HomeMy WebLinkAbout0051 BREZNER LANE - Health 51 Brezner Lane
Centerville P
A = 230 141
a
Omcford. NO. 1521/3 ORA
10%
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No. coS• Fee $5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZippYication for ;Dtopogal 6pgtem Construction i3ermit
Application for a Permit to Construct( )Repair:K X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.Lot 56 Owner's Name,Address and Tel.No. Daniel Brown
51 Brezner Lane Ce terville,Mass. 51 Prezner Lane
Assessor'sMap/Parcel ,Zap qj Centerville,Mass.02632
Installer's Name,Address;and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.Nc5 0 8—7 7 5—9 7 0 0
J.P.Macomber & Son Inc. Ronald J. Cadillac, PLS, RS
Box 66 Centerville,Mass. 02632 P.O.Box 258 W. Yarmouth,Mass. 02673
Type of Building:
DwellingXXXNo.of Bedrooms 3 Lot Size 1 3, 1 7 0 - V ft. Garbage Grinder IN)
Other Type of Building Q S. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 350 gallons per day. Calculated daily flow 3 X 1 1 0—3 3 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 1 500 q,; nn5 Type of S.A.S. 2—S00 's Chambers,
Description of Soil 0"-1 8"=Sandy loam. 1 3"-30"=Sandy Loam, 42"-1 32"=medium sand
trace of silt 10% gravel
Nature of Repairs or Alterations(Answer when applicable) Omit t i n q cesspools,Installing
1 -1500 gallon tank. 1 —Distribution box and two 500 gallon leaching
chambers. Drywells will be set 6 ' apart with 3 ' of stone all around.
X
Date last nspe0"
Dte cted 2
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 Certifi-
cate of Compliance has been issue by this Bo o e
Signed A A Date 9 3 0
Application Approved by d- 5 Date
Application Disapproved or the following reasons
Permit No. Date Issued
`Fee $50.00
THE COMMONWEALTH OF MASdACHUSETTS Entered in computer:
Yes
- PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
•F
Application for 30igpo9;a1 *pgtem Con!tructton Permit
Application foraPermit to Construct( )Repair'( X)Upgrade( )Abandon( ) O Complete System O Individual Components
Location Address or Lot No.LOt 56 Owner's Name,Address and Tel.No. Daniel Brown
51 Bre'zAer Lane Centerville- Mass. 51 Brezner Lane
Assessor'sMap/Parcel -210 )I � � Centerville,Mass.02632
Installer's Name,Address,and Tel.No. 5 0 8-7 7 5-3 3 3 8 Designer's Name,Address and Tel.Nos 0 8—7 7 5-9 7 0 0
J.P.Macomber & Son Inc. Ronald J. Cadillac, PLS, RS
Box 66 Centerville,Mass.02632 P.O.Box 258 W. Yarmouth,Mass.02673
Type of Building:
DwellingXXXNo.of Bedrooms 3 Lot Size 1 3;170 Blq.ft. Garbage Grinder NO)
Other Type of Building I 0 S, No.of Persons Showers( ) Cafeteria( )
Other Fixtures
i
"Design Flow 5.0 gallons per day. Calculated daily flow 3X 1 1 0-3 3 0 gallons.
Plan Date Number of sheets Revision Date
Title .
Size of Septic Tank 1{500 r�rawl 1 onst Type of S.A.S. �_r,0(1 ChamhPrs
D.4cription of Soil 0"-18"='`Sandy loam.18"-30"-Sandy Loam.42"-132"=medium sand
trace of silt 101 gravel
f
/Nature of Repairs or Alterations(Answer when applicable)Om i t t i ng cesspools.install i ncr'
1-1500 gallon tank.1 -Distribution box and two 500 gallon leachtLig
chambers. Drywells will be set 6' apart with 3' of stone all around.
