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0069 BACON LANE - Health
69 BACON LANE, CENTERVH LE A= • fil�ill�0•►•� oF� Town of Barnstable P# s� Department of Regulatory Services tetwernere, Public Health Division Date MASS a639. d� 200 Main Street,Hyannis MA 02601 • IA Date Scheduled � /I I Time Fee Pd. —W— Soil Suitability Assessment for Se e Performed By: Witnessed By: r LOCATION& GENERAL INFORMATION Location Address 60L 3s--d 01, G,V i l/Q Owner's Name C n i Address /, LC h L h ' Assessor's Map/Parcel: Z ?_ Z Engineer's Name 11T• tqQr'rr Kf NEW CONSTRUCTION REPAIR Telephone# Land Use SFff Slopes(9'0) 3 ` Surface Stones Distances from: Open Water Body 2/d�B ft Possible Wet Area .7 A,-0 ft Drinking Water Well N�ft Drainage Way �!N ft Property Line ®t Z V ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) BACON LANE % P r t \ do • O ,00 Parent material(geologic) O� ao� Depth to Bedrock Depth to Groundwater. Standing Water in Hole: !yI y Weeping from Pit Foce r� Estimated Seasonal High Groundwater > DETERMINATION FOR SEASONAL HIGH WATER TART- r Method Used: J U "Zi) Depth Observed standing in obs.hole: __ in. Depth to soil mottles: �` � ^�-In. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ` `aft. index Well# Reading Date: Index Well level,_,,,,7_ AdI,factor- Adj.droun twater Level- PERCOLATION TEST >vgte x'lntp K Observation #Z Hole# Time at h" r,. k_" �f Depth of Perc � Time at 6" Start Pre-soak Time @ d d _ Time(V-6") End Pre-soak J.! U Rate MinAnch > 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:4SEP'rlMERCFORM.DOC i DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,% ravel p-rZ L S to y re,3Z- •tip �z-zsr �w s d /oyr�s/� tin 6 f-1 Zo G Z ,Neal sa'd -Irk-a- o� -� �D DEEP OBSERVATION HOLE LOG Hole# Z- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% el .0-/ o ,4 5, vy0 /Z �G U -76 /3k/ ser-i^ct 0 xer ti Z6-6( G / -Cf •1'0-.,'d /U y/L s 4 N J GG -1 Zd G Z z 's/' y tir) fyPge DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Flood Insurance Rate Above 500 year flood boundary No_ Yes ._.___✓_ Within 500 year boundary No= Yes Within 100 year flood boundary No._._,_ Yes � o Depth of Naturally Occurrim 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? Yc -- If not,what is the depth of naturally occurring pervious material? Certification I certify that on /v f�9� (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 trai ' e permsr;ejiecen �described in 310 CMR 15.017. jSignature C / +�%J Date y/ " Q.\SBPTIC\PERCFORM.DOC t I No. l PO 14 �"� 1 a Fee C t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes applitation for misposai opstem cunstrut " permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) omplete System ❑Individual Components Location Address or Lot No. L,% C.e.q v -Owner's Name,Address,and Tel.No. Assessor's Map/Parcel -ZA-7 4- 01-0 A`t/_V'kLr- 2.,13 14—'44ZI Installer's Name,Address,and Tel.No. Tee) 42,S{-qy-) Designer's Name,Address,and Tel.No. 7?q 13 f_j Type of Building: Dwelling No.of Bedrooms Lot Size kcCo sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33Q gpd Design flow provided �� gpd Plan Date p�t 1971 1 lF Number of sheets Q Revision Date Title Size of Septic Tank i c_ne Type of S.A.S. `��a Description of Soil Nature of Repairs or Alterations(Answer when applicable) MtA.1_j (S-17L -,,% Date last inspected: Agreement: The undersigned agrees to ensure the c nstruction and ' enance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E iro ntal Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board Signed Date `-l0 , l Application Approved by L Date 6 ` — ( 3—kL- Application Disapproved by Date for the following reasons Permit No. Date Issued