HomeMy WebLinkAbout2020-3-12 - 234 Long Hill Road - Septic As Built83.3’113‘2828 21 :54 413279135?BILL K¢‘1Nt-_UL.“UL
Town of South Windsor «Health Department
1540 Suilivan Avenue,South Windsor,CT 06074
Phone:860-644-2511 ext.250 Fax:860-644-7280
SEPTIC SYSTEM As-BUILT PLAN
Date é/Ag/éwgo ParmitNumber
Street Address
.
New Septic System g Repair of Septic System ‘_Alteration of System
Number of Bedrooms é OR Design Flow of Bowing.A/ZH
Type of System ,
Installed Qgi%
(e
’44;
g stone trenches,infiltrators,galleries etc)‘
Square Footage of System Total Length
%’4%
Width a2?{QEffectlveLeachmg
Area
Capacity of Tank Tank Ne Emstm
Length of Hause Sewer Pipe
Minimum Distance Between Septic Tank &Foundation @1otd Mk/
Minimum Distance Between Leaching Field &FoundatiouJX)AKMX
Minimum Distance Between Sewage System &Nearest Well %%J£H 4/
Public Water Supply
Minimum Distance Between Leaching System and Property Boundary &d ég &&
Curtain Drain Required?M
Minimum Distance From Leaehing Systemr to’drains
(eurta
(1%?én,foundation,storm water,etc.)
“*DRAFT DRAWING ON REVERSE SIDE OF FORM
d
.
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SEPTIC SYSTEM AS-BUILT PLAN (Conn-nu ed)
Adams a?9’Date ‘£
Locatlon of System gMMM side of house
W Frunt,Back)
Draft a substanually correct drawing showing separation distances of septic system insallation.
Include all of the followmg mformatwn to pmwde an accurate record of the entire system
location
At least two sldcs of the bmldmg nearest the system,septic tank house sewer,
dlstubutlon boxes,trench ends,dry walk,curlmn dram,potable water supply wells,and any
other features affech'ng the system and ts location.-
Installer’s Name Llcense #
Inetaller’s Addres s (street,my,state,mp code)
C’&57‘vInstaller’s Emai é
Aw;#1LL /?d
Point #1-#2 _#3 #4 #5 #6 #7 #8
Distm from comer “A"6]y I /If
Dismwe from corner “B”1/2 2r I‘
Distance from earner (‘Cd’x;’4 I'
Distance from corner “D”
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