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13-073 Letter to Huntley, Responce to Rockridge ProjectCOLER & COLANT'ONIO ENGINEERS AND SCIENTISTS May 9, 2003 Y Mr. Ned Huntley, Assistant City Engineer Department of Public Works City of Northampton 125 Locust Street Northampton, MA 01010 RE: File #03- SP -53, proposed addition and site improvements, Rockridge'Retirement Community, 25 Coles Meadow Road, Dear Mr. Huntley: We are pleased to provide herewith our responses to your review comments regarding the Rockridge project, as outlined in your memorandum of April 9, 2003. We have provided responses to all of your comments except those regarding the effect of additional water usage on the City water system, and looping of the water system. We have spoken with Charlie Borowski, but he has not had time to review a copy of the plans yet. We will respond to any comments that he may have as soon as we receive them. We have provided the balance of our response at this time to allow you to review the bulk of the information. Carolyn Misch has informed us that she will need to have a final response back from DPW by May 15, in order to get the information out to the Planning Board members with some lead -time prior to the May 22 hearing on the project. We greatly appreciate any effort you can make to try and meet the Planning Department's schedule. Your original comments and our corresponding responses are presented below. Sanitary: The applicant does not provide information as to sewer capacity of the City system as it relates to their expansion. The King Street sewer line is overloaded (especially during rainfall events) and the increase in flow could be detrimental to businesses further down gradient to the expansion. DPW recommends that applicant perform full sewer study prior to approval. Based on our discussion at your office on April 16, we have designed a supplemental holding tank and pump system to be incorporated into the sanitary sewer system at the site. The purpose of this system is to allow for storage of the sanitary sewage flows with discharge to the municipal system at several off - peak times. This will minimize the potential for aggravating the overloading of the trunk line that is occurring further down King Street during peak use periods and rainfall events. It is understood that this represents an interim solution to the existing problem, and that at some point in the future, the problem downstream will be corrected, and a direct connection to the municipal sewer will be made. 55 Bobala Road 413 313 -0100 Holyoke, MA 01040 Fax: 413 31 3 -01 90 10 recycles paper The proposed holding tank and pump system will store flows from the facility expansion and release to the City's sewer system at off -peak hours. Electronic timers will be set to operate the proposed pump system twice daily at 2:OOam and 2:OOpm. The flow to the pump system is based on metered water use records for the existing facility from October 1, 2001 through March 5, 2003. The anticipated flow from the proposed expansion is approximately 1,700 gallons per day. The design is presented in the following attachments: sketch SK-5, plan view of the proposed installation; Pump Chamber Detail -Plan View; Pump Chamber Detail - Typical Elevation; Pump Notes. We have also attached copies of the Water and Sewer Bills. New sewer line as proposed is set to run under a light pole. Either one should be relocated. The site plan has been revised to show t hat the existing light pole in question, along with three others nearby, has been relocated to make room for the new sanitary sewer alignment and the widening of the existing driveway. This information is shown on attached sketch SK-1. A clean out should be installed at the property line. A clean out has been added at the recommended location. A clean out detail is shown on the project detail sheets. This information is shown on attached sketches SK-2. Saw -cut lines should be moved east of the sanitary sewer to be included in the work Saw -cut lines have been adjusted on the site plan to correspond to the proposed sanitary sewer main location. This revision is shown on SK-3. Although this will be a private sewer system, the DPW has concerns regarding the location of the sanitary sewer line under any structure (interior ramp). The site plan has been revised to indicate that the sections of