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HomeMy WebLinkAbout0031 BABBLING BROOK ROAD - Health 31 Babbling Brook Road, Centerville A= 188 - 152 4 i a Illl YC`V0`D� Smeac�o 2 Iu� UPC 12543 o- No. 53LOR �t°bn•coNS°`�W HASTINGS. MN Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments (,.wA wM 31 Babbling Brook Road �w Property Address Nancy Komenda `' Owner O 0riwner s Name information is / , required for every Centerville V MA 02632 8/17/2J- 7 page. City/Town State Zip Code Date of`tnspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford key the return Name of Inspector Y Ford Septic Services LLC V rab Company Name P.O. Box 49 Company Address rem Osterville MA 02655 Cityrrown State Zip Code 508-862-9400 S12482 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Ev I tion by the Local Approving Authority 8/23/17 Inspe o's Signature Date The s m inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Y - w Commonwealth of Massachusetts Title 5 Offici:al Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303.or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by ,the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N . ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) .Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: . ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts _ Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? El Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercialtindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per-day Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 lit Commonwealth of Massachusetts t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. CltyFrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: unavailable Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system 0 Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •. 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed -9/26/1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 14' feet Material of construction: ® concrete ❑ metal ❑fiberglass 9 El polyethylene El other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal. H-10 Sludge depth: 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 31 Babbling Brook Road Property Address Nancy Komenda Owner information is Owner's Name required for every Centerville MA 02632 8/17/2017 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 29 .Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 10 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present. no sign of leakage Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass 9 El polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date (Sins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts FEW- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w.. 31 9 Babblin Brook Road Property Address Nancy Komenda Owner Owners Name information is Centerville required for every MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box was under brick walkway. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 - 1000 gal. 2' stone Elleaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The pit had 1' of water on the bottom. There was no sign of failure The cover was 25" below. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is required for every Centerville MA 02632 8/17/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(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.): N/a 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 k Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ., 31 Babbling Brook Road Property Address Nancy Komenda Owner Owner's Name information is required for every Centerville MA 02632 8/17/2017 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately B\ A , a 1 l to A I , 1 /S ra a ,s ao 333 331 3 O 1 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Babbling Brook Road Property Address Nancy Komenda Owner Owner's Name information is required for every Centerville MA 02632 8/17/2017 page. CityfTown State Zip Code Date of Inspection D. System Information (cont-.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 26' +/- feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Topo and water contours maps Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 31 Babbling Brook Road Property Address Nancy Komenda Owner Owners Name information is Centerville required for every MA 02632 8/17/2017 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 17 of 17 I OCTiV I CERTIFIED SEPTIC SYSTEM REPORT 61y�� lep LOCATION 31 BABBLING BROOK RD . CENTERVILLE , MA 02632 MAP 188 PARCEL 152 LOT 20 PREPARED FOR SELLER MR. & MRS . ROBERT F . KOMENDA 454 PINE CREEK AVE . FAIRFIELD, CT 06430 BUYER MR. & MRS . JEFFERY KOMENDA 31 BABBLING BROOK RD . CENTERVILLE , MA 02632 PREPARED BY HILLIARD HILLER P .O . BOX 250 CENTERVILLE , MA 02632 508-778-1472 I_ I A/' V Commonweolth of Massachusetts aim Executive Office of Environmental Affairs De artment of Environmental Protection WNUM F.weld Trudy Coxe Argeo Paul CNlucel David B. Svuhs CommWiaur SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Addiesa: ,�i ,gL/,C/G ,�,�odi� ,Q(J Address of Owner. Date of Iospeation: G viEiLti/G G,c" (If different) ��y Name of Inspector. /� L? Company Name,Address and Telephone Number. 