HomeMy WebLinkAbout0083 BLANTYRE AVENUE - Health 83 'Blantyre ®rive
Centerville F/k
A 229 010
I�
I�
No. 4210 1/3 ORA
Pendaflex'
100
Commonwealth of assach.u�efti
.- - e m .
Title 5
+ " - Subsurface Sewage-Disposal System Forrrt=Not for.Voluntary Assessments"
Blanre Ave
f
- «_
Property Address .
Alex Rodolasis -
4.
D.rvner
_
Owner's Name
information is Centerville Ma 026.32 5/16/2013
required for every,.:
_
Git /Town State Zi Code Date of ins eebon,,
:page. y p: p. .. .---_
Inspection results must be;su amitted on'this f rrti inspection forms rna.y not bd:.Altered in any
Way. Please see completeness checklist at the dhd ofAhe form
'important:When a ell taI 4nfo:r tIa��
filling out forms
onoo
the computer,
useoNy the-aeb 1.. InSpi;Ctor:--
key>to move your
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cursor,-.do not
'Use the return Sean M Jones
key,,. Name of Inspector
Caewide;Enterises��Qd'
Company Name
153.Cornrr ercial St
" Mashpee.....:_ Ma 02649
..... .:.. ..
- Cityrrown State Zi'p'Code:
508"=477=8877 SI 4522
Telephone Number, License--Ndmber
B..Certifit ion:
I certify that I:have person 'lly-inspected the,,s age disposal systemat this address and that the
information reported eiowr is true, accurate-and complete as ofjhe time of the inspection Tl e inspection
was,performed:based on.rny raining and experience in'the proper function arid maintenance of on:site
sewage'tlisposal sys#erns. 1 a'm a Pap rowed yst�i inspector piarsuar>t to Section 15 3 0 of
1 itle 5(3!O CMR46 OOQY) The system
® 'Passes ❑ `Gonditonally:Passes. [� Fails'
❑. Needs Further Evaluation by the Local Apsroving AuthOnty u c
.: _._. _
-�
f
Inspector's Signature Qatea
u5
The system inspector shall submit a copy of this inspection report'to the Apprgviig Auirity hoard
of.Health or DER)within;30 days of completing this inspection'. If the system is a shared systei l or
lias;a design flaw:of 1 Q,0(}0 gpd or greater,.the inspector and the system owner shall submit the
report to he appropriate regional office of the DEP The.original-sh6uld'be sent to the;systern owner
and,copies;;sent;to the pt y- .if"applicable, and the approving authority.
** *This':report;onlydescribes cor ditrotls atthe tirne.:of inspection and #i,ridefthe`condijons o fuse
at tt st:time This.inspeetion:.d'oes not addtess.ho the system''will eifiorin in the future under..
the same-car differefiVedri itions.of:use.
t5`ins•3173 -Title 5 0ffciai Ynsp o r ;SubsurfacdTSewage DisFosai 5ys?an-'Pagel: 17
f
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�^M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. Cityfrown 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:
® I 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 dwelling located at 83 Blantyre Ave Centerville is served by a Title V septic system consisting of
a 1500 gallon septic tank, 1000 gallon pump chamber, distribution box and a leach field 32'xl4'with 3
laterals. The system was found to be in proper working condition at the time of inspection.
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):
l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
f -
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
, 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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 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
15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. Cityrrown 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 1/2 day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�^M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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
El ® 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.
t5ins•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 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. Cityrrown 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): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 332 gpd
provided
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
TOWN OF BARNSTABLE
LOCATION 03 --�,'AMT"'IKA� "VD SEWAGE #Z " oq
VILLAGE C�F�(I�Z.t1tLL� ASSESSOR'S MAP & LOT 7 — 10t
INSTALLER'S NAME&PHONE NO. L (,,Am R Too yl Q8 77) 4�W%
SEPTIC TANK CAPACITY �`2L� &4L
LEACHING FACILITY: (type) 11�15-? (size) Y-
NO.OF BEDROOMS _
BUILDER OR OWN
R A 1
PERMTTDATE: COMPLIANCE DATE: 5 �3
Separation Distance Between the: 1
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 i
within 300 feet of leaching facility) I Feet
Furnished by��}�(&►.Il t&L,, M wn �� -
® _ ,
vi
ci
iI
-1 17
IkAlmI _ �1�
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 4
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
Seasonaluse? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail
Water Usage—2012— 116,000G &2011 —94,000G
Sump pump? ❑ Yes ® No
Last date of occupancy: current
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
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:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013.
page. City/Town 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:
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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:
systen installed 3/23/2004 per town records
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 3
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.):
Joint were ok, no leaks, vented through the roof
Septic Tank(locate on site plan):
Depth below grade: feet
Material of construction:
® 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 gallons
Sludge depth: 6„
l5ins•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
83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. Cityrrown 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
3"
Scum thickness
3"
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
10"
How were dimensions determined? opened covers, took
measurements
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 does not need to be cleaned now but should be done soon and again every 2 years for proper
maintenance. water level was even with outlet, tank was not leaking and was structurally sound. Inlet
cover on riser
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. CitylTown 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.):
M
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•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
;M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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
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.):
Distribution box was in good condition, no rot, water level was even with outlet invert.
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.):
Pump chamber was in good condition, pump cycled and alarm sounded when floats were manually
activated.
