HomeMy WebLinkAboutClementine Dr. #19 - 8/17/1988 - not developedTOWN OF MANSFIELD
APPLICATION FOR ON -SITE SEWAGE TESTING
Number
Date
Fee PaidE,
Lot to be tested, address 1L- OT-t,, OVoe "/ L (--
Owner of Propertyy IQ/LN d,gI Phone( ),7-31
Address 3?1 Cr1rl�ntdvl J f 4 fiAC¢41,5
Engineer AI M �Vt Phone act - 3 2 3
Licensed Installed}(} kM6vJA GX ;f,i. s dr Phan
Address
1. In order for the Board of Health to take action on the application, you must
get numbered address and map and parcel number from the Town Assessors office.
No application will be accepted without this information.
2. Fee is $100.00. Application and fee must be filed 10 days before testing
date.
3. On -site sewage testing for in season water table testing; December 1 to
April 30.
4. Percolation testing may be done all year. All seasonal testing applications
MUST be received by March 31.
5• You must know before the Town's Agent comes out to your lot, as to where
you wish to have on -site sewage testing done.
6. Requirements needed at time of testing:
a. your own engineer
b. back -hoe or similar equipment, which would be able to dig 10-12
feet for pits or galley trenches
c. enough water for on -site sewage testing
d. sufficient 4" pipe for a monitor well
7. Permit will become invalid if percolation test is not performed within
the current percolation season, provided that the season has not been
suspended by the Board of Health, pr if an out -of -season approval is
granted. Fee is non-refundable.
8. All septic system plans and DWCP applications must show soil testing
number, street number, and lot and plot number.
1 copy for applicant
1 copy for treasurer
1 copy for Board of Health
REV. 8-20-86, 9-17-86
Ottice at
50west street
Town of Mansfield
Massachusetts
Board of Health
Report of Soil Examination
Applicant:
Euelyn Ailen` Trust
Application 9 88- 147
Date: Aug. IT;--1988
Location: '"
- Lot .-16,-19 Clementine Road
Fuller Estates
Mail Address:
379 Franklin St Mansfield
Tel. No.
339-2734
Engineer: _
RIM
Tel. No.:
339-3731 _
Mail Address:
North Main St Manafi al
l
DATE August
9, 1988
WITNESS BY
Scott Leite Health Agent
_
TEST HOLE_
gw depth None
rust mark
0-30" Top & Sub
30"-120" Ice Contact/Outwash
120" Bottom
RATE 2 MI
DEPTH 48"
Recommendation,
Town Water Available ( )
SOIL LOG
TEST HOLE
n
TEST HOLE
APPROVED> ¢f;.
ate_
PERC TEST DATA
PATE
DEPTH _
a'6�-
RATE
DEPTH -
TOWN OF MANSFIELD PERCOLATION TEST REPORT BOARD OF HEALTH
MAP LOT STREETr .E�YiW sOWA/BIIILD�R t i
WITNESS BY
PERFORMED BY
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