�29 'X10' 10"X2'
1 Date last inspected: r
f
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 Certifi-
cate of Compliance has been issue• by this Bo d of��e 1
Signed mil' Date 9/3/0..2 ,
Application,Approved by L S Date Ca IQ f b2
Application Disapproved f r the following reasons l
Permit No. ��2 - 3�S �, Date Issued 1 Ll
a
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certifirate of Com'phance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired,(XX)Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc,
:- at 51 Brezner Lane Centerville,Mass. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit N-.-2U:R S dated 9
InstallerJ.P.Macomber & Son Inc. Designer Ronald J Cadillac PLS. RS_
The issuance of this permit shall not be construed as a guarantee that the sys�wAjJ
i .furic °on as desig----------------------------------------
' Date JJ Inspector
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
ltgogar *p5tem Conotruction Permit
Permission is hereby granted to Construct( )Repair Z�X)Upgrade( )Abandon( )
System located at 51 Brezner Lane Centerville,Mass.
i
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.
:l
Provided:Construction must be completed within three years of the date o this permit
Date: c, /C]2 Approved by
� ���
TOWN OF BARNSTABLE -�
LOCATION e :zwe SEWAGE #A66.2 -
VILLAGE C 'f*j e A 1/1-12 e ASSESSOR'S MAP & LOT 230- �`Il
INSTALLER'S NAME&PHONE NO. f,,o ,Pi /f c 6 ,41 d zl
SEPTIC TANK CAPACITY l-5--0 O
LEACHING FACEL=: (type) _ /, Y (size) .2 %' /O h) X
NO.OF BEDROOMS
BUILDER OR OWNER 0 vtl e rO w,n
PERMTTDATE: UZ COMPLIANCE DATE: UZ
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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►>re7Atr
TOWN OF BARNSTABLE FC_
LOCATION / e 7
/1/ E' R Z-11 SEWAGE #AC6d 2
VII-LAGE_C PA1 8 1/I p ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO. J/- _//A ,Q C A A4
SEPTIC TANK CAPACITY f ®O
LEACHING FACILITY: (type) (size) _ 9' /O—.//5 X
I
NO. OF BEDROOMS__
BUILDER OR OWNER o-vt r e. o W.A
PERMITDATE: OZ COMPLIANCE DATE: 0� k
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on.site or within 200 feet of leaching facility) Feet
,. Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility)
Feet
If Furnished by
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Fs e E
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/ Town of Barnstable P /06
Department of Health,Safety,and Environmental Services
"41 Public Health Division Date
$ 367 Main Street,I lyannis MA 02601
f eeartareaus. '
rfd'A 1
��� Date Scheduled a �I I Time ` ram Fee Pd. 6 y —
Soil Suitability Assessment for Sewage Disposal
Performed By: �i te �S Witnessed By: DGtO'U
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Location Address ( I R f Owner's Name D t
L-D 5 l k7 Q^�Qti I R Address S 1 lf;,/'c 7,NE712 nn /
Assessor's Map/Parcel: Engineer's Name �,, J.
NEW CONSTRUCTION REPAIR Telephone 5706-771 g766
Land Use Yt Slopes(0/0) Surface Stones W
Distances from: Open Water Body nO ft Possible Wet Area 610 R Drinking Water Well f7(3ft
t ,
r Drainage Way l ft Property Line i d ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc�tteests,locate wetlands in proximity to holes)
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LDtS�
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Parent material(geologic) &rrm S 4 ue R%f , l l 1, Depth to Bedrock ,
Depth to Groundwater: Standing Water In Hole: / -Weeping from Pit Face
Estimated Seasonal High Groundwater 64,v,, � 7
-77o,V . / low v 6IS
................:...:.............:...........:...:.....:...:..::.:;. ..,. .:...:.... .•.:.:....:..................;........:::.:...................::.::,..,..,:...:.::.::;:::::.:,;:.:.>:.::.;:;.:.
