HomeMy WebLinkAbout0017 ARGYLE AVENUE - Health 17 xygle Avenue, Centerville
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UPC 12534
No.2_OR
HASTINGS, MN
No. OL e + Fee
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pprfcation for Migo9ar 6ps�tem Con5truction Verntit
Application for a Permit to Construct( ) Repair(kill"Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. /7 4R G Y L 4 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
1
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 26) sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons (, Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) :3 30 gpd Design flow provided 3 Z/-7, gpd
Plan Date Number of sheets .Z Revision Date
Title
Size of Septic Tank /S' ,l(/iftj Type of S.A.S. )3/e2diflustys
Description of Soil gpp
Nature of Repairs or Alterations(Answer when applicable)JA),S tI d'�p S S ,va 1 C
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this B of H alth.
Sign d / Date /
Application Approved by Date6 /;?
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued
-------------- — — -- --
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No. 7< ..;.,�c,.�; -_..- Fee� t
THE COMMONWEALTH OF'MASSACHUSETTS Entered in computer: �✓
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZIpplication for Digogal *pgtem Con4ruction Permit
Application'for a Permit to Construct( Repair Upgrade O Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. /7 4R6 y I.E AV the Owner's Name,Address,and Tel.No.
(,Nn1Te/'J MQ u �JPS
Assessor's Map/Parcel
Installer's Name, ddress,and Tel.No. Designer's Name,Address and Tel.No.
booglGs A 131 h n) C ,Nsri,Ns Wdik�
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Type of Building: "
Dwelling No.of Bedrooms Lot Size 9 6)S_)o sq.ft. Garbage Grinder ( )
Other' Type of Building No.of Persons (_2 Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min..required) gpd Design flow provided gpd
Plan Date Number of sheets 2 Revision Date
Title "
Size of Septic Tank /$ AIC-0 Type of S.A.S. 8le7d,/I uscn.l 1 Y 25-
Description of Soil �,p4o_V iord
Nature of Repairs or Alterations(Answer when applicable)lA)5 fiG 1� OftJ t)•1-t Q T Seal I C
1
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boa d of Health.
Sign d / Date
Application.Approved by Date `l7 a
Application Disapproved by: Date
for the following reasons
Permit No. �� ` 6 Date Issued 17
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (ti'11"Upgraded ( )
Abandoned( )by L. /Jrh 5 64t Blowu
at )-7 jZ6\1 f y a has been constructed in accordance //� 1f
with the provisions of Title 5 and the for Disposal System Construction Permit No. �' - t0
E;c dated �� /G� .
Installer a2QOG t A �Gcn Q) Designer
#bedrooms Approved design flow 1 y ,.A / , gpd
The issuance of this permit shalllnot .e constru d as a guarantee that the system illYunction as design6dJ _
Date ( /7 Inspector
-------------------------
No. 00 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS
'Wi5po5ar �&pgtem Con5tructfon Permit
Permission is hereby granted toI Construct ( ) Repair (c/) Upgrade ( ) Abandon ( )
System located at / 7 ff f�(��f�. �/� 6e,14-y-/V,i/
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Construction rmust be completed within three years of the dae off thi pe �ti .
Date 6 I ( 7/�� Approved b
TOWN OF BARNSTABLE
LOCATION 17 ARSE L F, NU SEWAGE#
VILLAGE r 6l)l e ASSESSOR'S MAP&PARCEL A.1,C(°-t
INSTALLERS NAME&PHONE NOz e lak h Zf0w6') 509-420--yS3y
SEPTIC TANK CAPACITY
LEACHING FACILITY.(type) l�ipc�t�E�(S U"a2a (size)
NO.OF BEDROOMS
OWNERJG��1P�
PERMIT DATE: 4/1/0 COMPLIANCE DATE: O
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility.(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
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Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
Public Health Division
i.moo.
3� Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: �°/mac U� Sewage Permit# ; fib 1 9,G1 Assessor's Map\Parcel ZZ� 'O'Z
��✓ �c-�,v►+ems /
Designer: 6En N f n�� ?Wo r��5 Installer:
Address: f Z f/N CZi
4 sSt;e 1 d P�7c] Address:
t ass -dale /"169 U�Z� K 67ekJ--er✓J Le M4q 026 32
On T A , 3 ra,--i n , I n c , was issued a permit to install a
(date) (installer)
e
septic system at 17 Ce A-If, GLv\fi-er4.)Ne based on a design drawn by
(address)
d'jF dated 6 J'3` OF
(designer)
I certify that the septic system referenced above was installed substantially according to
the design Y, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State&Local Regulations. Plan revision or
certified as-built by designer to follow.
