HomeMy WebLinkAboutLot 61-AD
DWCP No.
DISPOSAL WORKS CONSTRUCTION SUMMARY
TOWN OF MANSFIELD
BOARD OF HEALTH
DWC LOCATION k%'YY7 -'.L-Z-'� � �-- "��,�� (4' �
SUBDIVISION LOT NO._
APPLICANT TELEPHON
STREET TOWN STATE ZIP.
FEES:
150.00 Perc for New Construction Date Received
_$150.00 Construction, Upgrade Date Received
_$ .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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ammon ealth of Massachusetts Town of Mansfield
Soil Suitability Assessment for On -Site Sewage Disposal
Fee $150.00 ❑ New ❑ Upgrade Site Number
Location address: EL_" S9EIE-7 Applicant: L 1-jov A S_ P, wAL —S H
Subdivision/Lot: u5-�— (t ?CLL �Ca �0.1� v u Address:
Owner: Tele hone: P—� �� � � M� , OZ:7 C 3
p Sog.�gq2g1�
Performed by: R 1 M E [ -\I meE_ZI t L6 Co,, t w Witness: Scott Leite, Health Agent (Site Evaluator)
Address: ISO NOR t k A Mt i N �—j � —4 Address: Six Park Row, Mansfield
Telephone: (5c)P,) 33`'1-37Telephone: 508 261-7366
Office Review
Soil Survey published 1978
Soil limitations
Publication scale 1:20,000 Soil Map Unit K- L Drainage Class 41 N CAC_L�
Surficial Geologic Report not availpble. Geologic Material G( j�sC.1,4( _ C)Or6UA-S Landform PLA] Lt
Flood Insurance Rate Map: Above 500 year ❑ Within 500 year ❑ Within 100 year flood boundary
Wetland Area: National Wetland Inventory Map (unit) Wetlands Coon, s/ervancy Program Map (unit)
Current Water Resource Conditions (USGS) Month )Z ) Range: El Above Normal e Normal ❑ Below Normal
reviewed:
Summary
TH ( TH 2._ Locus
Soil class
Percolation Rate 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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