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HomeMy WebLinkAbout0015 SASSAFRAS LANE - Health 15 SASSAFRAS=LANE MARSTON MILLS TOWN OF BARNSTABLE LUCA.TION /, � '�J ��'v SEWAGE # VILLAGE ASSESSOR'S "MAP & LO �o INSTALLER'S NAME di PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL O PUBLIC ATER BUILDER OR OWNER T � . DATE PERMIT ISSUED: C7 �l DATE COMPLIANCE ISSUED: .VARIANCE GRANTED:, Yes No L .Iz.. r Town of Barnstable P# 9515 f Department of Health,Safety,and Environmental Services �I Public Health Division Date Q, 367 Main Street,Hyannis MA 02601 r ■AMEMABLB, UfA93. Date Scheduled G -3o� b���9 Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: — J Witnessed By:MMY r4-(0,}01 LOCATION & GENERAL INFQ RM. ATION Location Address Vs __f4 1 ,�` Owner's Name L r 1� Address Assessor's Map/Parcel: Engineer's Name JA4.V-- e4a- -7 -a� NEW CONSTRUCTION REPAIR Telephone# 8—15j40---+_55 Land Use CAI i4t. Slopes Surface Stones LLY, Ql,�tw Distances from: Open Water Body ft Possible Wet Areal Z60 ft Drinking Water Well --*—_ft Drainage Way . ft Property Line �W I ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 1'letl�z ,� de� Parent material(geologic) dam, _•.- Depth to Bedrock Depth to Groundwater: Standing Water in Hole: dam, ossw i7 Weeping from Pit Face Estimated Seasonal High Groundwater cj tuxxj some r- D TERMINATION FOR!SEASONAL HIGH WATER'TABLE .. .. Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: ,in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level_____ Adj.factor_ Adj.Groundwater Level PERCOLATION;TEST Date Time Observation Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch 5MIA) � Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant _ _ . . _ DEEP OBSERVATION HOLE uOG Hole . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel A Siq 1.0Aw4 c� 2-toe 61 S 1. i0 e' too-I3Z! ell to r DEEP OBSERVATION HOLE LOG Hale ..._. ...._ ..._ . _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel DEEP OBSERVATION HOLE LOB Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel DEEP OBSERVATION HOT,E LO;G Bole# _.._: ................. - . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) I � � f � I Flood insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No— Yes V Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator 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. Signature Date 99. ,. i r TOWN OF BARNSTABLE �- LOCATION SEWAGE # VILLAGE �u✓� ASSESSOR'S MAP LO INSTALLER'S NAME &i PHONE NO. SEPTIC TANK CAPACITY—. LEACHING FACILITYArype) NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER ApV�- �Cr %r i t d ry DATE PERMIT ISSUED: T? DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 4 i J . i 7 � 5 I(� II �I s� + o �~ z-✓ � Fee . lob No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migozal *pztem Con.5truction Permit Application for a Permit to Construct Repair )UPgrade Abandon ❑Complete System ❑Individual Components Location Address or Lot No. /5— Lj f 4-'�J5 Owner's Name,Address and T��I�k. Assessor's Map/Parcel �Lv}A��'I"/ AVf -0,le — a 6 O/ Installer's Name,Address,and Tel.No. Designer's Name,A dress T No. `Z �� Li( , k 3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow © gallons per day. Calculated daily flow gallons. Plan Date G/ Number 9f sheets Revision Date Title Size of Septic Tank �� Type of S.A.S. Description of Soil Nature of Repairs oyAltera9ons(Answer when applicable) 1,A1� f �� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of He th. Signed Date el"/,?? Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued ' �`•;� No. ' ! Fee • r THE COMMONWEALTH"OF MASSACHUSETTS Entered in computer: .