PETER T.
McENTEE a
staller's Signature) o CIVIL
No.35100
A
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
Town of Barnstable P#
Department of Regulatory Services
ELAMIM
„BLA : Public Health Division Date
=MAS&
16 y �� 200 Main Street,Hyannis MA 02601
3
Ep Ott�
Date Scheduled Time� Fee Pd. V Q L.h1
Soil Suitability Assessment for Sewage Disposal
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Performed By: �� t �� Witnessed By: a^ a l � �` S C� -S
LOCATION & GENERAL INFORMATION
Location Address l^� A r-cb- Owner's Name 'D•e r,064 k p.$V,e,s
cj�l �6 Address `1? rTc-qj-f to—IQj-f
Assessor's Map/Parcel: Engineer's Name 1:144
NEW CONSTRUCTION
,/ REPAIR /'r Telephone# 5d7"O-7 f-3
Land Use V �" � A ( Slopes(%) Surface Stones �L
Distances from: Open Water Body 7 U ft Possible Wet Area< ?--� ft Drinking Water Well�f ft
Drainage Way !YJ ft Property Line 3 d ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
U
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A-
PQ
A/
GcfrLVCU ? 1 Z- r
Parent material(geologic) Depth to Bedrock _ ._ _ _..._
Depth to Groundwater: Standing Water in Hole: ;JI/ Weeping from Fit Faec N
Estimated Seasonal High Groundwater 7 2
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to sail Mottles: _.. _____ In.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment _____.__ ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST now Elms
Observation
Hole# Time at 9" — —
Depth of Perc ` Time at 6"
Start Pre-soak Time @ it 18 Time(9"-6")
End Pre-soak
i t S"3 CAop )
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:GSEPTIC\PERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole# i
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistent %Gravel
A tci 12t/z�
Coarse LS 1 `I t2s/8
C Nted, 'S 2SY l y -- (yti S-"
DEEP OBSERVATION HOLE LOG Hole# �-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistent %Gravel
0 -3G l=u_
6 CaA�u �-s to \t VZ-5-ik
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistent %Gravel
G
,l
�-U
DEEP'OBSERVATION HOLE LOG Hole# k
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. t - J
Consistencv. o Grav
Flood Insurance Rate Mau: �(
Above 500 year flood boundary No_ Yes !
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? _
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on I ft.6- (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.Signature Date--ig G a 0G
Q:\SEPTIC\PERCFORM.DOC
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�\ COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL � 3
DEPARTMENT OF ENVIRONMENTAL N
k9iONE WINTER STREET,BOSTON MA 02108 (617)2 -5v� 0 � `
RECEIVEQ
wII.LIAM F.WELD 1
MAC 1 1997 Q� Secretary
C
Governor P 70"OF@
ARGEO PAUL CELLUCCI d HFALTHpEPTT(E D STRUHS
Lt. Governor ommissioner
�r
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: �� `d�'�-��(C°+" '�'t�� Address of Owner:
Date of Inspection: 315'`J]� � (If different) A00
1-�
Name of Inspector: ,Company Name, Address,an� Telephone Number: I
t . Z
n(- U� Po.�xZ���, �s , ".,-. 62J.45% Sots-ti�� zv
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
F 'Is
Inspector's Signature: Date: 1S'9-7
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority.
INSPECTION SUMMARY:
Check A, B, C, or D:
A] SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
B] SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not.
The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health.
(revised 11/03/95)
A
t. Printed on Recwlcd Pacer
Y •
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
_ CERTIFICATION (continued)
Property Address:
Owner:
Date of Inspection: f�
B] SYSTEM CONDITIONALLY PASSES (continued)
Sewageibackup or breakout or high static water level observed in the distr' ution box is due to broken or obstructed
d ppe(s) or ue to a
2broken, settled or uneven distribution box. The syste will pass inspection if(with approval of the
Board of Health):
_ / broken pipe(s) are replaced
/ 1 obstruction is removed
distribution box is levelled or replaced
_ The system required pumping more than four times a year due o broken or obstructed pipe(s). The system will pass
inspection if.(with approval of the Board of Health):
' broken pipe(s) are replaced
obstruction is removed
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEA H:
Conditions exist which require further evaluation by the and of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
i) SYSTEM WILL PASS UNLESS BOARD OF HEALTH ERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH A SAFETY AND THE ENVIRONMENT:
_ Cesspool or privy is within 50 feet of surface water
Cesspool or privy is within 50 feet of bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD F HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A NER THAT PROTECTs THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tan and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
The system ha5 a septic t nk and soil absorption system and is within a Zone I of a public water supply well.
feet of a private water supply well.
and is within 50 PP Y
it absorption system a p
The system has a septic ank and so p y
_ The system has a Sept' tank and soil absorption system and is less than
100 feet but 50 feet or more from a private water
supply well, unless well water analysis for coliform bacteria and volatile organic compounds indicates that the well is
free from pollution rom that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5
ppm.
