2024-0295 I
SEPTIC DISPOSAL PERMIT Office Use Only
` y APPLICATION Permit#: P262all - 0.2g5
`y Il 1 E S. c2O
Town of ucrnsbu [ TL7 !J
eimit Fee:��
742 Bay Road,Queensbury,NY 12804 JUN *OF
P:518-761-8256 www.queensbury.net I e tic Varianc-? Y
TOWN OF QUEENSBUR" Fl od Zone? Y
BUILDING& CODES-- ��
" —Wetlands? Y Reviewed By: 6/5(a)
Project Location:
I �
� +�� ram,o�r/
Tax Map #: ',
RESIDENCE INFORMATION:
Year Built Gallons #of bedrooms: X gallons per =total daily flow
per day _ bedroom Garbage Grinder Yes No
1980 or older 150 Installed? (choose one) ❑_ 1
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 , , v �� Installed? (choose one) ❑
3 i 4.je ems,
PARCEL INFORMATION:
Topography igFlat Rolling ❑ Steep Slope % Slope
Soil Nature g Sand ❑ Loam ❑ Clay ❑ Other, explain:
Groundwater At what depth? —
Bedrock/Impervious material At what depth?'
Domestic Water Supply ,,Municipal ❑ Well ❑Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: /;i14j per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size hop gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub zLi;if
System Absorption field w/#2 stone Total length 17 ft.; Each Trench ':i' 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:
Name(s): 5/Za G
1
Mailing Address, C/S/Z: 1ior I2- t L>ec(fG
Cell Phone: ° `Z_' 7,Z7o7 Land Line: v-8
Email: c/ec.p.p 5 .�,e- 1,4c gig:// "
• Primar n s
Name(s): e r
Mailing Address, C/S/Z: / 7 , f";G,l /`, coet,pri d 2
Cell Phone: _ Land Line:5) 7f-777L
Email:
❑ Check if all work will be performed by property owner only
• Contractor:
Contact Name(s):
Contractor Trade: --�'
Mailing Address, C/S/Z: Are ;ME r� 3"..di, 'Za
Cell Phone: a; 7 Zr-.... o = Land Line:
Email:
**Workers' Comp documentation must be submitted with this application**.
• Engi
Name(s): - 0 in,ccei �1
Mailing Addre,s-ss C/S/ZZZS�
Cell Pho e: f;-a/7-oo y Land Line:
Email: 11S-
Contact Person for Compliance in regards to this project: C�
Cell Phonp: Oro Land Line: M ti'_
Email:deafrO 4 I-c,,.-i )d etiC:5 r Gb ,�,
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 th own of Quee bury Sanitary Sewage Disposal Ordinance.
in
PRINT NAME: tt, fol,(2)
SIGNATURE: - --' DATE: 1.-/7-
Septic Application Revised July 2022
742 Bay Road, Queensbury,NY. 12804-5902
•
•
Septic System Checklist •
L..Planto scale . •
4Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and • •
``A chitects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects)
M6All wells on property and adjacent properties shown •
. 1 Water line shown Municipal or well 10'separation to any part of system •
•LI .Setback to property lines show 10'or more for any part of system '
I Septic tank and pump stations 10'from foundation.50'from any well/lake/wetland 10'from any waterline
`septic 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)
• -L-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 well 10'from water line Bk-A.4sv� 1
PIA-Seepage pit 150'from•we1150'from septic tank •
1 eepage Pits 3-times diameter apart •
1 --(_
Septic tank and pump stations over 30 gallons 50'from watercourse .
or wetland
I distance from bottom of trench or systC1}—
'edrock or mottling 36"within 1000'of Lake George •
Leech field 100'from watercourse or wetland
. )l oe of mound or bottom of retaining wall•10'from property line 100'from well 20'from •
Foundation
ti Provide'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
All tanks anchored or 2'above flood elevation
NEW YORK Department
STATE OF
OPPORTUNITY.
of Health
KATHY HOCHUL JAMES V. McDONALD, M.D,, M.P.H. JOHANNE E. MORNE, M.S.