1J NAB '.blt .1✓ . b . fit✓: .:.;: Tt ' ilrl
C..:...........zt ...............5..... ......: ..........H...
'V ..............
i inoa usi e
::: :.:. .
Depth Observed standing In obs.hole: _ in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment R.
,..Index Well NAf ,_ •Rnading Date:.fUn�C Index Well level _ Atli.factor 4Z Adj.Groundwater Level _ lf 7
Z /qO2-
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R
....•
... +"
..
Observation Hole
Hole N •j- Time at 9" �
Depth of Pere - Z— Time at 6"
Start Pre-soak Time @ P SJ Time(9"-6")
End Pre-soak go 6/ (5 6o j6)
Rafe Min./Inch �Zmio�
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Hcalth.Division Observation Hole Data To Be Completed on Back j
Copy: Applicant
..;...,... .........:...........:
....:::.:.... .
.. E.
Depth from Soll Horizon Soil Texture Soil Color , Soil
Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
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� n Nc-
� '.'
Ve-
'
DEEP`:.:OBS.EI� AT..It]1I:.H ?. .;Ltd: :..:::«::<;.;:<:.; .:.::.: ::.>;::,;:;;
Depth from Soil Horizon Soil Texture Soil Color Soil . Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
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::. :`t is :� ::5:' 2:Y•'::> ?`. �.+..;:. .`;�isi:? ::::::::: �::: ': ::::2�s:::��: :':;:
:..:::.;:.;:::�D
. . ............ . then.. ....
Depth from Soil Horizon Soil Texture Soil Color Soil 0
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,%Gravel)
it
i
Depth from Soorizon Soil Text Soil Color Soil Other
il H Texture
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
0
I
i
Flood_ Insurance Rate MAV
Above 500 year flood boundary No Yes
fix " � 9
. t .
COMMONWEALTH OF MASSACHU,SETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTE! ��Tt 3
b ► /3
ONE WINTER STREET. BOSTOTr. MA 02108 617-29?-SS � ��/
a3 0
�1'ILLIAM F.WELD / RfCEIVEO
y T=itUDY C4
Govemor APR 11998 �' Sccrc
ARGEO PAUL CELLUCCI TOWN OFBARNSTABLE DA` P.STRU
Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION M HEALTHDEPL G mmissio
PART A r
CERTIFICATION
to Q 1
Property. Address: 51 Bre er Ln, Centerville Address of Owner: Ethel
7 �8r �r
Date of Inspection: /0`/ -�7 (If different)
Name of Inspector: Wm E Robinson Sr
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: Wm E Robinson Septic c;ervir
Mailing Address: PO Box 1089 , rpntpryillp, IAA 02632
Telephone Numbers S O f3 ` 7 7 5_8 7 2 6
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate)
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
asses
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails .�
Inspector's Signature: Gc. :• tC r Date:
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owns
and copies sent to the buyer, if applicable, and the approving authority.
INSPECTION SUMMARY: Check A, B, C, Or D:
i A] SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303
Any failure criteria not evaluated are indicated below.
COMMENTS:
i
B] S TEM CONDITIONALLY PASSES:
ne or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, up(
ompletion of the replacement or repair, as approved by the Board of Health, will pass.
Indicate es, no, or'not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance (attachr-di indicating that the tank was installed within twenty (20) years prior to the date of the inspection;
the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tan
failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(revised 04/25/97) Page 1 of 30
DEP on the World Wde Web: http:lt*ww.mapnet.State.ma.uydep
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
.CERTIFICATION (continued)
Property Address: 51 Brezner Lin, Centerville
Owner: Bryer
Date of Inspection:10 -11-9
BJ SYS EM CONDITIONALLY PASSE$ (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health). Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Health):
broken pipets) are replaced
obstruction is removed
C) FURT ER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM 15 NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
HE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
NVIRONMENT:
The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
�\ private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates IN
the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to of
less than 5 ppm. Method used to determine distance (approximation not valid).
3) THER
(revised 04/25/91) Page 2 of 10
r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 51 Brezner. Ln, Centerville
Owner: Bryer
Date of Inspection: /d
DJ SYS M FAILS:
You must t dicate et:•.er "Yes" or "No" as to each of the following:
I h ve determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for is determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the ilure.
Yes No
Backup of sewage'into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped _.
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. li the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
El LA GE SYSTEM FAILS:
You m t indicate either "Yes" or "No" as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (large System) and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
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)
The o ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requir ents of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 04/25/91) Pay 3 of 10
s
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 51 Brezner Lin, Centerville
Owner: Bryer
Date of Inspection: �o _ / j_j,
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes, No
Pumping information was provided by the owner, occupant, or Board of Health.
✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or
as pan of this inspection.
_ As built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
✓ _ The system does not receive non sanitary or industrial waste flow.
_ The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of
baffles or tees, material of construciion,•'dimensions, depth of liquid, depth of sludge, depth of scum.
—The size and location of the Soil Absorption System on the site has been determined based on:
ILIThe facility owner land occupants, if different from owner) were provided with information on the proper maintenance
Sub-Surface Disposal System.
_ Existing information. Ex. Plan at B.O.H.
Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) (15.302(3)(b)J
(revised 04/25/97) Page 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection:!O c'i 'I
FLOW CONDITIONS
RESIDENTIAL: 1
Design flow: 3.3 a g.p.dJbedroom for S.A.S.
Number of bedrooms: 3
Number of current residents:
Garbage grinder (yes or no): A-o
Laundry connected to system (yes or no):&Q
Seasonal use (yes or no):- - S n
Water meter readings, if a Table (last two (2) year usage (gpd):
Sump Pump (yes or no):jd::5>
Last date of occupancy:
ERCIAIJINDUSTRIAL:
Type establishment:
Design ow: gallons/day
Grease rap present: (yes or no)_
Industr' I Waste Holding Tank present: (yes or no)_
Non- nitary waste discharged to the Title 5 system: (yes or no)_
Water eter readings, if available.
Last dat of occupancy:
OTHE • (Describe)
Last da os occupancy:
GENERAL INFORMATION
PUMPING REC05DS a d source of information:
System pdmped as part of inspection: (yes or no)_&
If yes, volume pumped: ttallons
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)
VA Technology etc. Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information:
Sewage odors detected when arriving at the site: (yes or no) /fi d
(revised 04/25/91) Page 5 a 10
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: /6
BLHt
ING SEWER:
(locate n site plan)
Depth low grade:
Materi of construction: _cast iron _40 PVC_other (explain)
Distanc from private water supply well or suction line
Diamet r
Comm ts: (condition of joints, venting, evidence of leakage, etc.)
SEPTIC TANK: / 1�(locate on jite plan) /
Depth below grade: A/ fJ
Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain)
If tank is metal, list age _ Is age confirmed icate of Compliance _(Yes/No)
Dimensions:
Sludge depth:
Distance from top of sludge to bottom outlet tee or baffle:
Scum thickness:
Distance from top of scum to top outlet tee or baffle:
Distance from bottom of scum to onom of outlet tee or baffle:
How dimensions were determine
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence pf leakage, etc.)
GREA TRAP:
(locate site plan)
Depth be w grade:
Material construction: _concrete _metal _Fiberglass _Polyethylene _other(explain)
Dimensio s:
Scum thic ness:
Distance rom top of scum to top of outlet tee or baffle:
Distanc from bottom of scum to bottom of outlet tee or baffle:
Date o last pumping:
Commen s:
(recomm ndation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity evidence of leakage, etc.)
(revised 04/35/97) Page 6 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
-Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: 16 -7— 3 rJ
TI T OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) `
(locate n site plan)
Depth low grade:
Material of construction: _concrete _metal Fiberglass _Polyethylene _other(explain)
Dime sions:
Capac gallons
Design w: gallons/day
Alarm lev I: Alarm in working order _ Yes; _ No
Date of p vious pumping:
Commen :
(conditio of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX:V
(locate on site plan)Depth of liquid level above outlet invert:-'ao
Comments:
(note if'level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.)
PUMP HAMBER:_
(locat on site plan)
Pu sin working order: (Yes or No)
Alarm in working order (Yes or No)
Com ts:
(note c ndition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 04/25/97) Pay 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non intrusive methods) ;.
If not determined to be present, explain:
Type:
leaching pits, number:_
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:��
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hyd ulic failur , leve f pon ing, condition of vegeta`n, etc.)
o C 6 Q ,
.tom 41
' O:i✓
CESSPOOLS:
(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert: g0lz V
Depth of solids layer:
Depth of scum layer: 5/
Dimensions of cesspool- k
Materials of construction:
Indication of groundwater:�• d
inflow (cesspool must be pumped as pan of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level of pooing, condition of vegetation, etc.)
a! a • A c
PRI :_
(locate site plan)
Materials f construction: Dimensions:-'
Depth of olids-
Commen
(note co dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 04/25/97) Page / of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: �o—/7-4 7
t
Depth to Groundwater/(Z Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
--Z— Observation of Site (Abutting property, observation hole, basement sump etc.)
Determine it from local conditions
Check with local Board of health
Check FEMA Maps
Check pumping records
Check local excavators, installers
Use USGS Data
Describe in lour own fiords how you established the High.Groundwater Elevation. (Must be completed)
Z -o #4� A,zj
(revised 04/25/97) Page 10 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: -,7
SKETCH OF SEWAGE DISPOSAL SYSTEM: 1
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
I
i
�l
' � sf
.w
(revised 04/25/97) Page 9 of 10
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET. BOSTON. MA 02108 617-292-5500 j2
A.
O
W ILLIAM F.WELD c ���
Govemor As TRUDY CORE
Secretary
ARGEO PAUL CELLUCCI �� DAVIUB.STRUHS
Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM hFyt � Commissioner
PART A Soxi ice,
CERTIFICATION
Property Address: 51 Brez er Ln, Centerville Address of Owner: Ethel
Date of Inspection: l0 -7 — v (If different) r y
Name of Inspector: Wm E Robinson Sr
1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: Wm E Robinson Septic Servi
Mailing Address: PO Box 1089 Ccntc-rvi 1 1 a'_MA 02632
Telephone Numbers 5 0 8 ` 7 7 5_R 7 7 6
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
asses
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails s�
Inspector's Signature: Z. L L Date: 16— —Q9
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
INSPECTION SUMMARY: Check-A, B, C, or D:
A] SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
COMMENTS:
B] SY TEM CONDITIONALLY PASSES:
ne or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon
ompletion of the replacement or repair, as approved by the Board of Health, will pass.
Indicate es, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or
the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank
failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(revised 04/25/97) Page 1 of 10
DEP on the World Wide Web: http:liwww.magnet.state.ma.usldep
e'j Printed on Recycled Paper
4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection:/0—/ 7-9
B) SYSTEM CONDITIONALLY PASSES (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health)- Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four 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
C) FURT ER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
_ Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) YSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
HE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
NVIRONMENT:
The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply.
_ The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
_ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that
the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. Method used to determine distance (approximation not valid).
3) THER
(revised 04/25/97) Page 2 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 51 Brezner- Ln, Centerville'
Owner: Bryer
Date of Inspection: j(-/?_g -
DJ SYS M FAILS:
You must i dicate e,;t:er "Yes" or "No" as to each of the following:
I Ave determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for is determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the ilure.
Yes No
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded. or clogged SAS or
cesspool.
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Required pumping-more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped _.