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
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
GSM 83 Blantyre Ave. ,
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
® leaching fields number, dimensions:
32'x14'
❑ 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.):
Soil and stone in s.a.s. was probed and found to be dry with no sign of past saturation.
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
t5ins•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 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is .required for every Centerville Ma 02632 5/16/2013
page. City/Town 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:
i
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
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page;, city/Town ` .' S,e Zip Code. Qatei-of Insoe ion
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..... —at leas#two:permanent reference—land arks.,or�bencftrnarks 'Locate:all welds within 10t3.feet. Locate
.: where public water supply enters thi building: Check ene;of the boxes Belo w
hand sketch rn11,the ar2a.below
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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 to high ground water: 12'+
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: 12/31/2003
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:
Design plan indicates that groundwater was encountered at 78". systen was designed and installed to
have a seperation of 5' between bottom of s.a.s. and adjusted high water level.
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
r
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 83 Blantyre Ave.
Property Address
Alex Rodolakis
Owner Owner's Name
information is required for every Centerville Ma 02632 5/16/2013
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
" moo. 0 � � Fee
Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS
Y r�
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS
`� 2pplication for Zigool bp6tem Construction Permit
I
application for a Permit to Construct(, . )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components
Location Address or Lot
/1No.
,10 ��j caner' Name,Addre�sysr a/n�dQ Tel.No.
Assessor's Map/Parcel V �� � m A' ���Ir LQ
�-`1
Installer's Name,Address,antl,Tel.N. l�lY1� :S Design's N e,Addre and Tel.No.
Pr0�2
Type of B ding:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures y�
Design Flow _3 U gallons per day. Calculated daily flow 73 - gallons.
Plan Date a-,:?)1 b J 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) iMST SUPERVISE
aminCERT—IFYIN WR
WAS INSTD IN
Date last inspected: AG'Ct)RD"E TO PM
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 vironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been• s o . f ea
Signed p Date D
Application Approved by Date
Application Disapproved for a following reasons
Permit No. Date Issued
Fee �✓
' ;�'
r -..
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
,.Ye /
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS,
Rpplicaition for Miopogal &p.5tem �Conotruction Permit
rDOD
X
cation for a Permit to Construct )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. �3 �� ♦ Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Des, n er's N r �� �(��s � arp nA.,ddreis and Tel.No.
a an ok r Y i Pr 44 hgrl� Yn
Type of BiWding: �2 /�`
Dwelling No.of Bedrooms Lot Size 7�. U sq.ft. Garbage Grinder( )
Other 'I�ype of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow - gallons.
Plan Date f 'Ci J Number of sheets Revision Date
Title
Size of Septic Tank 3�� Type of S.A.S. ft,d7 611 Li
Description of Soil 0.),40.n , A,&� y4nxj
Nature of Repairs or Alterations(Answer when applicable)
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 theTnvironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued-by this Boar,'of Heal
Signed i ° !I c� r/l, Date ` 7
Application Approved by "' ' i � � a - 0 �`, Date
Application Disapproved for the following reasonsAlf
s - it
Permit No. Date Issued \` l/ it
— ----------f---------------- — — -----
Y
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CE TIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned( )by _ � U n hO r i,
at -?)(if*-a to- VA Nf�M f I Z° C ion has been constructed in accordance
_.. with the provisions of Tafle 5 and,thP.fnr Llicnnca1 Svsten:CL'.^.str,-,-t.:on Permit No date
_ r
Installer IZ • Iit�( r Designer __5.C. )�LQ I tom .
The issuance of this permit shall not be construed as a guarantee that the systgm`will futicti'on as design` c
Date 1� n t I Inspector
J
No.
/ Fee L
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migogal &p5tem Construction Permit
Permission is hereby granted to Construct&- ep.air( )Upgrade,( )Abandon
.System located at V ( N17 �. 1 I M,
U 1 r
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: o truc i6n m st be completed within three years of the date of this permit.
Date: Approved b
PP Y v
TOWN OF BARNSTABLE q
LOCATION SEWAGE SEWAGE #-
VILLAGE lI�ZtI1Ll3� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. M LIAM Z OLM iE5 C,09 771 4 ZO'7
SEPTIC TANK CAPACITY
LEACHING FACILITY- (type) l+zl� (size) `� Y, [y
NO.OF BEDROOMS _
BUILDER OR O R it 1
PERMITDATE- COMPLIANCE DATE:
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) PS: ,PS- Feet
Edge of Wetland and Leaching Facility(If any wetlands exist 2
within 300 feet of leaching facility) a Feet.
Furnished by ( l��j Q LIT(11 c
e V4
-OR
j
-D do- 0-01\4 IQ
� � � 1 .1 � t t 1 ► � �
- ��N
�h -s
Town of Barnstable
Regulatory Services
1 Thomas F.Geller,Director
Public Health Diviiioo
Thomas MclUmq Dhvdar
Zoo Meta Street,Dyaaab,MA 02601
®ffica: 308•561-4444 Fax: $08-7904304
� tAIS er Cgfi tt=Forsa
Date:
Duipgr3 �C n. i �r1ln xn C. Installer: Erik ur4 o'd
Addrum,. '� Cr,�� crr I�w1 Address: $Te-AWa�er S��ve �!i✓�
on 3 !� o ,_ VRT f t AA Ll i� Wass issued apainitto inaw a
septic rjmm at A6 besnd on a dot&fLin by
u
LTC
En i teem 0 G dated laA 0 t1'
I oerdt that the septio system referenced above was inatalM subi=dm ly to
the des , which may include minor apPM'Ved ctaanges such ae lata�l rogation the
dioWbudon box and/or sap is tank.
