HomeMy WebLinkAbout0049 BEECH LEAF ISLAND ROAD - Health 49 Beech Leaf Island Road
A= 187-079-001
Centerville
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No. 2-153LOR
UPC 12534
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�mVc. 08 2015 0027 Jim The Inspector Man 5085349919 page 1
�■ Commonwealth of Massachusetts �g� ��9 b�J
Title 5 Official Inspection Form
-U1WSubsurface Sewage Disposal System Form- Not for Voluntary Assessmerits
49 Beech Leaf Road
Property Address
Gretchen Bates r'
Owner Owner's Name
information is required for every Centerville ✓ MA 02632 1i7-15
page. CityFrown State Zip Code dife of inspection
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 s ���`s\�H�F
on the computer, �J �t_ "•• 4�
use only the tab 1. Inspector:
a
key to move your �g:' JAMES .•'•u'
cursor-do not
James D.Sears SE
use the return .�
ke Name of Inspector 3
Y.
Capewide Enterprises, LLCT "o�.�`
Company Name NSP�G```�
153 Commercial Street
Company Address
Maspee MA 02649
City/Town State Zip Code
508-477-8877 S1623
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 Evaluation by the Local Approving Authority
12-7-15
nspector's Signature Date
The system 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 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
10�#V5
Dec 08 2015 0027 Jim The Inspector Man 5085349919 page 2
•
i
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cityrrown 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:
The system is a 1500 Gal.Tank D Box and two three pipe leaching trenches.
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-3Y 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 3
Commonwealth of Massachusetts
lugTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
Information is required for every Centerville MA 02632 12-7-15
page. Cityrrown 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 break out 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
l5ins•3l13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cityfrown 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 inv
ert due to an overloaded
❑ ® or clogged SAS or cesspool
❑ ® Liquid depth ink is less than 6"below invert or available volume is less
than %day flow/ AEA C`111 e
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 or 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
w 49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owners Name
Information is
required for every CentervilleMA 02632 12-7-15
page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
El ® 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 it 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 flaw of 2000gpd-
10,000g pd.
❑ ® 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
[I El Area
system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area- IWPA)or a mapped Zone If 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.
151ns•3113 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 6
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. CitylTown 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?
El ® 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
t
Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example:. 110 gpd x#of bedrooms): 440
15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 6 of 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
The system is a 1500 Gal. Tank D Box and two-three pipe trenches.
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available last 2 ears usage d NA
9 � Y 9 (9P ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: NA
Date
Commerciallindustrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(9Pd)
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:
t5ire-3113 Title 6 Official Irspedion Fonn:Subuwface Sewage Disposal Syslem-Page 7 o117
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 8
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cityrrown 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: NA
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
❑ 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):
t5ins•31c3 Title Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 117
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 9
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is
required for every Centerville MA 02632 12-7-15
page, Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
1989 Permit 89-432 /2015-New D Box.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 4'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,):
Pipeing is 4" PVC SCH 40.
Septic Tank(locate on site plan):
Depth below grade: 38"
feet
Material of construction:
® , I
concrete ❑ metal fiberglass polyethylene 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. Precast H-10
Sludge depth:
4'
t5ins•3h3 Title 5 Official Inspatlion Form:Subsurface Sewage Disposal System-Page 9 of 17
Dec 08 2015 00:27 Jim The Inspector Man 5085349919 page 10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
V11j:-
Property Address
Gretchen Bates
Owner Owners Name
information is required for every Centerville MA 02632 12-7-15
page. Citylrown 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
26"
Scum thickness 1
Distance from top of scum to top of outlet tee or baffle $11
Distance from bottom of scum to bottom of outlet tee or baffle
17" '
How were dimensions determined? Asbuilt-Tape-Plan
Sludge Judge
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank at working level. Tank at 38" below grade w/both covers at 14". In and outlet tee's. No
sign of leakage or over loading.Tank pumped w/D Box replacement.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑metal ❑ fiberglass ❑ 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
t5ins•31 1 13 TRIa 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Dec 08 2015 00:28 Jim The Inspector Man 5085349919 page 11
Commonwealth of Massachusetts
�t Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is
requined for every Centerville MA 02632 12-7-1 5
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 ❑ other(explain):
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
t5ins-3113 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
t
Dec 08 2015 00:28 Jim The Inspector Man 5085349919 page 12
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information Is required for every Centerville MA 02632 12-7-15
page. CitylTown State Zip Code Date of Inspection
D. System Information (cunt.)
Distribution Box(if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert 0
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.):
D Box is 45" below grade w/six lines out. Box is new 12-2015 w/cover at 6".
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
Dec 08 2015 0028 Jim The Inspector Man 5085349919 page 13
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cltyrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number.