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
El LA GE SYSTEM FAILS:
You m st indicate either "Yes" or "No" as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
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)
The o ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requir ments of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 04/25/97) Page 3 of 10
a
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: , 6. /j_cp/I
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes _ No
Pumping information was provided by the owner, occupant, or Board of Health.
✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or
as part of this inspection.
As built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
The system does not receive non-sanitary or industrial waste flow.
_ The site was inspected for signs of breakout.
_ All system components, excluding the Soil Absorption System, have been located on the site.
_ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of
baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
—The size and location of the Soil Absorption System on the site has been determined based on:
The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of
Sub-Surface Disposal System.
Existing information. Ex. Plan at B.O.H.
Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) [15.302(3)(b))
(revised 04/25/97) Page 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection:!U^!7^Ot 7
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 32 o g.p.d./bedroom for S.A.S.
Number of bedrooms: .3
Number of current residents: 0
Garbage grinder (yes or no): A-o
Laundry connected to system (yes or no):A,�.o
Seasonal use (yes or no): 1A
Water meter readings, if a ilable (last two (2) year usage (gpd):
Sump Pump (yes or no):j6:2L>
Last date of occupancy:
COM ERCIAUINDUSTRIAL:
Type establishment:
Design low: gallons/day
Grease rap present: (yes or no)_
Industr' I Waste Holding Tank present: (yes or no)_
Non- nitary waste discharged to the Title 5 system: (yes or no)_
Water eter readings, if available:
Last dat of occupancy:
OTHE • (Describe)
Last da of occupancy:
GENERAL INFORMATION
PUMPING RECORDS aid source of information:
System/p( mped as part of inspection: (yes or no)�i
If yes, volume pumped: gallons
Reason for pumping:
TYPE OF SYSTEM
Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
I/A Technology etc. Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information: O
Sewage odors detected when arriving at the site: (yes or no) 't e
(revised 04/25/97) Page 5 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: /6 —/ 7--9'7
B LX' ING SEWER:
(Locate on site plan)
Depth low grade:
Materi of construction: _cast iron _40 PVC_other (explain)
Distanc from private water supply well or suction line
Diamet r
Comm nts: (condition of joints, venting, evidence of leakage, etc.)
SEPTIC TANK:
(locate on ¢ite plan)
Depth below grade:
Material of construction: _concrete —met i I _Fiberglass _Polyethylene _other(explain)
If tank is metal, list age _ Is age confirmed by C ificate of Compliance _(Yes/No)
Dimensions:
Sludge depth:
Distance from top of sludge to bottom outlet tee or baffle:
Scum thickness:
Distance from top of scum to top outlet tee or baffle:
Distance from bottom of scum to ottom of outlet tee or baffle:
How dimensions were determine
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
GREAS TRAP:
(locate site plan)
Depth be w grade:
Material o construction: _concrete _metal _Fiberglass _Polyethylene —other(explain)
Dimensio s:
Scum chic ness:
Distance rom top of scum to top of outlet tee or baffle:
Distanc from bottom of scum to bottom of outlet tee or baffle:
Date o last pumping:
Commen s:
(recomm ndation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity evidence of leakage, etc.)
(revised 04/25/97) Page 6 of 10
d
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C .
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: /a•-L 7-13 7
TI T OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection)
(locate n site plan)
Depth low grade:
Material of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain)
Dime sions:
Capac gallons
Design f w: gallons/day
Alarm lev I: Alarm in working order_Yes; _ No
Date of p evious pumping:
Commen
(conditio of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX:/
(locate on site plan)Depth of liquid level above outlet invert:-,4& 136n\-
Comments:
(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.)
PUMP HAMBER:_
(looat on site plan)
Pum s in working order: (Yes or No)
Alarm in working order (Yes or No)
Comm ts:
(note c ndition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 04/25/97) Page 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: /b"/ I-0 1
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:_
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:Jz_1
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hyd ulic failur , level f pon ing, condition of vegetation, etc.)