I cer*that the seOc reftfa=d above was installed with moor ehaaSee (La.
lateral re�on of the SAS or any va doal relooatioa of aoy combat
of tlu septic aysterai)but in accoidance with State dt Local Regulations. Plan revision or
certified is-Wit by designer to follow.
Op
tt1rC Ci•OI., •. .
Or i 3gAa
No 41
• 1•r L
0 TLYM To BARNSTA21112 DMIZ4 , MA
QLMA 221 ikzmov
U.
i
Q:It dwSGpd&O4"w cwditdcm Form
Z0 'd L9£0 £LZ 80S 9NI833NION33r Wd 6S: Z0 b00Z-£Z-N"W
FAILED INSPECTION
DATE : 10/27/03
PROPERTY ADDRESS _ 83_Blantyre-Ave------- RECEQ%`tit.
Centerville
Mass 02632 -- NOV 1 3 Z003
-- - -- -- -
----- TOWN OF
HEALTH DEPT.
On the above date, I inspected the septic system—at the above address.
Trn's system Consists of the loll.owing:
7. 3-61X8' giock ce.6,3/zooP.6.
2. 1- 1000 gai-Pon /z/zecaz.t .'each.ing pit.
3. 7 h.i a .i.6 a -61211 t z y t e m. MAR
t3.aseo on my inspection, I certily the lollowing conditions.
4. 7h.i,3 1,3 nota .t-i.t.ge 4ive 3ept.ic 3l,6temi SOT
5. 7h.ia 1.6 a 3/2.9i.t sewage 3y-6.tem.
6. Lel.t z ide o f house ha.6 i-wo 6 'X8' gio.ck cep,3/2o oi,3 ..in 3e z ie,3.
7he-6e ce-6,3/2oo.gj 'ate .in hyd1zaueic �a-iiuze.
7. Right,3.ide o� hou,3e con.6 i-6.t3 o)e 1.6%X8 ' Uock ce,3,6.12oo e with a 1000 gaiion
pit a-6 an ove2l.✓?ow. ( g/zey wate2 iz main uze) l
Main 12ooi .in /a.i eu2e. The eeach.ing gib NAT U R
-iz .in /2/zo/2eiz wolzk.ing o zde2 at .the .
- _-:-- _ -- _- -
/Me,3entS, t '/p e. ,Na6.te watt 2 1,3 59" geiow .the
ars' Y . Macomber Jr .
.inve2t .12t12e, - - - - - - - - - - -.- - - - - - - --- -
8. 4 new .t,,.i-Up- rive zep.t.ic zyz.tem needs to ge .inz.ta-eied.
Ompany ; )45tQh Son, Inc .
------ --- -
C-essQCYt.LLP-- �ja - -Q.Z.632- 0066
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
JOSEPH P. MACOMBER & SON, INC.
Tank s-Cesspools-Leachllelds
Pumped & Installed
Town Sewer Connections
P 0 Box 66 Centerville, MA 02632.0066
775.3338 7756412
a •
r:
f:
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
s
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address.83 Blantyre Ave
Centervi e
Owner's Name: ,:Cons ance Tracy
Owner's Address: same
Date of Inspection: 1 0/2 7/0 3
Name of Inspector: (please print) J.P. Macomber Jr.
Company Name:Joseph P. acorn e n
Mailing Address: Box 66
Centerville
Telephone Number:rng_77,_3-1-4R
CERTIFICATION STATEMENT
I certify that 1 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
I Needs Further Evaluation by the Local Approving Authority
Falls
Inspector's Signature: Date:
The system inspector sh 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.
Notes and Comments
****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.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 83 Blantyre Ave
Centerville
Owner:�Constance tracy
Date of Inspection: 1 0/2 7/0 3
Inspection Summary: Cbeck A,B,C,D or E/ALWAYS complete all of Section D
YCIS
I s not fMd any information which indicates that any of the failure criteria described in 310 CMR
15.3.03 or in 310 CMR 15.304 exist. Any failure criteria not.evaluated are indicated below.
Comments:
new Lida —'Ive eep.t.i.c zyztem needs .to ge .inz.tai—ped
B. System Conditionally Passes:
,06 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.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please
explain.
V16vbe 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.
ND explain:
10&�6bservation 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
obstruction is removed
distribution box is leveled or replaced
ND explain:
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
obstruction is removed
ND explain:
2
Page.3 of I i
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A `
CERTIFICATION (continued)
Property Address: 3 Blantvre Ave
Owner: Con-stance ra
Date of Inspection: 1 0/27/03
C. Further Evaluatioo is Required by the Board of Health:
Ad 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.
I. 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
p public health, safety and the environment:
AV 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 any) determines that the
system is functioning in a manner that protects the public health,safety and environment:
/�O 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.
�C The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
)b 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 but5fi 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 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 5 ppm, provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other
7hiz i.6 a .612.11.it 6:yYz t em ?ean. hay Z-6 'X8' ��o ck
ce 3Z120o .-n e2 ' dzau is a.i.eu2.,e
121 ah.t tea hay - o e t
paecazt Zeach.eng pzt a,s an ove2 4124J 2A N0 112 ce.6-3/200 �
,iz .in Nazte wate)z -.z , 590 9eiow .the inve2 pipe o� .the
teaching 12it. R new t-i.tie 2?.ive use/2t.ic Zy,34em need,3 to ge .inz.taeied.
3
Page 4 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A '
CERTIFICATION(continued)
Property Address: 83 Blantyre Ave
Centerville
Owner: Constance Tracy r.,.
Date of Inspection: 1 0/27/03
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
Q•�l°i Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
squid depth in cesspool is less than 6"below invert or available volume is less than i4-day flow
t/ Re uired pumping more than 4 times ' t— q P P g to be last year NOT due to clogged or obstructed pipe(s).Number
/ of times pumped I .
� Zy portion of the SAS, cesspool or.privy is below high ground water elevation.
rd 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.
1s 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,
perfarmed at a DEP certified laboratory, 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 5 ppm, provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.)
(Yes/No)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 now of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no /
_ _lithe 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 11 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.
4
Page 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 83 Blantyre Ave
Centerville
Owner: C:c)n-,t---anr.P Tracy
Date of Inspection: 10 2 7/0 3
Check if the following have been done. You must indicate"yes"or"no" as to each.of the following:
Yes No/
u Pumping information was provided by the owner, occupant, or Board of Health
ere 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?
P 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 backup?
Was the site inspected for signs of break out?
Were all system components,;�kluding 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:
Yes no
XExisting 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(3)(b)J
5
Page 6 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 83 .Blantyre Ave
I > Q
OwoenConstanee Tracy
Date of Inspection: 1'0/27/03
RESIDENTUL
FLOW CONDITIONS
'
Number or bedrooms (design):—f�L— Number of bedrooms(actual) 3
DESIGN now bued on 310 CMR 15.203 (for example: 110 gpd x M of bedrooms):_ e 1W
Number or current residents: 2
Does residence have a garbage grinder(yes or no):),�
Is laundry on a separate sewage system ( e or no)Y.Q_ (if yes separate inspection required)
Laundry system inspected (.yes or no):
Seasonal use: (yes or no):A1201
Water meter readings, if available (last 2 years usage (gpd)). 2001 83, 000 ga-Uon,3 227, 40 CP D
Sump Pump (yes or no): _ a L eons-243. 84 CPD
Last date of occupancy:
COMM ERCIALANDUSTRIAL
Type oresublislhment:
Design (low(based on 3l0 CMR 15.203): d
Basis o(dcsign now(scats/perso,n,�s9/�sgft,ctc.):
Grease trap present (yes or no):!`7��1
Industrial waste holding Lank present (yes or no): �Y
Non•sanitary waste discharged to the Title 5 system(yes or no)-WX
Water meter readings, if available: )
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records f j
Source or information:
Was system pumped as pan of the inspection (yes or no):
I(yes, volume pumped: a Ion •• o was qV nary pumpeO determine ?
Reason (or pumping: d
TYPE OF SYSTEM 014) S
01bScptic tank, distribution box, soil absorption system
Single cesspool
Overflow cesspool d
4 P-dP`l4
0 Privy
.L Shared system (yes or no)or 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)
Tight tank AV Attach a copy of the DEP approval
Other(describe):
Appr ximate age�o�.f all components, date ' sta nd source of inf lion:Were sewage odors detected when arriving at the site (yes or no):,&
6
Page 7 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUB°SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
.Property Address: 83 Blantyre Ave
Centerville
Owntr: Cons.. _anne �, y
Date of Inspection; 1 0 22/ 7/03
BUILDING SEWER(locate on site plan)
Depth below grade: 0'zangeixe2g /2,./2e
Mucrials of construction: ,east iron 5�140 PVC_Zother(explain):
Disunce from private water supply well or suction line: .Ffi't
Comments(on condition of joinu, venting, evidence of leakage, etc,):
7Qi_ai n'nnori�^,r4hI Nn ouir/n'nrb � � v 7ho .6Idd ,tom Lb
vented .thaough .the zoo/ ventz.
SEPTIC TANW.,&&(locate on site plan)
Depth below grads: _tu
Material of construction: t19concrcte�L�metal�fiberglass�otyethylene
�/�othcr(cxplain)
If tank is metal list age: Is age confumed by a Certificate of Compliance(yes or no),,LO(anaeh a copy of
ccnificatc)
Dimensions:
Sludge depth:
Distance from top of sl dge to bottom of outlet tee or baffle: /6�
Scttm thickness:
Distance from top of scum to top of.outict tee or baffle:
Disuncc Uom bosom of soon to bonom of outlet tee or baffle:
How wire dimensions determined: w
Comments(on pumping recommendations,inlet and outle.t ace or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of•leakagc,etc.):
once z ziem '.'6. u4altadzd.,Puma , .the.. ,6e .tic- .:tank eve/ 2—.3 ye.aaz.
