The URL can be used to link to this page

Home My WebLink About819 Ellington Road ti Town of South Windsor — Health Department ` = 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address 1530 Sullivan Ave., South Windsor, CT 06074—Office Address ��'°"`°Yt_ Phone Number: (860) 337-6173, Fax Number: (860) 644-1930 PERMIT TO DISCHARGE Approval is hereby given to AA ay\ Mgn/pVN in accordance with Public (Property Owner) Health Code Section 19-13-B103e (h)to discharge to a subsurface sewage disposal system located at Street Address) in the town of S. W, r-46 C',i CT that will receive domestic sewage from a: Residential building containing 3 bedrooms. Single family(Y/N): Restaurant containing seats. Commercial/Office building providing square feet. Other structure as described: Design Flow= L(5'%3 gallons per day. Permitted Flow= Ll 3'-' gallons per day. The design flow shall equal the permitted flow, except for non-compliant repairs(See Section IV D). In order to provide a sufficient factor of safety it is recommended that the average daily discharge not exceed 2/3 of the permitted flow or 3 a gallons per day. Operation and Maintenance: Septic tank shall be inspected regularly and pumped as needed but not less frequently than every five years. The septic tank has an effluent filter(Y/N) A/1A . Effluent filters require periodic cleaning. Failure to clean filters can result in sewage backup into the building or effluent breakout. Restaurants serviced by external grease interceptor tank(s)require quarterly inspections and cleaning as necessary. Tank pump-outs tracked by local health department(Y/N) A/ If yes, stipulate pump-out requirements: Special Requirements and Restrictions: 1. In the future, if there is a septic system malfunction or failure it must be addressed. Exceptions(Repairs Only): File Information: Construction Permit No. Approved as-built on file(Y/N) Y _. Date of Final Inspection: ��t_Zc)`\\g Inspected By: ,�i \�Qo j Permit Issuance: Issued by: t.kQp(,4W Ooj�i3 , Q((ZfH-5 Title: £h,v• (Director of Health or Registered Sanitarian) ad Signature: Date: Town of South Windsor — Health Department 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address 1530 Sullivan Ave. South Windsor CT 06074— Office Address Phone Number: (8601 337-6173. Fax Number: (860) 644-1930 APPROVAL TO CONSTRUCT OR REPAIR SEWAGE DISPOSAL SYSTEM Approval is hereby granted for the construction/repair of a subsurface sewage disposal system at the property described below: PROPERTY OWNER(S): Alan Marsh STREET ADDRESS: 819 Ellington Road TOWN: South Windsor INSTALLER: James Throwe CT. LIC#3856 EXPIRES: 05/31/2019 RESIDENTIAL: #of Bedrooms-3 INSTRUCTIONS FOR INSTALLER 1. Construction plot plan submitted and approved by this office must be adhered to. 2. This office must be contacted for approval if any change is going to be made in the system location,size or design,or any changes in house,well or property line locations. 3. Any NEW sewage disposal system must conform to ALL requirements of Section 19-13-BI03 of the CT Public Health Code; installation must be under DIRECT supervision of a CT licensed installer(CT Gen. Statutes Sec.20-341) 4. The installer is RESPONSIBLE for VERIFYING LOCATIONS of PROPERTY LINES, WELLS, and BURIED UTILITY LINES Prior to construction. 6. Installer to notify South Windsor Health Dept.24 hours prior to the start of construction. 7. Installer to have septic tank covers removed at the time of inspection. SPECIFIC INSTRUCTIONS: 1. Install per approved plan, (James Throwe, Dated: 11/19/18). 2. Licensed Installer to field stake house, well (if applicable), permanent benchmark, and septic system. Offset stakes to include bottom of trench or flow line elevations. 