1�!v X 5-Z 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: _Ae-hasses Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signatm.•e: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of complaung 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 should be sent to the m owner and copies sent to the buyer, if applicable orugumal system p _ and the approving authority. INSPECTION SUMMARY: Chej!5R,C, or D: Al SYSTEM PASSES: have not found any information which indicates that the system violate&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 used 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 enfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street 0 Boston,Massachusetts 02108 a FAX(617) 556-1049 • Telephone(617)292-5500 w +il Pnnted on RecvcW Pape. - L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (oontinued) Property Address 31 Owner. Date of Inspection: B)SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The m um more than four times a due to broken or obstructed pipe(s). The m will_ syste re9uired pumping yam' P Pe system 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 HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM[WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMDTES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm. S) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (oontinued) Property Address: 3% 1,4191 Owner. Date of Inspection: DI SYSTEM FAILS: I have determined that the ryaem violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than V2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System. cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinlang water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operwtar of any such system shall bring the ryrtem 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Addnm- 31 i3/�'� i.UG /✓1/�UOi< /j4 c=�!✓i %2'UiG lid Owner. Date of.Inspection: Chack if the following have been done: i/Pumping information was requested of the owner, occupant, and Board of Health. L'14one 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. ✓As built plans have been obtained and examined. Note if they are not available with N/A. 1 /The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow 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 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Add:eas: 31 Ir . Owner. 1.7 .6i 1r4��v'%• Date of Inspection: 4�/- AXAG FLOW CONDITIONS RESIDENTIAL- Design flow: 33�lons Number of bsdrooms:� Number of current residents: Garbage grinder(yes or no): y Laundry a mneeted to system(yes or no): � Seasonal use(yes or no): .V Water meter readings, if available: -- �G II Last date of occupancy: COMMERCIALANDUSTRIAL• Type of establishment: Design flow: • ssllons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Nonaanitary waste discharged to the Title 5 system: (yes or no)_ Water meter.readings, if available: Lest date of occupancy: OTHER:(Deseibe) Last date of oempaney: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no),J If yea,volume pumped: gallons Resson for pumping TYPE gy RSTEM Septic tankAbstribution boxisoil absorption system Singis owspool OverOcw cesspool Privy Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(ea:plain) APPROXIMATE AGE of all components,date installed(if known) and source of information: Sewage odors detected when arriving at the site: (yes or no)�/O (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address 3/ �i9GsvG moor /'/� G�i C11UrGI✓.� Owner. Date of Inspection: SEPTIC TANK: (locate on site plan) Depth below grade: Haterial Of oamstsnction:!/concrete_metal_FRP—other(explain) Dimensions:1a ShXdge depth: Distance from top of aludge to bottom of outlet tee or baffler/;;1- scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: g Distance from bottom of scum to bottom of outlet tee or baffle: /3h Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) %/r/,�/f. //�y TEeS Lc�i'�p �G © /�L✓9d c/r'�L,C> r /� "7 N fl/i°.� Oa/�'!I .�cfrG H u� Tf�L• !