HomeMy WebLinkAboutLot 3,o
DWCP No.
DISPOSAL WORKS. CONSTRUCTION SUMMARY
TOWN OF MANSFIELD
BOARD OF HEALTH
DWC LOCATION
SUBDIVISION LOT NO. .
APPLICANT TELEPHONE
STREET TOWN STATE —ZIP —
FEES:
2 "-�6150.00 Perc for New Construction Date Received< =fir t
_$150.00 Construction, Upgrade Date Received
_$ .75.00 Septic System Plan Revision Date Received
_$ 25.00 Septic System Repair Date Received
_$ 25.00 Disposal System Reinspect Date Received
—$ 25.00 2nd Reinspection Date Received
SDS Certification Inspection Date.Received
INSPECTIONS:.
1st Inspection Date Approved Disapproved
Comments:
2nd Inspection Date Approved Disapproved
Comments:
Reinspection Date Approved Disapproved
Comments:
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Commonwealth of Massachusetts Town of Mansfield
Soil Suitability Assessment for On -Site Sewage Disposal
Fee $150.00 VNew ❑ Upgrade Site Number -
Location address: El v 1 St V k Applicant: Hov'A A S lam, W P4- S L4
Subdivision/Lot: Lc i 3 Rol_Ltq(� rlELj�,S \/ju_ Address: 6,0 fzOAt%
/Ni t 1Z_Bo2o t t--t,N , oZ-7o3
Owner: Telephone: Sob Gctq 2911
Performed by: ?W-�\ EtA6i N EE JW N(a C_O.'i 1 NC , witness: Scott Leite, Health Agent (Site Evaluator)
Address: So NcR—i N MA,k N 5 i—j _,Et7 Address: Six Park Row, Mansfield
Telephone: ( So`8i 339 -313 1 Telephone: 508 261-7366
Office Review
Soil Survey published 1975
Soil limitations
Publication scale 1:20,000 Soil Map Unit Drainage Class }-Vl NcY�-E::Y
Suriicial Geologic Report not available. Geologic Material �'l ( 1 N oI)TWAS 1A Landform PLA� I 1
,
Flood Insurance Rate Map: Above 500 year ❑ Within 500 year ❑ Within 100 year flood boundary
Wetland Area: National Wetland Inventory Map (unit)
Wetlands Conservancy Program Map (unit)
Current Water Resource Conditions (USGS) Month 1 Range: ❑ Above Normal ❑'14�onmal ❑ Below Normal
reviewed:
Summary
TH � TH '2-- Locus ,
Soil class
Percolation Rate Z Z
Adjusted ground water
Certification
I certify that on April 30, 1993, I have passed
the examination approved by the Department
of Environmental Protection and that the above
analysis was performed by me consistent with
the required training, expertise and experience
described in 310 CMR 15.017.
Scott Leite Date
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