407 Septic Permit Design & Pump Test CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City Northampton
OF .
;titration for Disposal is arks Construction Drrmit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at: to
Of f Audobon Road Lot #5 dacks.Qn..Suhdiuis;m"
or Lot No.
Location.Address
Alan Branch
Address
RPM-
::::
yt✓hV Address
Type of Building Size Lot 17.47 .(tc.,--9gt:daat
Dwelling—No. of Bedrooms 3 Expansion Attic ( ) Garbage Grinder (X )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow 82.S gallons per person per day. Total daily flow 495 gallons
Septic Tank—Liquid capacity 1500gallons Length Width Diameter Depth
Disposal Trench—No. 6 Width 3 Total Length 60 Total leaching'xxn _....B.so.fPD acif
Seepage Pit No Diameter Depth below inlet Total leaching ar?a sq. t.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by D.T. Huntley Assoc. Date 3-IQ-S.3.
Test Pit No. 1 2.L_Ominutes 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
Description of Soil 9" OTS 1 r0" silt, 8'3" compact
groundwater at 916"
sandy till with boulders
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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue b the board of health. //�1' � )�� �
Sieaed f:�f4 } .,�' -tnfyt.NCk 1213�' et AL/Lit-Cc
Application Approved By
Application Disapproved for the folio
9
asons-
Permit No !fF -Ll'
Issued.
Date
Date
PROPOSED DOHESTIC SUBSURFACE DISPOSAL SYSTEM DESIGN
Prepared For: Q/ (OjrGn ! h 1 LC/n GYq/1CC,
Location: L.0
f #S / padOdor) Rood / 4v
Number of Bedrooms: c 3 Garbage Disposal' Y
LEACH AREA DESIGN
3 Bedrooms x 2 persons/bedroom - G persons
(, Persons x 55 gallons of wastewater/person/day - ...3-3O total gallons of
wastewater/day. X /.S = 4/9S
Percolation Rate: 2/ min/inch
Gallon of wastewater/square feet of leach area for a Percolation Rate of:
2..5- min/inch - O. 44O Gal/SF Sidewall Area
O Gal/SF Bottom Area
* If a leach bed is to be installed, no sidewall is allowed.
* If percolation rate exceeds 20 min/inch, no bottom area is allowed.
- SEPTIC TANK -
* WITHOUT GARBAGE DISPOSAL:
Gallons of wastewater/day x 150% = REQUIRED effective liquid
capacity of septic tank.
RECOMMENDED: Septic Tank
* In no case will the septic tank be less than 1,000 gallons (effective liquid capacity).
** WITH GARBAGE DISPOSAL:
49,5- Gallons of wastewater/day x 200% = 990
REQUIRED effective liquid
capacity of septic tank.
RECOMMENDED: /SOO Septic Tank
** In no case will the septic tank be less than 1,500 gallons (effective liquid capacity)
ALVIER HUNTLEY. JR.. & ASSOCIATES. INC.
USING BOTTOM AREA ONLY:
LEACHING FIELD DESIGN
Gallons (Total Daily Flow) t
* With Garbage Disposal:
gal/SF = SF Leaching Field
(REQUIRED)
SF Leaching Field x 1.5 = SF Leaching Field
(REQUIRED)
SF Leaching Field (Designed):
' Long x ' Wide
LEACHING TRENCH DESIGN
SIDEWALL AREA:
0. 4/O Gal/SF x 3. o ' of effective depth x 1' length x 2 sides = Z- S/' Gal/1.F
of trench (sidewall).
BOTTOM AREA:
Gal/SF x ' wide x 1' length = O Gal/LP of trench (bottom).
Z V Gal/LF (Sidewall)
O Gal/LF (Bottom)
Z- c/ TOTAL Gal/LF of trench
Total of V95— Gal/Day (flow) t Z. 9 Total Gal/Day/LF = Zo(o LF of trench
trench (REQUIRED)
* With Garbage Disposal: 2-0 40 LF of trench x 1.5 = .3/ U LF of trench
(REQUIRED)
3&o LF of trench (Designed): 6 Trenches, 3 ' Wide x to O ' Long
with 3 ' Effective Depth.
ALMER HUNTLEY, JR., & ASSOCIATES, INC.
.URV! ( R' NGIAf FRs - PI AAFR•
•
•
SEWER 'me -S/ZE .R!Norco on/ALIN-
ALL ✓O/NT3 TO QE SATE/C770117"
SLOPE • *%PT/N/NJ
SEPTM TANK
0/37A/E1/7/0N• 02 TV at SET LEVEL.
SHIP R7aE6'
SIDE PEPSI
X
NEAOER P/PE3 FAQ/I THE o/,STR/QUT/O.V 00X
70 SE NON- PEA/VAI7 •0 AND LA/a0 LEVEL
AAA AT 1E437 ONE LENS TN op PIPE.
2 Y• (N/N.) &N/311 GRADE
PLAN LE:LI
//I' 70 S4•
WISHED 370N!
M'ASPEO S70NE
00770.41 Of FIELD 7D QE
Atop/20A/741..
♦'N/N. RJ O.tOUND HATER Oi /NtERY/Otti LAYER
3ECT/ON - X
gra
T
EFFECT/YE DEPTN(VARAESJ
•
II e -I _ TN/CE EfPECTIVE N/DTN_1
A T - (N/N.)
EFFECT/YE M/OTN •/• NO7 USED fOR RESERVE
(VAR/ES) AREA • f' 11/Al
/LO•N/ • /F USE FOR RESERVE AREA
• 6' N/N.
Alt WORK 70 SE
DONE /N AKORDANCE
w/TN THE $TATS
ENV/RONMENTAL
CODE ^ 7/71E S.
S
ALMER HUNTLEY, JR. & ASSOCIATES, INC.
SURVEYORS - ENGINEERS - MANNERS
125 PLEASANT STREET
NORTHAMPTON , MASS.
PROJECT NO.
SHEET OF
1t . 62?1 - 6 7/)-
Commonwealjh, of4vjas ks tts
City/Town of (� /�
System Pumping Record
Form 4
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:
When filling out 1. System Location:
forms on the
computer,use
only the tab key Address
to move your
cursor-do not
City/Town
use the return
key.
2. System Owner: t�
L1b7)?117` 11�i) UtCt3 RP/
Address(if different nt from location)
State Zip Code
City/Town
1 ee S
B. Pumping Record WI ( 'l L/0
1. Date of Pumping pate
3. Type of system: ❑ Cesspool(s)
State V k 07 L q / Zip Code
Telep one Number am/
2. Quantity Pumped:
Gallons
eptic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes
5. Condition of System:
If yes,was it cleaned? s ❑ No
6. Systempumped By:
Company
7. Locatio9.,where contents were disposed:
S
t5form4 dap 03/06
Vehicle License Number
Signature of Hauler
Date
Signature of Receiving Facility
Date
System Pumping Record•Page 1 of 1