins./inch) Shallow ledge (less thaa 7 ft.)
Underlying tight soil (less than 4 ft) Other
CONCLUSION
v .
Suitable for sewage disposal
Unsuitable for sewage dis
posal
sposal
Additional investigation required
$,Peek-jq G
Retest during Wet season
Engineer's plan, required
1 DESIGN RECOM MMATIONS
w�s-f Rd
\stigated by /Q .�Q �t-y Title
`Red/Witnessed by Title
cation
Elevation
G^s
TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install ( ew)/ epair subsurface sewage disposal system. To the Health Department,
Town of South Wi m4el
Fee Paid ,2o= 2- Date q�1��0 Permit Number
As a subsurface sewage disposal system installer licensed in the State of Connecticut, 1
��,d.•� cen.vSr /��LP%i cvi cr 4:— 5. F�.sT QO 1 30'7
Name, Address, Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system located at
9- 6 .7'/LO.v6 20,0D A®T 3 and owned by CevAAS
Street, Address, Lot Number Name
r,0
Address
Information to be supplied by Applicant:
Type of dwelling If non-residential, estimated daily flow
Residential,Commercial,Etc. G
Number of bedrooms � Size of lot
Number of fixtures above basement /a
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any o ,
Pumped or gravity flow,
Type of water supply I U/0 T1 If private,type of wellF��
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 b14Sgnal. f
�00
Date T'���8�
4ant&License Number
For Office Use Only /�
Permit issued by �[ - R-d Date
System installed by
Final Inspection Approval Date ra`// — ts�
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NOTES SOUTH WINDSOR HEALTH DEPART14ENT s�rD"5 Rd '
LOCATION 67 Y ofcl
OWNER — i► - a
TYPE OF WORK A"t,
DATE o-//-�rX PERMIT PIPE
INSTALLER W Cc Hsi•
INSPECTOR RO DRAWN BY D