Governor Commissioner Executive Deputy Commissioner
May 17, 2024 TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shall not be construA as
Ryan K. Riper, P.E. � Indicating the plans and specifications ::e in
FILE ..*���
RK Engineering, PLLC full compliance with the Building Codes of
225 Ruggles Rd New York State.
Saratoga Springs, NY 12866
RE: Forest Park Mobile Home Court, Facility 56-6822
Replacement Onsite Wastewater Treatment Systems at Briwood Lot 18
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, "Forest Park—Briwood Circle
Lot#18—2024 Modification," and was most recently received by this office May 2, 2024. The
project includes installation of two new additional laterals to serve the 3-bedroom home, which
failed due to 8 people living in the home with water meter usage of 550 GPD. The initial OWTS
plans were approved 3/18/22. 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.
Sincerely,
TOWN OF QUEENSBURY v� '(&itotaii
BUILDING & GOD S DEPT. Brendan O'Connell
Public Health Specialist I
Reviewed y: . NYSDOH—Glens Falls District Office
Date: l 77 Mohican St.
Glens Falls, NY 12801
(518) 793-3893
Glens Falls District Office,77 Mohican Street,Glens Falls,NY 12801,518-793-38931gfdo@health.ny.gov
cc: Rebecca Bussert, District Director, Glens Falls District Director
Dan MacElrath, Glens Falls District Office
Kevin Kenyon, P.E., Glens Falls District Office
Joel Brown, RHP Properties
John O'Brien, Town of Queensbury
GENERAL NOTES:
DESIGN INFORMATION * PER NYSDOH APP. 75—A(FEB 3, 2010); A 25% REDUCTION IN 1. SEE NOTE SHEET. CALL ENGINEER TO
DESIGN FLOW DESIGN PERC, REQ'D LENGTH OF TRENCH LENGTH IS ALLOWED WITH USE OF GRAVELLESS CHAMBERS CLARIFY ANY DESIGN LAYOUT DETAILS.
# BEDRMS GAL./DAY RATE. LATERALS WITH 1.6SF/FT OF BOTTOM AREA & VOLUME OF 7.5GAL/FT & OPEN
SIDEWALLS. TABLE 6C OF NYSDOH "GREEN" HANDBOOK. 2. USE DIMENSIONS GIVEN: DO NOT SCALE I,
3 550 GAL./DAY 1-5 MPI 230'-25%*=172' DRAWINGS. forest}Park
J —'� 3. ALL PERMITTING/VARIANCES TO BE OBTAINED
PROPOSED INSTALLATION: NOR I I BY CONTRACTOR AND/OR PROPERTY OWNER.
TRENCH SYSTEM WITH ADS HANCOR ARC 24 CHAMBERS
4, FULL TIME OR MULTIPLE CONSTRUCTION
TOTAL NUMBER OF LATERALS = 5 INSPECTION Is NOT INCLUDED WITH SCOPE
LENGTH OF EACH LATERAL = 35'-0" 6 RI WOOD CIRCLE OF WORK.
TOTAL LENGTH OF LATERALS = 175'
------ ------------- 308.14-1-52 2024-0295
PARKING Forest Park MHC
LOCATE WATER LINE AND PARKING j 18 Briwood Circle PROJECT LOCATION PLAN
MAINTAIN 10' HORIZONTAL L 6' I Residential Septic Alteration NOT TO SCALE
SEPARATION TO SEPTIC, TYP. I
1 I
It is a violation of NYS education law for any person,
unless he is acting under the direction of a licensed
professional engineer, to alter any item in any way.
EXISTING 3 LATERALS AT 35' I 2024 ADDITIONAL 2
Y I LATERALS ADDED.
EACH.ADS HANCOR ARC 24 J
a ADS HANCOR ARC 24 LOT INFORMATION:
CHAMBERS. SEE DETAILS. CHAMBERS. SEE DETAILS. TAX MAP : 308.14-1 -52
o CIOI 2024 ADDITIONAL 2 LATERALS TOWN OF QUEENSBURY
00 BOX
I INSTALLED DUE TO FLOWS LOT SIZE: 48.9 ACRES
o _j FROM DWELLING AT 550GPD
p °�w n MEASURED BY WATER METER
t 1 f1 I APPROVAL STAMP / NOTES
SITE INFORMATION: o I DUE TO 8 RESIDENTS.