sanitary sewer main that pass beneath the ramps will be constructed of heavy -duty cast iron. This information is shown on attached sketch SK4. DPW recommends maintenance of a 10' lateral separation between sewer and drain lines wherever possible We have maintained as much separation between the various utility mains as possible. However, due to the tightness of the site, we were unable to maintain 10' separations at all locations. A minimum 10' separation between water and sanitary sewer is maintained at all locations. co Water: Applicant does not address water usage for the expansion and the effect (s) on the City System. As mentioned in the opening paragraph, we are awaiting comments from the Water Division. All new water tie -ins will require final approval by the DPW— Water Division. This is understood. Notes on the general notes page direct that all materials and construction methods conform to all local standards. DPW recommends that the applicant minimize the number of times the water and drain lines cross. DPW recommends that DMH #1 be moved east of the existing waterline to avoid an additional crossing. This change has been made to the project plans, and is shown on attached sketch SK -3. All turns in the waterline should have thrust blocks. We have added thrust block details, table and notes to Sheet D -5 of the project All hydrants shall remain private. It is the applicant's understanding that all of the proposed improvements will remain private property. Size and type of proposed waterlines is not stated on the plans. This information has been added to the site plans. DPW recommends maintenance of a 10' lateral separation between water and drain lines wherever possible. We have maintained as much separation between the various utility mains as possible. However, due to the tightness of the site, we were unable to maintain 10' separations at all locations. A minimum 10' separation between water and sanitary sewer is maintained at all locations. 0paw New facilities will need to have plumbing plans reviewed to determine if additional cross - connection/back flow prevention devices will be required. The site plans for the project are at a more advanced stage than the architectural plans for the proposed buildings, in particular with regard to mechanical, electrical, and plumbing systems. As the project moves forward to the building permit stage, full details of all these systems will be provided to the appropriate City departments for review and revision as necessary for compliance with all applicable codes. Applicant should consider looping the waterline within the site to prevent stagnation of water at the end of the line. If this is not feasible, applicant should discuss with water division the number of times the hydrant should be flushed and how to deal with potential water quality problems. As there are a number of different ways that this issue could be addressed, we propose to wait to make our final determination until we have received comments back from the Northampton Water Division. Drainage: The stormwater system as shown will remain a private system. It is the applicant's understanding that all of the proposed improvements will remain private property. The submittal does not document the ability for the detention area under shallow cover to support vehicle load(s). The detention area has been designed to meet or exceed minimum cover requirements for H- 20/H -25 live loading based upon 2 tons /sf corner bearing pressure as published by the Contech Construction Products, Inc. Shop drawings will be submitted for review at a later date detailing connections and bulkhead designs. 0paw As the direction of the stormwater flow was not mapped/marked on the plans, it was hard to determine paths of drainage flow. A comprehensive drainage analysis and design has been completed for the Rockridge Assisted Living Facility. Storm drainage trunk lines generally flow from south to north before treatment and outlet to the underground detention facility. An invert table is shown on plan GU -1 that corresponds to a hydrograph routing program and subcatchment area diagram found in the drainage report. The stormceptor should be relocated out from underneath the dumpster, to facilitate inspections and cleaning. The dumpster has been relocated on the site plan to allow access to the stormceptor chamber. Sheet D -1 shows catch basins with a typical 3'sump. This should be revised to a 4'sump. The typical catch basin detail has been revised to show a 4' sump. Report states that no untreated stormwater to enter resource areas. Numerous drains (8" PVC schedule 40) and area drains enter the system after the stormwater treatment chambers. DPW cannot determine their function or their capacity to transport sedimentation to detention facilities. The 8" PVC schedule 40 drain lines do not appear in the drainage report and provide unknown volumes of stormwater or other flows to the system. The 8" PVC drains are included to provide connection points for the roof drain leaders from the proposed buildings. The several small area drains are utilized to drain small depressions in the lawn areas near the entrance to the new congregate facility, and the terrace at the proposed formal garden area at the north side of the main building. None of these drains will convey stormwater contaminated by suspended solids to the detention facilities. The drainage volumes conveyed by these drains from their respective drainage areas have been included in the calculations and sizing of the detention facilities. 0 ',pape` Stormwater management plan does not specifically state who will be responsible for inspection and maintenance of the stormwater system. If it will be on -site maintenance personnel, then special training should be conducted. Pages 11 -13 of the Storm Drainage Analysis and Design report comprise the Stormwater Operation and Maintenance Plan for the system. The first page states that Mr. Warren Jones, New England Deaconess' superintendent for the Rockridge facility, will undertake day - today operations and maintenance. Drainage system relies upon an infiltration system, however DPW could not find any documentation within the drainage report that states where groundwater elevation is, or if deep holes were excavated in the vicinity of the infiltration basins. Although soils classifications of and B will infiltrate, the system will not work if seasonal high groundwater is near the surface. DPW recommends on -site percolation tests and deep pits to verb design criteria. The drainage system as designed incorporates a partial exfdtration -type detention basin to recharge groundwater. Test borings were completed in January 1969 for a previous expansion of the facility (plan attached). The borings indicate a predominance of reddish -brown loamy -sands and gravels with no observed groundwater found to the depths of borings. These borings are consistent with the NRCS (SCS) USDA Soil Descriptions for Hinckley Loamy - Sands. A conservative long- term infiltration rate of 0.003 feet per minute (corresponding to approx. a 20 minute per inch perc. rate) was chosen in the hydrograph routing model. Confirmatory test pits and percolations tests are scheduled and will be completed to bolster this boring data. Report states exfiltration rate of detention system. No documentation provided for the 60" perforated pipes to provide this flow of water for exfiltration. The detention facility has been designed to exfiltrate a portion of the runoff through a perforated pipe with uniformly graded stone wrapped in a geotextile fabric. The perforated CMP pipe system as designed employs 3/8" diameter holes meeting AASHTO M -39 Class 2 and will provide approximately 2.5% open space area available for recharge. Boring logs by McClintock and Craig indicate observed ground water to be below 21 feet and the area near the detention facility appears to be dominated by reddish -brown loamy sands and gravels. 10 Report calculations for underground detention system do not coincide with plans (elevation and capacity). The underground detention system consists of a series of barrels connected by a header at either end. The system has been modeled for calculation purposes as storage by wetted areas determined by irregular sections. For operational considerations a gentle slope of %= of 1 percent was applied to the system profile to facilitate outlet of stormwater effluent. The computer model reflects equivalent surface area, perimeter, and open space percentages for each elevation of a flat section to determine cumulative storage and wetted areas for routing. The data input for the hydrograph routing model has been completed for the low invert of the detention system (low