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length:
6Q20'
❑ 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.):
Leaching is two sets of three 20'trenches I' deep-3' wide-20' long. Ck D Box, camera out
lines. No sin of over loading.
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
Wins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Dec 08 2015 0028 Jim The Inspector Man 5085349919 page 14
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments
` 49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is Centerville MA 02632 12-7-15
required for every
page. CitylTown 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.):
15ins•3113 Title 5 Otriclal Inspedon Forth:Subsurtace Sewage Disposal System-Page 14 of 17
pec 08 2015 0028 Jim The Inspector Man 5085349919 page 15
Commonwealth of Massachusetts
• Title 5 official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
Information is
required for every Centerville MA 02632 12-7-15
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cost.)
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
F1_
F✓�dam'
A
10
Alf
t5ins•3113
Tltle 5 Official Inspection Fomr.Subsurface sewage Disposal system•Page 15 of 17
Dec 08 2015 00:28 Jim The Inspector Man 5085349919 page 16
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is
required
wired for every Centerville MA 02632 12-7-15 .
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check.Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth t 10,
p high ground water:
feet
Please indicate all methods used to determine the high ground water elevation:
z Obtained from system design plans on record
If checked, date of design plan reviewed: 11-13-85
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:
T.H. on Design Plan 11-13-85 no G.W. at 10' below grade. Bottom of leaching at 5' below grade.
Bottom of leaching at 5' above T.H.Depih
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
tsins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 16 of 17
Dec 08 2015 00:29 Jim The Inspector Man 5085349919 page 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
49 Beech Leaf Road
Property Address
Gretchen Bates
Owner Owner's Name
information is required for every Centerville MA 02632 12-7-15
page. Cltyfrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
No. �" I ( Fee O�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zippfitation for -Misposal 6pstem Construrtion Permit
Application for a Permit to Construct( ) Repair 00 Upgrade( ) Abandon( ) ❑Complete System X Individual Components
Location Address or Lot No.qC( 1j6c—c-0 L6AI=_T$ Owner's Name Address,and Tel.No.
(-tr_C-rCt-iW 43 4TC-S
Assessor's Map/Parcel I�'1 ® c� Op ,� 4q D�-,(A LSAP �5�0 ZZ C JTE7P-\0 —
Installer's Name,Address,and Tel.No.508-+fZZ 8�1-7 Designer's Name,Address,and Tel.No.
l 5 ci e m-c- s-T— M A,S 0 eie-
Type of Building: /
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) A15-14 -4- L-4-;L0 h 6 0 K
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 Board of Health.
Signed---) Date 11-- a2 j-a 0 i 5
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. b -V / j�� Date Issued / 1 J
No. 01� Fee �0,�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -/
Yes
PUBLIC HEALTH.DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS >.N
ZIPPULation for MisposaY 6pstem Construction Permit
Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) ❑Complete System X Individual Components
Location Address or Lot No. t{q t3G&cN [tCAP:LS4AA)D Owner's Name Address,and Tel.No.
Assessor's Map/Parcel 0 B too ti �F -GN LEASE r- ����� r3SE 1:scrHVD � GENtF12V 1� ,
Installer's Name,Address,and Tel.No. 502—4111-S$77 Designer's Name,Address,and Tel.No.
CAPEwlnC- &JTTEK)4L5&5 LA C- /A
Type of Building:
Dwelling No.of Bedrooms - r'V. Lot Size sq.ft. Garbage Grinder( ) +
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) \ gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title w
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) T&J5-T44L4_ H-XO o—$O
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 Board of ealth.
Signe Date
Application Approved by ( i f Date J —1
Application Disapproved by Date
for the following reasons
Permit No. c) Date Issued l -1 S i
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
i Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( )
Abandoned( )by ���A-Pc— t D6 Eu7VRM:�Z
at ql-1 464F .TS(,A1V�b has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. C-) s-y� dated
Installer(2APCw(-DG &j-r,9oAj5ET L LC" Designer
#bedrooms ,�j I Approved design flow gpd
The issuance of this per it shall not be construed as a guarantee that the system wil c)tin as designed.
Date a- 3 Inspector / '�t v
�-------------------------------------------------- ----------------I--------------------------------------------------------------------
No. d ( �� �' 3 -- Fee hy) _
THE COMMONWEALTH OF MASSACHUSETTS ' w
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction 3permit
Permission is hereby granted to Construct( ) Repair()() Upgrade( ) Abandon( )
System located at 49 Q ec—ci4 ixA;p SS ROAD
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:Constru tion must be completed within three years of the date of this permit.
Date S ; Approved by ID
:} f
No ...... .............._
JITHE COMMONWEALTH OF MASSACHUSETTS
�/ _ i•, �p "BOAR® OF HEALTH,,
�... ' w1c/_......................oF....... <?2.rttLs:r✓t.7 . -----•------------...-----...............
