HomeMy WebLinkAboutLot 8r
DWCP No.
DISPOSAL WORKS .CONSTRUCTION SUMMARY
TOWN OF MANSFIELD
BOARD OF HEALTH
DWC LOCA'
SUBDIVISION LOT NO. .
APPLICANT TELEPHONE
STREET TOWN STATE ZIP
FEES:
1j:
_$150.00 Perc for New Construction Date Received .-�2 4�
_$1 moo Construction, Upgrade Date Received
_$.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:.
I st Inspection Date Approved Disapproved
Comments:
2nd Inspection Date Approved Disapproved
Comments:
Reinspection Date Approved. Disapproved
Comments:
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[Fee
mmonwealth of Massachusetts Town ofMansfeld
Soil Suitability Assessment for On -Site Sewage Disposal
$150.00 ®'New ❑ Upgrade Site Number -
Location address: Ct._LN -3t�2^j C\E1- Applicant: �toMa S P, WA""
Subdivision/Lot: L.o i i3 gd-U t-1G FtE�5 \/ tL L,Address: G o DIES SATE 2op,>
A\ tUE= oeo, MP• o-z�o3
Owner: Telephone: sc�g C,99 2q t 1
Performed by: R i M C-t,4 t NGE Kt N(o Co,) 1 NC Witness: Scott Leite, Health Agent (Site Evaluator)
Address: t SC) t l H H AI N Si-REZL--, 'Address: Six Park Row, Mansfield
Telephone: (.SOS 33`) _-3-73 1 Telephone: (508) 261-7366
Office Review
Soil Survey published 1978 Publication scale 1:20,000 Soil Map Unit CT_ � Drainage Class
Soil limitations
Surficial Geologic Report not available. Geologic Material
C7 lJ (IAi/�cs Landfonn
Flood Insurance Rate Map: M 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 t t Range: ❑ Above Normal (O Normal ❑ Below Normal
Summary
TH f TH Z Locus
Soil class
Percolation Rate -7 5
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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