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SEP-0699-2022 SEPTIC DISPOSAL PERMIT Office Use Only APPLICATION Permit#: Ob-ciPA- Town of Quccnsbury Permit Fee:$ Invoice#: •Lc:) © 1 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.queensburv.net Septic Varia ce? No Flood Zone? 10 Wetlands? i o Reviewed : • Project Location: / ci �izr Tax Map #: NOV 21 2022 RESIDENCE INFORMATION: TOWN OF QUEENSBURY Year Built Gallons #of bedrooms: X gallons per =total daily flow BUII DING&CODES per day bedroom Garbage rin er Yes No 1980 or older 150 Installed? (choose one) Z1- 1981-1991 130 Spa or Hot Tub Yes No / Installed? (choose one) 1992-Present 110 //o ❑ PARCEL INFORMATION: Topography Flat Rolling ❑ Steep Slope % Slope Soil Nature I7 Sand ❑ Loam ❑ Clay ❑ Other, explain: Groundwater At what depth? Bedrock/Impervious material At what depth? Domestic Water Supply 1 Municipal ❑ Well ❑Lake (if well or lake, water supply from any septic system absorption is ft.) Percolation Test Rate: per minute per inch (test to be completed by a licensed engineer/architect) PROPOSED SYSTEM INFORMATION: Tank size fro() gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub 11-is System Absorption field w¢#2 stone Total length Z-2.0 ft.; Each Trench sc ft. Seepage Pit w/#3 stone How many: ; Size: Alternative System Bed or other type: Holding Tank System Total required capacity? ; tank size # of tanks Septic Application Revised July 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: .,� ���� S Name(s): COI1e � Mailing Address, C/S/Z: ,130,.r' Cell Phone; - Z- 47t 7 Land Line: ,9€915 /D v Email: J /4 5 o / vS7 c 1 iGa,—,-, • Prima (s): q Name(s): .c Mailing Address, C/S/Z: l� z�,���• Cell Phone: Land Line: L5`�--77,52417771 Email: ❑ Check if all work will be performed by property owner only • Contractor: t. Contact Name(s): , 1i7c a,S ` ' et,"/ Contractor Trade: Mailing Address, C/S/Z Cell Phone: Land Line: Email: **Workers' Comp documentation must be submitted with this application** • En ine s Name(s): G p 'net", Mailing Address, C/S/Z: ZZ 17 of e , 74p i 12W Cell Phone: — —GAO Land Line: Email: Cie tv7f/�' <vS Jd Contact Person for Compliance in regards to this project: Cell Phon . 42- Z57' I7D 7 Land Line: $moo '/o 4 Email: - / GE,"-, Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations and agree to abide by these and all requirements of thq Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: - f/ti (77 r�zl- 7, SIGNATURE: �� DATE/d Septic Application Revised July 2022 lift TOWN OF ��� QUEENSBURY 742 Bay Road, Queensbury, NY. 12804-5902 Septic System Checklist I Plan to scale V4Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and Architects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects) All wells on property and adjacent properties shown l 'Vater line shown Municipal or well 10'separation to any part of system ja(Setback to property lines show 10'or more for any part of system iPt3Septic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline P"\eptic tank to foundation crawl space/slab on grade,grade in crawl space must be above top of septic tank for 0',Separation required (field verification required) Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each '1 Leech Field 20'from foundation 100'from any we 10 f m water line SI'epage pit 150'from well 50'from septic tank ) I'TSeepage Pits 3-times diameter