\ `b
firatinu for Dts osaf Murks Toustrurtioaa ramit
Application is hereby made for a Permit to Construct (,� or Repair ( ) an Individual Sewage Disposal
System at:
r:G'!j.. z`� A�s i��s L. / ,..... �s_9 .:'f�SLeB f 3�
.... >J -- ..............................................................
Location-Address e + may(//// or dot No.
say...: ice_.t�_.��e�� _&1Z. l,�l. i�t_.
Owner ems-Al"d 1s•,L> Y Address
Installer Address
U Type of Building ,/ Size Lota �::_ . / - feet
Dwelling=No. of Bedrooms_____________l�_(�e_�___ ' xpansion Attic (�/p) 'Garbage,Gander (°Ya)
Other—Type of Building ---------------------------- No. of ersons............................ Showers ti,( ) Cafeteria ( )
Other fixtures -------------••--••------------• "`
---------------------- --- -
W Design Flow............................................gallons per person per day. Total daily flow----.-.._._-_.__.____.._:_._:____..___...-_-gallons.
WSeptic Tank—Liquid capacity_YSI,' _gallons Length--Il. o"-_ Width_4-'._q�__ Diameter---------------- Depth_(e_�._l."..
x Disposal Trench—No. ........!____r_____ Width__.__..!t�!-..--__-_.. Total Length......0,?........ Total leaching area."._>3 S ...sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area....................sq. ft.
Z ; Other Distribution box (i.- � Dosing tank
Percolation Test Results Performed by---cJ '..Sq f✓d`*_. �ak ?+_?�2_.)___ Date.....
" as Test Pit No. 1....�.Z----minutes per inch Depth of Test Pit--_._._�0. ----- Depth to ground water-------K•--!.....4-07(, �d
44 Test Pit No. 2...—_-_-_-....minutes per inch Depth of Test Pit--------°C.......... Depth to ground water------ -_ .....
o -•-••••--•--•-••••..-:.•-••----•----•------•---------••-••••••••-•••--•---•-•-•-•-•-••--•-••.......... .... � ' ._f� �.z .......
x Description of Soil------- ------`S J`� r--C�--rwj/.t/----. N7 q�..........................................................................
U ----=-••----•-•--••------•-•-•----•-••••-•-•--••--•-•-----•-••••---••---•-•-•----•••-----•--------•-•--•----•--••-•-•---••----------•-----•.
W
x •---•------••----------------------------------••-•------------------•---••-•• ---------•-•-•---•••----••--•---•----------------------••------•---••-----------------•••-----------------------•••----•-
V 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 TIT1.� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i"bythe of health.
Signed-• ---• - ---------------•--•.Application Approved By- • C�.... -• ------- . ------. --•-Application Disapproved for the following re ns:..- ---------------------•----...................................................
.................. ........................ ------•-------------• ---------- - • ••--
Dat
Permit No.... ---------------- Issued_..-----
_ --- ---� --------•----
3�-� - - — — - Date - - _ 9\ - - -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............. orate--..........0F.......�3,t e s -, c •.--..-........
%T rfgfirFatr of T uttifiFaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed �) or Repaired ( )
by....................................................................................................................................................................................................
Install '/ _
has been installed in accordance with the provisions of r,i! r 5 a tate Sanitary Code scri the
application for Disposal Works Construction Permit No---- '_� � d-ated- ------ . --�� .. -
THE ISSUANCE OF THIS CERTIFICATE SHALT, NOT BE CONSTRUED AS A GUARANTEE TH THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector..................y...................... ..........................................
7 Y ..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ .__...................OF...........................................................
ApphrFation for Dhipoii al Worbi (non,itraartion Urrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
......................- ---............_........_...._.....------.......---.........._..-•-•------ --•--......------------------•-•-•---••--••-•---------------------.....•--•-•-••---•--------------
Location-Address or Lot No.
.........-•---••-•••••--•-------------------------------------------•-----••----•-------------•-.. .•--...•-•-------------•-----..._........_..-----......----•-•--•--...................-.....-•--•-
Owner Address
W
Instal ler Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures ..--•-•-•---------•-•--••---••------------------------.
W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons.
W Septic Tank—Liquid capacity............gallons Length-__-__-_-_-___ Width---------------- Diameter....------------ Depth................
W • Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
x ,
Seepage Pit No--------------------- Diameter............,------- Depth below inlet.................... Total leaching area..................sq. ft.
Other Distribution box ( ) Dosing tank ( )
W Percolation Test Results Performed bY-------- -----------------•--------•-•---------••----•-•---------•-_------ Date........................................
Test Pit No. 1----------------minutes per inch Depth of Test Pit__----_-----___-_- Depth to ground water_-_-_---.__-_____----.
f Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 ._..-----•-•----------------------------•...-----------------------------•-••-------......------•...-•-•-----...............................................
0 Description of Soil------------------•--•---------------•----------------•-------------•---------••-------•------------------.----...----------....------------•---••--------------------
x
V ..................................................... ---------------_-•--_----------•------•---------------•---------------------------------•---........--•--•-----•-•----..... ------------
W
------------------------------------------------• •-------- --------------------------------------- ------------------- ---------------------------------------------------------•--------
U 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 TITLE; 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 by the boaiF l of health.
Signed-/).... r Ls ..-------•--------•----- X Date/`
Application Approved BY _== = = }.k ` ------ = -
-----•-•------•-------------•---•------------•-----------------------------Date-------
Application Disapproved for the following reasons:ns:_____ -------------------------------- -_-._.
--•---------•---- -•-----------------•-------------------------•-----.---- --...-----•----------•-----------•------.....---------------- ............................
''-1 � -1 � Date
/ ��
Permit No...4=---- ------------•.._�.... ..... Issued_--------U� e &-----------------
Date
i
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF..................................... ....................I........................
(9rrtifiratr of ToanpfiFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by....................................................................................................................................................................................................
Installer
at................................................................................................................................................ ----•---•----_.._.------•---
has been installed in accordance with the provisions of !' T' S Q /T]�e,�State Sanitary Code �lescretiA the
ruction Permit No----
application for Disposal Works Const --------- :-_-_- dated. -- .. '�1_6 ---------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE TH/(T THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...........----------------------------------------•--.._......-----........--- Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH /
OF_ !�
....................L/ FEE....J..................
BOVo,oaa1 More C�omitruxtion amit
Permissionis hereby granted......----- -•----------•-•--•-------•-----•-------•.............•--•---------------------------...........--•---...........--------•--_-----
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
atNo.................................................................... --•----•--------•---------
Street 4 '?"---------------
^.... �_.._ __. .___ ......__
as shown on the application for Disposal Worksorks Construction Permit No . __._..l ate 1
`%
1 �
------------------------- ----------- ----------------------------------------------•-
Board of Health —
DATE :.. -----------------------•------•----•--- ----------
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
1
� ��
�� N�� I�r� � �'I
�_ TiTiw � ��dNN
C f
r
,
HRAOLEY. BARRY & TARLOIN, P. C .
ICI AHCH STRBCT
BOSTON, MASyAC"VSCTTS 02110
�.w♦19 711[�1A
May 24 , 11989
�a
Barnstable Superior Court
County Court C.ompICN,
Main Street
Barnstable , NIA 02630
Rc: Silvia & Silvia Associates , Inc..
Vs : ' Grcavc-,r C—M. & Parrish., M.D. , ct als
Suncrior Court. No. 88-541
Dear Sir or Madam:
Ploase find enclosed for filing in thr� above an Agreement
for JudgT^ent as executed by counscl for all parties .
I request that judgment be entered in accordance with the
Agreement for Judgmcnt with copies to counsel of record. If
there is anything we can do to be of assistance , please let
us know.
Sincerely ,
Robert J'. aum
RJA/oy
Cr.cicsurc:�
c c�; Ruth J. Weil , Assistant Town Attorney
Silvia. & Silvia A ;sociates , Inc. ;.
COM.MOMq AI,TH OF MASSACHUSETTS
BA(?NS'_'ABLE , ss . SUPERIOR COURT
C.A. 1.0. 88-541
SILVIA & S_ILV1A ASSOCIATES , INC. , )
Plaintiff )
)
V.
)
(,RoV;-:E% C .M. FARRISH , M. J . , AN;3 JANE )
FSHM-AUCH and J17\MFS F. CROC_,ER, SR . , )
inclividc.,r� I 1 at:c1 as thev arr. Mt-.! �bers )
of- the BOARD OF HEALTH oL the TOWN )
OF 11ARNSTABLE, )
Dofc nciaaLs )
)
AGR1:F'.mFNT FOR JUDGMENT
The parties hereto stipulate and agree that - 'judgment
shall rnLer for the Plaintiff and against the Defendants
e
as follows :
1 _ The Plaintiff shall be gran Led a variance Lrcm
the regulation of the Board of Health of the Town of
Barnstablc which requires that septic systems be located
at J.east 100 feet f row. wetlands , for the construction of
one single--fami.l.y residence and garage upon Lots 14 , 14A,
15 and 15A, Beach Loaf island Road, as further described
in I-he Complaint , and as more sp(- ifical. 1y described bc1c'.'4 .
