HomeMy WebLinkAboutLot 50_
DWCP No.
DISPOSAL WORKS. CONSTRUCTION SUMMARY
TOWN OF MANSFIELD
BOARD OF HEALTH
DWC LOCA'
SUBDIVISION LOT NO. .
APPLICANT TELEPHONE
STREET TOWN STATE ZIP
FEES:
z_$150.00 Perc for New Construction Date Received �?
_$150.00 Construction, Upgrade I Date Received
_$.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:.
1 st 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 ❑ New ❑ Upgrade Site Number -
Location address: ELM ' l—L Applicant: i-ko"A_S t vJP t.S 14
Address: �Oo wC ��%
Subdivision/Lot: t o ���(�� Fla_-bS YI lL Ailt LE $o2c _ t, crZ 703
Owner: Telephone: SOU L' 9 G , Z9 t )
Performed by: R 1 H ENA61 NE1 �_1 NCa (zo.1) 1 NC. Witness: Scott Leite, Health Agent (Site Evaluator)
Address: 1 So NOR i N M Al N S"—LREE —[ Address: Six Park Row, Mansfield
Telephone: (Sex, 339 —3-731 Telephone: (508) 261-7366
Office Review
Soil Survey published 1978 Publication scale 1:20,000 Soil Map Unit 14-jPA Drainage Class R 1 gC ALE
Soil limitations
Surficial Geologic Report not avail ble. Geologic Material 6 ( &U /k(_ Otj—tW A-,S [4 Landform N_A{ ''Y
Flood Insurance Rate Map: Bove 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 1 Range: ❑ Above Normal 2 Normal ❑ Below Normal
Summary
TH j TH Z Locus
Soil class t_
Percolation Rate 3 3
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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