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2024-0379 --------- Office Use Only SEPTIC DISPOSAL ' �IC °TION s fG iil'l '_ I ; ' Permit#: �Oo� " fJ✓2i9 I j ;1 JUL. 2 6 2024 I !ill 95 0,D o ill; ; Permit Fee:$ Town of Quecnsbury �� a Q 7 S•3 742 Bay Road,Queensbury,NY 12804 TOWN OF QUEFh'„: Invoice#: P:518-761-8256 www.queensbury.net BUILI-,i`JG &s COL)c Flood Zone? Y TYPE: ; Project Location: 4 .i� ,< Y<s tocol d6eS 49 Wetlands? Y E) Reviewed By: 0. -'—"k D Tax Map #: 3tj. i/ ,i - STRUCTURE r-2. INFORMATION Garbage Grinder Yes No Year Built Gallons #of X gallons per =total daily flow Installed? El I Per day Bedrooms Bedroom I 1980 or 150 Spa or Hot Tub older Installed? III E 1981-1992 130 1992-Present 110 _ 3 I/D. je) PARCEL INFORMATION TOPOGRAPHY Li tat Rollin DStitp Slope % Slope SOIL NATURE j and Loam Clay Other, explain: GROUNDWATER ' At what depth: -----' BEDROCK/IMPERVIOUS MATERIAL At what depth: `---- DOMESTIC WATER SUPPLY Municipal n Well n Lake (if well or lake, water supply from any septic system absorption is feet) PERCOLATION TEST i Rate: 2 per minute per inch (test to be completed by a licensed engineer/architect) PROPOSED SYSTEM INFORMATION TANK SIZE .QDD gallons (min. size 1,000 allons, add 250 g Ilons for each garbage tinder or spa/hot tub /�'tJj s / % ° SYSTEM Absorption field w/#2 stone Total length // ft. Each trench )f/ ft. Seepage pit w/#3 stone How many: ; Size: Alternate system Bed or other type: Holding tank system Total required capacity: ; tank size: • # of tanks: Septic Alteration Application Revised May 2024 CONTACT INFORMATI ON: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): O e �4 d.. GC c),,,,; Mailing Address C/S/Z: a e, `D. ca/a v •e. • r Ji'Z tiel< Cell Phon : --1. - , o Land Line: Email: e, �.� „ tzn vs fle,S-rn 0 • Primary Ow s : Name(s): o )1.i. o Mailing Address, C/S/Z: ! d c„/ - OVer A 4)0e) , itili-/2-02) Cell Phone: —7 —777 Land Line: Email: ❑Check if all work will be performed by property owner only • Contractor: eft„ ,-�f Contact Name(s): L a/C. r®tis�' Contractor Trade: r 6 Mailing Address /S/Z: ,Aa c A . 57- sc.„4 .I PCell Phone: �3 ;6 76 7 Land Line: - . ,0,4® Email: u$ "-pa „G® -r' **Workers' Comp documentation must be submitted with this application** • Enginee s): K"'"' Name(s): L ok,- ram.. i,.,r7 Mailing Address, C/S/Z: �� GILv > ��� s /�4�m��, /�.fp,1 Cell Phone:57141)•—Pds f , Land Line: l 4 Email: rya cx�1.1 i hr.ee•r, . 03 Contact Person for any questions d regarding this project: z/� 0' ,�r1• c Cell Phone: /j-� j Z' 7 7 d Lan ine: C2 -r5o//d>' Email: or 5 E),.r r tbeid1J`S --1(7 t cis cv1 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 requi -ments Towneof Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: n t, ,_, SIGNATURE: I ....