3. A bottom of excavation inspection is required. Existing topsoil must be removed and replaced with suitable select fill material. Select fill to be perced once in place. Current Sieve analysis (within 30 days)for select fill must be submitted to the South Windsor Health Department. 4. Permanent benchmark to be set within 50 feet horizontally and 12 feet vertically of septic system. 5. Install 495 square feet of effective leaching area, consisting of one twenty(20) foot row and one twenty five (25)foot row of Mantis 536-8. 6. Installer to schedule, and be present for final inspection with Health Dept. staff. Level to be set up for verification of elevations OR an engineer's/surveyor's as built will be required. 7. Installer to complete and submit septic system as built plan and drawing with ties to the house. 8. Existing septic system to be properly abandoned. -)�� SIGNATURE: Dn DATE ISSUED: 11/19/18 RENEWAL:_/—/ APPROVED BY: Heather Oatis,REHS, HHS EXPIRES: 11/19/19 EXPIRES: /_1 THIS PERMIT IS VALID FOR A PERIOD OF ONE YEAR FROM DATE OF ISSUE. IN ACCORDANCE WITH THE CT PUBLIC HEALTH CODE SECTION 19-13-BI03e(F)(I). ONE RENEWAL IS POSSIBLE PROVIDED SOUTH WINDSOR HEALTH DEPARTMENT IS NOTIFIED PRIOR TO THE EXPIRATION DATE NOTED ABOVE. IF PERMIT EXPIRES, INSTALLERS ARE CHANGED, OR ANY OTHER DEVIATION FROM THE ORIGINAL PERMIT,A NEW APPLICATION MUST BE COMPLETED AND ALL APPLICABLE FEES MUST BE PAID. FEE PAID: 100.00 CHECK#1656 DATE PAID: 11116118 U I x off- q- 'J 0.S n 9 tq�'d �9'�� `✓ � r M Jun ZO Z010 11:56:80 Via Fax -> 060ZBZZ604 Vonage Page 003 Of 005 Local Eco Pages Inc DATE ..............,/............../................. 280 Madison Avenue , suite 912 New York , NY 10016 Invoice#"'R-1326 Payment Types: Check Visa M/C Amex Name on card: Address: card#: City: exp date: State: Security code: Zip: Signature: r= MATERIALsTESTING INC. L �. �. 55 LAURA STREET• NEW HAVEN, CONNECTICUT 06512 • (203)468-5216 1� t 42 BOSTON POST ROAD •WILLIMANTIC, CONNECTICUT 06226•(860)423-1972 DATE: 10-15-18 REPORT: M-1510 CLIENT: Desiato Sand & Gravel 999 Stafford Road Storrs, CT 06268 PROJECT: Client's Information SUBJECT: WASHED SIEVE ANALYSIS (ASTM C-136 D-1140) Material: Sand for Septic Source: Desiato Sand & Gravel, Storrs, CT Sampled: by client and delivered to MTI on 10/11/18 Sieve Size Percent Passing Mantis Wastewater Leaching System Specification 3/8" (9.5mm) 100 100 #4 (4.75mm) 97 95-100 #8 (2.36mm) 81 80-100 #16 (1.18mm) 59 50-85 #30 (600pm) 37 25-60 #50 (300pm) 15 5-30 #100 (150pm) 4 0-10 #200 (75pm) 1.3 0-5 This material as sampled and delivered meets the listed specification. Materials Testing, Inc. Ric''hffajjrd C. Kearns VV William J. Soucy ��OF�ONNEc is 1 cc: Client T �.� •• snwt40- = y '`'• '� � =* • `�_' 1 Test reports may not be reproduced without the express permission of Materials Testing,Inc. Results only relate to items tested. {G�•• �� `� SIONN\-� �•`�. Form#3 Technical Standards for Subsurface Sewage Disposal Systems 1/l/11 n° "°*•< Application/Permit#: ` Final Inspection Report g'.......NusoR.co`�r� Local Health Department: Property Owner: Property Address: ( t '" (� �',�'t"1 �` Town: Licensed Installer: ` . ��'� ,' �..�f '+-'- x"':5+.��:� License#: Approved Plan Information Check one: New System ❑ Repair/Replacement System Residential Building: bedrooms Large Tub: YES No" Garbage Disposal: YES (Nt% Non residential Building/Residential Institution: GPD Plan Prepared by: �\s? �. Title: Plan Approved by: "` Date: Approval to Construct Date Permit Issued: Permit Issued by: p, Registered Sanitarian or Director of Health Inspection Information Licensed Installer Type Date Present? Yes/No Comments Field Stake Inspection(house, well,property lines,system etc.) e Strip/Scarification Sieve required(Yes/No) 1, Select Fill