TOPOGRAPHY AT TREATMENT FIELD IS RELATIVELY LEVEL. I INSTALLER TO LOCATE A E E UNDERGROUND
DWELLING SUPPLIED WITH MUNICIPAL WATER. I o UTILITIES PRIOR TO CONSTRUCTION.
I
NO ACTIVE NEIGHBORING WELLS NOTED/VISIBLE WITHIN 100'
OF TREATMENT AREA. SOLID 4"0 SCH40 AT " I APPROVED
PER FOOT, TYP. I
1000 GALLON CONCRETE I For Se`,`4'cge pispcspl
TANKS WITH FILTER.SEE L5 I NE1 R.VYO ° STA LEPARTf�'?`ENTOF HEALTH
SOILS INFORMATION: DETAILS.LOCATE AS FEASIBLE.
PT = PERCOLA1ION TEST (LOCATIONS, SEE PLAN) WATER LINE, MAINTAIN 10' '
DTP = DEEP TEST PIT HORIZONTAL SEPARATION TO
TEST PERFORMED ON 03-21-20 SEPTIC, TYP. ✓ 0^�'��
D , I ...w ., ..
0"-12" DARK SANDY TOPSOIL. I JN 17 7.j
12"-26" REDDISH BROWN SAND. ACTUAL SEPTIC COMPONENT LAYOUT I �m� a ry
26"-61° GRAY COURSE SAND MAY VARY DUE TO BURIED UTILITIES I T � €y r e NQ URY(�'�",�
NO GROUNDWATER OR MOTTLING NOTED I SEPTIC REPLACEMENT DESIGN GRAVELLESS CHAMBER
SOIL CONDITIONS ARE SIMILAR FOR ENTIRE MOBILE HOME PARK, OR COMPONENTS. I B III _ s 'yw .M.a_
SEVERAL TEST PITS DUG THROUGHOUT PARK WITH SIMILAR I PROJECT: FOREST PARK —
FINDINGS. I LOT #18 - 2024 MODIFICATION
PT #1 STABILIZED PERCOLAl10N RATE: 1:45 MPI I
PT #2 STABILIZED PERCOLATION RATE: 1:40 MPI I 183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
I
AS—BUILT TIE—IN DIMENSIONS (FT) j ®Fj�R,y DRAWING TITLE:
K o RKENGINEERINGv PLLC SITE PLAN
A B C.` D 225 RUGGLES RD.,SARATOGA SPRINGS,NY
SEPTIC TANK EXPOSED RISER �,, ( 518.581.3893 SCALE 1" = 20'-0"
FILE NAME SITE
D—BOX SEPTIC SITE PLAN d�1 NO. SUBMITTAL / REVISION APP'D. DATE
DATE APRIL 2024
L1 BEGIN
L1 END PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY GIS �� s oC5 a ISSUED FOR REVIEW/APPROVAL RKR 2/2/22
REVISION 2
d 0 AND AS PURPORTED BY PROPERTY MANAGER. ,Q R t RECORD DRAWING RKR 6Jt7/22
W L5 BEGIN THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST A 0795® . SHEET
a a NOT BE CONSTRUED AS SUCH. �®FES5I®fit 2 2024 FLOWS AT 550GPD RKR 4/19/24 1 OF
L5 END C-001
2
MOUND TOPSOIL FOR SETTLING. PROJECT NOTES:
6' SEED AND COVER WITH STRAW. DUE TO GRADE CHANGE SPACING OF
6 BURIAL DEPTH WILL VARY AND 1. SYSTEM DESIGNED IN ACCORDANCE WITH 2O10 NYSDOH APPENDIX 75-A.
TYP. ABSORPTION SEE NYSDOH'S "APPENDIX 75-A, WASTEWATER TREATMENT STANDARDS -
MIN. EXCEED 24". INSTALL LATERAL TRENCHES = 6' O.C. INDIVIDUAL HOUSEHOLD sysrEMs'& "NYSDOH - (GREEN) DESIGN
END VENT >3' DEEP. HANDBOOK" FOR ADDITIONAL DESIGN AND INSTALLATION GUIDELINES. NO
GRAVELLESS NATIVE , GUARANTEE ON SYSTEM PERFORMANCE OR LONGEVITY.