Such a variance will not meaningf*ul.ly diminish th:: degree
of an cnvirun<en—La1 protection :;caught b1 the lioard oI:
Healt'n ' ': 1 ocal regulation zinc] the requirements of Title
5 of ::hs State Environmental Code , 310 C .M.R. 1S . 00 et
scu.
l � ;
`d15��C.)ccl - WCIf'�iS 1nSLc311dL1��t1 p7��rT1St :ilia 5-a ..1c
Until r i'w plan: , in conformance with the ccndit1CnF, oL
this variance , have be^n approved by the Barnstable Boar.;'.
of Health .
3 . Roth the primary and reserve areas for the septic
system for the above--mentiened dwc:ll.ing shall be located
s;,ve-nLy-seven ( '17 ) fit or more from the wetland limit
as shown an Lhe pro jcc_t Flans pruv i cusly submitte:i to the
Board cif He:-alth with Plaintiff ' s petitions for varianc.:c .
4 . The proposed dwelling may have the following rooms :
4 bedrooms plus 5 other rooms , not including bathroorns ,
which may have any or all of the following uses : living
room, ici tchcrr , dining room, family room, den , study, library,
or wc).r kshop . For Lhe purposes of sc;wage flow determination
and whether a reserve area must be built , the proposed
dwelling shall constitute a six-:bedroom home:.
'There shall be no restriction on the number of
closets , storage areas , nor upon such oth�. r
spaces as hallways , foyers and entries , nor shall there
hr.- any resLrictions an t:hc! size of t.hc! garage .
6 . There shall be no future expansion of the septic
system and there shall be no future expansion cf the
habitable: spaces of Lhe dwc�.l. l..i.ng constructed bclond the
design of said system without the approval of t-he Board
of Health.
7 . The bottom of the septic Facility shall be
es Lablished at an ele ation of I L . 1 feet mean sea . level .
-2-
'Thp var a ice�granto in cc QY.da_t,ce,he_resvith shad"1'--�
u:i foc a pari.ocd �3t be -,
aL three l-e_ars from its< .-2
of issuance and be ttierPa,£ter_s �al_1—cor¢t nu __ asipermitte
9 . The capacity of scptic system for the dwelling
to be constructed shall meet the present requirements of
Title 5 of the Stat^' Eriviranmental Code and the regulations
of the Town of Barnstable Board of ficalth .
i
! tl . IL is agreed that each party has cooperated in
chr_ draftinq .and E.:r-c[)arinq of thi ; for liLidgmie.-it .
llencc , any constrtic:t:on to he made of this Agreement shall
not he construed against any party by virtue of the party ' s
role in draftsmanship.
11 . P1ai.ntiff and Defendant, agree that this Agreement
is binding upon and shall inure to the benefit of the
Pl.airitiff and Defendants hereto , their respective agents ,
employees , representatives , off:.ioe-rs , directors , divisions , '
subsidiaries , assigns , heirs in succession in interest,
and shareholders .
12 . In all other respects the Complaint is dismi.ssod
with prejudice and. no cos:n or at.tor-leys ' fees shall be `
assessed on either side ,
GROVER C.M. FARRISH, M.D. , SILVIA & SILVIA ASSOCIATE , I:vC .
et al. , BOARD OF HEALTH , erc. , Plaintiff ,
Defend ants , By Lheir attorneys ,
1 Y .t ic,i.r at orncjs ,
Robert D . Sm th , Town Counsel Robert J . ' Baum
Ruth J . Weil , Assist. iant TOWn Brad.lev , Barry & Tariow , P . C .
Counne! I , Town of BarnstabJ.c 101 �r.c:� StrPe*..
375 Main Street , New Towi: Boson , MA 02110
Ha l 1 , Fyc-inni S , MA 0250.1. ( 617 ) 931-2900
( 508 ) 775-1120
Dated : iiay 17 , 198; . Dated : )
f -:3-
���ttr 3D d c a is
Floe Fbe
000
.001
r00 at roe
tt ® 100 Ka '�aojts /
r \JV ��
n
dtsesst btAVOOM A
• .a
a
r
cA- O a
I� r.
o -a
Ltd Leo
Second
. b%tk
Lai
A.M. Wilson
Associates Roo fi 13 ee o& Lea-C Lav% amj
Inc. � ce%%+ev 0 4L Nib. Figure
911 Main Street Osterville/MA 02655 4281450
L—
.mr.
t
SOIL TEST PIT DATA.
MANHOLE COVER TO FINISH GRADE
11 NO OF OUTLETS. FINISHED GRACE Revisions:
1 15 I /
2 ES. DATE NOTES: DESCRIPTION. O
;. 1
,1 FI LL.AND LOAM
INDICATES
D AT C ES
10 12 MIN. 11
L D/STRIBUTI N - ...