No.U V "� 1 rs�i Fee r a THE COMMONWEAAL --H OF MASSACHUSETTS Entered in computer:1. c_/ PUBLIC HEALTH DIVISION -TOWN-'OF BARNSTABLE, MASSACHUSETTS Yes Rpphratlon for Bisposaf Opstetn ConstrUttion 3permit Application for a Permit to Construct Repair Upgrade( ) Abandon( ) i omplete System ❑Individual Components Location Address or Lot No. (pQ 04cw% L N GcgrC4-✓c t Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Z,47 '-- MI-0 Gwe-.tr\ Aotc.5, i c.r- 2o(3 Installer's Name,Address,and Tel.No. (,_!;old �Q-{�-�-�� Designer's Name,Address,and Tel.No. L'7-4 13r-1q) Tony Gi t, Se.-a-� �a�Lc I+arr; Type of Building: ' Dwelling No.of Bedrooms Lot Size, sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �y Design Flow(min.required) 33g, gpd Design flow provided `S gpd Plan Date p+ '9-] Number of sheets � Revision Date r Title Size of�,Septic Tank �� Type of S.A.S. � G G a � C-L. - Description of Soil' Nature of Repairs or Alterations(Ans'w,erjwhen;applicable)i ,4'�, r/\/Q l r t r* { °r ;Date last inspected: Agreement: . The undersigned agrees-to ensure the construction airitenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E vironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board Hea` '. Signed Date Application Approved'by �,t ") G�'_ (�J S Date Application Disapproved by Date for the following reasons Permit No. O �� (l1 Date Issued f ~� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate,of Compliance � THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by . L,, ( �jj- ,rt-}A `�°��l'i ',otcj►J�GI�9 I'I t( at �pC{ $4COn L`� C_P a Gw a � � has been cons)ructed i accord with the provisions o Title 5 and`the for Disposal System Construction Permit No.4; �/ J ate k, Installer A Designer bedrooms' ° ` � � ''t �: ! t' Approved design flow :,.. , _, gpd The issuancp o his pdmit s:all not be construed as a guarantee that the system wtl ''tint designed. �( Date /J l Inspector _ s V _ No.r Fee - - '"'THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION lw BARNSTABLE,MASSACHUSETTS misposal #pSteltl-ConstrUttlon Permit Permission is hereby granted to Construct(, t), � Repair(;'r)° Upgrade( � ) . Abandon,(y System located at /4 Z9 :.. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must e co m leted within three years of the date of this permit. y�,� Date Approved by f S ' S Town of Barnstable Regulatory Services 51, Thomas F. Geiler,Director i MRN"ARM Public Health Division ►`� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Sewage Permit#/20/ - Assessor's Map/Parcel Z-0 7-0 Z O Installer&Designer Certification Form Designer: 10r,f dn'AW Installer: +0(!j Ci� Address: 9 le-Ch 4p t-ce Address: 54-c� ®?'6T F— M t�,�s'te�1r� et f�k� On 1 7111,v C.,'Nfb .,W, was issued a permit to install a d to (installer) septic system at 6 (41 based on a design drawn by (address) �/ / 61C.9p; L- Z4-p-rr i AL), dated l 17 r (designer) AL). ` I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the se system referenced above was installed with major changes (i.e. greater than 10' eral relocation of the SAS or any vertical relocation of any component of,the•septic stem) but in accordance with State&Local Regulations. Plan revision or certified . -built by designer to follow. Stripout(if requ' ected and the soils j w ee and sati tory. F GUN ERIC nstaller's Signature) HARRINGTON No.1070 %N (Design s Si ature) (Affix Des p 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. gAoffice fonnsldesignercertification forrn.doc j it \_ [I-ctf 7- I F7 f { { i I V.J I I i � I � TOWN OF BARNSTABLE LOCATION:o& �y� �tti✓�-1- SEWAGE# 'F VILLAGEC��wc, .,ASSESSOR'S MAP1.