OSWPCA: Sunshine / DPH Commissioner Mullen re CRAHD's Exhibit A, 21Mar2012

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[Letterhead]
STATE OF CONNECTICUT
DEPARTMENT OF PUBLIC HEALTH
Jewel Mullen, M.D., M.P.H., M.P.A.                Dannel Malloy  
     Commissioner                                Governor
March 21, 2012

Joel R. Anderson
13 George Drive
Old Saybrook, CT 06475-2636

Re: CRAHD Exhibit A

Dear Mr. Anderson:

This letter is in response to your February 25, 2012 correspondence that concerns "Exhibit A" utilized by the Connecticut River Area Health District (CRAHD) in conjunction with the Town of Old Saybrook's Decentralized Wastewater Management District. We appreciate your concerns.

Your correspondence included a copy of Exhibit A (Application for Initial Investigation and Upgrade of Septic System...) and Form #1 from this Department's Technical Standards for Subsurface Sewage Disposal Systems. In your letter you asked whether the Department approved Exhibit A as equivalent to Form #1 in accordance with Public Health Code Section 19-13-B103e (c) (2) (B). The answer to your question is no.

It should be noted that Form #1 is entitled Application for Approval to Construct a Subsurface Sewage Disposal System. The Exhibit A document is not such an approval to construct application. The actual approval to construct application form utilized by CRAHD is entitled Application for Approval to Construct a Septic System, and I have attached a copy for your information.

If you have any additional questions concerning regulations or standards governing septic systems you can speak to Robert Scully of this Department's Enviromnental Engineering Program at (860) 509-7296.

Sincerely,
(signed JM~)
Jewel Mullen, MD, MPH, MPA
Commissioner

JM/kg

c: Mary Jane Engle, RS, MPH, Director of Health, CRAHD
   Robert Scully, Supervising Sanitary Engineer, Environmental Engineering Program, DPH

PHONE: (860) 509-7101   FAX: (860) 509-7111
410 CAPITOL AVENUE - MS#13COM, P.O. Box 340308, HARTFORD, CONNECTICUT 06134-0308
Affirmative Action / Equal Employment Opportunity Employer



[Form]
Connecticut River Area Health District          860-661-3300
    APPLICATION FOR APPROVAL TO CONSTRUCT A SEPTIC SYSTEM 
Date ________________                        Permit #_______________
Application is hereby made for an approval to construct a
subsurface sewage disposal system for a:_________________
   (Residential Building, Restaurant, Retail Building, etc.)
Located at:_____________________________ Town: _____________________
Number of bedrooms _______________  or   Design flow (GPD)__________
New ____ Repair_____ (Reason for repair)____________________________
WELL_________                                PUBLIC WATER___________
Garbage Disposal Yes____ No____           Large Tub  Yes____ No_____
Owner________________ Address______________________ Phone___________

INSTALLER________________________ PHONE#_____________ LIC#__________
Engineered Plan (Y/N):____ If yes, Name of Engineer:________________

Proposed system:
New tank only___ New leaching only___ New tank & leaching______
Other _________________________________________________________

Proposed tank(s):
Pump chamber yes__ no__ Size_____ Grease trap yes___ no___ Size_____
New tank size 1000gallon__ 1250gallon__1500gallon___ 2000gallon ____
Tank material     Concrete______ Plastic_______

Proposed leaching field:
Perc. Rate:____ Application rate for non-residential_________
Required ELA ________ Proposed ELA_______________
*MLSS Calculation: HF___x FF___x PF___=___MLSS(Feet)

*MLSS Calculations are required if there is a restrictive layer
<60 inches

Leaching type: _______________________________________________
Size (height)________ Total linear ft.________________________
Exception(s) required YES___ NO___ List:______________________
All code separation distances must be maintained unless an
exception is obtained. A recent sieve analysis is required for
select fill
(Old Saybrook only) Is the property in the Wastewater Management
District (Y/N):___

Systems in WWMD must have a minimum of 2/3 ELA and 24" to Water
and/or Mottling 

Applicant certifies that the above information is correct and that
construction shall comply with the CT. Public Health Code.

Engineered systems are required to have the engineer verify with the
installer that the elevations are correct prior to covering the
system.

Installer is required to follow and have on site the most current 
design and installation guidelines for proprietary leaching products

Applicant (print)___________ Signature_____________ Date__________

------------------- OFFICE USE ONLY ------------------------- 
Design plan approved (Y/N):___ Date of approved Plan:_______
Revision Date_______ 
Date installer notified plan approved:__________Time:_________

Approval to Construct issued by________________ Date__________
FEE _______ CK#_______ CASH___________         revised: 1/3/12