HomeMy WebLinkAbout0319 BUCKSKIN PATH - Health '319 Buckskin Path.
Centerville P
A = 171 028
ECYCLFD
UPC 12534 �
No. 2 153LOR
HASSTINGS. UN
No. ?,007— 1 b-5 4 Fee 1 0 /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: (/
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Tipprication for �Digooar *pgtem Con0truction Verna
Application for a Permit to Construct( ) Repair(Af-Upgrade(4�—Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3/g O ner's Name,Address,and Tel.No. /-
C�hrri�:/�/�
Assessor's Map/Parcel.
�a8 a8-3G2 Installer's N el Address and Tel.No. Designer's Name,Address and Tel.No..s
�aje_�T X 0,;wa�5 0,jfr214 K9�/ye4
31 /y W-G /&
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when pplicable) �y g� '1 -,lll'D Gq/
-W"T�i Y"_5, ot9r 1} 7 2-•
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of.
Compliance has been issued by this Board of Health`.
Signed / Date
Application Approved by Date S-Lf`0 7
Application Disapproved by: Date
for the following reasons
Permit No. o,0-0 7 — IVS Date Issued ' - 0-7
aDU7 - I V� '�-y* t 'Atwi No. 9 ,�� ' Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Miopooal 6pg;tem Construction Permit '
Application for a Permit to Construct O Repair(A-r Upgrade(4-)r Abandon O ❑Complete System ❑Individual Components
Location Address or Lot No.3/y �UG,�S/�ih f7/�1'Gl O ner's Name,Address,and Tel.No.
Scab cros&y
Assessor's Map/Parcel
p
/9 �S
s08-?go-'l7s�
SAAV
Installer's Name,Address and Tel.No. Designer's Name,Address and Tel.No.�a8-3G2
Clv�'r� /2c/ arsP'ohSI /_=gas/
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( )
Other ' Type of Building No.of Persons Showers( ) Cafeteria( ) =
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer whe/''applicable) Zystr!1I� 2 d0 l� 69GG� / �1its`ji=ys
r' 2�' /VC14
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed � -�l I/ Date 0 7
Application Approved by ! - Date S'L'-C) -7
Application Disapproved by: Date
for the following reasons
Permit No. a� 7 — Date Issued S ' L-1 " O
i —
——————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIIFY,that the On-site Sewage Disposal System Constructed (e---) Repaired Upgraded ( )
Abandoned( )by /Gt.St!I Z2-. 9,,4 ,lnGf
at /3416IC5/C-/G7 /014T4 CIC-OrI f 1//11ia has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. rg a 0- 1 8 S dated ' L-/ ` D 7
Installer c/D.IGp/ �i /��7iy'a 5 Designer Pwety_=`J
#bedrooms Approved design flow
The issuanp&Of this permit shall not be construed as a guarantee that the systemW
s designed.
Date /� / Inspector �fl'' 11 ,
———————xr — --- -- --- /'-- — � /
No. .-
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
igogaY 6pgtetn Con5tructionernYit
Permission is hereby granted to Construct ( Re
air ( ) Upgrade (c_) Abandon ( )
System located atwG�Gf'/C/", pwT-i
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of th�i_s_Rern.it:
Date � " t'j � � Approved by
(,� r
v
r b
Town of Barnstable
EVE Regulatory Services
. ; Thomas F. Geiler,Director
1639.
MAW Public Health Division '
Thomas McKean, Director
0 Main Street,Hyannis,NIA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
d�J Date: ' �? �� Sewage Permit# Assessor's Ma \Parcel /' '- af�'
P a� �i
Designer: I _M _11Ne_Y1_ Installer: ( 014 � ,w-eas,
Address: -( Address:AAA
dl��rsrvy.4 ��//f
On _,-- t/^O �DS,,t5V 42, was issued a permit to install a
(date) (installer) /
septic system at &zek '.4i� based on a design drawn by
g (address)
dated
(designer)
1� I certify that the septic system referenced above was installed substantially according to ,
the design, which may include minor approved changes such as lateral relocation of the
distribution box an&or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
Ureater than 10' lateral relocation of the SAS or any vertical re f any component
of the septic system) but in accordance with State & Local tiDDQ -an rev inn or
certified as-built by designer to follow.
