HomeMy WebLinkAbout2013-9-5 - 101 Colony Road - Septic InspectionTown of South Windsor — Health Department
Subsurface Sewage Disposal System Inspection Report
PROPERTY LOCATION:
BOTTOM OF EXCAVATION:
PERCOLATION TEST "FILL CIIECK":
DATE:
42L—
DATE: 4-
al-
DEPTH HOLE # DEPTH HOLE #
TIME READING TIME READING
PERC PERC
FINAL INSPECTION: SANITARIAN S1�� }.�� �� ..` �, DATE:
1. SEWER LINE: 4 K^'L
A. SEWER LINE CEMENTED AT FOUNDATION (Y/N) °"`L ' ^`" '"""� PEE LENGTH �7
� * pR FT
B. PITCH (.25 inches per foot min) REQUIRED (s . ' Z � FT ................ OVIDED t3.7.''
D. PIPE TYPE & ASTM SPEC. . c-!b .............PIPE SIZE (INCHES)
2. SEPTIC TANK:
A. MANUFACTURER ':22tL DATE MFD i SIZE. Gib GALLONS
B. TANK COMPARTMENTS PLACED PROPERLY
C. INLET BAFFLE (not in middle of opening). ; ��OBSERVATION OPENING (slag removal)
D. OUTLET BAFFLE FILTER TYPE c1, k w RISERS NEEDED (YIN) L SIZE
E. TYPE OF PIPE A S 1 t. A 303 -, (approved by code)
3 PUMP CHAMBER/GREASE TRAP N
A. PUMP CHAMBER MANUFA E� ... SIZE GALLONS
B. TYPE PUMP ...........PUMP ALARM CHECKED (Y/I�
C. FLOAT CONTROL ELEVATION VERIFIED (Y/N). .....TYPE OF PIPE
D. GREASE INTERCEPTOR TANK SIZE GALLONS ........ MANUFACTURER
4. D BOXES:
A. LEVEL (Y/N) SERIAL DISTRIBUTION (High level overflow within top 3') .......
C. LEVEL SYSTEM (Ends tied together) (Y/N)
5. TRENCHES:
A. LENGTH OF TRENCH ............ 1. +�2. 3. 4. 5. 6.
B. GALLERIES (stone around all units). L 2. 3. 4. 5. 6.
C. CENTER -TO -CENTER SPACING Lj nr FILTER FABRIC PRESENT (Y/N) TYPE
D. APPROVED AGGREGATE FREE OF SILT DIRT & DEBRIS (YIN).
F. AGGREGATE MEETS PHC SPECIFICATIONS (Y/N) TYPE OF PIPE
G. LEACHING SYSTEM DESCRIPTION: i
6. SEPARATION DISTANCES CONFORM VaM APPROVED PLAN (Y"
SEPARATION DISTANCES FIELD VERIFIED (Y/N)
PASS FAIL COMMENTS:
WELL INSPECTION: SANITARIAN DATE:
WELL LOCATION Sanitary Well Cap
Rev. April 2012
PROPERTY LOCATION:
PROPERTY OWNER:,,
INSTALLER: � , ,,..,
FINAL INSPECTION ELEVATIONS
TOWN:
SANITARIAN: DATE:
LEVEL TO BENCHMARK (ROD READING)
BENCHMARK ELEVATION
HEIGHT OF LEVEL , f
SEWER LINE AT FOUNDATION
e4diameter f i FE
-�'_.-i•
SEPTIC TANK INLET
SEPTIC TANK OUTLET
PUMP/GREASE TRAP INLET
PLW/GREASE TRAP OUTLET
D-BOX # 1 INLET
FLOWLINE RIGHT
FLOWLINE LEFT
ti
OUTLET
AA vv
D-BOX # 2 INLET
FLOWLINE RIGHT
FLOWLINE LEFT
OUTLET
D-BOX # 3 INLET
FLOWLINE RIGHT
FLOWLINE LEFT
OUTLET
TRENCH # 1
T�,
p,�,
RIGHT
LEFT
TRENCH # 2
RIGHT
LEFT
TRENCH # 3
RIGHT
LEFT
INVERT ELEVATION = Top of Pipe + Diameter of Pipe — Height of Level
HEIGHT OF LEVEL = Benchmark + Rod Reading
Reference: