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HomeMy WebLinkAbout0062 BRIDGET'S PATH - Health ,62 Bridget's Path Centerville A= 170—240 S M E A D No. 7-153M.OR UPC 12534 smead.com • Made in USA jacvc4 u. r TOWN OF BARNSTABLE OCATION &�r/06:V�71P 400�47-f" SEWAGE#J®may 0,7 VILLAGE ASSESSOR'S MAP.&PARCEL-10>® -� �® INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY i�'�/�' 'F "0 o O LEACHING FACILITY.(type) eo—4-A e1-7e W,44Y,�%y,r(size) NO.OF BEDROOMS 3 OWNER Z PERMIT DATE: . COMPLIANCE DATE: Separation Distance Between the: hs® ✓,�ly�� P� , Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /-I Feet Private Water Supply Well and Leaching Facility(If any wells exist orr 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 V >,00,- �exx C �00 ® , 3 /—ao -�— cx / EFDI I gL /#.10 D-,dial 1 q I No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ptlYitation for 33isposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. ['-7 476P/�d!r-*,7-' Gci47-11 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. y. (T//Yf G L��OLP L//r�'� /�� ??3'0?�7 ��-,-/.b Type of Building: Dwelling No.of Bedrooms -2; Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 41-0 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .3' ---$ O gpd Design flow provided ��� gpd Plan Date -/9 /� Number of sheets / Revision Date Title Size of Septic Tank -_'X1 ��''G Type of S.A.S. Description of Soil 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 the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board op4cflth. Signed 14Date 7 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. U Date Issued - I��,�,1 No. a r 1'+, = i Fee I//Co Fee THE COMMONWt'&TMgF MASSACHUSETTS ; Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 21pplication for Vspos4l �6pstrm Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) [:]Complete System Individual Components Location Address or Lot No. d a 49GP40e--, .l► (4i f ri% Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /, G - J 0149 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building &�;V 4-�,P No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 G gpd Design flow provided 30,- 9 gpd Plan Date Number of sheets / Revision Date !;a Title Size of Septic Tank ce-Xi J'i��''G /n m a Type of S.A.S. dr;74e Description of Soil cJ-e-e- 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 the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of lth. Signed n Date Application Approved by �z- Date 3 - Application Disapproved by Date for the following reasons Permit No. '9 U f L - 0 Date Issued.,_ Th E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(,/,�Upgraded( ) Abandoned( )by OJ'W zewae of J ��G `r`G at ej ��1--P64 ,P l.Pi4 has been constructed in accordance - q with the provisions of Title 5 and the for Disposal System Construction Permit No. .20/Lj -070dated 3 Installer l3,:" n'! — Designer d�i'/l7 �'•j.Yl�.!'oy"' �'+J'. #bedrooms Approved design flow .39 J n/ . gpd r / � The issuance of this permit shall ZM4- Inspector �f be construed as a guarantee that the system will;function as designed. L/// i U 0 Date -7_•� i�� / r No.� � i - ��U Fee �vV THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at �<of ec�r� ���/� e',.—_77 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit,--- Date 3 l Approved by MAR/19/2014/WED 07:47 AM FAX No, P• 001/001 Town of Barnstable • op T �°.� Regulatory Services Richard V. Seah,luterim Director 9� M Public Health Division Thomas McKAxn,Director 200 Main Street,Hyannis,1VIA 02601 Office, 508-862-4644 Fax: 508-790-6304 r bstaller&Desloer Certification Form Date: qI. Sewage 'er'rni�t#�o/Si OHO Assessors 1�iXaplarcEl Desiper: 11f] w"ur ctill Installer: TPM v 'F tw:!�&L Address: 1�5. �11�(A`) .Address: H 1vv T, pn —/� TM ,vas issued a permit to install a (date) (installer) septic system at �Z � based on a design draw�a by �A� �( *R, (a dress) t1r4� dated (designex) certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocatioia of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than. IQ' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Reguladoias. Plazr revision or certified as-built by designer to follow. Strip out(if requited) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in co "ance with the terms of the I\A approval letters (if applicable) DAViD , � a B. G tk l`�1�5� (Installer 5 Sip e) �fo.1066 (3t AY i kph° (Desi®a r s Signature) (Afffx Des' p Here) �k = PLEASE PIE RN TO BA.RNSTABLE PUBLIC BEALTR DMSION. CERTVICATE OF COIYIPLL�NCE ALL N®'T BE ISSUED U14731 BOTH THIS FORM AND AS•- B 'l~ CARD A RECE�IED TY THE BARNSTA13LE PUBLIC MALTH D ION, THANK YOU, QAScptic\Dcsiper ccitMcation Fom Rcv 8'-14-13.doc Vif Town of Barnstable r# ' Department of Regulatory Services R��LK Public Health Division Date Q� �A rs39 200 Main Street,Hyannis MA 02601 d Date Scheduled_ Time Fee I'd. Soil Suitability Assessmentfor Se e Ibis os c Performed By: ��y �,�f0 Al � Q/ Witnessed By: /" 1 ]LOCATION& GENERAL INEORMATIOlN Location Address ��.�($�+�/}�C�a/� �,V7,f, Owner's Name<tGe-'W+'_��r'� Address Assessor's Map/Parcel/,>SX.1 Engineer's Name�/%d'/�s�/f1���� ✓� cT/'mil NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&c perc tests,locate wetlands in proximity to holes) - �V LAJ LV rTV Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Pace Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In, Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment f[. Index Well# Reading Date. Index Well level _ Adj,factor- Adj.(Iroundwater Level PERCOLATION TESL' ]bate_._ Time Observation Hole# Time at h" Depth of Perc Time at 6" Start Pre-soak Time @ 'Time(9"-6") End Pre-soak Rate Min./luch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORKDOC -- 1 DEE,ROBSERVATION MOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling _ g (Stnucture,Stones;Boulders. onsistency.%Gravel) DEEP,OBSEIIVATION DOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistency,%Gravel) DEEP OBSERVATION HOLE LOG Bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muusell) Mottling (Structure,Stones,Boulders. Consistencv.%O e i DEEP OBSERVATION HOLE LOG Mole# r' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, d Flood Insurance Date Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No= Yes ' Within 100 year flood boundary No._ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _— If not,what is the depth of naturally occurring pervious material? __�____ Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis waa performed by me consistent with . the required training,expertise and experience described in 10 CMR 15.017. Signature Date Q:WEPTIC%PERCFORM.DOC i Town of Barnstable P# ~ Department of Regulatory Services V BARNWABIZ Public Health Division Date KAM 059. 200 Main Street,Hyannis MA 02601 FD Mld� Date Scheduled Time Fee Pd. ---���'''���S,�o��_il Sui'ttaaabili ��A(�!/ssess ent for Sewage Disp�(/A��•�gQ}al Performed By ��/�/i ���� / Witnessed By `��r �7 LOCATION�&yGEN 'I'`t INFORMATION Location Address Owner's Name I �y Address Assessor's Map/Parcel: ` I Z��/ Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area It Drinking Water Well It Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) �Z Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date Time Observation Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time Q I Time(9"-6") End Pre-soak Rate MinAnch r Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC C �H f � :. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel (�-- In A,r /D i 0s DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) Flood Insurance Rate Map: 0 Above 500 year flood boundary No. /Yes l� Within 500 year boundary No ✓ Yes Within 100 year flood boundary No_ Yes_ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pery o Wienal exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of n lly occurring perfious material? 411 Certification ``^^ I certify that on W (date)I have passed the soil evaluator examination approved by the Department of Enviro ental Protection and that Ihe above analysis waWplerfied me consistent with the g,expertis de e nc a ed in 310 CMR 15Signa Date U, Q:\SEPTIC\PERCFORM.DOC Commonwealth of Massachusetts R. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address _Nancy C. Munn Owner Owner's Name information is required for Centerville MA 02632 August 3, 2007 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your David D. Coughanowr cursor-do not Name of Inspector use the return key. Eco-Tech Environmental Company Name 43 Triangle Circle Company Address Sandwich MA 02563 City/Town State Zip Code 508 364-0894 1328 Telephone Number License Number c � B. Certification =;ry t< . I certify that I have personally inspected the sewage disposal system at this address and_that tl.e information reported below is true, accurate and complete as of the time of theinspection. The inspection was performed based on my training and experience in the proper function andE aintenance 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 ❑ Fail ❑ Needs Further Evaluation by the Local Approving Authority Iml CL an, P—S 'August 3, 2007 Inspector's Signature Date P.EVrIsed Sep+ (0, Z007 The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. for revis'cew Me er-t-o be4r©owl c00nt 0h pate 7 t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pa 1 of 15 a Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is required for Centerville MA 02632 August 3, 2007 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 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: Inspector's Note==> Aseptic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. 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. Answer yes, no or not determined (Y, N, ND) in the ❑ 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. ND Explain: ❑ 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 ❑ obstruction is removed t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is required for Centerville MA 02632 August 3, 2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: 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 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. t5-pass.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is g required for Centerville MA 02632 August 3 2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 ❑ ® 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. t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,. 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3 2007 required for 9 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cunt.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w„ 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3, 2007 required for every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? outlet only ® ❑ 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)] t5-pass.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is g required for Centerville MA 02632 August 3 2007 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: 3 Number of bedrooms (design): 4va. Number of bedrooms (actual): 24AS QPq DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 51 gpd Sump pump? ❑ Yes ® No Last date of occupancy: currentDate 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: Last date of occupancy/use: Date Other(describe): - - t5-pass.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3, 2007 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Owner 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Age: 28+years. Certificate of compliance issued 12111178(Board of Health files). Were sewage odors detected when arriving at the site? ❑ Yes ® No t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form I we Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is g required for Centerville MA 02632 August 3 2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2feet 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.): Sewer appears structurally sound with no evidence of backup or leakage into dwelling Septic Tank (locate on site plan): 1 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: 8.5 ft x 5 ft x 5 ft(1000 gallon) Sludge depth: 15 in Distance from top of sludge to bottom of outlet tee or baffle 19 in Scum thickness 2 in Distance from top of scum to top of outlet tee or baffle 9 in Distance from bottom of scum to bottom of outlet tee or baffle 13 in How were dimensions determined? Probe to top of tank t5-pass.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3, 2007 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping is recommended at this time and maintenance pumping is recommended every two years. Tank and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was observed. Inlet cover is under deck and cannot be accessed. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: concrete metal fiberglasspolyethylene ❑ other(explain): ❑ ❑ ❑ 9 ❑ t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3 2007 required for g every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert At outlet invent Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box appears structurally sound with no evidence of leakage in or out. Some solids in sump. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is required for Centerville MA 02632 August 3, 2007 every page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soils above leaching pit appeared unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. A bucket of water was poured into the distribution box and was observed to pass through in a rapid and unobstructed manner, and could be heard splashing down loudly into the leach pit. 6-pass.