INDICATES OBSERVED O BOX TO WITHSTAND H 10 5
PER COVER 6 r----- LOADING .. PLUG ENDS /2/89 REV. INVERTS
C •,� O DlNG UNLESS UNDER PAVEMENT DR/YES
.r GROIrJND1IATER � ' 4 PERFORATED PVC _ -�
S O.00S
OR TRAVELED WLOADING -- --, . . .. . ._ . . .. . . ._ . . . ..• ,. . . . WAYS WHEREBY H-20 - ---
TEST
- - - ---- - - - 1 ► _
r (
� SHALL APPLY.
1 ■ u
r ,
r
n
4 INLET 1 I �
aw r o eb EFFECTIVE, . ECTIVE
_ K I 15
12
1 2
2. PROVIDE LEVEL BOTTOM P
'� INLET TEE AS H LE
SHOWN WHERE
LOT 14
LOT' 15
i TEE DEPTH
TP No. SLOPE TP S O E OF INLET PIPE No. EXCEEDS 0.08 FT FT, (IE E NOTE tl
1 .. 1 11 /
i
L-----� OR IN_ A PUMPEDSYSTEM.
6
1 1.9 H 20 _
t'
13.8 _ 3 18
L. GRD.EL. _
GRD.E
_ r
.. ,
PREC
AST,STEEL � .
1 •
,,. 3. FIRS
T TWO FE
ET EET F O PIPE
OUT OF 'TH
E E
6
5. I
1 1
5. I D - _ DISTRIBUTION _
REINFORCE UT/ON BOX TO BE LAID LEVEL.
GW.EL. _ 5 I L.
GW.EL. _., .. PLAN VEW -
C
ET
TANK T OUTL h
SEPTIC T � INLE -
i
5 _
MIN 138 4 0
0 � 6 I I
4. RECOMMENDED 0 I CO MENDED MAN FA 1.9 _ T U CTURER
TEE 4 9 PROFILE
1500 GAL.
TEE ..
I LIQUID DEPTH-, ROTONDO OR APPROVED EQUAL.
A &
Q
U L.
LOAM a
LOAM
i
I .
. MEASURE E SUR„ E SLOPE AT TH
IS HIS POINT
SU
BSOIL SO L _ REMOVA
BLE ABLE COVER'
, - I
34 4 O11 ..
'- SUBSOIL
6 MIN.3 T 2 STONE
DIST. ISO x.. ... .. .� . . .. : SLOPE
. .. •-. . . . � � . �. ., - S DIA.OUTLET S
LOAM AND
II.3
9.4 �_ '2'0Y MIN. FINISH GRADE
OTTOM ON LEVEL-STABLE BASE SEED
� .`8'. _ PROM
• O o
3 A „ -. .c.• 8 • e • o 0 40
3 SANDY SANDY w � •'• •; WATERTIGHT.
24 DIA.MANHOLE COVER 12"
GRAVEL
GRAVEL »
JOINTS (TlrP.) ------- '
4INLET. ., MIN. ••
„
. »
4 ' I
4 r r f ences
T T Ref
erences:
4 OU LE
1 2 MI F
R T VIEW
N.0 IBTO
AN VIEW CR
OSS SECTION PLAN fE
O
1.5
_ i 2 WASHED STONE
6.9
7
1
/2 2
8.8 5 NOTES: LO
5 .. - 5 1/2 »
DUI.
SEE SHEET I OF 2.
L --J
MEDIUM TANK TO WITHSTAND N 10 LOADING 3. INLET AND OUTLET TEES TO BE AST IRON, • • '-
MEDIUM
1. SEPTIC TA C O ........ . >.. INLET.. I
6
`-
R R TRAVELED SCHEDULE PVC CAST-IN-PLACE BOTTOM ON
$ UNLESS UNDER PAVEMENT, D IVES O TR V U 0 C OR CAST IN PLACE CONCRETE.' 3 »
SAND °i^� _ a .
i�- 3 4 TO_ ,t / /2 DOUBLE
SAND WAY WHERE BY H 20 LOADING SHALL APPLY... TEES TO BE CENTERED UNDER MANHOLE V 2 P•� S. O COVER. LEVEL�STABLE � p -
o t CLE R
ry
s WASHE
D STONE o 1���C'7i' SLOPE fine
BASE 0 E G+ )
7 t
7 ( )_ _ ra
2. ALL PIPE CONNECTIONS AND.CONCRETE CON L RECOMMENDED MANUFACTURER ROT NDD R »O O
_.
APPROVED EQUAL.