„..i�� DATE: 14f-a q .' Septic Alteration Application Revised May 2024 • TOWN OF UEEASBRY b.,� 742 Bay Road, Queensbury,NY. 12804-5902 • • • • Septic System Checklist • Lt Plan to scale Received Deep hole pert test results from engineer/Architect if applicable(Town Approved Engineers and • • Arc itects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects) • • • '" All wells on property and adjacent properties shown Water line shown Municipal or well 10'separation to any part of system • : .t.Setback to property lines show 10'or more for any part of system ' {L( 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) • ' Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each • ILeech Field 20'from foundation 100'from any well 10:from water line (deepage pit 150'from•well 50'from septic tank . • Ake. epage Pits 3-times diameter apart l Septic tank and pump stations over 30 gallons 50'from Watercourse or wetland ' • • 't distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000'of Lake George • Leech field 100'from watercourse or wetland . Moe of mound or bottom of retaining wall'10'from property line 100'from well 20'from Foundation ,Provide'Engineer/Architect stamp for bed or desi s • .•. • Department of Health Approval for mot b fe ome new systems Flood Plain requirements • 0)2'above established flood elevation to bottom of system AZAll tanks anchored or 2'above flood elevation fiCNEVIIYORK Department STATE OF OPPORTUNITY. of Health KATHY HOCHUL ,TAMES V. McDONALD, M.D., M.P.H. JOHANNE E. MORNE, M.S. Governor Commissioner Executive Deputy Commissioner July 8, 2024 3 CEOwiE JUL 2 6 2024 Ryan K. Riper, P.E. RK Engineering, PLLC TOWN OF OUEENSBURY 225 Ruggles Rd BUILDING &CODES Saratoga Springs, NY 12866 .�_ RE: Forest Park Mobile Home Court, Facility 56-6822 Replacement Onsite Wastewater Treatment Systems at Briwood Circle Lot 15 and Gregwood Circle Lot 8 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#14, Gregwood Circle Lot#8," and was most recently received by this office June 13, 2024. Each system includes the installation of a 1,000-gallon concrete septic tank and 110 LF of absorption trench with ADS Hancor ARC 24 chambers to serve one 3-bedroom home. 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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DESIGN INFOR ATICN 1 AEI rOFF I I!I T. AI I [NrdNII I R .F0 .ELT LNF0R ATI0N: ��I..�kc-FY AN,Y ICI r.:'.lG ��r`OLI I D TnlI S.O LENCTH OF BEdRAd'S AY 1�6 1_ IF_Rau fi TOPOGRAPHY AT TREATMENT FIELD I5 RELATIVELY LEVEL. REQ" T r NORTH 2. US[ ralY"LNS'ICsNd G,10 N: D) N01 ":;+CAI I' ( r DWELLING SUPPLIED NTH MUNICIPAL W+PATER. ° 3 330 GAL./DAY 1-5 13B°--25 1 AWIN(:;,a;. �. .. ^ NO ACTIVE NEIGHBORING W ! 1 INJ�� IdIAN04( BE MINI` WELLS NO S TED/'\ASIBLE WITHIN 1OO' !M ,IYM[ � A � � � �� � PROPOSEDINSTA,LLATI 7N: OF TREATMENT AREA. B I f ON7F�AC IO ,L 41)/OR G"�RQ F R I Y "�04 R, PP �r i "�� a TRENCH SYSTEM NTH ADS HANC'OR ARC 24 CHAMFERS COMPLETELY REMOVE OR FILL IN EXISTING 'SEPTIC: 4, IFULI., 11Iv<7E tllti Ndi.JI iffl I C0N'S1R CH(:fV � COMPONENTS. N U I.(rIICI9 lii NO INr;I_IJGL[) W11H !SCOPE r TOTAL NUMBER OF LATERALS = 2 0 WORK. LENGTH OF EACH LATERAL — —0" ... w _ . TOTAL LENGTH OF LATERALS = 117' GEGW OD CT. IPROJECT tDCA LOCATE WATER LINE AND * PER NYSCdOH APP. 75—A('FEB 3, 2010); A. 25 REDUCTION IN _..._ TRENCH LENGTH IS ALLOWED USE OF GRLLESS CHAMBERS 'PITH 16SF,/FT OF BOTTOM AREAH& VOLUME OF 7.5G,AL/FT OPEN SEPARATION TOSEPTIC, TYP. P R OJ E T LOCATION PLAN SlIDEWWALLS. TABLE 6C OF NYSDO-N "GREEN" HANDBOOK. ___— _—_,__ _—__ PARKING SOILS PARKING _�, M.. ,. NOT TO SCALE INFQRMATICN: I ........ _ (I'" 12 DARK SANDY ityl ;;11I. � � o vinr(l on of� N)r r_"¢:1i.a ahorr love firf any pe"i aern, ar iar l i d a riml Under the Iarx;ch pi (it o li en (.d 12" 26" RLl)Ifl Itl EdL2 '1�N `,NAIJC:J. profe,°`rional rng;reer, €o alte any Iem on uriy way. L '. 41' Lh� 1J1)i 'SAND 0 z NO C`r1ChlJNDWA1k 11 01N M01 h,IN G NOIED J D � I�w,`I_I Yy1NN71I'IIUrJ ; AIFIIFIJ,IrMf1Il rN'f:}II AN �I4,Ifl�'zllr Ike�hNK,)�II I Ilr)ML I��r<eF;K, � LATERALS AT � � r ITII �,IMII,�r" � LATER EACH. r L,i FINDINGS. r? � LOT INF MATT N zo ADS HANCCR CHAM'BERSR.0 T , MAP ...._ ct� CD TOWN OF QUEENSBURY DETAILS. fn Wz LOT `SIZE: 4 . ,SORE PT 1 STABILIZED PERCOLATION RATE: 1:55 MPN J CaJ M CO PT' #2 STABILIZED PERCOLATION RATE: 1:35 MPI W APPROVAL STAMP NOTES bi ` L1 `I` /Al I I I 1 ' 6 0 0 1. rry", U N C,I IJf1�_ I Ii `S f i '1�.,F"' I ( f,j` f 'IJE'; IIC)N. I— OO EXISTING TANK j FOR LOT 10 0E \ I NEW 1000 GALLON CONCRETE TANK WITH FILTER.SEE 0 DETAILS,LOCATE AS FEASIBLE. D—BOX PURPORTED ELECTRIC LINE. SEPTIC DESIGN CRAV'ELLESS CHAMBER LOCATE IN FIELD. PROJECT: =-A GREGWOOD, CT. ACTUAL SEPTIC COMPONENT LAYOUT MAY 'VARY L DUE TO BURIED UTILITIES OR COMPONENTS. 183 PITCHER ROAD, OUEENSBURY, NY (TOWN OF QU'EENSBURY) a QIRAWNra AS—BUILT THE—IN DIiMDIMENSIONSFT � �'F N1 t `x KENGINEERING, PLLC SITE PLAN A B C D L r"N ; 225 RUGGLES N"1D.SARATOGA SPRIN(3 NY " .stl�.� 'SEPTIC TANK EXPOSED RISER FIF'TI SITE PLAN 'I �f SCLE ALE CALE 1.w NAME � I�CY_G"E D—BCC .