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Migogat *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 45 � A �j Owne,F's NamAddress�d�. Assessor's Map/Parcel r �lJ�/�'("/ A - U6P — a Installer's Name,Address,and Tel.No. Designer's Name,Address Te No. xeok 3,0 z- Type of Building: '5 p Dwelling � No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) 'Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 gallons per day. Calculated daily flow gallons. Plan Date g / `� `� Number of sheets Revision Date Title r7 L f��l`j" , 1,47/L AP Size of Septic Tank /D� 6144 -- Type of S.A.S. .' Description of Soil r " Nature of Repairs or Alterations(Answer when applicable) 5 r k ( ff L Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Hea th. q Signed Date Application Approved by Date tq e Application Disapproved for the following reasons Permit No. .1457 Date Issued `` f --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTITY, that the On-site Sewage Disposal System Constructed( )Repaired( XQ Upgraded( ) Abandoned( )by e �X dAl y ,we— at /v• has been constructed in acconda ce with the provisions of Title 5 and the for Disposal System Construction Permit N dated Installer Designer 11411110PLv !l�y The issuance of this permit. all not b90 ed as a guarantee that the es -will fu, -tio as igno I Date Inspector Y t/ � 1 / J& ti No. '' �TT � -------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migogal *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abando ) System located at ,:�A 66 f- r 'e, and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completedwithin three years of the date of this t. Date: Approved byG' V 5 3.X • S'N� 5 o 36. 5�4�5�, 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby cert that the application for disposal works construction permit signed by me dated �' concerning the property located at � y7 � meets all of the following criteria: J • The failed system is connected to a residential dwelling only. There are no commercial or business Juses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. J • There are no wetlands within 100 feet of the proposed septic system J • There are no private wells within 150 feet of the proposed septic system J • There is no increase in flow and/or change in use proposed J • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the ma.-amum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor Imethod when applicable] �1 If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevati� +the&LA-K High G.W. Adjustment . _ / 9 DIFFERENCE BETWEEN A and BJ , SIGNED : E41A DATE: [Sketch proposed plan of system on back]. q:health folder.cen � TOWN OF BARNSTAi3LE LOCATION k A(, w�a j Lh. SEWAGE # 3y� VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.Cc ve C,�a �o(S \c S SEPTIC TANK CAPACITY VXC (:; - LEACHING FACILITY:(type) (��e-casT e \ (sue) NO. OF BEDROOMS t2 -tIVATEEti;-OR PUBLIC WATER BUILDER OR OWNER MC I<PQf) �051Q00 DATE PERMIT ISSUED: /, — - !'S 7 DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �/ •. 4. ' �� �_... 1 �, l f ��` �, ` �9� �� �' i e � i ,��c q,� ---- r No... .��.4Z /9' b 3 QZCl F:zs.. .._. THE COMMONWEALTH OF MASSACHUSETTS BOARD fF s-�I .......................OF..... ................. ........... ........................................... Appliration for Disposal Works notrnrtion Prrnti# Application is hereby made for a Permit to C truct ( or Repair ) an Individual S age Disposal Sys � f� � ............... ....... .......... ..................... ---•-- - -- --• --••--••- C ation. d s or Lot No. Wc7 — — ....... — ^—• • Address........... .... .......... ..... staller Address d Type of Building Size Lot.,----���. Sq. feet U Dwelling—No. of Bedrooms............. Expansion Attic ( ) Garbage Grinder 46 ----•--------------•-•-- `k Other—T e of BuildingNo. of persons............................ Showers Cafeteria Other fixture (/e --•--- .....................gallons per person ter Total it flow.......... _.....gallons. W Design Flow............... . g P P Y• Y WSeptic Tank—Liquid*capacity/ gallons Length... �4-- Width. v�... Diameter................ Depth ---------. x S Disposal Trench—No.�_.._.... .:.. Width................... Total Length................. leaching area...........1....sq. ft. Seepage Pit No. f'._._.. lameter._... ....... Depth below inlet...�K. 5..... Total leaching area?=e Z®.7 .sq. ft. Z Other Distribution box ) Dosing tank (� '-' Percolation Test Results rformed by.._.�®......1. 1 1.`..__. ..... ............... Date. �a Test Pit No. 1........1�_.minutes per inch Depth of Test Pit/--��-.... Depth to groun .._ _.......... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GG ..----- --•------------------•------.......---..................--•-••...........•-•-•------•-•.........................................................O Description of Soil......................•-....---••--•--•---.....------------------•-•---...............-•-----•--••--------------...-----•-----•----......-----•--------....._......----- W V ......................................••-••---•--•-••-•----•..........•----•-------•-•-••.............-•-•---•..........-•--•-------•----•--•--•-••-----•----•-•------.....-----•----•-......-•-•---•---- W -------------------------------------------•--•--•---------------._...--------------•------.....------------------------------------•-•----••-•-....................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...----••-----------•----...--•------•---------•--•--•----•---•------•--•----••.......................•----------....-------•-•--------------•-----------------............--------...............----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI.E 5 of the State Saghasn The un signed further agrees not to place the system in operation until a Certificate of Compliance by t oard of health. Si '........_... -4 )4 Application Approved BY-------------•-- -•--....... /j�� Date Application Disapproved for the f o 'ng reasons:............................... ------•--•.....-•---•----•......•-••------•--•••.....----•--•------•-...----- ....................^---•---•-••----............----•-•--...................----•-^--•---•--...------.....................---------•------•---••------------........-----•---- -Date-•-----•-..... PermitNo....�7..-. V-/�-------------------__.. Issued-............---------------•--•---••--•---- ate.....-- Date b4 - r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF�HEAL Applutttion for Dispnnl Iforks Tonstrudiun ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Sys at' . 2 X _ __ ........^ .`_... » ?•-•.»�. -•• ................. == »....z1� �/77• - ••- •••--- / x j- C 'at n Address •- •- - or Lot No. Y - •• ••- ..........................'.................................................................... ........................................... �- .................................. ddress ✓Installer Address . S U Type of Building � Size Lot��....� .�....--1�.. q. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (�)' Other—T e of Building e�..................... No. of persons............................ Showers — Cafeteria d Other fixture ._.._._ 3. ._ -------------------------------- W Design Flow..............6.. .........._..._._._..gallons per person, er day. Total daily flow-_-...._.���>_� �._.__.._...........gallons. WSeptic Tank—Liquid capacity2 lZZ gallons Length.��...X... Width.