3) OTHER
(revised 11/03/9 2
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner:
Date of Inspection:
D] SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria a defined in 310 CMR 15.303. The basis
for this determination is identified below. The Board of Health should be contacted to etermine what will be necessary to correct
the failure.
Backup of sewage into facility or system component due to an overloade or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surfa waters due to an overloaded or clogged SAS or
cesspool.
Static liquid level in the distribution box above outlet invert due o an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or avail le volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NO due to clogged or obstructed pipe(s).
Number of times pumped_.
Any portion of the Soil Absorption System, cesspool r privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 et of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a one I of a public well.
Any portion of a cesspool or privy is with' 50 feet of a private water supply well.
Any portion of a cesspool or privy is I s than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If a well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic mpounds, ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
The following criteria apply to large ystems in addition to the criteria above:
The system serves a facility with design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to
public health and safety and th environment because one or more of the following conditions exist:
the system is withi 400 feet of a surface drinking water supply
the system is wi in 200 feet of a tributary to a surface drinking water supply
the system is ocated in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a
public water supply well)
The owner or operator of an such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 11/03/95) 3
v
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:
Owner: (} A� t
Date of Inspection: t5
Check if the following have been done:
Pumping information was requested of the owner, occupant, and Board of Health.
None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
ditAs built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
The system does not receive non-sanitary or industrial waste flow.
Y rY
The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-
Surface Disposal System.
(revised 11/03/9S) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 1'% Re-ol v"
Owner: If�gjxdn�.
Date of Inspection:
'FLOW CONDITIONS
RESIDENTIAL:
Design flow: S_7>0 gallons
Number of bedrooms:Q�,
Number of current residents:_0
Garbage grinder(yes or no): /JV
Laundry connected to system (yes or no):—LP
Seasonal use (yes or no): �)b
Water meter readings, if available: ��,,.� ,,,yyt_,� u6&j�t
Last date of occupancy:�1mN�2 Mom
COMMERCIAUINDUSTRIAL: V
Type of establishment:
Design flow:_gallons/day
Grease trap present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non-sanitary waste discharged to the Title 5 system: (yes or no)_
Water meter readings, if available:
Last date of occupancy:
OTHER: (Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING FECORDS and source of information:
j_igR►n Mir,ru r A i rue ni i shin a U
System pumped as part of inspection: (yes or no)—&)C� 0-
If yes, volume pumped: eallons
Reason for pumping:
TYPE OF SYSTEM
Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Other(explain)_
APPROXIMATE AGE of all components, date installed (if known) and source of information:
Sewage odors detected when arriving at the site: (yes or no) f�V
(revised 11/03/95) 5
,, .
— SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
SEPTIC TANK:_
(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _FRP —other(explain)
Dimensions:
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, /off level,in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
GREASE TRAP:_
(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _FRP _o/r(explaiK)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee 7teor
Distance from bottom of scum to bottom of oule:
Comments:
(recommendation for pumping, condition of intees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
(revised 11/03/9S) 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) -
Property Address:
Owner: 1{G &
Date of Inspection:�Slcl�
SOIL ABSORPTION SYSTEM (SAS):�f
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:_
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:
Comments: (note condition of soil, signs of hydraulic failure, leve! of ponding, condition of vegetation,etc.)
CESSPOOLS: t�.s
(locate on site plan) 1
Number and configuration: 1 2oln�c�
Depth-cop of liquid to inlet invert: )>g,4
Depth of solids layer: *I — uP * !)-,—
Depth of scum laver: 0¢
Dimensions of cesspool: r4 — I-a ldc y 2 W-7
Materials of construction: e fCbkgoa aiK t
Indication of groundwater: 420
inflow (cesspool must be pumped as part of inspection) jk)
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: rid
(locate on site plan)
Materials of construction: Dimensions:
Depth of solids:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 11/03/95) 8
R "
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
_ PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
TIGHT OR HOLDING TANK:_
(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _FRP —other(explain)
Dimensions:
Capacity: gallons
Design flow: Rallons/day
Alarm level:
Comments:
(condition of inlet tee, condition of alarm and float switches, .c.)