apart 6 Septic tank and pump stations over 30 gallons 50'from watercourse or wetland j 3/4 distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000'of Lake George iqLeech field 100'from watercourse or wetland /0-Toe of mound or bottom of retaining wall 10'from property line 100'from well 20'from V4rovide Foundation Engineer/Architect stamp for bed or design systems department of Health Approval for all mobile home park new systems Flood Plain requirements 2'above established flood elevation to bottom of system WAII tanks anchored or 2' above flood elevation no.noorl en si'nV1 jORK. Department ATE OF.. OPPORTUNITY.. of Health KATHY HOCHUL MARY T.BASSETT,M.D.,M.P.H.: KRISTIN M.PROUD Governor Commissioner. Acting Executive Deputy Commissioner October 19, 2022 LCCIEOW Ryan K. Riper, P.E. NOV RK Engineering, PLLC 2 l 2O22. 225.Ruggles Rd TOWN OF QUFENSBURY Saratoga Springs, NY'12866 BUILDING CODES RE: Forest Park Mobile Home Court, Facility 56-6822 Replacement Onsite Wastewater Treatment Systems at Lots 4 & 6 Tiimber.Lane Queensbury (T), Warren County Mr. Riper: We have this day, approved the plans and specifications for the above-referenced project. Application for this project was duly made by you on plans titled, "Replacement Septic System," and was most recently received by this office October 12, 2022. The project includes installation of replacement onsite wastewater treatment systems to serve Lots 4 and 6 Timber Lane. The system consists of two 1,000-gallon septic tanks and four 55' laterals with ADS Hancor ARC 24 chambers, to serve two 3-bedroom homes. Lots 4 and 6 will each have their own 1,000-gallon tanks but will share a leach field. Approval of these plans is conditioned on the following: 1. That the proposed works be constructed in complete conformity with the approved plans or amendments thereto; 2. That all components of the proposed works be installed, operated, and maintained as per the manufacturer's specifications; 3. That approval be granted by other agencies or municipalities have jurisdiction; 4. That the design professional inspects the construction and provides certification to this office that construction was completed in accordance with the approved plans. Certification shall also be provided to the Town Office Building and Code Enforcement. The responsibility for the design of the sanitary system lies solely with the design professional and the proper operation of the sanitary system lies solely with the owner. The purpose of the Department of Health review is for compliance with the New York State Sanitary Code and in no way guarantees proper system operation. A set of approved plans is being retained in our files. 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IN E,XS7ING SEPTIC A, I }. �=M 0'`� VU ' i.,� COMPONENTS,, 1 � 1n„ j 6 �o; ,ilt _U[,I1r mfH w r, .. PPA SHED NEW' 1000 GALLON U E.IS` * PER NYSL OH APP. 75—A EES 3, 2LT1TD}; A 25 REDUCTION IN TANKS WITH F VL � TRENCH 9H LENGTH ET CuL"SAULOWED BOTTOM AREA WITH USE OFLE LD VE:LLIESS CHAMBERS � �N(,R � F 7,5 AL/FT OPEN PROJECT JEC LOCATION � IEIE AALLs. TALE 6C OF NYSa H "GREEN'" HANELIBELC71K. „ CILID UH 01 A i PER FOOT, T , NOT SCALE ..SDI. _ REMOVE TANK. �j jI, of Nys cw lo, on, I r� Ua Y . .� , yf j c . a fic e,r : I `f K SANDY 1 )F , 0 iorrl s s , wriy' y, L o- N/ ob IV 1pAl "�l°rI< m t rl�.1lY.,C,�I 11� d a a ��r a �,IhAII of 1 w' � ` , �i 1 F �X,,.h" � T1 N'`:L 1 4F d` o A r _ ! TAX API 3018. 