Seat is ,tanAc -&3 no t R2ezen,_,
CREASE TRAIFi2-1(locate on site plan) r" ✓•
Depth below grade:16
Material of consavction. coneretc i)Ametal�/?fibaglassd polyethylene? other
(explain);
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:)' d
Distance Uom bottom of scum to bottom of outlet tee or baffle 40
Date of last pumping:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
gi2ea3e t2aR i3 not R2eien.t
I
Page 8 of 1 I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 83 Blantyre Ave
Centerville
Owner: Constance, Triacy
Date of Inspection: 3
TIGHT or HOLDING TANK (tank must be pumped at time of inspect ion)(]ocate on site plan)
Depth below grade: A44
Material of construction: A�Lconcrete.f4 metal Allf fiberglass�olyethyleneWet other(explain):
JIA
Dimensions: i
Capacity: Q gallons
Design Flow: y. gallons/day
Alarm present(yes or no): ;w—
Alarm level: fl,4 Alarm in working order(yes or no): XJ,4
Date of last pumping:
Comments(condition of alarm and float switches, etc.):
7•[.Gh.T` O O.9d ng Irink </n0 rzoi Q/70hDnf
DISTRIBUTION Bow(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Ott
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.):
PQX .i or DR-P ,ynf
PUMP CHAMBERVeV,& (locate on site plan)
Pumps in working order(yes or no): 4)A
Alarms in working order(yes or no): 4)4g
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
�PUm/2 Aeni
8
Ppge 9 of I I
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:83 Blantyre Ave
Centerville
Owner: Cons an e Tracey
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required)
tx Left zeaz. 2-6 'X8' giock eee.6/2ooi,3. 1?iqht zeaz. 1-8'X8' 9, ock
ce,3�3/2ooi. with a 1000 gaiion /zzeca,3t Leaching /z.it ass an ovez�.Pow.
If SAS not located explain why:
Located: See ,2acgy. 10
Type
leaching pits, number: J
leaching chambers, number: 6
leaching galleries,number: 0
leaching trenches,number, length: 0
leaching fields,number, dimensions:
overflow cesspool, number: I
12 .innovative/alternative system Type/name of technology: /'�
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition 6f vegetation,
etc.):
Loamy. .6and to medium "ine nand. CgzzRoo.es aze .in hyd1tauiie Ja.iiuz-e.
rnnr/ o))Q1?,e9n)j nq QJPA aao rlaw,p Vegetation .iz hea.P.thy .ivy.
'Leaching 121 .ins .in wozk.ing ozclez.
CESSPOOLS: cesspoounust umped as Hpffiof�ntion)(locate on site plan)
Number and configuration:Depth—top of liquid to inlet invert:>JaAe .J .0W. AIC*4-,?
Depth of solids layer. f—,V
Depth of scum laver: %— `" 5P—A1' FA/ -7-4-c '`
Dimensions of cesspools 6/
Materials of construction: a< faZ. dam&
Indication of groundwater inflow(yes or no): 41,0
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
Same nA n6o_z)g
PRIVY�N(locate on site plan)
Materials of construction: X44
Dimensions: A(M
Depth of solids: AO
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
21z,L)E{ ,i A no# Rn A n -
9
Page 10 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
.PART C
SYSTEM INFORMATION (continued)
Property Address: 83 Bian;�y2e Ave
Cent 71U)i e..�.e;.,fa�3a.
Owner: aay & 0rz.e ance 1 acey
D2te of Inspection: 10127103
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties tout least two permanent reference landmarks or
bencharks. Locate all wells within 100 feet. Locate where public water supply enters the building.
1y
i
i p
1
J I
I
� •I
10
Page I I of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART C ,.
SYSTEM INFORMATION (continued)
Property Address:83 Blantyre Ave
Centerville
Owner: Constance Tracy
Date of lospectioo:1 0 27 03
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
7
Estimated depth to ground water fQ feet
Please indicate (check) all methods used.to determine the high ground water elevation:
N0 Obtained from system design plans on record • if checked, date of design plan reviewed: NR
y!LS Observed site (abusing property/observation hole within ISO feet of SAS)
NL Checked with local Board of Health-explain: NA
V--� Checked with local excavators, installers- (anach doctunentation)
qC4 Accessed USGS database-explaink t 2://.town ka2n 3. aP,—Pe. ma. uz.
You must describe how you established the high ground water elevation:
1,3ed: Cah 2ea (7ode.0 12116194 Gaound watez eieva.t.ion-6 agove zea .levee.
l.6ed: 11SG use 1992
lied: LLSy i�in 911)_ 100 1 P a .P#2 Annua-9 2angez o 2oun wa.te/c
utrot vrouna
Leaching
/
Pit 1�i .ccl
V'
F `
Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 t f per Fnmptcr Method
Therefore, the vertical separation distance between the bon t
Of the leaching pit and the adjusted groundwater table isJA
feet.
II
y,. r+...n.-R:.•r. -�- rT.-'r..nm r+-�.^.-z,r.m.r.:•.r--mr:�-r-rnr-inr-w mcn-�T.nr '.. .
TOWN OF BARMTABLE WARD OF HEALTH
SUIISURPACF SEWAGE I)ISI'OSAL SYM.M INSPECTION FORM - PART D - CERTIFICATION
•.•T•••_T••.••.'.t^.T.11�^.�.T.T..'Tt'R:TT,Tl Ti',TTlT ST•I"T1'.T'.'1'R,'1'RTt.TTRR"'1^RT,TR'RC 'RT9
. RRIRTm�Tt1TTt-T'TTRT.•,—nl-•T- T � —..