&PARCEL lol-/0�2-0 INSTALLER'S NAME&PHONE NO. ,�-K_ �Git`GS 0'n l:il,'�tLI�J SEPTIC TANK CAPACITY LEACHING FACILITY:(type) � /�1, 1J (size) �$k NO.'OF BEDROOMS �3 r= OWNER SUe, PERMIT DATE: COMPLIANCE DATE: l0 Z Q 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 306 feet of leaching facility) T Feet ` FURNISHED BY I y _r���,` h.2 a Z� J U N(►e E�� �l;�I 1 w . f7 _ ay r 1 .. T l 1f��Q•� �U �;%,aS�Q ►it•,It- by �� I TOWN OF BARNSTABLE 20� t LOCATION `a I Saco l l Cok-191- SEWAGE #' �- VILLAGE Q V Aery, LQom-ASSESSOR'S MAP & LOT 20 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.I'I'Y: (type) size) NO.1OF BEDROOMS 3 BUILDER OR C,x (2 12N PERMITDATE: COMPLIANCE DATE: Sepaiation 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SKETCH OP SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references,landmarks or benclnnarks. Locate all wells wItIdn 100 Feet. I 7 ut DEPTH TO GROUNDWATER: / Depth to groundwater: i4 Feet Metl of peterndnation or Appjo:in yztion:� .Go.Y2�iDr' �eo[e+yi Flwun •n:r ri i-- iJAo r 7- Ct BORTOLOTTI CONSTRUCTION, -INC. 45 INDUSTRY•ROAD, MARSTONS MILLS, MA 02 508-771-9399 508-428-8926 FA-i: 508-428-9399 SUBSURFACE SEWAGE DISPOSAL ':i STEM INSPECTION FORM PART A CERTIFICATION Property Address: 9 Date Of Inspection 00 In )ector's ame: ier's Name Ond Address: CERTIFICATION STATEMENT: I Certify that 1 have personally Inspected the Sewage Disposal System at this address and that the informa- tion reported below is true,accurate and complete as of the time of Inspection. The Inspection was perform- ed based on my'Training and Experience in the Proper Function and Maintenance of On-Site Sewage Dis- posal Systems.'I'h ystem: ('asses Conditional( ses Needs Fu ie va a io By the Local Approving Authority Failur Inspector's Signature Date: W The System Inspector shall submit a copy of this Inspection R-y+«rt to the Approving Authority with'Thirty (30)Days of completing this Inspection. If the System is a Share,( System or has a Design Flow of 10,000 gpd or greater,the Inspector and the System Owner shall submit the Peport 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_ A) SYS7 PASSES: I have not found any Information which indicates that the System violates any of the fail- ure criteria as defined in 310 CMR 15.303. Any Failure Criteria not evaluated are indi- cated below. B) SYSTEM CONDIT!GNA1LLY 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,nor,or not determined(V,N,OR ND). Describe bases of determination in all instances. If"not determined",explain why not. The Septic Tank is Metal,Cracked,Structurally Unsound,shows Substantial Infiltration or exfil- tration,or Tank Failure is imminent. The System will Pass Inspection if Existing Septic Tank is Replaced with a conforming Septic Tank as Approved by the Board Of Health. 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): - 1 - SUBSURFACE SEWAGE' DISPOSAL. SYSI IF,M 's1NSPEC` ION FORh1 PART A CEWFIFICA'FION (continued) Broken pipe(s) replaced Obstruction is removed Distribution Box is leveled or replaced The System required pumping more than four times a,year due to broken or obstructed pipe(s). ']'he System..will pass inspec.tion.if(with approval of The Board Of.Hea.lth): 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 HELLTH DETERNUNE9 THAT I'HE SYSTEM 1S NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT PILE 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 SUPPLIFR, lF APPIZOPRIA 1 E) DETERMINES"I'HA'1'`''l IlE`SYS'1'ElV1 IS FUNC'1'ION- 'INC IN Ay MANNER''1 HA 1 PRO'I"EC'I'9 l'1-iE PUBL1t~? HEALTH ANll'SAFETY AND'ru '. ENVIRONMENT: The system'has a Septic'I'aiik and Soil Absorption"Systeiii:ui`d'is`w f ihi 100 Feet to a Surface Water Supply or Tributary to a Surface Water'Suplily: The System has a Septic'Tank and Soil Absorption System and is with'a Zone 1 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 Weil. 