114 - ��1 5 LA`T�ERALS A'1- 5. E A E••i� FOWN OF ADS HANCOR ARC 24 . � L PT ALEDRRA1RT1EP � " .� ,��... ,.. .�. ,... RE CHAMBERS, SEE DETAILS � _ 2 STABILIZED PERCOLATION 1E. , Z CaI �.I .. ,... .� .__ fy 0 APPROVAL STAMP NOTES x Li W Co I. 1 Tf� �...__ ACTUAL SEPTIC COMPONENT T LAYOUT NEAP VARY 'I "MIN. DUE TO BURIED UTILITIE S OR COMPONENTS. PARKINC PARKING LOCATE WATER LIME AND TIMBER 1E�� LANE MAINTAIN 110' HORIZONTAL TAL SEPARATIONT.0 SEPTIC,, T SEPTIC REPLACEMENT VE TO GRA�"ELLE;SE CHAMM E'I ' ' 183 PITCHER ROAD, QUEENSWRY, NY (TOWN OF QUEENSBURY) if NP A Sp BUILT TIE--IN DI EN IUI IiE E "T' ;; ___... . kRENGINEERING, PLL ,I E.� PI.AN A B C D ?O s RU ('11,ES RD,,S3AI"ZATa".'aGA SPBft.;,S.Nl Y,. 598.5813893 FNLE NAME SyINL.�p�^ SEPTIC TANO EXPOSED RISERS ---------- SCALE = 20 0" 7 r. S'C I � IE 1, 5UHrri M 0 ON DATE SE::PTFANE3ER 2C22 " „,D 1 % a ISSUEC FCR REVIEfAPPRCVA9 RKR irraAx ul yE, BEGH ... . „ .,rvrv,, .. o a .._.�— RE'MSIU N 1 L'i END 4. ____ _ < C LwN Y "U OR' � I.Oj � r r Y 1,r AN A :J Cwj AA Y a ''� / ro RECORD CDRAW9INCs! RKR' 1/19 2.3 .. .... ._..«..J w�d 1 ........._........__..._._...__.. ______._.._..........µ f < 'Ir; �, i ` ����'( .`Y �I.P,Ii ,r `Y'd,. ,I I� px �_ E 5 BEGIN � ��,Itr.r,r ,, , N �. v�Y N , .� 1 rr, ��. '., .. .. U_..UU1 SHEET , y �57 MOUND TOPSOIL FOR SETTLING. G. SEE PLAN FOR NUMBER SEED ICE COVER' WITH ETN� AW, E LATERAL LINES 1., p , 1 � IR Ol' �` IN VP ^+ ( 'f ( D;7f I A1 P f_I I tD /5 A A sir /", r O( ICJ r 'M4 tJ IA I ihf'DI ...... I d [LIT w rI I I I .....,. _,,,..... ..._.._...»,,,...,.w......_____._ ..._....,,,.. ,.. w....,_„_,_.._._..____..,_,..W..._...,.,. ..._......__._.,,._..... ........_.w.........,.-_,,.__.. o"�1dlJr�1,it "' ,r D N � , A, i A[1(,) Ir f_.. W r. NC) G A,1, A . V a It, �,.c[ clkGRAVELLESS NATIVE � . ¢C'HAMBER EARTH _._. . & ��,. Eil_N_ ,�. 'r� wh a, �,tw�rVauoNK� [3 I rCd r 1 s st,I �I";1 [ F r., r,p, r71 Ir, = ;7rhl.t[�� G XF,0, [: ,,; r fl1 P,[N lw,l_AP I" 11Na,: PURL r, M ,`f Fnf f-1 �",�: i'!J1f"�d r1 J i:.. � J "W�/I I lG _ ..,... ._... .,w.. __.. ._.. r ,., . . l LEI PROPOSED L)k 'ECGRADE, SLOPE TC� r',L1I V, W,'ro� A . ,N "I,,,I< J°wllr ',v.�T, ru rprrTlr Ar.wll;,�r-[ DRAIN,, SEED AND MULCH.LY .�..„„.._„.,. _....�.0........................m....�y.. Ai A I ,Jk 1 Vl (OCA�_ I A wq , iL 7A !,,At 1 . DO NOT SMEAR SOILS DURING INSTALL LL. LEVEL. REMOVE .......,,..E Q A." A LI. _ _. .._. CAE B' IS, RAKE FLOOR & WALLS, .... �'"�x''� � � ......,,..... 7 �lE„ a 1l.)r-IUI he r', til Jlk; KEPI I ,"��EI'1 4 w�{,.iu� ,v'Lm If I ,`,`�s'f�Y'E' I I f(:"', ONE CHAMBER � �. GROUND WATER, EEC C:P ° n l_4_ , a I AI ONr, r�� y�,,,JT [ I LONGITUDINAL SECTION IMPERMEABLE T ATA ',4e91 y,nl i) �wl'ti�A,wMr'°d L n.r,l,.A (I I,OY»,';; ti�f'1f9 wAlI .;; dsPMl"; �.. xS4. ""a'yKFD. PER NYT150H APP. 75—A T"E6 T, 201 O; A 215 H I I �r,i M R[UUCTnON IN TRENCH LENGTH IS ALLOWED NTH USE OF � TI rd i � F ta J`r�,M i` GRA"NE:LL,ESS CHAMBERS NTH 1.65E/F"T OF BOTTOM! AREA ADS HA NCOR ARC 24 CHAMBER IVIBL.R ODL. L VOLUME OF 7.5GAL.fF"T & OPEN SIETEMMAV.I..S. I L 'EL.L_E ' CHAMBER TRENCH TREATMENT SECTION 6. A ,1111:,M.w1 , [ - , PI OP, Ir11.r ,TI Vd['11 ,;HOJID iAlA i,)v i� Aomr,If "r CU,r,��'IY�Jr 1r xa� M,ffJ r, 1M?Arl0N (,ILV, I`J;; IA L.D S'CALL NITS WFI I UVA"f'.P (,r IrhL['I -FROM SEPTIC 'TANK _.._.. W.. ... 