8f4 TO
STRUCTION TO BE WATERTIGHT. SECTION VIEW
CROSS
C T
8
8
1V2 STONE.:
BOSS SECTION VIEW
I
H 2 O
BOTTOM HOLE
15 00
- 5.IL NS. ,F GAL O
DETAIL No. o DISTRIBUTION I TI N BOX DETAIL
_ SEPTIC TANK S R BU O C LEACHING T
2.9 G TRENCH DETAIL �
s - 9LOCUS MAP
Q
A .
T T LE NO O SC T T ALE NO O SC T T A _NO O SCALE
A � tV
BOTTOM E SCALE: 2083 0 HOLE 3.8
10 10
11 I
DESIGN ANALYSIS
12
12
DESIGN FLOW.
y _ 110 GPD/BEDROOM
4 6 I
P 9 6 P 4967
i
DATE. DATE:
4 BDRM x O GPD BDR 440 GPD
/13/85 II/ 13/85 II / M
PETER SULLIVANSULLIVAN
N PETER SULLI
_ resr By.
rEsr BY.
BANYE
TE & Y BA R N XTER 81 NYE
Pro ect Ti
tle:
1
BY:
MESSED BY.
WITNESSED
1I/T
JIM CONLON
i PT N REM J IM 'CONLON SEPTIC TANK REQUIREMENTS:
ENTS.
Q
0
440 GPD 1 _ 660
E.
i 4 x 50 to
.RAT .
ERG. RATE. PERC
P
13EECH
2 ...>
ilf! INCH A(IN. INCH
N. /
SYSTEM
ST PROFILE A A USE 1500 GAL. TANK
NOT SCALE
TO S L
' .LEAF
TP No. TP -No.
D.EL.R ._
G D.EL
GR
L.
GW L.GW.E
MANHOLE AND COVERBROUGHT, , ISLAND
0
0
FACILITY 4 4 G D
LEACHING AC CITY REQUIREMENTS: 0 P
FINISHED GRADE ',
Q
` TO INIS ED R DE
_ o
r
FINISH GRADE T HAVE 2 /o S 0 N.
G TRENCH I DEEP x 3 WIDE x 6
1
i
TOP OF FOUNDATION
FINISH GRADE 9
SLOPE �E LEACHING FACILITY 0 OVER ROAD
- A i - -BOTTOM AREA 3 x x SF' LOGP %SF 2 7 GPD
15.5 0 69 2p7 ( D ? 0
2 0
ti
Lad
� , ,
10 � _
VC � _
I AREA I _
SIDE RE 2x x69 138 SF(25GPD/SF 34�
,v I MIN. COVER
}
3 3 1/8/ FT _ ,
1 /$ /FT i I 4 PVC (TYP)
8 FT TOTAL GPD
o -
0 T 5 a2
4
e LOT
13.00 .
i2.75 - , , ,
12.64 , 5 S 00
_ 12.4 •7
12.I0 I
5 /
5 1500 GAL.
4
13
I -
2. 5
0 DISTRIBUTION
SEPTIC
6
I• -B = t s OX
BOTTOM I L10
TANK
BOT 0
T N
4 15 �.
TO BE INSTALLED N A
H 20 0
LEACHING FACILITY PROVIDED:7 7 I
.-I*""",- _ .. LEVEL STABLE BASE
-
. TRENCH I DEEP x3 WIDE x
8 8
,:� � 69 L O N G
a LEVEL
5.1 :OBSERVED GROUNDWATER LE L
CAPACITY PROVIDED 552 GP
9 9 .
n
4 CAPACITY REQUIRED, 40 GPD
1 ,.
;V
0
1 0
. I
I
..NOTES I
12 12
T T
NOTES
S TE IS NOT LOCATED. WITHIN A GROUNDWATER
ADJUSTMENT Z
DATE. DATE.
N ONE.
PREPAR
ED FOR
i
UNSUITABLE WITHIN 25 2 I F ENCOUNTERED, A L UNSU TA LE SOIL - _L 1 UNLESS OTHERWISE NOTED ALL CONSTRUC
TION METHODS AND MATERIALS HALL ' N-
. S CO •
OF THE .LEACHING FACILITY .SHALL BE REMOVED
• rEsr BY. TEST BY. , , S I L V I A 8, S I L V A-
AND REPLACED WITH CLEAN SAND AND GRAA/EL.
FORM TO TITLE V OF. THE STATE ENVIRON-
MENTAL CODE .AND ANY APPLICABLE LOCAL
BY:WITNESSED WITNESSED BY.WITNESS RULES AND REGULATIONS. ASSOCIATES , INC.
2 GROUT T BE USED AT. I W O US ALL POINTS HERE
PERC. RATE. PERC. RATE. . ,' PIPES
ENTER OR LEAVE ALL CONCRETE
TR _
y
STRUCTURES /N ORDER TO PROVIDE A WATER
A!!N./!NC At/N. INCH
/ TIGHT SEAL.
-G S ..