invert 191) as the program does not allow for input of a sloped barrel cross - section. In accordance with the manufacturers recommendations we have shown a design with approximately 10% excess volume to compensate for the assumptions made in the routing model. Drain line from DMH #15 to northerly detention facility has several bends. Most construction requires manholes for access to any bends. The drain line in question is a 36" diameter corrugated steel pipe that will be fabricated and braced to provide the appropriate bends. We do not feel it is necessary to provide manholes at these bends. A report on the maintenance of the stormwater system should be sent to the DPW once a year. We have advised the applicant's site superintendent of this requirement. DPW questions the long -term reliability of corrugated steel pipe (especially with winter salt residuals) for the detention basin and some of the drain lines. Other materials are available that may provide better longevity. The detention facility has been designed with 12ga. (0.109 ") Aluminized Type 2 Corrugated Steel Pipe because it combines the corrosion resistance of aluminum with the strength and economy of corrugated steel pipe. Long -term field- testing dating back a half century has proven Aluminized Steel Type 2 as a superior product for storm sewer and drainage projects. Based upon current conditions of surveyed pipe installations, the data indicates a minimum service life of 75 years for 16 ga. (0.064 ") Aluminized Type 2 Corrugated Steel Pipe when installed in accordance with the manufacturer's recommendations. We feel that this service life is more than adequate for a private detention facility. 10 Road. Coles Meadow Road was recently paved. Five (S) year pavement moratorium applies. We will comply with the requirements of the Northampton pavement moratorium, L e., milling and repavement 20' each side of any cuts made in recently paved areas. Other. Filter fabric should be placed around 4" drains behind retaining walls to prevent fines from migrating into pipe from drainage aggregate. The retaining wall cross - section detail has been revised to show a filter fabric wrap installed on the subdrain behind the wall. We trust that the information provided herein adequately addresses your comments. Upon completion of the review process by the City, we will issue the DPW a complete set of project drawings incorporating all of the revisions outlined here, as well as any others that may have been made through the review process. If you should any questions or require additional information, please contact me at 413 - 313 -0121. Sincerely, Coler & Colantonio, Inc. David M. Thompson, Jr. Project Manager Cc: New England Deaconess Association Encl. 0paw LIGHT POLE R ELOCATION COLER & COLAN TON 10 z o ROCKRIDGE AT LAUREL PARK ADDITIONS AND SITE IMPROVEMENTS COLES MEADOW ROAD AT ® NORTH KING STREET NORTHAMPTON, MASSACHUSETTS SCALE: 1* ° 20 DATE: MAY 6, 2003 SK -1 ADDENDUM / 1 SEWER CLEAN OUT COLER & COLAN TON 10 ROCKRIDGE AT LAUREL PARK ADDITIONS AND SITE IMPROVEMENTS COLES MEADOW ROAD AT NORTH KING STREET NORTHAMPTON, MASSACHUSETTS SCALE: I' ° 20 DATE: MAY 6, 2003 SK- I_1i.� :�.:�.1. SAWCUT LINE REVISION WATER /DRA CROSS REVISIO COLER s► COLAN TON K3 EMONE mm erwwTtc.c ROCKRIDGE AT LAUREL PARK ADDITIONS AND SITE IMPROVEMENTS COLES MEADOW ROAD AT NORTH KING STREET NORTHAMPTON, MASSACHUSETTS SCALE: 1" - 20' DATE: MAY 6, 2003 SK -3 ADDENDUM ! 1 SEWER MAIN REVISIONS COLER & COLAN TON 10 2 ENGOEM mo �„�,c ROCKRIDGE AT LAUREL PARK ADDITIONS AND SITE IMPROVEMENTS COLES MEADOW ROAD AT NORTH KING STREET NORTHAMPTON SCALE: 1 a 20' SK -4 SSACHUSETTS f_ DATE: MAY 6, 2003 ADDENDUM 1 1 SEWER STORAGE & PUMP CHAM BER COLER & COLAN TON 10 ma scimms-Is ME ROCKRIDGE AT LAUREL PARK ADDITIONS AND SITE IMPROVEMENTS COTES MEADOW ROAD AT NORTH KING STREET NORTHAMPTON, M SCALE: 1' a 20' SK -5 DATE: MAY 6, 200 1 ADDENDUM j 1 • NAME: LOCAnONG-()GC-C ACCOUNT #: u rt FROM: TO: ------------ DUE. :CLi;tljnp "XNW X 'nETER (2 " 1 VA ­ .W_ -- - e TER 505-400 A' 4t SEWER RESIDENT. 118100 118100 '182 Days Wrn- tn; g .!PONTR0L# DATE PAID/ w wlu AT ATER-'R -;EVER RAT EV-ER RAT VITY RA ACTUAL ACTUAL VIT HOUT W—METM CHARM EMWTW OTHM FC4 INTEREST at the M * Of 14% PER AW&W wM accrue on • overd Pawrmft Urd paynxxt i ma See back ofbN fOrnwm k&m'Sdln. 4000 S0114.;i3 , ........... ­,­ll ------ PLEASE RETURN THIS STUB WITH YOUR REMITTANCE CITY OF NORTHAMPTON WATER AND SEWER 40 169013-. '714 . 