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3, 2007 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name MA 02632 August 3, 2007 information is Centerville required for City/Town State Zip Code Date of Inspection every page. D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or the building.benchmarks.nchmarks. Locate all wells within 100 feet. Locate where public water supply enters LOCATIONS A J�E- jt62 1 24.5 fL 44LEPACH 2 2� �t 8O2❑ O-BOX SEPTIC TANK o EXISTING DWELLING W _Z J w W F- 3) BRIDGET ' S P /�TH NOT TO SCALE Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 t5-pass.doc•08106 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Bridget's Path Property Address Nancy C. Munn Owner Owner's Name information is Centerville MA 02632 August 3, 2007 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 15+ Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: Barnstable G/S Department records You must describe how you established the high ground water elevation: Town of Barnstable GIS Department records indicate that the property is over 15 feet above groundwater table. t5-pass.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Town of Barnstable �pF THE Tp� Regulatory Services QL,AR,,S,ABLE ; Thomas F. Geiler, Director 9oAlF�p � Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. LO C AT 10N S WAGE PERMIT N0. VILLAGE ' 1 INSTA LLER'S • NAME i ADDRESS ,J B UILDE1R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED .g� �1 �A--c 1 ell No.............. ..o. �,. Fm:z....2:::f`.Zisposal THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTHTw y �: 0F�.....1. . .. .�-�. . - ,ale Appliration for 11iipngal Work,6 Towitrurtiun rruti# Application is hereby made for a Permit to Construct (/ or Repair ( ) an Individual Sewage System at tiA5r> � �� A, 7 Oat .. e� 77 a����� Ll� �................v ........... -- . ......... ....•-----------..............----............ - ..................................................---------------........_ / twn-Address Lot No ���y� u Owner Ad r 002 a _ --------------------------------------------------- ..... ------------ Installer Address Type of Building Size Lot. ?_`------Sq. feet aDwelling—No. of Bedrooms....____....................................Expansion Attic Garbage Grinder (/ e, p-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other Mures -------------------------•------ . W Design Flow...........�....................gallons per person er7 day Total daily, flow....... _.. _��..__.___._______....._gallons. WSeptic Tank—Liquid capacity Pgallons Length.. ! Width------ Diameter................ Depth.._ _........ x Disposal Trench—No_____________________ Width_.,................ Total Length.._....___.y....... Total leaching area....................sq. ft. Seepage Pit No......./----------- Diameter.._-_____.._. Depth below inlet.._�___________�Tota11 leaching area_�d.�...sq. ft. Other Distribution box (�) Dosing tank© �`� ` Gt ~' Percolation Test Results Performed b .... .__�. i� _.__.._ ._ Date...._f. ' �'_t1,�� ..._.... Y 3-------------•- . Test Pit No. 1----- ......minutes per inch Depth of Test .............._ Depth to ground water.... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R' --------- ------ --- -------....... ------.....-_ ODescription of Soil----------------------;al...'�.... ..... d 1 -�.......... ..�'----------------------•- - U ---•-------•---•---•--------••••••-•------•-----------------••-----------------•---...----------------------••-••-•-----•-----•----•--••-----•-•-----------••--•••--------...--••-••-------------•----- W -----------•-----------------------•---------•-----------------------------•--------------------•-••--------••-------•--.......-------•-----------------------•-•-----------....----------------.....--- UNature of Repairs or Alterations—Answer when applicable............................................................................................... •---------------------------------••-----------•----------•------------------------.....--------------••---•---------------------------------••----------------...------------------------------_-•---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with F the provisions of iITT,:. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by of health. Sign d --- -•---- �" '7..