� 101 iru N4f7 ".;11E3fw11 i I"M htiI 1tiElIC)hk Ctf-'f"CJ I)ATE � 1,ty7C L1 BEGIN 6 100 'I_rsl PLAN INf ?I1r IIr.T1"a I)rlrnlrll L, I lw°~.rTn Nnf f1C II (�GaI�NJT'r rsl�T; A ISSUED FOR REVIEW/APPROVAL RKR 6/3/24 ¢ M— L1 END '. °,. t fA / I RECORD DRAWING RKR a/tk/2t W rv,l�, ra 1,I.II,� r�1NIr1_� l+r T^h$c r t ITr`v NhnNla� I r�r � 10 r L2 BE'CIN 12 1 CAD NrHIS{)T I�R G: N a Ir(JILhY �� i���l I°ar N 1 n 1 nlvl:, .rII�rF_r AND w-1 sT ��,. �5� �� � 7�� L:_ C7C11 L2 END 9 47 SUCI I, _r..._ MOUND TOPSOnL FOR SETTLING. PJCj Th S: SEED AND COVER WITH STRAW, 1'. SYSII:�M DI- IN ACCO'kDAWCE WITH 2010 NYSD(Xf APPUlaNX /5--A SiA, �110'&)()11'�S "Al-:F1P1JDIX' 75 A, AASTI-I.WAIER "IFUAFMENT, SrANDARDS INU',NJDUA1. MDUSFHOLD SY'STLIV�,"& "Nw'SDOIH (GREFN) DF',,�IGN HANDBOOK" d01N AUMITIONAI- FA SIGN AND NS"IAHA['I(:N G1J1IDLl.1Nl ,'-, NO GRAVELLESS NATIVE CAJANANIFJi ON SYSTEM �au�EARTHCHAMBER 4, 2, R[ RAWN(, UA�,, 0 )NF IsHF r�',�If WSPLCTIOi,1 oP NSIAIJFD BACKFILL lXPOSLO COMPONENTS, NO UNIARIHNC 3, CON'SINUCINDN `-"HAU, BF A':; 'SHIOWN ON DIP"J' DRAWING.`� AND 12 (-HAMBER N ACCORDANEF W1111 AIL NYSE)OI-1 AND SYIAIM IVANUFACI MRLR�.11 ONE CHAMBER LONGITUDINAL SECTION PROPOSED GRADE, SLOPE TO DO NOT SMEAR SOILS DURING 4, A I I W 0 K M U',S f C 0 M P LY W)I I l ,0 C A L, ";I A I L & 1:E I)E RA L S A I—F'I Y 2 DRAIN. SEED AND MULCH, EXCAVATION, RLGIJILAIION,, (NY'MOH, OSHA, NYSID0f) PEPAIIIIING l,)1l-QU[RI[Mf.N`S ARNM INSTALL LEVEL. REMOVE flIt ICI.',qPONSIIBlh ITY OF Id-Ir OWNIR DEBR�S, RAKE FLOOR & WALLS. -R,FAT M f!N I�l 10 I �� 5, N AV( I QUIPMLN I SHAI I AF K;W AVVA,f HROIIA HE I Ni9 V1 b I I C 1,[-S A�I 0 WL D )N J H A l N,1 I N I l-I I: GROUND WATER, BEDROCK OR IMPERMEABLE STRATA 6, ',-;Mf A14 D IRF A IMFN i ARFA R 00R,-, AND WAI I I-0 BI RAKED, PER NYSDOH APP. 75—A(FEB 3, 20105; A 257. REDUCTION IN TRENCH LENGTH IS ALLOWED WITH USE OF 7, IRLA F f 1) '.d Al C Ffl' URADi 1) Q SI fED RAINI'M L. AND ,10 GRAVELLESS CHAMBERS MITI 1.6SF/FT OF BOTTOM AREA ADS HANCOR ARC 24 CHAMBER MODEL PINFIRf Sl11wfPJ'1 l:flJN(*F FRIDIA ADJACENT ARIAS & VOLUME OF 7.5GAL/FT & OPEN SiIDEWAIJ-S. GAVELLE SS CHAMBER TRENCH TR E R ATMENT SECTION 8. lfl'C'010MLNDAIIONI 00WINSLOPr' OR SHALLOW WE,I,,I,S SlR)11,1) HAVI, SCALE� NTH UV IR'LAIMIN'l OR CIR.0131111AFION AND H ',"I IRAM)1`14 -;YSF )TM NS`IALLIA . WHA- WANER' Q�JAHFY SHOUID Rl 11,,iffl PERK)DICAIAY 24" DIA FROM SEPTIC TANK ----------- 9, RLADII Y VIS61 F' W['I J S ARF �`A]OWN (04 Fl[AW . NO f A[I, WFIP.