/JG.C�/ 6 �G,E T �t/c'/I.S GREASE TRA 6 (locate on site p Depth below grade: Material of construction:_concrete_metal_FRP_other(explain) Dimensions: Scum thickz w: 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, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address jl �f/� i,�� �✓��/ -1<451 Owner. i�y Dade of Inspection TIGHT OR HOLDING TANK (locets an site plan) Depth below grode: Material of construction:_concrete_metal_FRP _other(esplain) Dimensions: capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX (]ovate on site plan) Depth of liquid level above outlet invert: y^ Casements: (note if level and distribution is equal evidence of solids carryover, evidence of leakage into or out of box, etc.) t,JG'/,mod i7 fsC:V'© - /S iQS G ? i' '� , Th:G � /'T.r✓ T/�.U�.'. i Lr/irifvdi rL'�isi���iyv T/tip uw�Gi' PUMP CHAMBERa--,/— (lonte an sits plan) Pumps in working order.(pes or no) Cots: (note condition of pump clamber,condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 f r 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART C SYSTEM INFORMATION (continued) Property Address:Owner. P �G6,C �!/iN1 �G�i�j; Date of Insppootion: /v1%Ac SOIL ABSORPTION SYSTEM (SAS): (loans on mite plan,tf potable;excavation not required,but may be approximated by non.intrusive methods) If not determined to be present,explain: Type: letcbing pits, number: Inching chambers,number:_ Inc hing galleries, number: Lachiag trenches, number,length: leaching fields, number,dimensions: overflow cesspool, number: Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) A14:;:1 /✓/Gr//'L•. .1J.�'Si_,ci O�('/�t�i�/c'>S Sr�'r�r.� ff �X� /�i1 �i1?ice .�' c%� Sic.iCi.� ?NG Fir tr�Aa .yyT !>i4,%i7 CESSPOOLS: (locate on site Ph Number and configurtition: Depth-Wp of bjuid to inlet invert: Depth of solids layer: Depth of am layer: Dimensions of ossspool: material of construction. Indication of groundwater: inflow(Cesspool must be pumped as part of inspection) Comments:(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.) PRIVY: (beats site plan) materials Of acm on. 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 f V SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION (continued) Property Address: 3/ Owner. Date of Inspection: SKME OF SEWAGE DISPOSAL SYSTEM: brbide ties to at Lest two permanent references landmarks or benchmarks locate all wells within 100' j-RoH q " a�Z 0 - - i i i S; DEFM W GROUNDWATER Depth to vmdmW,.. y- feet mothad of dotwmination or apprau=tmn: 6A,Si611 1'97 !z-G (revised 11/03M) 9 No. •- -- ---- f Fizz..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town---- --- ...............OF..........Blsins-tables..................................................... Appliration for Disposal Works Tnnitrnrtiun jiumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Babbling Brook Rd. Lot #20 ................_................................................................................ --••••••-•---•....••-•--•-----------•----••••-------------•-------••-•--••--••---•----.........•-- Jeff and Nancy K�S`i�a�'fd&ddress 508 Main St, Centerville ....................... - .......... .................................... ........._........................................................................................ W Arch Construction Owner Hyannis, Maw Address Installer Address ^5,,ZOO d Type of Building three Size Lot____`_+_......................Sq. feet U Dwelling—No. of Bedrooms---- ._. __ Expansiop Attic ( ) Garbage Grinder ( _) Other—Type T e of Building Wood frame-------------- six _ x _ Pk yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( —) Q' Other fixtures ------------------------•------• - W Design Flow...............55........................gallons per person per day. Total daily flow..............119.........._............gallons. WSeptic Tank—Liquid capacity-1,00gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No. ___N/A........ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage P N�.___one--_-_---- Diameter.......12--ft Depth below inlet.....�.___f:t.._. Total leaching area....2L4.......sq. ft. z Other Dist ution box (x ) Dosing tank ( ) aPercolation T t Results Performed by.......................................................................... Date__-J ._an �4...___�984____ a Test Pit o. 1.__4__2_.__._minutes per inch Depth of Test Pit.......1.2___ft. Depth to ground water-----none---encountered Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water--------to...12---ft. a ----••--•--------------------------------------------•----•-•-•---••-------•••••-•-•.....-••---•••--••-•-•-••--•-----•--••••-----•-•--••----••-......_....-- O Description of Soil........0 f1-2 ft. loam and-_subsoil __ .._.. V 2 ft-12 ft. med to fine sand -----------------------------•-------------------------------•-•------------------•------------...