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 from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: have determined that the System violates one or more of the following Failtire 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 he necessary to correct the failure. Backup of sewage into facility or system component clue to all overload or clogged SAS or cesspool. Discharge or ponding of"effluent to'the surface of+the ground o'r''surface waters due to an overloaded or.clogged,SASigr,cesspool F Static.liquid level in the distribution box above outlet invert due to an overloaded or cloh- SAS,.or..cesspogl. St jg a f lvi s Liquid depth in cesspool is lessr thane" below.myei•t.or 1vailable volume is less than 1/2 day flow. , Required pumping more,than�4 times in the last year NOT;due to clogged or obstructed pipe(s). Number of times pumped 2 - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A . C AITIFICATION (continued) 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 l 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. E) LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to(lie criteria above: The design flow of a system is 10,000 ggd or greater(Large System) and the system is a significant -threat to public health and safety and the environment because oiie or.niore of the following conditions exist: The'system is,within 400 Feet.of a.surface..drinking wate.r.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 11 of a public water supply well The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 315 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE, SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B. CHECKLIST Check if the following have beer: done: Pumping information was requested of the owner,occupant,and Board of Health. ,None of the system components have been pumped for atleast 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. V_' As-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 J,---Ihe site was inspected for signs of breakout „ f All.system components,excluding the Soil AbsorptionsSystei i,have`beeu located on site. The septic tank manholes were uncovered,opened,and the iiiterior'of the septic tank was in- spected for condition of baffles or tees,material of constructuoir,dimensions,depth of liquid,. , . depth of sludge;depth of scum. _,Z11'he size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. - 3 - SUBSURFACE SEWAGE DISPOSAL;SYSTEM -INSPECTION FORM PARTB . CI-IECKLIST(continued)., 'he facility owner(and occupants,if different from owner) were provided with infornia(ion on the proper maintenance of Subsurface Disposal System. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ..... - -- PART C SYSTEM INFORMATION . „ .. FLOW CONDITIONS RESIDENTIAL: / Design Flow:3,;�D gallons Number of Bedrooms: Number of Current Residents: Garbage Grinder: L Laundry Connected To S•ystem:(hA Seasonal Use:.< ,(1—' Water Meter Readii s,if ailabie: (7 Last Date of Occupancy: ,l� —( /7. COMMERCIALANDUSTRIAL: Tyl)e'iif Establishment. Design Flow:. . gallons/day. Gegase.'I'r`apPresenf:•"(yes or no).: u .r;^;' ;. .,• . . ....;:,., Industrial Waste Holding Tank Present: Non-Sanitary'Waste Discharged To The Title V System: _ Water Meter Readings,If Available: Last Date of Occupancy: OTHER: (Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS any source of information: A21I System Pumped as part of inspectio If yes, volume pumped: gallons Reason for Pumping: TYPE OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool . Privy Shared System(If.yes, ttach prev•io�,u/s�i,nspection records,if an _Other ex lain : r �j�/hJ A) 1/PRyO�I/M�AT.E,AGE of all,compnnet�ts,date installed (if known) and source of inforntat►on. . Sewage odors.detected when arriving at the sitey� -4- c: SUBMRFACE SEWAGE DISI'OSAI.; 'SVS'I'E M INSPECTION FORM PART C GENERAL. INFORMATION (continued) SEPTIC TAN K: Depth below gra e: Material of Construction: concrete metal FRP Olber (explain) Dimensions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,conditioin of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) GREASE TRAP: Depth Below Grade: Material of Construction: concrete metal FRP Other (explain): Dimensions: Scum Thickness: Distance from top of scuin to top of outlet tee or baffle: Comments: (recommendation for pumping,,condition of inlet and outlet'lees or baffles,:.deptlrof.liquid level in relation.to outlet.invert,structural integrity;evidence;of leakage,.etc.) TIGHT OR HOLDING TANK: Depth Below Grade: ater►al of Construction: concrete metal FRP Other (explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP..CHAMBER:.. __._....__.....:......._.�. .._..I'.ump is_in.woekin order: Count euts:_(note condition of pump clamber,condition of punlps:►nd appurtenances,etc ` 4 5 _ -,SUBSURFACE: SEWAGE DISPOSAL. SYSTEM INSITCTION FORM PART C. SYSTEM INFORMATION (cpntinued) SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible; excavation not required,but may be approximately by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits,number: Leaching chambers,number: Leading galleries,number: Leacabing trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: / mments: (note conidtion of soil,signs of hydraulic ' ilure lev of ponding,condition of vege Lion,etc.)_ r CE,SSI'OOLS: i Number and configuration:/— C� :X , '"•Depth-top of+liquid to inlet invert: ' Depth of solids layer: Depth uf'scu►n layer: Dimensions of Cesspool: 62 'Lod y Materials of construction:�'xe" �/�,� Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Cones ts: (note condition of soil,si ns of hydraulic fai ure,lev I of ponding,condition of ve etation, etc. C ft PRI V Yk, Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil,signs of hyddraulic failure,level of ponding,condition of vegetation, etc.) • N •7 - G SUBSURFACE-SEWAGE' DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references,landmarks or benchmarks. Locate all wells within 100 Feet. �P DEPTH TO GROUNDWATER: / Depth to groundwater: Feet Meth; of Determination or App oxim I10 tiou: :L n e r)dr 6 e��. " - 7 - ALL OM IPES 97.12' SITE PLAN DISTRIBUT�IONPBOX SHALL EE //� oN �� I € "- SET LEVEL FOR AT LEAST 2 FT. 12" CONCRETE COVER G E N E R A L N O T E S o I SCALE: 1 =20 BENCH MARK ON C.B 1 FND 3 - 5"OUTLET . !:�.• 2" 1. ADDRESS: #69 BACON LANE, CENTERVILLE 3 �a B.M . ELEV.=100.00' ASSUMED OUTS t. 2. ASSESSORS NUMBER: 207-020 ( ) KNOCK _ 3. DEVELOPER'S LOT: LOT 26 - 15.5" OUTLET 12" INLET 4. TOPOGRAPHIC INFORMATION WAS COMPILED FROM AN 1856 Store ON THE GROUND INSTRUMENT SURVEY. ,e 98,78' = 6"; 8" '<.~ 5. TOWN WATER IS PROVIDED TO SITE & SURROUNDING PROPERTIES. iv C' • + ;:...... ,•,:.;y._ :•., ,. w: ,': 6. REFERENCE PLAN: PLAN BOOK 614, PAGE 70 & L.C. PLAN 20895-A Um s R Ville Library a V.- CB 1 Pnd " 2" 7. NO WETLANDS ARE LOCATED WITHIN 150 FEET OF SAS. c,0a 15.5" 1.75" 8. NO POTABLE WELLS ARE LOCATED WITHIN 150 FEET OF SAS. qc n 9. THE SITE IS NOT LOCATED WITHIN A ZONE II. p. Q .... ......... ""`' `'`""`"" PLAN-SECTION CROSS SECTION 10. UTILITIES WERE LOCATED BY DIGSAFE CONFIRMATION #20134903709................ :......... ..: 100.52' 3 HOLE H- 1 SITE ................. . ... 