DAR E �N
o . ER
1140
�— (Installer's Signature) GlsTF��`�
\ L S'9NITAR\P� Q
l
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARN )BLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE l ED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q: Health/Septic/Designer Certification Form 3-26-0¢doc
J
r
Town of Barnstable P#_Vg
Department of Regulatory Services
Public Health Division Date 3- 3- -7
f61¢ 200 Main Street,Hyannis MA 02601
EED r'
Date Scheduled 1"""" �— , C 67 Time Fee Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address 31p �u_LS�'u TI_ Owner's Name `5-Co—t -CrVSb�
Ce 1n 1 CAV�1` �� 11 564rt— k C r
Ch
Address Gas-64 C� — tss/
Assessor's Map/Parcel: j 7//O;R a Engineer's Name Z)o; c / JCM
NEW CONSTRUCTION REPAIR Telephone# 7&/'1161y —6?/{t9
Land Use Rejc�,i Slopes(4'0) Surface Stones
Distances from: Open Water Body ft Possible Wet Area ?%ft Drinking Water Well eft
Drainage Way l®� ft Property Line t ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands 1n proximity to holes)
SE_ ge P16-
_Wc�_3
d&W 9-fp_ 11 F, 7-OD�
C'la611',l bU/a' A S Depth /vL�
Parent material(geologic) � J1 P l
Depth to Groundwater. Standing Water in Hole: N G A Weeping from Pit Face v/A
Estimated Seasonal High Groundwater
DETERNIINATION 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 _ B•
Index Well# Reading Date: Index Well level— Adj.factor K Adj,Groundwater Level Ts
1 f
PERCOLATION TEST bite Thne
Observation - �
Hole# _ Time at 4"
Depth of Perc Time at 6" _
—rvo oq-
Start Pre-soak Time @ lewC_ 'TSme(9"-6") ---
End Pre-soak. A-1
Rate Min./Inch
Site Suitability Assessment: Site Passed Sitc Failed: Additional Testing Needed(YIN)
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:XSEPTICVERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Cons stency.% ravel
VM4
37�-7q�� �I vim--Nle.�-Sa 2.S ��Wl-IIg'' G Sips L o" /oY,e 6/d`9 713
DEEP OBSERVATION HOLE LOG Hole# _
Depth from . Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
' Consi ten % ravel)
16 t Loa
Sritnd R fj> N t4 wl Asst,�
Y36 I'1'Icssrv� a��
�i
(5 fixe-Jul - a�rl a15/y/ . `oosc rG�wv/AV
g�'' C �t' Cv y / Rb/ s 6
9 Gwv4_
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) SDA) (Munsell) Mottling (Structure,Stones,Boulders.
Con i to c o G veI
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones;Boulders.
Cnsitn I
Flood Insurance Rate Mau:
Above 500 year flood boundary No Y_ Yes
Within 500 year bounda YN No/ Yes
Within 100 year flood1boundary No Yes
Depth of Naturally Occurrine Pervious Material
Does at least four feet of naturally occurring perv'ous 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 Q
I certify that on (0 9. (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the requir in' g,expertise and experience described in 310 CMR 15.017.
�-
Signature� Date
Q:1S.EPTICVERCFORM.DOC
1
flo�-E :down cape enaineerin4 inc FAX NO. :15083629860 Aor. 06 2007 01-4
- :vr=care engineering, inc. SIEVE SOILS ANALYSIS 319 buckskin.xis
IiA I E Or REPORT: 4I6/07
JOB : GRAIN SIZE ANALYSIS-SIEVE TEST FOR DARREN MEYER
SITE: #393 BUCKSKIN PATH, CENTERVILLE, MA
LOCATION: TH1
SIEVE ANALYSIS Weight Sample(Grams): 747.5
SIZE RETAINED WT. RET. %RETAINED: o PASSED
(sum) _
------ --------- --- 0.0-----------0.0%; 100_0%
314" ------ ------ ------ 0.0"'------- -0.0°%: -------------100.0%°
1i2"-_ 0 0----------0.0°'/0:----------- 10U.0%
3/8 �_i— -------
0.0 0.0-----------0.0%;--------------100.0%
10 ------- ------------- 45_4 45.4 --- -6.1%:~ _ "_-------93.9'k
0 183.1 228.5 30.6%� 69.4%
------------- ------------------- — --.—�
0 352.0 580.5 77.7%; 22.3%
80--------v------------146 7 727.2__-------97.3%�-------------- -2:7%
- -LO-N-�:
- —_ -------— 16_3 743.5--------99.5"/0:--------------- 0.5%
4 0 747.5 100.0%;---------------- 0.0%
E- --------- -747 -
NOTE: TEST ON PASSING#4 ONLY,7%RETAINED ON#4<45%O.K.
