HomeMy WebLinkAboutLot 4DWCP No.
DISPOSAL WORKS.CONSTRUCTION SUMMARY
TOWN OF MANSFIELD
BOARD OF HEALTH
DWC LOCA'
SUBDIVISION LOT NO. .
APPLICANT TELEPHONE
STREET TOWN STATE ZIP,
FEES:
�$150.00 Perc for-Ne'w Construction
_$15o.00 Construction, Upgrade
_$ , 75.00 Septic System Plan Revision
_$ 25.00 Septic System Repair
_$ 25.00 Disposal System Reinspect
_$ 25.00 2nd Reinspection
SDS Certification Inspection
INSPECTIONS:.
Date Received 2 -/ la
Date Received
Date Received
Date Received
Date Received
Date Received
Date .Received
1st Inspection Date Approved —Disapproved —
Comments:
2nd Inspection Date Approved Disapproved
Comments:.
Reinspection Date Approved Disapproved
Comments:
word_dwc —
Coln)nonwealth of Massachusetts Town of Mansfield
Soil Suitability Assessment for On -Site Sewage Disposal
Fee $150.00 "ew ❑ Upgrade Site Number -
Location address: ELV-1 S i REE—T Applicant: 1 PcrmA, S tom• WP LSI-�
Subdivision/Lot: L o—t ppt s N� ddr�F�
Owner: Telephone: S�ggcl� I M� , aZ-7o3
Performed by: 1�1 M E1,-k(li1 N EE 1, \ �A6 C-o• 1 NC, Witness: Scott Leite, Health Agent (Site Evaluator)
Address: 1 S o Np t 1 t-A N l A i 1 1✓�T Address: Six Park Row, Mansfield
Telenhone: 31)`) —3731 Telephone: (508) 261-7366
Office Review
Soil Survey published 1978
Soil limitations
Publication scale 1:20,000 Soil Map Unit Drainage Class 1 N K- E Y
Surficial Geologic Report not available. Geologic Material ``l.( P h�l_ OU I l.l'PS Li-Landform Pc�1
Flood Insurance Rate Map: 127 Above 500 year ❑ Within 500 year ❑ Within l0o year flood boundary
Wetland Area: National Wetland Inventory Map (unit) Wetlands Conservancy Program Map (unit)
Current Water Resource Conditions (USGS) Month—"'__'� Range: ❑ Above Noanal 9BNormal ❑ Below Normal
Summary
TH I TH 2 Locus
Soil class �_ 1
Percolation Rate 2-
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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