DISTRIBUTION BOX:_
(locate on site plan)
Depth of liquid level above outlet invert: • _,
Comments:
(note if level and distribution is equa, evidence of solids carryover, evidence of leakage into or out of box, etc.)
PUMP CHAMBER:_
(locate on site plan)
Pumps in working ord r:(yes or no)
Comments:
(note condition of ump chamber, condition of pumps and appurtenances, etc.)
/,.-d 11/03/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:, 1-1 fkQAA\-.w .
Owner: k4x.
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
G
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A �
A 1 ^4z'
DEPTH TO GROUNDWATER
Depth to groundwater: feet 1
method of determination or approximation:
(revised 11/03/95) 9
EXISTING BE CESSPOOL W/
Ben/dma dk Set c���N� ' -" -.. _� '�SAND & ABANDONED
I
EI.=98. 76 (Assumed) $Ml 'ram �' S 75°1 20" E
198.07' } X g5 3
56 VENT
gg `'.� dye of�Qw f 9� •96 f(
g9z Shed,
91
c A3 N
rA ,,.., y ,
c` am
DISCONNECT &;PLUG 'OUTLET
1o��3g •'� � •••c .S �v gg•.R �.o
PROPOSED
o SEPTIC FTANK 10'-�I
1 , � \ Lots B4 & 14
i ao TP-1 p PROVIDE NEW SEWER/EX/STING r f /
OUTLET, INv 97�7'HOUSE (#17) /
j ,� 4 ' , 28,510E S.F.
TOF=100
( 5 ff / Map 229
As
Parcel 12
EXISTING SEWER
j OUTLET, INV.-96.90,/`% GARAGE'
` /
DISCONNECT
_ r PLUG OUTLETCD
/
10136 gg 31 gg g4 EXISTING CESSPOOL
, \ TO BE PUMPED, FILLED W/
SAND & ABANDONED
\Q' 10� lapP EXISTING CESSPOOLS , x gg 31
TO BE PUMPED, FILLED W/ Stone Drive
�� g g3 SAND & ABANDONED g ` P�
�. ix `�
N 74 56'40" W
-98
N Long Pond 1\00 x 1 X
® Edge of povement 933
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76 ARGYLE A VENUE
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PROPOSED SEPTIC SYSTEM UPGRADE PLAN
r Pyv 3 LEGEND o PETER T.
o Locu -D McENTEE 17 ARGYLE AVENUE, CENTERVILLE, MA
•--•---- 98 -..... EXISTING CONTOUR � CIVIL
Main St m a i No. 35109 Prepared for: Douglas A. Brown, Inc., 252 Main St., Centerville, MA 02632
x 100.98 EXISTING SPOT GRADE �£C/SSE `� Engineering y
Pine. Street ��� Q En �neerin b Surveying by: SCALE DRAWN J06. N0.
5 EXISTING WATER SERVICE OWNER OF RECORD ` 16$-08
_ W_ FS ` EngineedngWorks WARNER SURVEYING 1"=20` P.T.M.
- EXISTING OVERHEAD WIRES ESTATE OF DEREK HUGHES 12 West Crossfield Road 22 Long Rood
O.H.W.
17 ARGYLE AVENUE a Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO.
LOCUS MAP TEST PIT MA 02632 CENTERVILLE, (p�3�0 a 6/3/08 ,
NOT TO SCALE (508) 477-5313 (508) 432-8309 P.T.M. 1 of 2
y }
� NOTE: TO PREVENT,BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:93.88
FOR A DISTANCE OF 15' AROUND THE
PERIMETER OF THE S.A.S.
PROPOSED TANK PROPOSED D-BOX PROPOSED S.A.S. 21 5-4" POLYSEAL OUTLETS
INSTALL RISERS & COVERS OVER INLET �c INSTALL RISER & COVER INSTALL INSPECTION PORT OVER END_ UNIT 2" 3" 1-4" POLYSEAL INLETS
T.O.F.
OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE t
EXISTING F.G. EL: 98.8(MAX.) VENT
F.G. EL.=99.Ot F.G. EL: 98.8± ;
f MAINTAIN 2%itGRADE (MIN.) OVER S.A.S. N O O
INSPECTION 00
L = 21'(MAX.) L = 11' L = 7(MAX) PORT
@ S=2% (MIN.) CAP S=1% (MIN.) Cn S=1 . (MIN.)
wwawm
4"SCH40 PVC 4"SCH40 PVC 4"SC'H40 PVC 3
yy s' N Top View Section
6. 11.3' To D-BOX
I'LL14" INVERT
FINV.=96.50 48" LIQUIDLEVELADD INV.=95.00 INV.=94.83 4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25.0'
GAS BAFFLE
INV.=96.25 INV.=93.44
PROPOSED D-BOX SOIL ABSORPTION, SYSTEM (PROFILE) GENERAL NOTES:
PROPOSED SEPTIC TANK 4 OUTLETS (MIN.) ESTABLISH VEGETATIVE COVER
TIE IN TO EXISTING BACKFILL WITH CLEAN NATIVE OR 1, ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
SEWER, INV.=96.90 PERC SAND TO TOP OF CHAMBERS BOARD OF HEALTH AND THE DESIGN ENGINEER.