RESULTS:
SOIL CLASSIFIED AS AASHTO A-3(GRANULAR,SAND)(UNCOMPACTED)
PERCENTAGE OF MATERIAL PASSING 04 SIEVE MEETS:
#4 100% (TEST ONLY MATERIAL PASSING#4)
#5010%-100%
#100 0%-20%
#200 0%-5%
REQUIREMENT FOR"FILL"IN TITLE 5. �NaF rtr
<5%PASSING#200 SIEVE icy
DANIEL A. cs
RESULTS:PERMEABLE MATERIAL-CLASS 1<5 MINJIN.MATERIAL u O CIVIL Cn
t°a
NONCOMPACTED No.46502
SOIL DESCRIPTION:MEDIUM COARSE SAND
n / TOWN OFBARNSTABLE �►
LOCATION P,4 / SEWAGE # 2 00 7--193—
VILLAGE ` �tNfFrV1111G= ASSESSOR'S MAP & LOT 171- OZ9'
INSTALLER'S NAME&PHONE NO._S 08-5120-97.38 Js�P� O1 I.,,,,5
SEPTIC TANK CAPACITY 1000 /
LEACHING FACILITY. (type) 2- ,S'd0 e61 WA-1 " (size) /3 X 2.:r'
NO, OF BEDROOMS � n L
BUILDER OR OWNER 14M!!GS r/.14C'GG�C
PERMIT DATE: S ' -O 7 COMPLIANCE DATE: S"-I 'O 7 f
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 leachin faciili ) Feet
Furnished by
S '
., �
�.d.IS
,� . .
��'
• - P
39� �S, ��
yr
No......................... FER..✓.........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ .. .._........................OF.........................................................................................
Appliratiuu -fur 15i.ipuiitt1 Workii Tumtrurtiuu Vrruiff
Application is hereby made for a Permit to Construct ( ) or Repair
p( ) an Individual Sewage Disposal
System at:
--------'---- c-� ....- ,.............. ......•••--•.....-•-•---•••••-••••••........-•-•-----------•--•-•-••..................••••-
`e• ation•Address -• or Lot No.
AA
------•--- /�•'��
................
AA,11AM
Owner ddre s
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
per, Other—Type of Building ._--._-__-________________ No. of persons............................ Showers ( ) — Cafeteria ( )
A' Other fixtures ----- ------------------------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth..--_-.__.__--.
x Disposal Trench? Width Total Length
leaching
g1 q
Seepage Pit No __ _ � D_________ iameter_( YDe t below inlet leachigirea. _.__......____.sc• it.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date-----------------------------------------
Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...-._--._--___.__.__.-.
(� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-----------._-_-____----
a ----------------------------------•----•-•-------------------------•---•---------------•-----------•--------------•--•------•-•--------•--------------•-----
ODescription of Soil----------------------------------------------------------------..........................------•-•-------------------•---•-----------------------••-------------------
x
U -------------------------•-----••-------------------------_------•-----------•-•----.--------------_---------------------•-------------------------------------------- ---•-------------•--
-•--•-•---------------------- --------------••----•----•---------------------- '
'• �f} -
V Nature of Repairs o 1 ions—Answer when applicable.-��1�_----- ?✓----- - -®` ...,tvy,1-�-- ----------- ..
•------------ --------
Agreement: �' a
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article NI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b- sued by the boar of_.P'.
.
Date
��l...z_ _�/
Application Approved By------, --------------- - ----- f 4----- ----------------------------- :.`3......
�...._
Date
Application Disapproved for the following reasons---------------•---- ------------•-------------•---_.-..------•-----------_-------------------------------......
