The URL can be used to link to this page

Home My WebLink AboutSeptic Repair 99 Chapel Road w a00re Town of South Windsor — Health Department 1640 Sullivan Avenue, South Windsor, CT 06074 C f.J Phone: 860-644-2611 ext. 248 Fax: 860-644-7280 PERMIT TO DISCHARGE Approval is hereby given to Robert and Robin Klemba, in accordance with Public Health Code Section 19-13-B103e(h)to discharge to a subsurface sewage disposal system located at 99 Chapel Rd. in the town of South Windsor,CT that will receive domestic sewage from a: Residential building containing 3 bedrooms. Single family(YIN).Y. Restaurant containing seats. Commercial/Office building providing square feet. Other structure as described: Design Flow=450 gallons per day. Permitted Flow=450 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 300 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)Y. 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) . If yes, stipulate pump-out requirements: Special Requirements and Restrictions: 1. In the future if there is a septic g stem malfunction or failure it must be addressed. Exceptions(Repairs Only): File Information: Construction Permit No.201501125. Approved as-built on file(Y/N) Y . Date of Final Inspection: 8/20/15 Insp ted : He er Oatis Permit Issuance:jIssuby: Title:2:�4& irect f H th or R �stered Sanitarian) Signature ate: k 2 d � � ... . :. .: .. �:' .. .....................::...I!,_.....:.��..1!..I:..:......!.......I::..............��...:..1�......................:I..1.�..:.-.�....I..........r........,"lo...:.:.��.w....I....II..:e......1...'...........:..I.�......:��..:...........—.........�1....—....P......!.:....:.1I�7....:...-e....I..—...........II-,...:.�I..._-........"........:.:....x1.I..��.1..........-.........I��_�......A..�...-.�..�.�._.....,.....�..1...:I:�.2....:��:I.,�.....I..,....�1-;..�i.......�.��,..1II...:,�..��;.......I,...�—..........P.-.:1...��...:;..�..1.�....._..I....X�11..�.0.._�...I-.��:8:....I....i:1,......I.�...I..�-......:�o..�.....z1..,�.._:.�0..i1�i'- ��._.-�.1.0L�...o...:.........I...�s.1I1..... . . .. ....E:�I.[I.,I..I..O;.�...";.I.w....�I1.�.,iv-=I.7'.,,III.r.:�....""I...:�.._...:..:..�.:.;�A2,�.:....�.I....:%...,:.II. .. .. .. 1... .., .. .. rrkL N::.. .. aM " . ... " :, w : .. ,..:..........::.....�.1.�I.p . } P'" `� Y ►T5,-1itTi►I�' Ctw'�T) i...�A.:.I4�...I....,.....�I.....:o ...;�.�.I...II...,..i-��....":..I.....;1:I"...k......I"....,.;!..1.�_.-:v... L..1I..' .:.*.. .a:...:...:'..I... } . . Y na ". : : 1ti tcafEo+hfm . ". : . side [toes " iV..8 DIY:,tray,pacic� i t s l oft..i .. . showing separ tton disfancss ►, system�hstaii tiun Include Ali ;. due" infrmat#on•tr prate an: ccamtr i +�d aenrtstm Iat+an S :. a iitt.fi !twwty sides of the t�ailin�r at fhe Systen� � an tw�se si~; istrixiiion byes,trench tt webs our a�rr�d ir[, of ik i wetnr.> u piy vrnl,i[s n i y o �r fea u r tin9 the system a •i t♦on.; I. . is •.. u : ; O .r. 4, 1 -- . .. . ... : ,_ "�1 r . ;� . . . .. . r , k .. ::. ,:. -: ; . . .. . . .. . .. . . .. . . . ::Al. .. . ... ... . . .. . . . . .. . 1:... . .- . . .. . .. "°. .. ,...; ... .. . . :; :. . ...;.. ":: , I •. . .. ..: . .. . ; ....':':. .. . .. ...... { .. :.. .. .. ':' .:. .. ... .. .' : .. A".. :.: ..::. . . .. ".:. ... .. .... .. .: .. .. .. .. . ..:.:... ....:. ... . .. :; . . . .... . ..: ..... .:.: : ..... :. s '. : . .. . ... .. - . . . : .:. ..:....: _ .. . :.. ' ..• : `� 8 # # #8: # # rric�efro 'Qomr%A'' 1: fsT `� a an�e tram comer.'"�" j � p s cefrom come+'11 ]��:: * 0i eW6. ritel'"E}` . . r I ELEIVEC3 .. : : . . ., . . . AUG 2'Q 2r115 S;OU7H.WINDSOR HEALTH� 1T. 't .. k ... ... < :: y('i w"tw � . Town of South Windsor -- Health Department 1540 Sullivan Avenue, South Windsor, CT 06074 k Phone: 860-644-2511 ext. 248 Fax: 860-644-7280 Subsurface Sewage Disposal System Final Inspection Report Property Owner: V,4g/k 4 b4 - A l/Permit# Z,6\6� fl 1 ZS" Prope ' Address: '1 Town: S• W 1 Licensed Installer: \ �-'+� License.#: 01 ?„{mil' '�'?