�_`_ '/. rr Date ------.(Z -7 -- Application Approved By-- _� Application Disapproved for the following reasons:................................................................................................................ --••------•--....----•-------------------••-•---------------•------...----•---------------------------•---------••---------•-•--•--------------•-----------------••-•--•---------------•--------------- �� Date Permit No......................................................... Issued_.....f ---..- .J .............. . -----....... Date J 3 No........... • - ---- Fmi............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....--.. ..�..�-'..�..-----....OF...-.. �„�.Q...k':..1.7..3..�.G..h_/ .....------------------------- Appliraiion for Dispvii al Works Tutuitrur#ion 1hruttt Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: ......o .......... - ---------------------------- ----- -------------------- -----------------------------....----._._...... --- / -- tion-Address // r Lot No. op - .... ----•---- _--- -- ------ _..-----• .............................. owner + A_________ W ++ � a ---------- -- ------------------------------------------------- --- ...9 ... Installer Address Type of Building Size Lot .......e__0 1_____-Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( c� aOther—Type of Building ............................ No. of persons................. -------- Showers ( ) — Cafeteria ( ) de Other fi to es ---•--•----•--•--•----••-••-•--• --•------------------ ----------------- W Design Flow___...__..��....._.............../ gallons per person e;lw� Total daily flow.............�.�p ...................... ions. WSeptic Tank—Liquid capacity/0-.--gallons Length...-Ft+..�-_._ Width...-Nj-•........ Diameter________________ Depth._ ........ x Disposal Trench—No..................... Width ....... Total Length..........y........ Total leaching area o.. ....sq. ft. Seepage Pit No.__.__1...._._.__.. Diameter..8.•-.-__----. Deptl below inlet___ ?..., ! o ea i g rea..................sq. ft. z Other Distribution box (! ) Dosing ank ) ~' Percolation Test Result Performed by..._ �_. o» + __r____________________ Date___- % ____ _... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-__-______---__-. ' (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ............ .............I,t D Description of Soil---------------------- M -`3--.�-'..-GG .....�-- �--�•-•-------------------•---•-•----......-•------------- W ---•-•-•-•--•---------------•------•----------.....---•--••-----•-------•-------._._.....•-••--.....------------••---•-----------------•-----•-•---•-•--••-•----•....._.........._.....-----------_..... UNature of Repairs or Alterations—Answer when applicable............................................................................................... l Agreement: t The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions c T I T 11Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certifica.te,of Compliance has b n issued b Vie--b-( of health. Si --. - - ----------- e ?!�'.--�.._..--•--•----....... ......�� - Y Application/Approved B Date Application Disapproved for the following reasons------------------•---------.....-----------------------------------------------------------------.....--------- -----------------------------------------------------•-•-•-----=-----------------=------....------------.................................................................-..................-......... Date PermitNo.........................'-==-•----------••.............. Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O'R HEALTH > .......................................... ..................................................................................... %vrtifiratp 8 bout It- aurr .. T �SYiu e gees .t .. t, c s or O by - _-_W.---•- -•--- -- "� t ' Installer at-------- ------••----------------------.....---......•--••---••-----•--•----•:.:.:: has been installed in accordance with the,provisions o Fr+ �The State Sanitary f� �as#scribed in the application for Disposal Works Construction Permit 1 dated-_.---- ..................................... THE ISSUANCE OF THIS CERTIFICATE SFJALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY."K. DATE................... -------............................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS— - BOARD H T1 0 :P .... . ► ....................................O F..:...............................ti...........................................