--•-••-•-----•••-----••---- UW ----------------------------------------------------------------------------------------------•--------------------------------------------------------------------------------------------------_----- Nature of Repairs or Alterations—Answer when applicable-------------------------_...................................................................... ----------------------------•-----------------------------------------------------------•-•------------------------------------------------------------------------------------------._...._.__...-•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i ITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y the board of health. •g Date Application Approved By-----•-- .................................... ........... .------ Date Application Disapproved for the following reasons:---•-----•----•-------------•-----------••-------•-•------•----•-•--------------•-----•-----------._....._•••- _.._._..•-•-••--------•---••-----••••---...-•---•••••---------------------------••-•-_•--•----•-•---__._...---•-•••••-•-•-•----•--••-•-----••------------------•------•--••-------------._...•----_---••- Date PermitNo......................................................... Issued_....................................................... Date 1,. T JP THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -----Town... . .................O F.........Barns teab-lL-...------------...-----------------------.-.-.-.------ Apptiration for Disposal Works Tonstrurtion tirrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: } A Babblir��_.�rRnlc.Rd..........-•'-•---•••..............•-•••.......---•---- ............Lat.424..................................................--................. Location-Address or Lot No. �.�ff.. ns�..PJ zt�y.._Kamsns ............................................ ..�.QS._-Main..Str_-cemtesuia.la...................................... Owner Address w �h -•-•-'---•-------------•---•--•------•--••--•----------- -$yaxlr"s•-Ma•------•---...------------..........---••-------•--........---- Installer pq Address VType of Building Size Lot...4.52IIQ...........Sq. feet Dwelling—No. of Bedrooms.._...tl=p...........................Expansion Attic ( . ) Garbage Grinder (_ ) PLI Other—Type of Building .wQod-_f wwe.. No. of persons...six............. Showers (x ) — Cafeteria (s ) Q' Other fixtures ..._..... ; Design Flow.............. .-------------------------gallons per person per day. Total daily flow------------- p--_-------___----•---•gallons. Septic Tank—Liqui capacity�.©eogallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No._. ��---------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit Nr,!---one---------- Diameter.......12_._pb7. Depth below,inlet..... Total leaching area..._ sq. ft. Z Other Distribution box (X ) Dosing tank ( ) aPercolation Tess Results Performed by......................................................................... Date__Jam.24....1984.•_..... Test Pit No. I_(..2.......minutes per inch Depth of Test Pit...... __f�� Depth to ground water____norre--encountered 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.._-__tom ------------------'------••---...-•---.....------................---•---•--......................................................... O Description of Soil.......G-.f-t-2... sebeell---•----------------- ...........2.44-1-2••€-tr--meth-•to•ft-ne--e-and---------•-------------••-•--•----......................................................... W UNature of Repairs or Alterations—Answer when applicable............................................................................................... •--••--•••-•-••--•••-----•-----•---•--•--------••-•••---••••---•-••--------------•--..........-•----•-------•-•--•••----•------•---•----------••---•--•---•--•-•••-•--•••--••-••------•--•--•---••••••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T IT1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued the board of health. Signe © � Date Application Approved BY '� ''� --------- � •1��r�$"� ....... . . .................•-•--•--------------- Date Application Disapproved for the following reasons: - ---------------------------------------------------'-------------------.... ..................•.*----------Date-----• PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... fe wrtifirab of Tumplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY-•--------•--------•�•••----•---• --•------------••----•--- ---•----------------------------��---- h----"---------- •--------- Install has been installed in accordance with the provisiol-/of TITLEr� 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ dated-.---------------------------.................. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �j ��(, DATE--••......................•--•--............._J_LIJ )L........•. Inspector.............a.c.-�f=3---........