---...-•-•-•--•-------••-•-•--------------•--.--......------------------ --------•--•----------------•-•---------------------------------------•---••--------------------------------•.-----------------
Date
PermitNo......................................................... Issued................... ................................
Datete
�G 1 f o :il .. t°►
No.....���.... --.... ....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_. ............OF...................................... ...................................
...........
Appliration -for Uhipaoal Works Cnonutrurtion V.ermit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
Location-Address or Lot No.
,+.� //A.�AA a_
.....IyOwner ddre"
� J
do .-+�- �- .' .h �i� -2 ` °�.... 'u.-.......'--------------•-. v..,t .---
Installer Address
UType of Building Size Lot----------------------------Sq. feet
.-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a4Other fixtures -----------------------------------------------------------------------------------------------------------------------------------------------------
W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacity------------gallons Length________________ Width................ Diameter------.--------. Depth.-_--___-------
x Disposal Trench—No...__.._...A -------
Width-------------------- Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.1-r"-Itiameter._L_.14.�._.. Depth below inlet____________________ Total leaching area---------------_sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by------------- -----•- ---------------------------------------------------- Date---------------------•-•--------------..
Test Pit No. I................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water-..----..---------..-.--
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---_..____--.-__----....
n: -----------•-----------------------------------•---.....................................................•------------------•------•---------------•---•-----
ODescription of Soil......................................................................................................................... -----------------------•--------------------
x
V -------------------------------------------------------------------------•-----•-•------------------------------------------------------------------------------------------------------------------
VW >- '...---- ---
Nature of Repairs or, 1 ions—Answer when applicable._.�1..___---. _-f �_---- � •..__ >.t-S-__':_�................
•---------••----------------- ------------------•------•----•-•----•------------------------------------ -----------.------•---•------------------------------------•------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been-issued by the board f health. /
�Oh�e3.... --- - -•.._...` �'---- •-- .�2 .. / Date
Application Approved By----7 - -- ` r .....
_;F.Da-7-.G r
Date �
Application Disapproved for the following reasons:--•-••-----------------••-----•-••--------------------•-------•-----------•-•-•-------------------•---•---------
-•----•---------------------•---•-----------•-------•-- --------•---......----------•-------•--------•-----------------........---•-• --------•-------------•------..----------------•.---------------•-
Date
PermitNo......................................................... Issued----_-----_----------------........................
Date
1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
ri+.. .......OF.......... .1�/Gh: '�.... .......................
Vat
.Putifiratr of QUIomplinnrr
TH IS;110ARTIFY, That/he In�4vic}ctgl Sewage Disposal System constructed or Repaired (")
by.. `� ! --------------------- - ---- ---------- ------------••--------
-•----
J� -W sta er 12
at.>..".. . ` 1 •-J/* 11 C� fir_`'A - W A G ..............
has been installed in accordance with the provisions of . t"l X�I/of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No----_-----______l-.z ............ dated-- 9__��...'.7C•_-_._........•..
THE ISSUANCE OF THIS CERTIFICATE SHALE. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM W L FUN SA CTORY.
CT r DATE -
Inspector._...- .• �
THE COMMONWEALTH OF MASSACHUSETTS
7 BOARD OF HEALTH
,�/� L/ J' 1f1��......... . .F........... �.. u� ..............
No........................ FEE-- ..............
DiriVntittb r ion tr rtioa rmit
Permission is hereby grante ..�__Il.,-_-fvJl. �t��'-'?-�"_.. _.. -
to Cons ct ( ) or epair ( fin Individual ewage ' ispcal Syste
i i /
St eet
..r
as shown on the application for Disposal Works Construction JPfrtN/o. ,, Dted_-.-__ .......
kink ----------------------------
DATE. - --•-•-•---------•--------• Board of Health
FORM 1255 HOBBS & WARREN.. INC.. PUBLISHERS
LOCATION " 5EW IE PERMIT UO.