O t�
Ae O
CESSPOOLS:
(locate on site plan)
Number and configuration: ` G
Depth-top of liquid to inlet invert: AJVZ 1)
Depth of solids layer: 3•--/''
Depth of scum layer: IV '
Dimensions of cesspool: 1
Materials of construction: lc e_)-� s
Indication of groundwater: /L 0
inflow (cesspool must be pumped as part of inspection) /2
Comments:
(note condition of soil, signs of hydraulic failure, level of porxding, condition of vegetation, etc.)
O A it — r La
o e cCuTv
r
PRI :_
(locate site plan)
Materials f construction: Dimensions:
Depth of olids-
Commen
(note co dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 04/25/97) Page 8 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brezner Ln, Centerville
Owner: Bryer
Date of Inspection: 60 19—Or -,7
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
� v
I
i bG�
� 0 `
9 � '
i
(revised 04/25/97) Page 9 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 51 Brez.ner Ln, Centerville
Owner: Bryer
Date of Inspection: GO—/7—q �
Depth to Groundwater Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
/
t/ Observation of Site (Abutting property, observation hole, basement sump etc.)
Determine it from local conditions
Check with local Board of health
Check FEMA Maps
Check pumping records
Check local excavators, installers
Use USGS Data
Describe in_your own vyoros how you established the High Groundwater Elevation. (Must be completed)
.5 ! W o/r l5 9 1 A-4 A- ,teaoZ G d'n- 'f.'Z�44/
Z5 ,
AW
(revised 04/25/97) Page 10 of 10
JOB NO. B01-21
NOTES Brown5.dwg Pond
1. LOCUS IS A.M. 230, PARCEL 141. St.
00
2. ELEVATIONS SHOWN ARE TOWN GIS f0.2' vc
6 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. � Brezner �
a' 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) oc
N 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. v
N BENCH MARK--TOP OF MAG. NAIL y
IN PAVEMENT= 43.93 GIS t0.2' 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. " Great Marsh Rd. c
ro 7. INLET TEE TO PROJECT DOWN 13 , OUTLET TEE DOWN 14 .
a- 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW Qc
D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET.
a. 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. NOT TO
BUILD UP COVERS TO WITHIN 1' OF GRADE. MORTAR CHIMNEYS IN PLACE. SCALE
42 ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. LOCATION MAP
10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP.
11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND,
CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC.
12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TEST HOLE 1
/� IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3).
�+ 1 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN DEPTH (inches) ELEV.(feet)
LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. 0 44.5
Z
14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS.� A layer 10yr 3/3
N E R sandy loam
BENCH MARK--S.W. CORNER OF 4 3 6 9 ` TEST HOLE DATE: December 6, 2001 (P10106) 18"
�\ P PERFORMED BY: Ron Cadillac, Soil Evaluator
CONC. PATIO= 45.80 GIS f 0.2' B layer 2.5y 5/4
� 46.6 WITNESSED BY: David W. Stanton, Inspector sandy loam
/ S\ Top Found. PERC RATE: <2 -00 /inch (C layer) 30"
��-4-2-2 6 • 4 3,9 3 SOIL SURVEY(1993): Eastchop loamy fine sand C1 layer 2.5y 6/4
4 1 44,5 / �O Line A-Invert 43.71 GEOLOGIC MAP(1986): Barnstable plain deposits sandy loam
/ , / 8 Line B-Invert 42.70 42" 41.0
N/F / Q / 4 8 NO GRADE CHANGES A-Exist. C.I. Invert 41.85
TOBIN , �� // / ARE PROPOSED B-Exist. Orangeburg Use Gas Baffle 2 DRY WELLS �, C2 layer 2.5y 6/6
W / LOT
T A 4 B Invert 41.20 56"a medium sand
/ I (6 / "/ Proposed
°�-0 0 4 5 S-min. ft Top Conc.=41.8 (trace silt)
x4 / x 4 5,2 - ,� _ (10% gravel)
6 �`' Proposed S-1/4 /ft+ S=varies Top Peastone 41.5
13 170_ S. F.