0 DISTRIBUTION BOX 0 .:....:::::.::::: :. .. ea9 �/ NOT TO SCALE tre 7................... ... (r .......................... ,, a Main S of ti� O Cst r e V 3-24' DIAM.ACCESS MANHOLES CENTERVILLE............ of LOCUS 3 102.46' V 10 -s \: •3 _ ..• NO SCALE. w.� . .�>•9.•fit'. x l02,06' :�� '•� , I ................... ..... 103,04' dy THE ACCESS COVERS FOR THE SEPTIC TANK. , ? / INLET - OUTLET DISTRIBU11ON BOX AND LEACHING COMPONENT SHALL BE WITHIN 6" OF FINISHED GRADE. INSTALL TUF-TiTE GAS BAFFLES OR EQUALS .:.: ON ALL OUTLET TEE ENDS T 2 6 J STEEL REINFORCED PRECAST CONCRETE .................. A= 1 6 08 SO-FT. PLAN VIEW ............. .... Design Calculations ' 3-24• REMOVABLE COVERS Number of Bedrooms: 3 j Garbage Grinder: NO, GRINDER NOT ALLOWED WITH THIS DESIGN Q w 3 104,3e' ,, Septic Tank Capacity Required: 330 gpd X 200% = 660 gpd. 1,500-GAL MIN. REQ'D. :,•,• � . Y 3 ; _1 s mini clearance Septic Tank Provided: 1,500-GAL SEE CONSTRUCTION NOTE#14. GARAGE i ,�( INLET 0• min. 2• min. inlet to outlet - 'N'�verve • Leaching Capacity Required:-330 Gal./Day 4 N r X 103s?" 105.05' -min. .. OUTLET �- .� 9 P Y q ugwd level Leaching Area Required: 330 Gal:/(0.74 Gal./Sq.Ft.)=446 Sq.Ft. o h 1 rid g and elec., tel. & c ,o•min. _ "' " Proposed Leaching Area Provided: Sides: 65 X 2 X 2 = 260 SQ. FT Co 0 5. _7• •:. .;5 _7• Ends: 3' x 2' x 2 = 12 SQ. FT.- ArD NV 2 p 69 ii x 1oa.a9' eg sera. ".. •r 4'-0• min. Bottom:' 65' X 3' = 195 SO. FT. LEV=100.17� ESN i0s� ba Liquid depth Total Leaching Capacity.Provided = 467 -SQ. FT. > 446 SQ. FT. e / �� Proposed Leaching Area Provided: 467 SQ. FT X 0.74 GPD/SQ.FT -- 345 GPD . . .. .. •..... ...:.. .. Leaching Capacity P 5 gpd gpd. req'd Ex�STIN / •.�•• ^r•• r• Total L Provided: 34 > 330 101-0* x to .eo- ,.,n 'WOOD'pE'� L=105.9p' CROSS-SECTION END-SECTION 0 TYPICAL 1500 GALLON H-10 SEPTIC TANK NOT TO SCALE i " aa1 r 108 USE WIGGIN PRECAST OR EQUAL SEE CONSTRUCTION NOTE #14 89.99' 101,43' (`T �, STR I n hl _ I __. . -RAIseD -__ C 0(�. , ,,�!<, , ION i� , .C T��.>--- i "�•�. c.o. FLOWER BED:. - ••--- WOOD STAIR Lu - RET. grgL a s � 2 1. Contractor is responsible for Digsafe notification O L W and protection o1 all underground utilities and pipes. X 94.3T " PERK TEST & SOIL EVALUATION P 14223 2. The septic tank and distribution box shall be set rn 2 0 Date of Perc.' Test & Soil Eval.: December 11 2013 level on 6" of 3/4"-11/2" stone. o 3 3. Backfill should be clean sand or ravel with no S V ^ Test Performed By. Glen E. Harrington, R.S. 9 HED Q N c stones over 3" in size. 41 3 WITNESSED BY: Donna Miorandi, R.S. ee.63® is alai o EXCAVATOR: JESSE JOYCF LANDSCAPING 4.'This system is subject to inspection during installation Norwalk Pines TH M1 rn b Glen E. Harrington, R.S. crNBER d PERK RATE: LESS THAN 2 vlPI Y 9 89.23'© 6 ' 7.45' BLOCK 10p -„ RerA 5. The contractor shall install this system in accordance PERK with Title V of the Massachusetts Environmental Code 98 Test Hole Test Hole E K TEST P RE and the Regulations of the Town of Barnstable. ' .. :::•..�:::.... �RVE No. 1 No. 2 DEPTH. 36-54 AREq 96 6. Provide a Wi in Precast H-10 1.500 al septic tank - ......... 99 p H 10 DB 3 D Box or equal. DEPTH SOILS ELEV. DEPTH SOILS ELEV. ......... .:.:.::.:...... rH 1t2 BEGIN SOAK. 0 MINUTES 7. No vehicle or heavy machinery hall drive over the :. :: :.:........ 5' 94 ' END SOAK: 8 MINUTES septic system unless noted as H-20 septic components. w .. 10, P , P , 8. Install as baffle or equal on septic ;,. outlet-tee end. ••••••��••••• loamy sand loamy sand TIME. 8 MIN.= UNABLE TO SOAK- . 9 P, __ se :•:::... '" T 10YR3/z " 1p,Ra z 9. All existing inverts o .1 .:.Its cond[ions .F•, .,.I be verified b contractor ntc se 12 to / USE <2 MPI FOR DESIGN 9 y tb <C :.:.