`Z. ... Diameter................ Depth____... x Disposal Trench—No. .................... Width.................... Total Length....................Total leaching area......_...__........sq. ft. Seepage Pit No.n A-- Diameter...../d....... Depth below inlet-- .... Total leaching area... 1J. ...sq. ft. Z Other Distribution box (_ )____�. Dosing tank (_) Percolation Test Results Performed by-_-.NT:_......7 1/)21_ Z/ a ....................••----- Date-7------ ,----�-'--•------.. a Test Pit No. 1__.._._. minutes per inch Depth of Test Pit., . .__._._ Depth to ground water___............. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' •----------------------------------------••------••----•-.......................----------.......--......................................................... 0 Description of Soil........................•---••-----•--•-----.........-------------•--...........----------------••---........---•--------------------........--••-----•--------•---•-. W U ••------....--•------------------------•--•----._....__...........-•---------•----••-•---••-•••------....---•-------:---- ••----•---•-------...---..............-•-------------..._..._•-------•---- W -----•--------------••-----•-----------•----------•-•--------------------------------..............----------•-•--------------------------------------......---------------------------•---•--••--•---. UNature of Repairs or Alterations—Answer when applicable............................................................................................... -•------------------••-•--------.............---•------------•-•--•-•--.........•-------•---......._•---•------•--------------••----•.........--....---•--------............------------....•-••-••----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code-F- The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the/board of health.Signed � .. / :. .... .. �� ... ....... � // . _f �� �....... Application Approved BY.._.....---•---- ....................Date Application Disapproved for the following reasons::........................• ---- --------------.........---•-•--•-----------------------------•------.........» ---•-----••------------------------------•---•---...---------•-----------•------....-------•-•------.............----------------...-----.....---....---------.......................................... Date PermitNo..................•--------------••-----------._........ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD�OF HE TH / .W.........................OF........... n ..... ...... ::.......................................... (I of iratr of Tomplianrr � 1 HIS IS T rCfiIF.fiY, ha -t e-Indiv>dual Sewage Disposal System constructed (�) or Repa><red.�by( = ..........` .. G.1 C`' -------- ------------ ......-----------.......------------------•---------•-•--------.----------------•-- �� Installer at............... ---------•-----.............-----• .........q........�................�_r4------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..... dated.. ;_n....Z _.._ N............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. q� DATE....---•-•--•-•---..�.:-...1..�. ........................... Inspector -1:esr` F.�.:".__.'_ .. ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `) .......... ........OF....`. �::;r r �r .rt. 5:( ,....................... �\ i f V Ni ..._. ................ FEE........... ........ �ia�rnsal Works �unstrl�rttinn rrntit Permission is hereby granted ,tom=.... �,^ _..R ! �.r� �_.........-. to Construct (P--y-or Repair ( ) an Individual Sewage Disposal System at No. >lr-....... :e% --.... _ 'ems!. ...................... Street as shown on the application for Disposal Works Construction Permit No._, „�ated.............. ........ ...... { .. ........ .t .................................................. Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON r r M GREF-�-- SF�Cf 1q V I l� • n c� a fND.-�L YS� zY I z SfJSS A��� 9z_0 �o. I- . l 3 T / v✓ T /lV/L /3 8 3 S,sF .Zo✓E A! - .30 /.f ZCo s/<7���f'��= 3 e 3 ,SCALE : Uf'�El�CAP,E E'NG/�tIEER/.VG .TdB ND. �� = y0 Via. a G/ i ,/ SHEET i OF �— DArZ EV_ z /7 �iC�Eoi/ ��a i/) EL TOP OF FOUNDATION 3 ��iSE,Q ,•., t • __ � � ? TE COVER �.' CONCRETE COVERS e .4 CAST IRON 2 MAX. fit/6Q. YY.o OR SCHEDULE 4� „ram I "MAX. , P.V.C.' PIPE 4 SC4EDf1LE 40 PV.C.(ONLY) :PITCH I/4 PE'A FT. PIPE - MIN. _ PITCH 1/4"PER.FT. LEACH. . u,e PIT o' IN,,yyERT / PRECAS ' EL/3XQ � � a LEACNIt. �,� INVERT SEPTIC TANK INVER y` INVERT :% W a.� : PIT OR E�?� % DI ST. ELf�ZZ _ EOUiV 'a EL�rZJ,( •/d.� . :GA INVERT Box _� . �- �. INVERT � ELF3:Y1: ;•: rri w w 3/4 TO 1 f E0��X1? WASHEI. W .. ST NF D1A y - PROF LE OF ,1/(9 GROUND ;WATER,TABLE SEWAGE: DISPOSAL' SYSTEM t % NO SCALE. P ... s S0 L-, LOG WITNESSED BY DATE . TIME. Th'07. . BOARD OF HEALTH TEST HOLE ..'' TEST HOLE 2 T: Ti'tCOr3 i ELEV. . ELE,V..F. •3 . . . . ENGINEER • • . . .. . ..: x4�P 0/tTio v DESIGN DATA ; NUMBER OF BEDROOMS - TOTAL, ESTIMATED :FLOW31?; GALLONS/DAY i . - flOTTOM LEACHING AREA ?p• SO.FT./PIT SIDE LEACHING AREA SO.FT./ PIT GARBAGE DISPOSAL . ! 40: ..(50%.AREA INCREASE : TOTAL' LEACHING AREA SOFT' PERCOLATION RATE .4'�.$ S 2 MIN/INCN LEACHING-AREA PER PERCOLATION RATE .. . . *..WATER ENCOUNTERED SOFT. ' . NUMDER OF LEAAC ING ; PITS. PSG APPROVED BOARD OF HEALTHR �• 3'iy r DATE. (.� o y .- -s. .a.?� S. AGENT OR':INSPECTOR 1 N PA,L Sq •(oT: � . . . . . . t JOHN a /y1�TE�Qi�9L wok /0 FT/.✓. .9lt .. JACOBI Cw. . . ' ,OI►QEc7-10 IS- �9.✓O To dN No.814 '• ./.I,ri�EP�! :Cl/.�To n. ,���'l�.ui. �.t. 'o,o ���,�o�w �N PETITIONER �( EAl _. "'!KQ4'4 5?U8� , .�`l/6 L S. S�/Y• yo :,vr e GR���SJ_°AcE — �8•y�y ` J 4oL-zZ Al � � Y•s o iy' zY ' 3 d� • I � �1 f15 L�✓ _�. •/ o"V'{i`d i• V✓ T /V iL /3 8 ,SF ,zo✓E .P! 3 o -1-r f �J/ 2 .S/4 S�/0�l'iC, 3 S o a SCA�C.E =L�6�0:PZER 67 V61 VEER/•VG "0 ND.. SHEET , of �— EL. J� Q TOP OF FOUNDATION 3 �,QiSE.Q @BRERPTE COVER •,' CONCRETE COVERS ..I •1 ♦• • -••.•...��. - 1 . 4 CAST. 11 . . IROW . 2 MAX.x. Fia ca. py o OR CNEDULE 4� 11• • � 1� MAX, :P.V.G: PIPE a 4 ,SCHEDULE 40 PV.C.(ONLY) ' PITCH 1/4 PER FT PIPE MIN: - LEACH °�• 1 PITCH 1/4"PER FT.' PIT ' PRECAS �IN,yERT / / J ELX3X.Q a PIT Okit Ro'• SEPTIC,.TANK , INVERjj GIST.. INVERT' � . � p' . ° INVERT EOW�6 `. BOX .ELf•�1�F ' : EOUIV 'a E GAL' ELF.3:Y3 INVERT ni W W 3/4"TO I I .• E0 - . ; WASHEI qNST •o •• M �---- In' DIA I y / PROFILE OF a4/13­GROUND WATER TABLE SEWAGI 9.2-s. DISPOSAL SYSTEM NO SCALE SO L-: LOG YYITNESSED BY . ` DATE 7����7. ;' TIME T BOARD OF HEALTH TEST HOLE I� TEST HOLE 2 S- Ti�lOr3 ELE.V.`.�. •3 ELEV: . • ' . . ._ ENGINEER o- .DESIGN_ DATA NUMBER OF BEDROOMS ,3. ... TOTAL ESTIMATED FLOW 3 �; GALLONS/DAY 130T.TOM LEACHING AREA ?p• S0.FT. /PIT SIDE LEACHING .AREA lo.Jr'• SO.FT./PIT GARBAGE DISPOSAL . . !440. . (50.%.AREA INCREASE) . : �Z WOO TOTALLEACH ING. AREA d ,7 SO.FT�i ti� PERCOLATION RATE:.4�.4 S 2 MIN INCH': WATER ENCOUNTE RED - .. j i - LEACHING AREA PER PERCOLATION:' RATE .. . . ... SO.FT.:" !.. -. NUMBER OF LEAC ING PITS. PSG APPROVED . .. . . : BOARD OF HEALTH R 3'/y �. ' �� J J�(oPD J •� DATE. '/• • 11? ZCAI-): . . ,.4./`. .-� .S. 02•�� :S. 3C GA/-): i•AGENT OR IN l = ,.�.._.. i N\oAL Sq / 11 N ` A107; i9�.�tic9B.lEJ. T ,PEriodE �.L( �.NQEP!/roUS � �� 6)_ JOHN /oFT iAl Ae[ CL ACOBI •`s -Ssf,�A.s Cam. . . . ,0/QEcTiea/s. ENO 7-0 ?N N0.814 P C!mr n. ,�E�l•w. E.c, oL WEALSN PETITIONER ; �C