PROVIDE NEW SEWER 2, ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OUTLET, INV.=97,57 BREAKOUT=TOP
NOTES: 1) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO TOP ELEV.=93.88 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW:
GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED INV. ELEV.=93.44 310 CMR 15.405(1)(b):
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). BOTTOM ELEV.=92.50 III®toll IIIII®II 1) A 2' variance to the 3' maximum cover requirement, for no greater
2) INSTALL INLET & OUTLET TEES AS REQUIRED. 2 83' than 5' of cover. S.A.S. shall be vented and H-20 Rated.
3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' MIN. ABOVE BOTTOM OF 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.23 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE EXISTING SUITABLE DESIGN ENGINEER.
INVERTS PRIOR TO CONSTRUCTION. NO G.W., EL=86.2 = MATERIAL 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
SEPTIC SYSTEM PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE ENGINEER BEFORE CONSTRUCTION CONTINUES.
TYPICAL SECTION 5. ALL ELEVATIONS BASED ON ASSUMED DATUM-
N.T.S. N.T.S.
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
\` THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
:" \��*\ SOIL LOG 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
�
• � ~ \\
DESIGN CRITERIA 0 \\-\� DATE: MAY 8, 2008 (REF#12,194) 8. THERE ARE NO PRIVATE WELLS WITHIN 100' OF THE PROPOSED S.A.S.
SOIL EVALUATOR: PETER McENTEE PE 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
WITNESS: DONALD DESMARAIS R.S. AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
NUMBER OF BEDROOMS: 3 BEDROOMS �4y g,4 r HEALTH AGENT DIRECTED BY THE APPROVING AUTHORITIES.
SOIL TEXTURAL CLASS: CLASS I ti' �jNra ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
DESIGN PERCOLATION RATE: 5 MIN/IN ;/``.% 98.2 1 0" 98.2 0" THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
DAILY FLOW: 330 G.P.U. o;� �� . �' �� FILL FILL CONSTRUCTION.
DESIGN FLOW: 330 G.P.D. /�;Qoy�oy 95.2 A 36" 95.2 A 36" 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
SANDY LOAM LOAMY SAND IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE. S.A.S. AND
GARBAGE GRINDER: NO , o
10YR 4/2 1UYR 4,i
2 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
LEACHING AREA REQUIRED: (330) = 445.9 S.F. `•e� i, 94.4 46" 94.5 CO 44"
�`` B ARSE B COARSE PERC 12. ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SYSTEM
.74 �7� LOAMY SAND SANDY LOAM 54"/66" COMPONENTS NOT SHOWN ON THE PLAN.
PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY 1&R 5/8 10YR 5/8
PROPOSED D-BOX:: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED 91.2 C 84" 92.5 C 68" PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS S.A.S. LAYOUT q
/ NO STONE FOR AN S.A.S. WITH DIMENSIONS 1 1 .3' x 25.0' MED. SAND MED. SAND 1 /-7
ARGYLE AVENUE, CENTERVILLE, MA
CONTRACTOR MAY SUBSTITUTE WITH HIGH CAPACITY INILTRATOR UNITS 2.5Y 6/4 2.5Y 6/4 Prepared for: Douglas A. Brown, Inc., 252 Main St., Centerville, MA 02632
SIDEWALL AREA: NOT APPLICABLE Engineering by: Surveying by: SCALE DRAWN JOB. NO.
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.7 SF/LF OF BIODIFFUSER) 86.2 144" 86.2 144" EngineeringWorks WARNER SURVEYING NTS P.T.M. 168-08
16 UNITS x 6.25 LF x 4.7 SF/LF = 470.0 SF j 12 West Crossfield Road 22 Long Road DATE
PERC] RATE 3 MIN/IN. ("B" HORIZON) Forestdole, MA 02644 Harwich, MA 02645 CHECKED SHEET NO.
DESIGN FLOW PROVIDED: 0.74 x 470.0 = 347.8 GPD NO GROUNDWATER ENCOUNTERED (508) 477-5313 (508) 432-8309 6/3/08 P.T.M. 2 Of 2
I