714 2 ..... ......... PARCEU: _0 ()6 ., CC1 SILL: 'CS/21/02 NEV -ENGLAKD DEACONESS ASS 25 COLES ilEADOW RD -WIRTHAMPTOW CA DICLE COLLECTOR'S OFFICE 212 MAIN STREET NO RTHAMPTON. H AMPTON. WATER AND SEWER BILL TELEPHONE 587 -1293 REV ENGLAND DEACONESS ASS ------------ NORTH -KING ST-ROCKRITc-E UNIT: a.TL*l : ir!Cjmljrl!2 City of Northampton Office of the Tax Collector 212 Main Street, Room 305 Northampton, MA 01060 -3191 P.4: 587 -1293 40 I 013008001 NEW ENGLAND DEACONESS ASS 25 COLES MEADOW RD NORTHAMPTON MA 01060 Rem loft a Name street, Po am a4c ST. ZP e WATER & SEWER BILI Remit Cop Please write your account rxxnber on Your ctm and enclose this portion of bill with your paymer Make check payable to: City of 1'Iorthan" K Detach and return the above portion with your payment X Make IV-- Payable and yap 10. City of Northampton Office of the Tax Collector 212 Main Street, Room 305 Northampton, MA 01060 -3191 PH: 587 -1293 WATER & SEWER BIL Customer Cog Keep this - portion for your recor NEW ENGLAND DEACONESS ASS 0 NORTH KING ST- ROCKtIpGE 4040006900 013008001 84579 03/28/2003 04/28/2003 METER (2") 03ro`5/2003 10/10/2002 0 WATER 03/0512003 10/10/2002 0 0 10.00 SEWER RESI 813200 0 146 88600 27.54 C ONTTRH ROL 8600 ,11 72460 N Days 82,888.36 C APPROVED By S DATE PAID /C( Mterest at" rate 14% per annum "a accrue on until payment is made. sos.rsvwse side for knporfairt. • 00 .00 51015.90 -45,015-90 WATER RATE $2.39 PER 100 CUBIC FEET WATER IS PRECOUS ....... PLEASE CONSERVE SEWER RATE $3.26 PER 100 CUBIC FEET 100 CU. FT. '= 748 GALLONS Rate Is per 100 cubic feet Make Checks Payable to; Remit To: For as Correspondence or in person: CITY OF NORTHAMPTON OFFICE OF THE TAX COLLECTOR CITY OF NORTHAMPTON 212 MAIN STREET, ROOM 305 NORTHAMPTON, MA 010603191 City or Northampton 125 Locust Street Norlijampton, MA 01060 8:30 AM TO 4:30 PM Monday through Friday Collector : 413 -587 -1293 Baling: 413- 587 -1570 EXT.104 OR 105 84579 I 04/28/2003 I $5,015.90 Consumption billed In hundreds of cubic fel Non - receipt of issued bill not deemed excu: for failure to pay. Properly owner responsih for protection of meter from loss and from h water, freezing or other damage. Any perst other than an employee of this Wat Company who turns water off or on at a ma or pipe belonging to the City, witho Permission, shall be punished in accordan4 with Chapter 165, Section 11, General Lav of the Commonwealth. —.. ..4 I..n uuaurtpiof) Office of the Tax Collector tame 212 Main Street, Room 305 skeek P0 Box Northanipton, MA 01060 -3191 PH: 587 -1293 ter. sr. zr s+o�e 4040006900 013008001 76253 12M%'2002 5,722.15 NEW ENGLAND DEACONESS ASS 25 coLES ME RD NORTHAMPTON MA 01OW WATER & SEWER BILI Remit Cop Please write Your account nt number on your uhe and enclose this Portion of bill with your paymer Make eheck pay" to: My of Nodhj,. d " RUN Now 'Wake t.'l1ftft p tae arid 'MsN b: an Detach d return the above Portion with your Payment x MY of Northampton WATER &SEWER BILI Office of the Tax Collector 212 Main Street, Room 305 De&gUenct Noth NOrthanPton, MA 0 1060 -3191 Customer Co PH: 587 -1293 Keep this portion for your recon NEW ENGLAND DEACONESS ASS . 0 NORTH KING ST- ROCKRIDGE 40400 06900 I 0 13008001 METER (2") 10110J2002 2 WATER 10MIM2002 SEWER RESI APPROVED B DATE PAID/ ACCOtlttTs__ 20 - /n pay aE Ure late 141 ire sk►e on OVerd rriG7 payment !s made. f WATER RATE $2.39 PER 100 CU. FT. SEWER RATE $3.26 PER 100 CU. FT. Make Checks Payable to; Remit To: For all Corresponden0e.or in person: Office Hou m: Phones: 76253 11 IiOs/Z002 12f0512002 0 0 .0 10.00 0 623500 193 101100 2,416.29 Days 101100 3,295.86 .00 .00 5,722.1 S • 5,722.15 CITY OF NORTHAMPTON OFFICE OF THE TAX COLLECTOR CITY OF NORTHAMPTON 212 MAIN STREET, ROOM 305 NORTHAMPTON, MA 01060.3191 City or No Locust Sh NOrgemPton. MA 01060 8:30 AM TO 4:30 PM Monday twOugh Friday Calector: 4 13 -587 -1293 BMV: 4 13 - 587 -1570 ExT.104 OR 105 WATER IS-PREClOW....... PLEASE CONSERVE 100 CU. FT. = 748 GALLONS Rate Is per 100 cubic feet Consumption billed in hundreds of cubic feel Non - receipt of issued bill not deemed excuse for failure to pay. Properly owner responsibit for protection of meter from loss and from ho water, freezing or other damage. Any pm other than an employea of this Wate Company who turns water off or on. at a mail or pipe belonging to the City, withou Permission, shall be punished in accordance with Chapter 165, Section 11, General Law: of the Commonwealth. 