V I LL A GE CFI -
- - — — — — — — — — 1—:�—1
'11`►ST� LERS IJ�NIE � ADDRESS
bUILDER 5 Q &MF- ADDRESS
D1�►TE PERMIT 155UED
DATE COMPLI &MCE ISSUED ;
• � /U �
S/� �a
,�S�0
J
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
MAP
Property Address: 319 Buckskin Path PARCEL ®2
Centerville, MA 02632
Owner's Name: Peter Salmon r -
Owner's Address:
RECEIVE®
Date of Inspection: November 14, 2003
Name of Inspector: (Please Print) James M. Ford DEC 1 o Z003
Company Name: James M. Ford
Mailing Address: P.O. Box 49 TOWN OF HEALTH DEPT.
Osterville,MA 02655-0049
Telephone Number: (508) 862-9400
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 the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
✓ Passes
Conditionally Passes
Need urther Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Date: November 19, 2003
The system inspector shall sub racopy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
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:
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
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
Page 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 319 Buckskin Path
Centerville, M4
Owner: Peter Salmon
Date of Inspection: November 14, 2003
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.
_ 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 and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
3
Page 4 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 319 Buckskin Path
Centerville, M4
Owner: Peter Salmon
Date of Inspection: November 14, 2003
D. System Failure Criteria applicable to all systems:
You must indicate either"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 '/z 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.
✓ 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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large System:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd•
You must indicate either`yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
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.
4
Page 5 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 319 Buckskin Path
Centerville, AM
Owner: Peter Salmon
Date of Inspection: November 14, 2003
Check if the following have been done: You must indicate"yes"or"no"as to each of the following:
Yes No
✓ Pumping information was provided by the owner, occupant,or Board of Health
✓ Were any of the system.components pumped out in the previous two weeks?
✓ Has the system received normal flows in the previous two week period ?
✓ Have large volumes of water been introduced to the system recently or as part of this inspection ?
✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
✓ Was the facility or dwelling inspected for signs of sewage back up?
✓ Was the site inspected for signs of break out?
✓ _ Were all system components,excluding the SAS, located on site?
✓ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition
of the baffles or tees, material of construction, dimensions,depth of liquid,depth of sludge and depth of scum ?
✓ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes No
✓ 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(3)(b)].
5
Page 6 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): n1a Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents: 0
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no): Yes [if yes separate inspection required]
Laundry system inspected(yes or no): Yes
Seasonal use(yes or no): No
Water meter readings, if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Has been empty for some time
COMMERCIAVINDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no)
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: Unavailable
Was system pumped as part of the inspection(yes or no): 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:
A pit was added on Sept. 14176-per as built card
Were sewage odors detected when arriving at the site(yes or no): No
6
Page 7 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 319 Buckskin Path
Centerville, AM
Owner: Peter Salmon
Date of Inspection: November 14, 2003
BUILDING SEWER(locate on site plan)
Depth below grade:
Materials of construction: _cast iron _40 PVC _other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints, venting,evidence of leakage,etc.):
SEPTIC TANK: None (locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene
_other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions:
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:
Distance from top of cum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
How were dimensions determined:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage, etc.):
GREASE TRAP: None (locate on site plan)
Depth below grade:
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:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
7
f
Page 8 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: None (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:
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.):
PUMP CHAMBER: None (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.):
8
Page 9 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
✓ leaching pits,number: 1 -6'x 6'(1000 gal.)
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.):
The pit was dry. The scum line was approximately 4'up from the bottom. There did not appear to be any signs of failure. The
bottom to grade was 10'. The cover was 20"below grade.
CESSPOOLS: ✓ (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: 1 w/overflow
Depth-top of liquid to inlet invert: 5'
Depth of solids layer: 6"
Depth of scum layer: --
Dimensions of cesspool: 5'W x 5'T x T bottom to grade
Materials of construction: Cesspool block
Indication of groundwater inflow(yes or no): None
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
The cesspool was dry. No outlet tee was present. The cover was 16"below grade.
PRIVY: None (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.):
9
Page 10 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
Q,
A B
l Gq as
S►` 3S �
10
f
Page 1 I of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 319 Buckskin Path
Centerville, MA
Owner: Peter Salmon
Date of Inspection: November 14, 2003
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 25 +/- feet
Please indicate (check) all methods used to determine the high ground water elevation:
Obtained from system design plans on record - If checked, date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain:topographic and water contours maps
Checked with local excavators, installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
The bottom of the pit to grade was 10'. Using the Barnstable topographic map and the Cape Cod Commission water contours
map the maps were showing approximately 25'+/-to ground water at this site.