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G 2 ...........................................OF...........--.-..........................._.......................................... J No........ � L FEE........................ Disposal nrkg/Tunstrudion rrntit Permission is hereby granted................ - _----------------•-•-•------------------•--•-----------•----------.--.---------.-.-.----.-.--•-----•--- to Construct ( Repair ( ) an I idual Sewage Disp2A Syst ) atNo................... - 2- ---••------ Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ................... --•-----------------•----------•----- - .....................- DATE. Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON hldl" FLa� �lq IG &AAD5 0 ' G� - 10, cn AA, *. L.. �dE� LoChTICX.J o l .� Pei- aSne a b PY-A" �- -- 15, oc)(0 -n F. 1 Ioo"WIG'1-N _J/ Lc�-c ILo I / 0.00 S. 1= UPLh1r-.,CJ O Si"Pi�TiOtJ le) , 200 5. F. + MA(Q'v6ra 7 •_17 n nn n ,`'t IO �� a K �� . L2 . ( VE� KEc:.cRD PLA,J <� k: Ji Q a v 1 4 LG�A1 B'2 84 (2 IL — u4.J VA zZ ILO �a'± _��/ wµ?ter a 9 to Nso ;� •'J 4e.3 • �. C b Pr „p 3i'a � ;7 eu'r¢c DA-p cact.onGi tLP6r.DAD P(Ra3GC•..arG-0�,.,6 "'�.� 4 \ ' k o, ( uE C nt•c 15 -719.2 411. ` '1S,_ / M, 1 L. Np SUi ' e .ti A C3FLIf.1LiLcak: 41.;n" CPQ I',/AIE) i3•� ED66E of '. ETLA+,j6 ve6. rATloW <•1 u^ —_ 2s PmR t� #��T FLAW STET c_X IS'1"1 je= F-LI-EvAMCW .8c cc .tlex�� ' R ` w D ELEVATICAd 9eQISTE LoT "Lc, - 5-2>?:,-IW6 k'cx K slNrt�a�s , � APP9,2�aED: b=AP.D cF ►E!AuTW Llr D4TE AUNT CLIGUT: k'OMF,4DA I W6Q,EBY CERTIFY TWAT THe P9c* 1=LLL_1S 1„1= : 64-20 BuILDIIJ6 -_-AoWu cnJ TWIS PLAB 24 nn��SKJ=.GET LAu>= CouFokms TO T;4F- 2ow►m6 LAWS DQ.BY: J,Q.E OF $�tR.IJSTA , MA's5. G�UTEQvI11E, MASS., 0AU.,5 3'19.t�4• SL{EL'T' I of DATE AM,LAWD WajevbA Permit Number: Completed by HIGH GROUND-WATER LEVEL COMPUTATION Site Location: (— ,�., �u.J _ C.r-ff_,r_ ', T�_i _L' ,�.r_ Lot No. 'Owner-: 1C��FnE=1_rht•. �"��_,-..: r�. Address: _ Contractor: ")A Address: � Notes: i;L: )-L:,it i-.ri- f:I _i_r WA,ir_i.. L.. s =L ,/A i l�3ti.l c�F l ft, iD,ni .,rA iL.. ! ; ::• fj=i. >=: STEP 1 Measure-dep.t-h---to--+era-t-er.-Eab,4e to nearest 1/10 ft. g/2 /84 f2.o date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A iv A) Appropriate index well . . . . . . . . . . . . '? `"' B) Water-level range zone . . . . . . . . . . . . G STEP 3 Using monthly report"Current Water Resources Condit.ions10 determine current depth to water level for index well . . . . .. 2. / 1 mo yr STEP 4 Using Table of Water-level Adjustments for index well STEP 2A , current depth to water level for index well (STEP 3) , and water-level • zone (STEP 2B) determine 2. 1 water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP 5 Estinate depth to high water by -subi-Faeting the water- r level adjustment (STEP 4) from measured depth to water I�. > level at site (STEP 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a -- _ 4a, 1.1�-T� I F 1=I-rH E.L i+ 4 E S�PT'1 C. T{:v+J IL OIL DLO FT. MII.1. 'rt LEACNIub PIT f� MoRF-E TI•-IA" I Q., I I I G FT. M I�.J • _I — _ G t2A�E A 44~b I A kl1 Tr 2 C= erg Ta Q- i — {[.S/�_H-AL-L a3 �Ro�1C�-fr -ro GRAfl� DpI�wAYS 4" R/G P I PC- � �I P.E AI.-I f-=XT><2A H EAVY Dc rr�G4� I Qo►� c�o�/>={Z / M I IJ. Prrr-- I =L= 3 I.S /�c��E25 '/$ PE�R FT. A �GRAD� /' COVER— CLEAI.ISA+.1D i R � BY PIPE I DO O o p c�4(f,^.IE.-( �•� wAs+IE �D jE- (.nlu. Pi7c44 GAL. PEa Fr. --5f=Prk- TAR-►IL o , p Q 0 O e • 1 1 I/,- W ASH E D STOLITE ° J • e • 1 1 D e O 0 1 1 1 �.-- lI-►VEQT >=L /ATIOI_IS 18A.S x 2.5 = 4-, 1 cz/D o o e 1 e o e o e • / — PlT oQ E�cJflL— �a. 5 IIJ�lEQT AT BuILDi"62 28.5 FT. rr - 6, FY D/AM. LET 51=PTIC TAI-1� 2-1.S FT• h�!`CAPAGI7�('. �jd9 / D 10 FT. DI�/vt C SEE TAi cXAT >") CUTLET SE PnC TAIJr- IT 3 FT.2! S _ 4. 5T• M u ER _� IuLET DiST�IPxmo- Bo iD1= v +`t - j .arrL.E'T DrSrQI&sr'>a.-I Lox ��.3 FT. inn P�, IIJLET LEl1Gt-}flab wA PIT �LS,1 Fr. eSa DI SP/mS A L SYSTEM � LEAc►-111�6 PIT DES16L1 CQIT>= Kf� xs1t� 114 I � d �IM>=l.r�lOu A FT. D t M Ea►51 au 8 Ca Fr. IJ`,M o f D I m Eu siou C 4 FT. G,4QaAC�E L1sR��.L c�R-I(T �loui �_b I L LOG i TCSrA L E` T7 A/1 ATi=D FL GU\ti/ 33� 6AL. DAY --o I L NEST i.1' i -Sc),I L TEMT 0`2 5�1 L- TEST j N u M 6E� of LE-A44 I c16 P IT5 I 1=L ' j�T1= of �..�-�t L SIDE Ll-=A,--Hiu6 PER-- AIT 188 5c74. Fr, RESuL15 nR : l._`/%::,w LcntiA goTTt�M LE Phi 41 ub PEA I T 1 8 'Sc?. FT. Da-P=iLAT ou LATE Q'I I �55 TCTAL LF-A<-H I1 16 /��'A �Lio�o SCR. P7. ( Q�I�TOf--1 {�PcT1_ �� �T'�.�A"!•�•� M IIJ I IUG ;P.3=5E�vE LEA--N4 i 6 �A �L L-o FT. ? o 15 MEL OF L=J7 /Lo - (3r\�?t�Li►r:ca I."k 2�r 4 w3f ,_�, i o Terso a c a It.11 1-1 MV--4 ,—ET LA"E, MASS V arI►rtllan�w [� IJo GRa�RaD WATER T=uc�1-rrEQD f SUR G i_I�I.tr : I.A D A D/4Ti= '19 3 -.D;- w<a-rEQ.� `_ + m ,: \V A-im" _ OVA' t� { L. i \ti'rL CGI r{,�, E L .