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED
STREET ADDRESS 83 Blantyre Ave Centerville
ASSESSORS MAP , DLO_CK AND PARCEL # 229-010
OWNER ' S NAME Constnace Tracy
PAR7' D - CERTIFICATION I
NAME OF INSPECTOR Joseph P. Macomber Jr
COMPANY NAME Joseph P. Macomber V'ton Inc
COMPANY ADDRESS Box 66 Centerville Mass 02632
Street Town or City Stet• IIP
COMPANY TELEPHONE ( 508 ) 775-3338 FAX ( 508 ) 790-1-578
CERTIFICATION STATEMENT
I certify that I . have personally inspected the sewage disposal system at
Arrmamthis nddress and that the information reported is true , accurate , and
AF in
omplete as of the time of .- inspection , The inspection was performed and any
% recommendations regardilig upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of 011-
site sewage disposal systems :
Check one ;
Syste6 PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
healLh or the environment as defined in 310 CMR 16 , 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
his form :
System FAILED$
The inspection which I have con' Ucted has found that the system fails to
Protect the public health and the environment in accordance with Title
5 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection. form ,
Inspector Signature gate
AW
PR
ne copy of this c.ification must be provided to the OWNER , the BUYER
( where applicable ) and the 130nRD OF MEAL'1'll ,
* If the inspection FAILED , th)- owner or "operator ehall upgrade ' the eyetem
within one ,year of the ante of the inspection ; unless allowed or required
otherwise as provided in 3.10 ChiR 16 , 306 ,
partd , doc
PROVIDE PRECAST CONCRETE EXTENSION -- "
TOP OF FOUNDATION= 36.00 5 DIA.OUTLETS O " FINISH GRADE OVER LEACHING FIELD= 35.5-35.66 GENERAL,. NOTES
RISER WITH CONCRETE COVER TO WITHIN 4 SCHEDULE 40 PVC MIN.SLOPE 1%
6"OF FINISH GRADE OVER OUTLET COVERS REMOVABLE CONCRETE COVER TO SLOPE @ 2%MIN. OVER SYSTEM 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION
WITHIN 6"OF FINISHED GRADE
2"SCH.40 3/4"TO 1-1/2"DOUBLE WASHED STONE TO CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE
FINISH GRADE @ FND. EL.= 34.00 FINISH GRADE OVER TANKS EL.= 33.00 - 35.00 TO D-BOX FINISH GRADE OVER D-BOX= 35.8 2"OF 1/8"TO 1/2"DOUBLE WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES.
20"MIN.ACCESS COVER 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD
(TYPICAL FOR 3) 36"MAX OF HEALTH AND THE DESIGN ENGINEER.
4"PVC OUT TO 4"PVC PERFORATED PIPE
EXISTING 4" 36"MAX. EACHING FACILITY SLOPE AT.5°� TOP OF S.A.S.= 34.5-34.66'
tS=L053=r:mn.=r6
.I. DRAIN PIPE 4.�H 9 MIN. 3. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL
" 2"DROP MIN. " 40 PVC 36"MAX. BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED.
9" 34.0PROPOSE 3"DROP MAX. sLOPE � mmEND CAPS 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
"SCH.40 PVC L=5 ELEVATION=34.66'FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS
" "V LI ID INV.OUT=14 ALARM ON 1A 40
Q 31.05' o THE LINERES NOT LESS T LINER
HAN THE BREAKOUT ELEVATION.FEET FROM S.A.S.AND THE TOP OF
LEVEL 31.00' 'MP ON L 33, Q SLOPE 1 /°min. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
INLET TEE - 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM.
INV. IN= ET E
31.30' _ LIMP 6"
10.3' --I OUTLET
- 34.50' 34.33' 6"EFFEcTivE 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
DEPTH.
TEE 6"CRUSHED STONE 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN
30.75 " 34.16 BOTTOM OF FIELD TO BE LEVEL EL.'= 33.5 -
GAS BAFFL OVER MECHANICALLY 6 CRUSHED STONE SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO
COMPACTED BASE OVER INLET TEE OVER MECHANICALLY 2' 5' 5' 2'
BAFFLE COMPACTED BASE
32' BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH.
LENGTH 10'-6" WIDTH 5'-8"DEPTH 5'-7" LENGTH 8'-6" WIDTH 4'-10" DEPTH 5'-T 8. ELEVATIONS BASED ON ASSUMED N.G.V.D. DATUM OF 35.00'MSL
5 OUTLET DISTRIBUTION BOX TO 14
1500 GALLON SEPTIC TANK 000 GALLON PUMP CHAMBER BE INSTALLED ON A LEVEL STABLE OBTAINED FROM TOP OF PK NAIL AS SHOWN ON PLAN.
BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= 28.3'
PIPES TO BE LAID LEVEL. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
TANKS SHALL BE INSTALLED ON A LEVEL STABLE BASE 5 MI THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE
TYPICAL FIELD PROFILE FIELD ENS VIEW AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY
CROSS SECTION VIEW DISCREPANCIES TO THE DESIGN ENGINEER.
1500 GALLON SEPTIC TANK & 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE
DISTRIBUTION DETAIL FIELD DETAILS
I STRUCTURES SHALL BE MADE WATERTIGHT.
1000 GALLON PUMP CHAMBERBOX
NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR
NOT TO SCALE NOT TO SCALE ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH
=j DETERMINATION FROM APPROPRIATE AUTHORITY.
12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
• 1'e8t TEST PIT DATA LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE
TREES TO BE REMOVED •. Pt THEY SHALL WITHSTAND H-20 LOADING.