24°" OIA 1W i�'LAL)IL ' (,..„„����,.,..,�..,....m..»,...._.._...._....., �..�_.�._... Jlr i5G f V'Viif faf^ `f I{::iWfW r., J I ;,l^,d`' f`d.,Y ,J I hf1_iel.". 1VA'r BITC 4" OIA. SOLID PVC I N I 'y I-) A I E,t 1 4' 1 , k I6NLEF(g III ^ OUTLET1O (,'A u(, Gr GrgiPN[,C R` I/ WAi I I Y ,4, h„P�°al Mw� H N )T A i IA(f H I E N f I T;;"wanh, F,nlLl,ry4 (,1 ",f„w'r SL,iV"h✓I INLET OLJT'L.E;'I' �.�_.�.___... .___._.-_ ___PRQV9UF EFFLUENT _ .. _ _. _ _ FILTER. SEE NOTES. APPROVAL STAMP ,J NOTES LOC14A6LF COVER. tr ._ I., i toy I _.. �.. INSTALL FIBER & EFFLUENT E�L.TE P OI,_.``r`L O I"�L__--12 i t �J e t f.l' � ,„r.4 it r" ,,� 1 1,�2 PRECAST �n'r{� ., ^„r , 4.�;x, �lv .rir,p ,f r.ty CO C"RETE BAFFLE BACKFILL WITH CLEAN � . OR EQUAL BAFFLE ON—"ITF MA ER1A LAC rT'OP �01 GRADE REMOVABLE COVER IN NNMd LN:F1 ANI TAMT EFFLUENT N.UEN p F LFEI ' FS:FTM°ECCYIF SEAL CII °m -POLY RISER � I OVER. .... \ rr �C ' INLET INNER f ABOVE dN INLET OUTLET INVERT ... OUTLET INLET CAUL_KE[)__- a CAULKED . OUTLETJt NT -Luqu PCMNF ...-SANITARY TEE WW/ SAKI I ARY L.E VE EFFU.TEN'T FILTER 2"° MIN. TEE °� �" -BVJLiSHEaVE3 12'° MIN. 3* MIN LEAN SAND, PEA GRAVEL OR AGGREGATE IF DES I N O T UISE EXISTINGESEPTIC TANK PUMP�OUT'�ANID INSPEC"I" EXISTING TANK. PROVIDE WRITTEN REPORT TOIENQNE:ER, SYSTEM COMPONENTS SHALL BE ] MAINTAINED, TANKS SHALL BE. PUMPED SEPTIC REPLACEMENT DESIGN GRA,VELLESS CHAMBER 1, MINIMUM TANK CAPACITY AS FOLLOWS: OUT AND INSPECTED EVERY 2 YEARS 1. PIPE JOINTS TO BE SEALED LIQUID TIGHT', — FOR 3 BEDROOMS OR LESS TANK SHALL BE 1,000 GALLONS, 'NTH � � �� RMANCIEs ', R —. ] -i OR LESS FOR OPTIMAL PEKE"'O P1E� a y Tl Ali T «TT S.F SURFACE AREA. �, � .. . � .� s 2. SPEED LEVELING DEVICES SHALL BE USED ON ALL — 4 BEDROOMS "HALL HAVE A. 11,2'SO GALLON TANK %TH 34 S.F. ��� EFFLUENT (FILTER (IF IN�FALLED) SHALL I OUTLET PIPES,, SURFACE AREA 6 E CHECKED A N,D C LE AN E D 1,011 °M-4"4__ — FOR EACH ADDInONAL BEDROOM ADD 250 GALLONS & .2 ' ` � REGULARLY, OTHERWISE PREMATURE3, SEPTIC TANK TO D--BOX, 4" PVC' OR SGR21, LIQUID SURFACE AREA, F A I L, U R E C O U L O O C C U R . 183 PMTCHER ROAD; QUEE'NSIBURY, NY (TOWN OF QUEENSBURY) TIGHT JOINTS, MAIN, SLOPE 1/6" PER FOOT. — FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250 GALLONS '1O TANK SIZE FOR EACH, ORAIWING TT' BETWEEN THE 4, DISTF SLOPE BOX AND IDISTSRI UTIION LATERALS 2, BIUILONG TO SEPTIC T"ANK,: 4'' PVC SCH. 40 PIPE, LIQUID TIGHT JOINTS, O � � %;, RMENGINEERING,� LL DET, IL.�51-PoCMLILO 6E SLOPImE� AT LEAN 1/32' PET M"OOF MUN. ,�E.GPE 1/4m PER FOOT '°�a P" AND CONSTRUCTED OF 4' PVC SCH, 40 OR SDR21 � �, , 225 ITgLGGL,E S LCC ,SA'fArf.) ,A SPRINGS,NY S, SEPTIC TANK TO D—B OX OR PUMP 4" PVC SC'H, 40 PIPE OR � !18,581 Tk3W1TH LIQUID FIGHT JOINTS SOR21, LIQUID TIGHT JOINTS, MIN, SLOPE 1/6" PER FOOT. FILE NAME DETAIL SS ...�...�,,,......._.�...� �__...__....._._..� :5,. USE (DOUBLE SIDED STICKING RUBBER BUTYL FOR � F, _._w.. _, _ ._. .a. _..w SCALE AS NOTED DOSED SYSTEMS. 4, SEPTIC TANK TO CONSTRUCTED PER NYSTOOH GUIDL€?NIES, ww....._.,.._. ............ ................»...,......._, .. ..........�... ...., m.,._...,,,.�.. ._..—.._....,,. 9l1PI'_I�As ___�_ , � _ ....... ..__1 . DATE SEPTEMBE R 2G22 °>/a ISSUED FOR FE EW/APPROYAL RKR N aV4 L REVISION BOX SEPTIC TANK RECORD DRAWING RKR 1/19/2;sDISTRIBUTION E r E ( .u� ..... c t SHEET' SCALE,: Elll'~�E. " CLEF NONE �"� 5�� --- � —1 � � OF &-' r I 2