N F Invert 42.10 1500 Gal.
/ Proposed - -- - - „
4 5'8 CON N OLLY I 24 132" no water 33.5
T '... I i T
Invert 41.37 39.0
C Invert 41.00 5.5 '
p, ,� / pone 6 4/0 y0 g I 16" Stone or compact Proposed Proposed 4'3 Bottom
8 --J-A-20� I--- I I N I 3' El. 33.5
e en B 13'I B 14' 12 16, El. 34.7
f x 4 5,2 mV 4.7' USGS Adjustment
TH 1 \ 2� \�� Bottom TH1 Using MASH29-June 92
N E 4 1 \ ` 4 5 °raw, : A DESIGN DATA GroundZwaterone D--30 Town ma
\ tit d_ ( p)
BEDROOMS: 3
4 4 8\\ 'ti 4 9 < x 4 W GARBAGE GRINDER: No LEACH_-AREA
.
\ x 4 6 462 REQUIRED CAPACITY: 330 GPD USE 2 DRY WELLS SET 6' APART WITH
4 5 9 SEPTIC TANK: 1500 GAL. 3' OF STONE ALL AROUND FOR A 29' BY
X, 4 5 \4 5,4 CN "4- BOTTOM LEACHING AREA: 314.1 SF 10'-10" WIDE BY 2' DEEP LEACH AREA.
��' \ 45.7 00 In x 4 5,4 [(29' x 10.83')]
SIDE LEACHING AREA: 159.3 SF
N/F <\ ��'� L \ • 4 5 5 4 LC) N [2(10.83'+ 29') X 2' DEEP)]
FINK 4 5'1 \\��1 �� 0..:' r- 0 DESIGN CAPACITY: 350 GPD
\\ i ::. ��� 45,6 [(314.1 SF + 159.3 SF) X .74 GPD/SF]
S z �
RUN SCH 40 BACK TO CAST �� u
i
IRON PIPE, IF POSSIBLE. O° x
�6 2
LINE APPEARS TO GO UNDER 'PJ 47, 4 6,0 p
STEP. PITCH IS ALMOST
FLAT IN EXISTING LINE, 'PO'�
IMPROVE PITCH, IF 47,4
i
POSSIBLE:
47.7
x 45,7
1
N/F 5,9 N/F SITE PLAN
LEWSEN ROSS FOR
LEGEND THIS PLAN IS A VALID COPY ONLY IF IT BEARS
AN ORIGINAL RED STAMP AND SIGNATURE. DANIEL E. & MURIEL S. BROWN
TH 1 TEST HOLE LOCATION, NUMBER e13EC
��✓ WATER LINE MARKINGS 1 Mqs .. ,��� OF LOT 569 51 BREZN ER LANE, CEN TER VI LLE, MA r sq ,\
E OVERHEAD ELECTRIC WIRES (IF SHOWN) Boa RONAL ti��`�, �' » �
G GAS LINE MARKINGS ` i�c�NAL® N FEBRUARY 8, 2002 SCALE: 1 =20 JAMS � �� JAMS
CADIL CA! L°
x 9.5 X 8.7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) 1
Q OX
EXISTING CONTOUR SG�STE�
l Fs;,t
8- PROPOSED CONTOUR '= W°suVRa � RONALD J. CADILLAC, PLS,' RS
UTILITY POLE (IF SHOWN) 2- PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN
EXISTING DRAINAGE CATCH BASIN P.O. BOX 258
x FENCE (IF SHOWN, NOT ALL SHOWN) WEST YARMOUTH, MA 02673
TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE (508) 775-9700
C 2002 BY R.J. CADILLAC PAGE 1 OF 1
V
I