•.vrr..: >10. Prc.•i�a.- ., „ 9 Bw Bw a 4 alai obi <vatlon port with ;screw'cap 3 below ,grade awn. #1 H sand of , 6 t sand 11. Inv[.,t 1 services a second floor. bathroom which discharges to a ,..,., .,col of unknown ORC 124, ' c:>r " # g n location. HARD 25 ,,._.r 28 10YR5/e 89.33 26 10YR5/e 87. n ss 36 Connect Invert #1 to .;vent #2 internally _or provide a pipe from Invei. #1 to the septic tank. 2o7_oa1_oo ROAD. _ 2 VA fln.-as,and fine-c.sand 12. Cesspool that servi<:es invert 1 shall`be located and abandoned er`310 CMR 15.354. CANT t5x -' =i•rival PERK # P ss ,orRS s 5.es ss inns s Ass 13. Designer not respont'.,ible for undocumented .;,i;air, components on the property. _-/, y 9' x 14. If access does not allow a recast concret _1nk to be installed substitute w• .87•a3'x c2 c2 P ,- with the following tanks. 87.29' x msdlum sane medium sane Fralo by Roth, Model ST-1500 or Infiltrator,Model TW-1500. If used, the tanks shall be installed 90 trace grave' trace gravel in strict conformance with manufacturers specifications. 67.38' X 25Y7/4 .. 2.5Y7/4 P „ 15. Provide clean-outs at intersection of main sewer lines prior to s tic tartic. P P PROPOSED SAS i20 61ss 8 0 .0 5 I 16. Leachate contaminated soil shall be removed and replaced with fill meeting 310 CMR 15.255. 65 long x 3 wide x 2' deep 88 NO GRPUNDWA'zR ENCOUNTERED: P 9 leaching trench with•2 laterals #24 of 32 Ion pipe• pRC g pert. H Sold.L.,.,aluatlan rtlflcatlon ORCHARD '#4p �.; REi!ISED: 6/10/2014 BOH COMMENTS e0>,p2, PO �� ORC I ce ,f that on October, 1995, , 1 have passed the soil evaluator 1 ',� �! HARD examination approved b the DEP and that the analysis was performed b VqC 2o7_p ROA PP, Y Y P Y • ANT z1-004 D me consistent wah the required training, expertise and experience described PROPOSED SEPTIC SYSTEM REPAIR Ban, x VAC in 310 CMR 15.017• /// � AI�I�• r/ ._ PREPARED FOR JOYCE LANDSCAPING LEGEND AT SYSTEM PROFILE °� #69 BACON LANE EXISTING CESSPOOLS !' Not to Scale 0 To BE PUMPED AND REMOVED ' BARNSTABLE (CENTERVILLE), MA * TAB OWNER: CURRAN MACARTHUR 2013 REALTY TRUST 10 min. from *NOTE: ALL PIPES ARE TO BE 4 DIA. SCHEDULE 40 P.V.C. NOTE. CAP ENDS 0 F ALL D I STK I B UTI O N LINES 10001 PROPOSED 1500 GAL house to septic tank J ! / , H-10 SEPTIC TANK USE WIGGIN Provide 4" SCH 40 PVC //r'"' 1 _ S�J� I Existing House 3 HOLE H-10 observation port 3" below grade 4 x PREPARED BY: DIST. BOX 104.46 DENOTES EXISTING - I FF .=10 .90' EXISTING GRADE ELEV.=90'f OR EQUAL Existing Grade Elev.-68.5'f Finished grade aver system=2% slope away SPOT GRADE GLEN E H /1 R R I N/`"'•TO N, R.S. `' Tank covers shall be D-Box cover shall be S=0.005'/ft. inn Min. 2 1 8-1 2 Double-Washed Stone 95 EXISTING CONTOUR L I l/1�f`� /L7 J Invert/1 to be connected to Invert/2 S within 6" of finished grade within 6 f finished grade �.,,,r,v. ./s/s•as sa«at a a odod " max. ar geo-textile fl ter fabric � 9 L.E DA R 0 S E LAN E 0.02' ft.vb internal plumbing 6� Level for 2• s=p.p,•,{t, Pewtaoe owvert =._es.es'^.;, '{ [O, y y M A R S T 0 N S MILLS, MA 02648 6 PROPOSED Tom. DEEP TEST HOLE Cellar f 1.500 GAL. 33' 2, ce ar .` Co SEP71C TANK N 3/4•-,>4 oaaw.-wa.n.a stagy a 4 Approx. location TEL: 774-238-1813 ' p �^ Bottom of Leach Facility Elev.=84.00' H-10 � ,� Id W n$ a GAS OORR EQUAL g " 00 existing water line g > g 65' /EMAIL: GHARR88©HOTMAIL.COM 5' On. (4' provided. Confirm 5' at time of install) _c cl 8.OF 31e-11/'.t"STONE D o \ Approx. location 0 LEACHING TRENCH t Hole Elev.=eo.o5' existing gas service SCALE: 1 "=20' DRAWN BY: GEH APR 7, 2014 �M 5 GW anticipated on of atat MSL.sed SAS is 34' MSL 6.OF 3/4"-"/2•STONE D.P. Observation Port DATUM: ASSUMED FILE: JOYCE BACON LN SHEET 1 OF 1