Placement Other: t Final Inspection Was 24 Hour(min)Installer Notice Given(Y/N): Date Final Inspection Requested: Date of As-Built Final Inspection Completed by: Approval: Permit to Discharge Issued by: Date: Registered Sanitarian or Director of Health FORM#3 (Cont'd) Technical Standards for Subsurface Sewage Disposal Systems 1/1/11 Final Inspection Report House Sewer Information 6 , Pipe Type and ASTM Specification: )qa Pipe Size: Lkin. Pipe Invert Elevations at: r 3 Pipe Length: ft. Foundation Wall: Pitch Required: U -t , 1 Septic Tank: Pitch Provided: \ Tank Information Septic Tank Size: Gallons Tank Inlet Elevation: Tank Manufacturer: Tank Outlet Elevation: Date Manufactured: ` Riser Needed(Y/N): Outlet Filter Type/Manufacturer: Pump Chamber Size: Gallons Pump Alarm Checked(Y/N): Pump Chamber Manufacturer: Float Control Elevation Verified(Y/N): Grease Interceptor Grease Interceptor Tank Tank Size: Gallons Manufacturer: Leaching System Information Approved Aggregate: Free of silt dirt and debris(Y/N): Sieve Required(Y/N): Filter Fabric Present(Y/l): Type: Aggregate Meets PHC Specifications(Y/N): Select Fill(Y/N): Meets PHC Specifications(Y/N): Sieve Information on File(Y/N): Leaching System Description(product,size,length,number of rows,level or serial etc.): Effective Leaching Area Required: Ltj � sq.ft. Reserve Area Provided(N/A,Y/N): iv t Effective Leaching Area Provided: " sq.ft. Center to Center Spacing: ft. System Installed Per Approved Plan Elevations(Y/1): Elevations Field Verified(Y/N): Elevation notes: .l' } Z• 0 L V:,J C) 141612 2-0 ZS .�"7, Separation Distances Separation Distances Conform with Approved Plan(Y/N): Separation Distances Field Verified(Y/N):_\-1 c -r �aFYL � r � Cam lj c u Sen d1 Cap , h Qa"ie (4(a Re> �C7- �L ,* qo vy� r riq Y, qg 1 �P ou o M e Lo ri) g - Mg 2� *�SpVTW E�p�O�NT H��H D SEPTIC SYSTEM AS-BUILT PLAN (continued) Address ( FA �tG�� Date 2C)A_k1U Location of System .50 VA side of house (N.S.E.W.,Front,Back) Draft a substantially correct drawing showing separation distances of septic system insallation. Include all of the following information to provide an accurate record of the entire system location: At least two sides of the building nearest the system,septic tank,house sewer, distribution boxes,trench ends,dry wells,curtain drain,potable water supply wells,and any other features affecting the system and its location. Installer's Name Ua n IL r, z- ZC License#�� Installer's Address m ►n y �� ( J t nj J uv_ G r 66c)-1 (street,city,state,zip code) Installer's Email \_.. .' ,✓ 6 _4� ` Z z r Point #1 #Z #3 #4 #5 #6 #7 #8 Distance from corner"A" 5° � Distance from corner°B" � 1 � Distance from corner"C" Distance from corner"W' Town of South Windsor — Health Department o �. 1540 Sullivan Avenue, South Windsor, CT 06074 mow` Phone: 860-644-2511 ext. 250 Fax: 860-644-7280 �suR-, SEPTIC SYSTEM AS-BUILT PLAN Date U Permit Number AII Street Address_,1�f ��►axt'o� c� New Septic System Repair of Septic System Alteration of System Number of Bedrooms -,3 OR Design Flow of Building Type of System / Installed 14 ca c�� &3 q L� (e.g.stone trenches,infiltrators,galleries etc.) f Square Footage of System: Total Length Width Effective Leaching L r;<,.. Area 7 , Capacity of Tank 4 b y -� Tank: New - Existin Length of House Sewer Pipe Minimum Distance Between Septic Tank &Foundation Minimum Distance Between Leaching Field &Foundation J' Minimum Distance Between Sewage System& Nearest Well 5 Public Water Supply Minimum Distance Between Leaching System and Property Boundary Curtain Drain Required? 1 V 0 Minimum Distance From Leaching System to drains (curtain,foundation,storm water,etc.) RECEIVED NOV ? 12018 SOUTH WINDSOR HEALTH DEPARTMENT ***DRAFT DRAWING ON REVERSE SIDE OF FORM