-. -._....• No......................... FEE........................ r,� tt r o ttr##Wit rrutit Permiss�t�is'hereby gra ed._. ....._..A...... ..........•-=.-- :._.....--- • �. :.{.._.... to Co>Zst} t e a' ' Zen 1 $e at No (((���rr ..................................... treet �. ""�� as shown on the application for Disposal Works Consfructio mit o Dated.......................................... foard o t DATE.......... ._... __... h• FORM 1255 HOBBS & WARREN, INC., PUBLISHERS a ko; ' i :-. .. ., .,-'_ / -, a• - s_ t ��{\/� ^yr�•'y 4/ ., ! /7J, -5 /5 0 i' F ... ,,�rf, �1'/'7},rt yatr+'• _ _. i� E `1,,: '� //�'�y .��'t �GI �Jy� 4.:.+•�!` ,/J *. •, ,' " - - � •�� •+ _ P - L , - , q '�1Y4 �`�.1• �' �i�. 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"' k 2 ; F , y 4•n�'FM1 • , •- r , '' ��•. � ,FRANK W CONERY FRANK' No..6232 C CONERt�' �. Na.6573 0 ° _ MA , . � {� ' ,^- '. . . �. _ — gar • > . . ��' � � � • � .�:.. - - ; _ r ^ PLAN ofr 'LA ND • � ,.T'+" ',�•_ �•?_'�;!•�• ..e.•.. .f� r+.. � - ,W„"�p,: '�..•..• ♦,�', i.- N - - rr'-ow M • - , {,,,�.„+�. '4a�S .,u 41 d.'''<:I,}�,' ,n' .:�' ^�: "�,.R�++ ,.u. s ' A.:� r y N ., - • - ... T ..�. ;- .,v,:ji. •; »,l�r}. 'eR•. �..'/t,'pw '•br-: �,+.'.,rN'=� '•ify�-r�}� .,.r" ra -;t �v�-.M. riJ ,Y .. .. ^r. n..• w- ',..• ,• "',\.a:a`Fc_ `i:,'4y .° C' i ..•I - _- , r �4,�G ,*' d`� j. . K ry .- fy, i ��'I'W��,f�Vq .`•A��/1'�iiM��• i.',,r. .ram* -V -� r � •REdtt'1'lJ��D .��ti6'�.R�sdt t.`ANDSU�iVEYQ1Yl, � + ,�. y q SCALE I IN -2D FT. ///a'0176 V - i I I i ASSESSORS MAP : - I PARCEL : __-_ _.._._.�__M,�_.�_�,____.____._ .......___�.�. TEST S � ✓ T HOLE LOGS u __ __, . _. 1) 'fhe install, Hoil shall conji,;, witli 'Fitle V and 'Fawn of? � loard ol. FLODU/'ZONE. u_...._ .._,_._ ._. _ v n�._... ..., SOIL EVALUATOR ,V( I lealth IZegulatioiis. .-� REFERENCE: -° WITNESS 1 I�.(tti tb 1 2) The installer shall verily the location of utilities, sewer inverts and septic ��t f DATE: �•�, ' _ � components prior to installation and selling base elevations. PERCOLATION RATE: C 2m q � 3) All gravity septic piping to be 4 inch Sell 40 PVC at 1/8" per loot. The first two feet out of the d-box to the leaching shall be level. 4) 'This plan is not to be utilized for property line delerurination nor any other / TH- I " I TN-2 purpose other than the proposed system installation. 5) All septic components must meet'fitle V specifications. I 6) Parking shall not be constructed over 1110 septic components. 8 7) 'I'lie property is bounded by property corners and properly lines. LOCATION MAP tD 8) '1'lie property owner sliall review design considerations to approve of total design flow and number of bedroorns to be considered for design. Receipt of payment for the plan and installation based oilthe plan shall be deemed approval of the design flow by the ow-ner. 9) `1•lie existing leaching or cesspools sliall be pumped and filled with material per Title V abandonment procedures. '1•hose within the proposed SAS shall {� be removed along with contaminated soil and replaced with clean sand per Q Q �oV Title V specs. - 10)System components to be`10 feet from writer Brie. Sewer Iines crossing lire I • r,r ,rLj z� wafer lute shall be sleeved with 4 loch SCI 140 PVC with ends grouted if applicable. 'The proposed SAS is being installed below the water service . line. The line is to be sleeved as aforementioned and maintained irr place. 10 kid S E `I- I`C- S YS -I EM D _ 11) Ifa garbage grinder exists it is to be removed and is the responsibility of the C ! GN ' 0 owner to ensure such. / FLOW ESTIMATE 12) The installer is to take caution in excavation around the gas lure if such exists. I I l I 13)'fhe installer shall verify the location, quantity and elevation of the sewer r � , � � BEDROOMS �",T 'GAL/DAY/BEDROOM -` GAL/DAY lines exiting the dwelling prior to the installation. - 14 T plan is representative only that a system can fit or P p Yh Y r a property meeting SEPTIC TANK ) his t I I I Title V requirements. Lo I_C) �� GAL/DAY x 2 DAIS GAL I '` USE ICE GALLON SEPTIC TANK I tU'T_ _ g E / p }aL 1r 3 K9 I 'ON Y A SIDE AREA: I2t,?t ? " / Z ` BOTTOM AREA: _ . .. . I _„a.` 1 � �. �`' lid •`` � ` C SYSTEM SECTION J% i.ID Cm ' 1 O - .. �I� GALJ.�SEPTIC TANIt U)G ?° ° r1 7,16 31TE AND SEWAGE PLAN LO;CAT I ON A 4�5� PREPARED FOR : _�DWA ° 0. SCALE• �rr% b DAV I D` B . MASON75 DATE: ►D � DBC ENVIRONMENTAL DESIGNS W EAST SANDWICH . MA Z DATE I HEALTH AGENT ( 508 ) 833- 2177