CHAMBER EARTH
BACKFILL 1- 2. RECORD DRAWING BASED ON ONE SITE VISIT INSPECTION OF INSTALLED
-_ _ EXPOSED COMPONENTS, NO UNEARTHING PERFORMED.
' — I=1'2" CHAMBER ICI I PROPOSED GRADE, ONE CHAMBER 3. CONSTRUCTION SHALL BE AS SHOWN ON THESE DRAWINGS AND
II—II—III SLOPE TO DRAIN. IN ACCORDANCE WITH ALL NYSDOH AND SYSTEM MANUFACTURER'S
HEIGHT z SEED AND MULCH. LONGITUDINAL SECTION REQUIREMENTS.
2 4. ALL WORK MUST COMPLY WITH LOCAL, STATE & FEDERAL SAFETY
REGULATIONS, (NYSDOH, OSHA, NYSDOT). PERMITTING REQUIREMENTS ARE
DO NOT SMEAR SOILS DURING `� INSTALL LEVEL. REMOVE THE RESPONSIBILITY OF THE OWNER.
EXCAVATION. DEBRIS, RAKE FLOOR & WALLS.
5. HEAVY EQUIPMENT SHALL BE KEPT AWAY FROM THE TREATMENT FIELD.
GROUND WATER, BEDROCK OR NO VEHICLES ALLOWED ON TREATMENT FIELD.
IMPERMEABLE STRATA 6. SMEARED TREATMENT AREA FLOORS AND WALLS ARE TO BE RAKED.
PER NYSDOH APP. 75-AFEB 3, 2010 ; A 25% SEE PLAN VIEW FOR TOTAL NUMBER AND LAYOUT OF LATERALS
REDUCTION IN TRENCH LENGTH IS ALLOWED WITH USE OF 7. TREATMENT FIELD SHALL BE GRADED TO SHED RAINFALL AND TO
GRAVELLESS CHAMBERS WITH 1.6SF/FT OF BOTTOM AREA ADS H A N C 0 R ARC 24 CHAMBER MODEL DIVERT SURFACE RUNOFF FROM ADJACENT AREAS.
& VOLUME OF 7.5GAL/FT & OPEN SIDEWALLS.
GRAVELLESS CHAMBER TRENCH TREATMENT SECTION 8. RECOMMENDATION: DOWNSLOPE OR SHALLOW WELLS SHOULD HAVE
UV TREATMENT OR CHLORINATION AND FILTRATION SYSTEM INSTALLED.
SCALE: NTS WELL WATER QUALITY SHOULD BE TESTED PERIODICALLY.
FROM SEPTIC TANK I--T-T---------- 24" DIA 9. READILY VISIBLE WELLS ARE SHOWN ON PLANS. NOT ALL WELLS MAY BE
4" DIA. SOLID PVC I I I I I FEASIBLY LOCATED.
INLET II `f A OUTLET 10. GARBAGE GRINDERS AND WATER TREATMENT SYSTEM SHALL NOT ATTACH
I i''I I TO SEPTIC. NO SUMP PUMP DISCHARGE ALLOWED. LEAKING FIXTURES WILL
I 1 1 I I CAUSE FAILURE OF SEPTIC SYSTEM.
INLET OUTLET PROVIDE EFFLUENT
FILTER. SEE NOTES. APPROVAL STAMP / NOTES
INSTALL RISER & EFFLUENT FILTER (POLYLOK PL-122) It is a violation of NYS education law for any person,
LOCKABLE COVER, TYP unless he is acting under the direction of a licensed
1-1 2" PRECAST professional engineer, to alter any item in any way.
