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HomeMy WebLinkAbout2009-9-28 - 1096 Ellington Road - Septic ApplicationTOWN OF SOUTH WINDSOR ALTH DEPARTMENT Application for permit to install a new/ ep r subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid Date Permit Number S7rv^ s a subsurface sewage disposal s stem installer licensed in the State of Connecticut, I _Pts' T2�l.�c 1Ll ar", Name, Address, Telephone Number, License Number hereby apply for a gegnit to construct/repair a subsurface sewage disposal system I cated at ( 1� C11 ",s n . and owned by �t' Street. Address. Lot 4umbar Name Address Information to be supplied bjAppiicInt: Type of dwelling _ V1 ) A Residential, Commercial, Etc. Number of bedrooms 3 Number of fixtures above basement If non-residential, estimated daily flow Size of lot Number of fixtures in basement, if any 7k, A-4 Type of water supply C rk, N, d If private, type of well Public- rivale 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 Number of dry wells, trenches, etc. units. Distance from well on same property Curtain drain required Yes, No Height of system above ground water ledge , impervious soil layer If automatic closing is required, description Tubs, Sinks, Toilets, Etc Pumped or gravity flow, Trenches, Drywells, Etc. - Distance between individual leaching on adjoining property maximum ground water 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 by LDate S na ure of Applicant ILicense Number For Office Use Only , /. Permit issued by _I O<Z�Y System installed by �"'``�' i1 �"' Final Inspection Approval Date _ Date 710-w� 07e Sou� V&U&ot 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 TELEPHONE (860) 644-2511 PERMIT TO DISCHARGE Approval is hereby given to 1096 Ellington Road, in accordance with the Public Health Code, Section 19-13-B103e (h) to discharge to a subsurface sewage disposal system located at 1096 Ellington Road, in the town of South Windsor, CT, that will receive treated domestic sewage from a: Four (4) Bedroom residence Permitted Volume/ Design Flow = 600 Gallons per day *In order to provide a sufficient factor of safety, it is recommended that the average daily discharge not exceed 2/3 of the design flow or 300 gallons per day. Operation and Maintenance: The septic tank shall be inspected regularly and cleaned as needed but not less frequently than every five years. The septic tank has an effluent filter. Effluent filters require periodic cleaning. Failure to clean the filter could result in a backup of sewage into the building or effluent breakout. Special Requirements and Restrictions: 1. Wastewater (backwash) from a water treatment system cannot discharge to the subsurface sewage disposal system. 2. Use of a kitchen garbage disposal is not recommended. 3. Signs of malfunction or failure should be addressed. Exceptions: Date of Final Inspection: October 5, 2009 Inspected by: Robert De Vito, R.S. Environmental Health Officer Signature Date: 16 - Y d S SOIL GRADATION REPORT Quality Washed Sand & Stone Since 1917 Date: 08/1/2009 Gradation ASTM D-422 Project: Dunning Washed Concrete Sand Project Number: Client: Various Report Number: Use: Concrete Spec A: ASTM C-33 Source: N/A 09-105 Pile GRADATION RESULTS Sieve # % PASS SPEC - A (#4) 96.79 95 * 100 (#8) 83.3 80 * 100 (#16) 69.49 50 * 85 (#30) 53.29 25 * 60 (#50) 28.55 10 * 30 (#100) 7.57 2 * 10 (#200) 0.82 0 * 5 Complied with Spec A: Soil Description Sampled by: Tested By: Reviewed By: YES Light Yellow/Brown Sand - Trace fines Anthony Moura Brian Brooks Blair Crane { \ � _ \ ---- -----: --- -- ~ \--- --------------------- --- r //w -j ui § z < I . e / § § � ..> %f ❑ ❑ ` ) / z _ | 9 \ 2§ � � \ 7� w\ §2 ) >)§ 3 < ❑ ❑ ° % co \» (w■ ■w§ ^ k � ° m . ❑ g § %@ ; R f�, It � � -Ov� O-P slou� V&U&Colt 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 °SOR.Co" TELEPHONE (860) 644-2511 Septic System As- Built Plan Street Address LOL6 E1 jj nQ kli Date — A) S Permit Number New Septic System air of Septic System Alteration of System Number of Bedrooms or Design Flow of Building Type of system installed in &X) r" /� (e.g. stone trenches, infiltrators, galleries) Square footage of system: Total length Width Effective Area' 9 C-sr- f7— Capacity of Tank ] SD6 New Existing o0D L pkm Length of house sewer pipe _ 1 Sc- i1d 9 -P-j Minimum distance between septic tank and foundation % O�7/ Minimum distance between leaching field and foundation 7 z i Minimum distance between sewage system and nearest well Public water supply Minimum distance between leaching system and property boundary ��y Curtain drain required? Yes No Minimum distance from leaching field to drains Z� / (curtain drain, foundation, stormwater, etc.) Septic System As- Built Plan Address / 0 Date /y — S "y % Location of System $L15 'I r__ b (N, S, E, W, front, back side of house) Draft a substantially correct drawing showing separation distances of the septic system installation. 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. Installers NamLicense Number Installers Address � 7 I2 L O -Q (street, city, city, state and zip code) � I t t �pQrua �r1t)`"`� S Distance from corner A d Distance from comer B Distance from corner C Distance from corner D p i- W156 0 ,�/, IIA;9 ItE )054 N�SU Ll9�rrr, /C�—Za�.arcr Sq ram/ ML V p,-Vp,ri y3O --la ,1 Pa�Lh -see) vli i5�1 s� �A70 eon �f-e Town of South Windsor Town; S INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner: Date: Location: _ Q/— "o Soil Tests Observed By PERCOLATION TESTS Hole # Pit # Presoak © hours- ;a4'/ Depth _J '' Mark � � T Hole # Pit Presoak hours Depth Mark st Pit dge Mottling TDepth Depth Seepage Roots I�/WL r� -71 - Observation Rate min/in Rate min/in Test Pit / Ledge i Mottling Depth Seepage. f Roots Test Pit Ledge Mottling Depth Seepage Roots Depth Observation Depth Observation U LOCATION DRAWING Special Conditions Conclusions System design larger than 2,000 g.p.d. Suitable for sewage disposal Water supply watershed _ Possible seasonal high groundwater Unsuitable for sewage disposal Watercourse, marsh or pond y Possible seasonal flooding Additional investigation required Limited suitable area Excessive slope (over 25%) _ Retest during wet season Marginal soil (less than 5 ft) Shallow ledge (less than 5 ft) Monitor groundwater thru wet season Underlying tight soil (less than 4 ft) Other _ Engineer's plan required Testing For: New Lot / System Repair / B100a / Other commendations De72x #1 v,4I �� f� FT yo0t- ��'U1 ` I _ aJ f7 G G(JD/L /L- S 1711 -T k1-0e1L- ]eOrc.e�L a � Ao U4-0- Ads �-'-A-) Lew 7-y.08 q P, 7- Investigated by: Title: Date