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Lu �" 3 �' W Lx a �< m� a� m � W e m ( �S W� jx oU W mvNi 2 2< eW� WW 2 U2 0 ti m C e m e h� zz w Am ss W 2J < cc ul Ic W LL d h p a We $m $? `'� "N F O ? mz CL I W Sl °e m� i�v; S a eI Z U V 2 <o as m O Wv'i ° Wm( ~< a0 m J OO �(� H d (5 ia k eb e� h a2 z eo a� mo �� <a 12 a m k o as� �p °e < Z D WJ�� a� o iii < i mc�i o e� a W` WC �1 2< Q < �a0< �'' �' V V < �2e Uo° ao LL W O O N< ��� Nan h« oi 00 UU COLER & COLANTONIO z ENGINEERS AND SCIENTISTS May 14, 2003 Mr. Ned Huntley, Assistant City Engineer Department of Public Works City of Northampton 125 Locust Street Northampton, MA 01010 RE: Soil Test Pit Logs and Percolation Results File #03- SP -53, Proposed Addition and Site Improvements, Rockridge Retirement Community, 25 Coles Meadow Road, Northampton Massachusetts Dear Mr. Huntley: We are pleased to provide you with four deep hole test pit logs and two percolation tests to supplement the letter dated May 9, 2003 in order to fully address the departments comments to the planning board dated - April - 9; - 2003. - 7&" s Se-o the tests as discussed Burin 16 meeting is to determine observed g our April term infiltration rate contained within the Drainage Analysis and �i��as a estimated long - gn Rockridge Retirement Community. The locations of testing can be found on the attached sketch entitled Test Pit Locations. The deep hole test pits performed at locations 1 and 2 indicate strata of silt loam contained at approximately 5 %2 feet below the surface. Further to the south, test pit 2A indicates sandy -loams and medium sands to a depth of 13 feet consistent with the test borings performed b McClintock and Craig. We surmise that most likely the area between test pits 1/2 and 2A is near the former bank of glacial Lake Hitchcock. The silt loam is presumably the remnants of lacustrine deposits deposited when the lake covered much of the Pioneer Valley. Below this silt loam is reddish brown medium sand with no evidence of observed groundwater confirmed by test pit location 2. It appears that much of the silt loam construction of the main detention facility to meet the deli stratum will be removed during loam is remaining during construction, we recommend excavatinand removal of this material or the construction of stone wick drains through the strata, to facilitate improved recharge to the groundwater. A percolation test was conducted at test pit 2A and yielded a rate less than 2 minutes/inch for the main infiltration area; test pit 3 yielded a rate of 4 minutes per inch for the infiltration trench. These rates are more than adequate to support the long -term estimated infiltration rate of 0.003 feet per minute or approximately 28 minutes/inch expressed as a perc. _ rate is represented in our calculations to address the presumed variability of Soil st and complications of maintaining a subsurface infiltration system. 55 Bobala Road 413 313 -0100 Holyoke, MA 01040 Fax: 413 313 -0190 a paW -- - We appreciate your continued efforts to try and meet the Planning Department's schedule and ents, If you should trust that the information provided herein adequately addresses your comm any questions or require additional information please contact Mr. David Thompson, Jr. or myself at (413) 313 -0100. , Sincerely, CakA &- Colantoriio, Inc. Jesse Moreno Project Engineer cc: New England Deaconess Association Encl. • DIM All am al' � pl, ,II P 1 . 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No. 53"_ • 1 Sugarloaf Sheet •Enoi,.oe.... y_ o_,_ .. *South Deerfield, M 1 70 3 3 Date: $= COM MONWEALTH OF MASSACHUSETTS NOR M 4 mPIA M ASSACHUSETTS Address: 2 r e* rw �d R#" Owner: IV'F#10*4*WP p NES MR-- S Date: . 3_ Percolation Test* Obsevation Hole# Time: Z: Od — 3; 0 De th of Perc a Start Pre -Soak K dF End Pre -Soak Z : Zp Time 12" 3 2: 3 !2: 3 S Time 6» 2: 3S; 3p r 2•SO Time Time 9 "-6" Rate JInch * Minimum of 1 percolation test must be perform in both the primary area reserve area, 2h- - _4 k- 7a A�AI� u pEp1Z/'— Repair [] New Construction [] �Nfii"YRfkftdNl F'E7;�'rol� �ItCl�d1�/ Site Passed 5K Site FailedEl Performed By: Witnessed By: Comments: /N 6 F 7aX*,L ilsRss�7 5 .� DEP APPROVED FORM - 12/07/95