3 - 15 OAK ,�_ •. AGENT:
13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND
_ ) .:.MAP 229_ n.. +4r • '� EVALUATOR: John L. Churchill Jr., P.E. FINES.
8 TALL SHRUB • ♦ ♦ -
• •,� •
�� LO
PARCEL 108 M 0 • • DATE: Der�mber 2, 2003 14. WHERE REQUIRED CONTRACTOR SHALL REMOVE ALL LOAM SUBSOIL AND
4 WHITE PINE \ •, . ,
4' UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF
" EDGE OF PAVEMENT _ N/F HOSIE ♦ 'd� • • TEST PIT#. 1
2 - 2 WHITE PINE - - - I �' • • • LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH
87 OT25 *+; • • • • p ELEV TOP= 32.30' COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN
3 - 10" OAK N °
N87 OT25"E 84 00't C • •• • • ACCORDANCE WITH 310 CMR 15.255(3).
I 39' ti•. •�• « ELEV WATER 28.30'
Cp• •�,•• •• * • • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
♦ • PERC RATE- 2 MIN/IN
/ •. O : ♦ •• •O SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
n 4■4 " 16. PROPOSED PROJECT I LOCATED WITHIN:
00 BANK OFFSET � � � • � . DEPTH OF PERC 2 2 C S OC
/ p: • ASSESSORS MAP 229 PARCEL 10+109
TEXTURAL CLAS.�. 1
•• ¢• 17. OWNER OF RECORD: MS. CONSTANCE TRACY
/ DRIVE
DESIGNING ENGINEER MUSTS � � •*�" � - » ,
INSTALLATION UPERVISE , .. 0 32.30
I ADDRESS. 83 BLANTYRE ROAD
ALLATION AND CERTIFY IN WRITING • -
' ^ ?6: :. A Loam Sand
N 0' y CENTERVILLE, MA 02632
THE SYSTEM WAS INSTALLED IN STRICT Z
r � y MAP 229 � , - , YR 3/2
ACCORDANCE TO PLAN. � _ 12" 31.30 :
��
P RCEL 10+ 109 • �
QeC�1 18. FEMA FLOOD ZONE C
�2,904 sq.ft.t • g Lot my Sand AS SHOWN ON COMMUNITY PANEL# 250001 0005 C
t'n y< w w ;• h • • , 24" 16 r YR 5/6 30.30'
m l ' • Perc 19. PLAN REFERENCE:
�• '• -a .. • • � � �R ' " : 28.80' 1. PLAN BOOK 232,PAGE 103
.: M • ♦ . • • . 42 Medium Sand
+ •� • • C 2.5 YR 03 20. DEED REFERENCE:
U, C , 36 a
PATIO / J ♦ • • I 1. DEED BOOK 1454, PAGE 456
t
O • y • 48 Mot0ina 24, A...-..fSTL,R.aLL'itI�E.,s,�i-sr,�L,�E rcE.�a t�r�E�3 T�,10�-ciGii�AL Cl3ND1TION.
7.o YR 516
j
• • PRO
PERTY OPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
c� • • FOR SEPTIC:SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
p - 3�' z s
- . ., FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
EXiSYiNG CESSPOOLS ch • T
r ECK L0tE PUMPED AND w -
�' / EXISTING o = --
-C 3-BEDROOM FILLED WITH CLEAN SAND O 78 W i 78" ,
O z 25.80
C \ DWELLING / z vi O
m Q
TOP. _36.0' _--33-'/ u✓ * MAP 229 LOCUS PLAN
o i ., o 0
LEGEND
/ \ a.1 N PARCEL 15 SCALE: 1"= 1000'
m 0 °° N/F DUNBAR 96" 24.30'
; - 50 - - EXISTING CONTOUR
INSTALL 1-1/4"PVC TO HOUSE.JOINTS TO BE MADE
\ ( WATERTIGHT.WIRE PUMP AND FLOATS TO SIMPLEX 50 PROPOSED SPOT GRADES
is \V CONTROL PANEL No. 1-CC2 NEMA-1 MFG. HOOVER
3`Z� INSTRUMENTS. -���-- PROPOSED CONTOUR
4 7o r NEMA 4 JUNCTION BOX CORROSION RESISTANT 8
HOISTING CABLE 7 x 19 STAINLESS STEEL E/T/C EXISTING OVERHEAD UTILITIES
C' LIQUID-TIGHT CABLE CONNECTORS SUPPORTED
w �' 1/8 DIA./1 760 LB.STRENGTH
1000 GALLON
CONNECTORS SUPPORTED BY 1-1/4"PVC CONDUIT, � i
cr MP H --- --- EXISTING WATERLINE
\ _ PUMP C AMBE JOINTS TO BE MADE WATERTIGHT "
� , ., .; ( 2 BALL VALVE w/UNIONS SCH.80 PVC ��
33 i
,; / \ 13
HC 1 %- GEORGE FISHER CO. MODEL NO. 560
( )
2) •' � TEST PIT LOCATION
REMOVE AND REPLACE
�,, (v o ti 6 2 SCH.40 TO D-BOX
UNSUITABLE MATERIAL ' N io �i11>> a � , Q Q PROPOSED 1000 GALLON PUMP CHAMBER
TO ELEV. 30.30'WITH _
U
CLEAN, COARSE SAND S1FDTIC TANK \ 10" AwtM oN SCH.40 TEE w/CLEAN-OUT CAP
LC 1 �? O 32 PROPOSED 1500 GALLON SEPTIC TANK
( � � LC.2)' � 5�_7
14'x 32' �; N 101.8' MP or, _ 4"SOLID SCHEDULE 40 PVC PIPE
LEACHING FIELD
---
EOMEMBRANE LINER PuMP N 2"BALL CHECK VALVE SCH. 80 PVC 100
' - 2 SOLID SCHEDULE 40 PVC PIPE
CB/ ND ,r .,r... A d\ _ P.S.I.OFF FLOWMATIC MODEL No.208S
.j it
0. rrr - DISTRIBUTION BOX
DISTRIBUTION 80X _ .. ••. •
4-6 �
1 .