_ Approved Plan Information Check one: New System ❑ Repair/Replacement System Residential Buildi bedrooms Large Tub: YES no J Garbage Disposal: YES v� Non residential Building/Residential Institution: GPD Plan Prepared by: Title: Plan Approved by: Date: Approval to Construct Date Permit Issued: Permit Issued by: Registered Sanitarian or Director of Health Inspection Information Licensed Installer Type Date Present? Yes/No Comments W, l tA^a , S%jSkeYr\ Field Stake Inspection(house, 3 + S Yri t)��d h well,property lines,system etc.) b Strip/Scarification Sieve required(Yes/No) Select Fill Placement Other: $1V111� ��/� T✓dne I ph�� Final Inspection I Lo 9— w e/ kA v�kii 44 ' 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: Q, Date: lZ��t v (Registered Sanitarian oADirector of Health) Print Lookup Details Page 1 of 1 State of Connecticut Lookup Detail View Name Name MICHAELJKYC License Information lookup License Type License Expiration Granted License License Licensure Actions or Number Date Date Name Status Pending Charges Sub-Surface Sewage 2482 12/31/2015 01/01/1901 MICHAEL KYC ACTIVE None Installer Generated on: 811 91201 5 1 2:32:10 PM I https://www.elicense.ct.gov/Lookup/PrintLicenseDetails.aspx?cred=793029&contact 163... 8/19/2015 09/12/2015 14:00 8608716838 EASTERN WATERPROOFIN PAGE 01 1 � , RECEIVE® AUG 13 2015 SOUTH WINDSOR HEALTH DEPT. , FACE" lz SST DATE:--f FROG OF PAGRS INC. COWR: C4hodKwSc qj c t � 11 TO SHOO SOUTN �VIN 08/12/2015 14:00 8608716838 EASTERN WATERPROOFIN PAGE 02 t Town of South Windsor - Health Department 1640 Sullivan Avenue, South Windsor, CT 06074 Phone: 860-644.2511 oxt 248 Fax: 860.644-7280 1PPLiCATION FOR APPROVAL T UCT A SUBSURFACE SPO EM Application/Permit N: To the Director of Health,Town of: � Wl rj cj Date: Application is hereby made for an approval to construct a subsurface sewage disposal system for a: {� ( (Residential Btu Restaurant,Retail Building,etc,) located at: om l Qd (Street Address,Lot Number, Subdivision Name,Map,Block,Lot,etc.) New System Addition Repair + Other Owner D)C rn� ,_Address"{� 1 Tel.No. Installe Address 4'I L► ]�, 4) Te1.No. T6 Installer License No. In accordance with detailed information stated below. Application fee paid Signed (Owner or du autho z representative) GENERAL INFORMATION ` Soil Tests Conducted(Date): l('�� 1 I Lot size &(0 1Mb sq.It. Area of Special Concern(YIN): If yes,Reasons) Basis of Design(#of Bedrooms,Restaurant Seats,Building Size,etc.): Engineered Plan Required(Y/N):�_If yes,Name of Engineer: Address of Engineer: - Design Plan Approved(Y/N): Date of Approved Plan: Revision Date: Type of Water Supply If well,has location been approved(YIN): Well Driller's Name: Address: OFFICE USE ONLY Approval to Construct issued by: Date: (Director of Health or Rcgistcrcd Sanitarian) Signature: _—.___—Title: 08/12/2015 14:00 8608716838 EASTERN WATERPROOFIN PAGE 03 rke, TEMP •' 4T'•G -3a4 6Ir LEACHING ARl./► WWlC► ' 1�5Q "LLaw GEpltt 'TwaK 115E J' -a! w11M 0MILM44eO oil) —Akfi Qvies1ee0 � Xl iyl+n i. so lire' %/F':� -.11M1 LAS DRws. ~ • ,_ R►, ass. r Manca�° ' 9 CHAPEL 1 IAL PROPEWY OF nDELE H. JURGELM APEL ROAD 'SOUTH W DSOR COI EMIL . : LUCEK. ASS,OCI�ATES NO. R4V StaHS DATE 8"" r s40! DATE 8-24-78 CONSULTING ENOINEIN e OSKUKR 11O11b WGMM A.V.M. CHIM90 I.W.L.- SOUTH W11iom COOK& Va rnouar -�q aH��T i 4ak.uk *-K.., Form#2 Alternate Technical Standards for Subsurface Sewage Disposal Systems 1/l/15 SITE INVESTIGATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM Location: C f/, Weather: r- Percent Slope: Parent Material: Date: Time: Completed by: ,/ L , S Accuracy Assured by(if P.E.completed form): AMC P.E.or Certified LociffRealth Agent iJfieed�Local health Agent Others Present for Site Investigation: Q— 'E C�V f 11 N) 0✓S 67.i Vt g �I�LL/ f&O'Al - (Installer,Developer,P.E., etc.) Test Pit#: ` Depth to Observed Ground-Water(inches): Weep' *: Standing: Observed Ledge: Soil Depth Matrix Color Redoximorphic Features Soil Texture(USDA) Gravel Soil Roots Other Horizon (inches) (moist) Depth Color % I Percent Consistence N N Test Pit#: Depth to Observed Ground-Water(inches): Weep' Standing: Observed Ledge: Soil Depth Matrix Color Redoximorphic Features Gravel Soil Horizon (inches) {moist} Depth Color % Soil Texture(USDA) Percent Consistence Roots Other Test Pit#: Depth to Observed Ground-Water(inches): Wee pi Standing: Observed Ledge: Soil Depth Matrix Color Redoximorphic Features Gravel Soil Horizon (inches) (moist) Depth Color % Soil Texture(USDA} Roots Other Percent Consistence