CONCRETE BAFFLE BACKFILL WITH CLEAN
OR EQUAL BAFFLE ON—SITE MATERIAL PLACED INISHED GRADE
REMOVABLE COVER IN 8 INCH LIFTS AND TAMPED EFFLUENT FILTER TOP SOIL, SEED & MULCH
COVER �\ WATERPROOF SEAL
\ \ \ \ �z
12" MIN 4 g POLY RISER
INLET INVERT T
2" ABOVE
N O INLET OUTLET INVERT
OUTLET iV,md
INLET - CAULKED °� CAULKED 018nS Falls L.d.:?:ilCu Ice`e
JOINT z F JOINT
- OUTLET 9 W QUI
o SANITARY TEE W/ R TeIr tO mast s3haot for approved CUBed date and,signatu's'�:-r.
y, SANITARY o a LEVEL EFFLUENT FILTER
2" MIN. TEE i S �BUUKIHEAID
(( $g,�n4�8.a°•: �,,, °a a o 3" MIN
12" MIN.L �'0 o.,�•°° broby „
°� va,,a a�a� CLEAN SAND, PEA
GRAVEL OR AGGREGATE
(3/4" - 1 1/2") a o m e
•o `'.o:�m o ., o o• = o/
IF DESIGNED TO USE EXISTING SEPTIC TANKo-, PUMP OUT AND INSPECT _
EXISTING TANK. PROVIDE WRITTEN REPORT TO ENGINEER. SYSTEM COMPONENTS SHALL BE
1. MINIMUM TANK CAPACITY AS FOLLOWS: MAINTAINED. TANKS SHALL BE PUMPED SEPTIC REPLACEMENT DESIGN GRAVELLESS CHAMBER
1. PIPE JOINTS TO BE SEALED LIQUID TIGHT. - FOR 3 BEDROOMS OR LESS TANK SHALL BE 1,000 GALLONS, WITH OUT AND INSPECTED EVERY 2 YEARS PROJECT. -
27 S.F. SURFACE AREA. OR LESS FOR OPTIMAL PERFORMANCE; FOREST PARK
BRtWOOD
2. SPEED LEVELING DEVICES SHALL BE USED ON ALL - 4 BEDROOMS SHALL HAVE A 1,250 GALLON TANK WITH 34 S.F. EFFLUENT FILTER (IF INSTALLED) SHALL LOT #18 2024 MODIFICATION
OUTLET PIPES. SURFACE AREA BE CHECKED AND CLEANED
- FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F. REGULARLY. OTHERWISE PREMATURE
3. SEPTIC TANK TO D-BOX: 4" PVC OR SDR21, LIQUID SURFACE AREA. FAILURE COULD OCCUR . 183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
TIGHT JOINTS, MIN. SLOPE 1/8" PER FOOT. - FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250
GALLONS TO TANK SIZE FOR EACH.
4. THE SLOPE OF OUTLET PIPES BETWEEN THE DRAWING TITLE:
DISTRIBUTION BOX AND DISTRIBUTION LATERALS 2. BUILDING TO SEPTIC TANK: 4" PVC SCH. 40 PIPE, LIQUID TIGHT JOINTS, QF NEtijr
SHOULD BE SLOPED AT LEAST 1/32" PER FOOT MIN. SLOPE 1/4" PER FOOT. g Y RKENGINEERING, PLLC DETAILS
AND CONSTRUCTED OF 4" PVC SCH. 40 OR SDR21 11 225 RUGGLES RD.,SARATOGA SPRINGS,NY
WITH LIQUID TIGHT JOINTS. 3. SEPTIC TANK TO D-BOX OR PUMP TANK: 4" PVC SCH. 40 PIPE OR 1 518.581.3893 FILE NAME DETAILS
SDR21, LIQUID TIGHT JOINTS, MIN. SLOPE 1/8" PER FOOT.
5. USE DOUBLE SIDED STICKING RUBBER BUTYL FOR ar SCALE AS NOTED
DOSED SYSTEMS. 4. SEPTIC TANK TO CONSTRUCTED PER NYSDOH GUIDLINES. Z NO. SUBMITTAL / REVISION APP'D. DATE DATE APRIL 2024
ki NEW CONCRETE 14
tpo (j A ISSUED FOR REVIEW/APPROVAL RKR 2/2/22
DISTRIBUTION BOX CONCRETE SEPTIC TANK �d w� 1 RECORD DRAWING RKR 6/17/22 REVISION 2
Uj
a a SCALE: NONE SCALE: NONE OF79 50 01`Z 2 of
0 0 A� $SSI ty 2 2024 FLOWS AT 550GPD RKR 4/19/24 SHEET
C-100
2