WITH BAFFLE Z .... 81°2V30"W
�•• • "" (2)WIDE ANGLE CONTROL FLOATS 1/4 WEEP HOLE IN DISCHARGE PIPE
" - - 4"PERFORATED SCHEDULE 40 PVC PIPE
�--•3 0 (BARNES 073618)
-.i • :: f 2"SCH.40 PVC DISCHARGE PIPE
'30"W CB/FND
1: PUMP ON/OFF 120 ACTIVATION
^' S81°28 0 �.; 2: ALARM ACTIVATION BARNES SE411 PUMP,.4 H.P. 115 V 2"
B.M. v 103-
- � DISCHARGE PASSING 1-1/2"SOLIDS OR
Top ofP.K. Nail (LC3 W' 1000 GALLON PUMP CHAMBER EQUAL
Assumed \ B/FN N DOSING N T REV. DATE BY APP'D. DESCRIPTION
D\ DESIGN DATA S G & STORAGE REQUIREMENTS
3 PROPOSED SEPTIC SYSTEM UPGRADE
m NUMBER OF BEDROOMS DESIGN FLOW. 330 GPD
DESIGN FLOW 110 GAUDAYBEDROOM PREPARED FOR:
DOSING REQUIRED: 4 CYCLE/DAY_
m �s TOTAL DESIGN FLOW 330 GAUD" _ N TA
BUOYANCY CALCULATIONS �+
MAP 229 330 GPD/4 82.5 GAUCYCLE CO S NCE TRACY
-� SEPTIC TANK
PUMP CHAMBER: y PARCEL 11 DISTANCE REQUIRED BETWEEN PUMP LOCATED AT
m
N/F ELDRIDGE DESCRIPTION HCl HC 2 DESIGN FLOW X 200% = 660 GALLON SEPTIC TANK ON AND PUMP OFF FLOATS:
F PUMP CHAMBER EL._HIGH GROUNDWATER EL. 28.30 BOTTOM O UM C B 26 50 m LEACHING CORNER(1) 39.4' 58.4' USE PROPOSED 1500 GALLON SEPTIC TANK 82.5 GAUCYCLE = 250 GAUF;' = .33 FT/CYCLE 83 BLANTYRE ROAD
WATER DISPLACED=(28.30'-26.50')x 4.83'x 8.5'=73.9 C.F. USE 0.4'TO PROVIDE FOR BACKFLOW CENTERVILLE MA 02632
WEIGHT OF DISPLACED WATER=73.9 C.F.X 62.4 LB/C.F. =4,611 LBS. LEACHING CORNER (2) 20.9' 30.9' ' ' ) '
* THIS PROPERTY NOT LOCATED WITHIN A ZONE II INSTALL A 14 BY 32 LEACHING FIELD
WEIGHT OF H-10 1000 GAL. PUMP CHAMBER=8,300 LBS. >4,611 LBS. (ACCEPTABLE) '` O STORAGE REQUIRED ABOVE WOF;KING LEVEL: 330 GAL.
LEACHING CORNER(3) 34.9': 41.8' $IDEWALL CAPACITY STORAGE PROVIDED ABOVE WORKING LEVEL:625 GAL. SCALE: 1 INCH 20 FT. DATE: DECEMBER 31,2003
SEPTIC TANK:
LEACHING CORNER 4 48.3' 64.9' NO SIDEWALL AREA CREDIT TAKEN of o �0 20 ao 120 FEET
O RESERVED FOR BOARD Off'HEALTH USE �.
HIGH GROUNDWATER EL.=28.30' BOTTOM OF SEPTIC TANK EL. =26.80' BOTTOM CAPACITY JOHN C.
WATER DISPLACED=(28.30'-26.80' x 5.66 x 10.5=89.1 C.F. CHURCNILL PREPARED BY:
LENGTH x WIDTH) (.74 GPD/S.F.) _ GAUD" JR.
WEIGHT OF DISPLACED WATER=89.1 C.F. X 62.4 LB/C.F. =5,560 LBS. ( CMS JC ENGINEERING INC.
WEIGHT OF H-10 1 AL. T A = 1 > (14 x 32) (.74 GPD/S.F.) = 332 GAUDAY No. 41807
500 G SEPTIC TANK 2,000 LBS. 5,560 LBS. (ACCEPTABLE) 2854 CRANBERRY HIGHWAY
TOTALS: EAST WAREHAM `MA 02538
SITE PLAN TOTAL LEACHING AREA 448 SQ.FT.
508.273.0377
SCALE: 1 20 TOTAL LEACHING CAPACITY 332 GAL./DAY Z 31)03 Drawn By: BMB Designed By.BMB Checked By:JLC JOB No.587