-'i MAY Bl� 4" DIA, SOLID PVC `fASlHL'( LOCAH-D. INLETE� 11 r,)I OUTLET 10, cARBAGE. GRNDERS ANO WAILIr IREAIMFNJ SlfllJLA�A ,HAIL N(Df AI'1ACII FR OM '�V 10 `�[PIW� NO �,JdMF' PUMP DISCHARGI, AH-C.)WIA). LLAKING RXIUR[S WH L—LI——————---— CAUSE AR,URE OF ��d PIK] SrSFI'M INLET OU TLE T PROVIDE EFFLUENT FILTER. SEE NOTES, APPROVAL STAMP / NOTES INSTALL R�SER EFFLUENT F�LTER (POLYLOK PL-122), Il �s o vk)latiorl of 105 nduratlon low fiv orly pelson, LOCKABLE COVER,. TYP urfl�n�� Im is ading uncje� lhe diincUcin o� a hccro�cd 1-1v2` 4PRECAST profcsF�cjna� k) aRc� ony i(cm �11 �rly Woy C c C, CRETE BAFFLE BACKFILL NTH CLEAN OR EQUAL BAFFLE 31F GRADE INCH f�[-A�EE WISHED IN EFFLUENT FILTER-1 . TO REMOVABLE COVER AND AM �:P SOIL, SEED & MULCH %11!a�t—,WATERPROOF SEAL CCLV�R Ro"11�lw x 12 IN I z "'---POLY RISER W INLET INVERT 0 2" ABOVE INLET OUTLEt INVERT OUTLET INLET - CAULKED ' \—CAULKED OUTLET JOINT JOINT i W Quit SANITARY— LEVEL SANlITARY TEE W/ EFFLUENT FILTER 2' MI& TEE \-,jLKHEA0 12" MIN CLEAN SAND, PEA 3" MIN GRAVEL OR AGGREGATE 3 dow—(3/4" — 1, 1/2") Ir 4 4( 4 cr . .0 IF DESIGNED TO USE EXISTING SEPTIC TANK, PUMP OUT AND INSPECT EXISTING TANK, PR0ADE WRITTEN REPORT TO ENGINEER. SYSTEM, COMPONENTS SHALL BE 1, MINIMUM TANK CAPACUY AS FOLLOW MAINTAINED. TANKS SHALL BE PUMPED SEPTIC DESIGN GRAVELLESS CHAMBER 1. PIPE JOINTS TO BE SEALED LIQUID TIGHT, - FOR 3 BEDROOM$ OR LESS TANK SHALL BE 1,000 GALLONS, WITH OUT AND INSPECTED EVERY 2 YEARS 27 S.F. SURFACE AREA. OR LESS FOR OPTIMAL PERFORMANCE; FORHIST I)AHK - GREMOD ( T. Z SPEED LEVELING DEVICES SHALL BE USED ON ALL - 4 BEDROOM$ SHALL HAVE A 1,250 GALLON TANK WITH 34 S,F, EFFLUENT FILTER IF INSTALLED) SHALL OUTLET PIPES. SURFACE AREA BE CHECKED AND CLEANED - FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F. REGULARLY, OTHERWISE PREMATURE LOT #8 3. SEPTIC TANK TO D-BOX: 4" PVC OR SDR21, LIQUID SURFACE AREA. FAILURE COULD OCCUR . TIGHT JOINTS, MIN. SLOPE 1/8- PER FOOT, - FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250 1,83 PITCHER ROAD, QUEENSBUIRY, NY (TOWN OF QUEENSBURY) 4� THE SLOPE OF OUTLET PIPES BETWEEN THE GALLONS TO TANK SIZE FOR EACH. ITR�WWING TITLE: DISTRIBUTION BOX AND DIST'RIBUTION LATERALS 2, EIU�LDING TO SEPTIC TANK� 4" PVC SCH, 40 PIPE, LIQUID TIGHT JOINT% OF x, SHOULD BE SLOPED AT LEAST 1/32" PER FOOT MIN. SLOPE 1/4' PER FOOT, "�x RKENG11HEERING, PLLC DETAILS AND CONSTRUCTED OF 4" PVC SCH, 40 OR SDR21 WTH LIQUID 71CHT JOINTS. 3. SEPTIC TANK TO D-BOX OR PUMP TANK: 4" PVC SCI-( 4,0 PIPE OR 225 IRUGGLES RD.,SARA TOGA SPRINGS,NY SDR21, LIQUID TIGHT JOINTS, MIN, SLOPE 1/8- PER FOOT, 518.581.3893 FILE NAME DETAILS 5. USE DOUBLE SIDED STICKING RUBBER BUTYL FOR V, SCALE AS NOTED DOSED SYSTEMS, 4, SEPTIC: TANK TO CONSTRUCTED PER NYSDOH GUIDLINES. N 0 SUBMIIIA1 / RFV1SR)N—AF1l1T. DAF NEW CONCRETE A ISSUED FOR REVEW/APPROVAL �RKR 6/3/24 D�STRIBUTION BOX NEW' CONCRETE SEPTIC TANK RECORD DRAWING RKR 8/14/24TSti, 1 00 SCALE; NONE SCALE.- NONE SHEET's 2 F C-100 2