3 ALL HIPLAP JOINTS IN T H
I S 10 S SEPTIC TANK SHALL
BE SEALED WITHNEOPRENE GASKETS OR
ASPHALT CEMENT TO PROVIDE A WATERTIGHT
INVERT ELEVATIONS
SEAL.
{ 4 PRECAST CONCRETE SEPTIC TANK DISTRIBU-
TION BOX AND LEACHING FACILITY T WIT -
, C G C O H
4 INVERT AT BUILDING I0 INVE I3 STAND H-10 LOADING UNLESS UNDER PAVE-
MENT I V .
DRIVES OR TRAVELLED WAYS WHEREIN
. ; Wil
son
0
A SEPTIC TANK to I _ A.M.M � Cl
� INVERT T S ( ) 3.00 H 10 LOADING SHALL APPLY. ,
I
I TANK out 5
Associates
T EPT C 4 NVERT A S 17� _I (out) 2. S ALL- PIPES IN THE SYSTEM ' HALL BE H S S SC ED ;
4
Inc.
ULE 0 OR EQUAL.
4 INVERT AT DlST. BOX in 64
Q
INN ( )
6 WASHED
. 47
S CRUSHED 'STONE SHALL BE FREE OF
4 INVERT AT D/ST. BOX (out) l2.
( ALL DIRT, DUST AND FINES.
911 Main Street'
7 AT ALL POINTS OF INTERSECTION OF WATER
Osternl(e MA 02655
INVERTS AT LEACHING FACILITY.
LINES AND SEWER LINES, BOTH. PIPES .SHALL
61 - -14
i BE CONSTRUCTED OF CLASS ISO PRESSURE
7 428 50
NI N OF
4 INVERT AT BEGINNING i - `, PIPE AND ARE TO BE PRESSURE TES
TED STED TO
12.4
LEACHING FACILITY 5
..:ASSURE WATERTIGHTNESS.` Drawing Title:
9
T END O 8 SEPTIC
4 INVERT A S C TANK 'DISTRIBUTION BOX. ETC. .:
12. 10
LEACHING FACILITY � SHALL BE MANUFACTURED BY ROTUNDD OR
AN EQUIVALENT Q
U ALENT MANUFACTURER,.
-
ELEV
ATION AT BOTTOM OF
SUBSURFACE
II.10 C
LEACHING FACILITY I j 9 EXCAVATE ALL UNSUITABLE MATERIAL IN
LEACHING AREA AND BACKF/LL WITH CLEAN
GRAVEL OR COARSE
i CO S SAND.
WATER
OBSERVED GROUND
5.1 ,
E S W
ELEVATION 1 HEAVY EQUIPMENT . AGE
0 QU PMENT SHALL NOT BE ALLOWED
TO OPERATE OV
ER ER THE LIMITS OF THE
SEWAGE DI
SPOSAL ISPOSAL SY
STEMS STEMS DURING THE
COURSE OF CONSTRUCTION F O THE SYSTEMS. DISPOSAL DESIGN
11 NO' FIELD MODIFICATIONS TO THE SEWAGE
DISPOSAL SYSTEM SHALL BE MADE WITHOUT �x or �;••
PRIOR WRITTEN-APPROVAL... OF.THE ENGINEER ,,-- •�
s
AND THE LOCAL'BOARD OF HEALTH.
I . / , t
� r r
- 9 _
12 THIS SYSTEM SHALL BE INSPECTED AS RE �L:I
i
U/RED BYSECTION
Q 2.10 O1tiTITLE V. ra<< .., :, •.. `�
l
r�
_ � f a
13 A CERTIFICATE OF ` COMPLIANCE AS RE . .
sr!�yr�.�i. � ... .IFS°
UIRED BY SECTION .8 OF TITLE V MUST BE _.. `l
Q _� �,
$S
_ r
OBTAINED BY THE CONTRACTOR UPON COM �
PLETION OF THE ABOVE WORK.... IF AN AS
l
1 BUILT" PLAN IS REQUIRED DUE TO CONTRAC-
TOR „ _
DEVIATING FROM THESE PLANS, WORK
Scale. 1 - AS NOTED
FOR SUCH AS BUILT" PLANS SHALL BE
COMPENSATED BY THE CONTRACTOR.
E CO ACTOR. ..;
0 T
FEE
14 THISSYSTEM I IS NOT DESIGNED' FOR A
- GARBAGE DISPOSAL G UNIT.
Date: D ` No
_i I/78/88 w9
15 ALL ELEVATIONS :
ARE BASED ON Design:n
NGVD D s9 MJD
DATUM.
k.
,j Chet
N
N _ _
Drawn
M J D
f
Job No,: 2.0 2 92.0 Sheet 2 0 2
z
z
a ;
m