This report has been prepared and the system inspected and passed as of the date of inspection. This report is
not a warranty or guarantee that the system will function properly in the future. There have been no warranties
or guarantees, either expressed, written or implied, relating to the system, the inspection andlor this report.
11
Q T �OF BARNNSTABLE
LOCATION , 1 �V „C!ri 1'A SEWAGE #
1ILLAGE Wa—rV116- ASSESSOR'S MAP & LOT 17�" Oa8
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITYsp
LEACHING FACILITY: (type) �X �,T (size) jUl V 6.4
NO, OF BEDROOMS 3
CA BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
.within 300 feet of leaching facility) -�^ Feet
Furnished by =f1T0t ,.,7Tb^ .! _ �0�C
Gq as w
OILb 3s �
58
\ U
LEGENDca
PROPOSED CONTOUR d cn E
/ 98 PROPOSED SPOT GRADE �J IT Q
ji —— 98 —— EXISTING CONTOUR
56 �\I�\ ��\ \^�\ �?32 + 96.52 EXISTING SPOT GRADE co
z ONUS w 3
W— EXISTING WATER SERVICE �� �eRD -+ _ 2 ME y.
, ^`1 6 O TEST PIT� w o �SMIT UST1C DOUGLAS
c�r ¢ WAY
BENCH MARK (IV
' % --- e w �
�^ LO CCz
TOP OF CONC BOUND
ELEVATION = 52.58 54— /
BARNSTABLE GIS DATUM 8 p w co
— 0 1 LOCUS MAP N.T.S.
1 f
j r
GAs / GENERAL NOTES:
T -
O GA E
1.
� ALL CHANGE
S TO THIS IS PLAN MUST BE APPROVED
52\ E ist. 1,000 gal. �n �Q/� ji BOARD OF HEALTH AND THE DESIGN ENGINEER BY THE LOCAL
Septic Tank V 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
> OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS.
=n`� ! 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
o ./ i TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER.
/ �� O wOte % 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
73. \ �/j jj r S % FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
�0� e\�e ENGINEER BEFORE CONSTRUCTION CONTINUES.
5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
/VATER �u 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
5 ft. Soil Removal �
` /0 �� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
(see note 13) _ _ i G ATE n HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
—/— 5 4 Q� v\ 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
t / 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
/ TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
Existing Leach Pits\ \ �/ 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
THE LOCATION
(Note 10) 736 O \ \ O T \`�1 1 ;' �' �� CONSTRUCTION.OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
10. EXISTING LEACHING PITS TO BE PUMPED, CRUSHED AND REMOVED
AREA = 1 5 5 s f + �/ �� PER TITLE V, REPLACE WITH CLEAN MEDIUM SAND
j' 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
j 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
6y (VAND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
\ ,
/ 13. REMOVE ALL UNSUITABLE SOILS 5 FEET AROUND LEACHING TO
EL. 43.27 - 44.0 OR TOP OF C3 LAYER AND REPLACE WITH
/ CLEAN MEDIUM SAND PER TITLE V.
14. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING
�+ 52 J ( 15. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING ,
i
AR �
Ci
,: SCALE: 1 in = 20 ft20 0 20 ao J PROPOSED SEPTIC SYSTEM UPGRADE PLAN
319 BUCKSKIN PATH, CENTERVILLE, MA
0 10 20 m
STER�� �/ MAP. 171 Prepared for: James S. Peacock & Scott E.=Crosby
SURVEY REFERENCE: SANI TWPa LOT.•028 Engineering by: Surveying by: SCALE DRAWN JOB. NO.
L DEED BOOK:17969 DARRENM.MEYER,R.S. Eco—Tech Environmental 1"_20' DMM
PLAN OF LAND BY CHARLES N. SAVERY CO. DEED PAGE:009 PO BOX981 (508) 364-0894 Y
+ EAST SANDWICH,MA 02537 DATE CHECKED SHEET NO.
DATED: NOV. 9, 1970 I 508-362-2922 04/08/07 DMM 1 Of 2
-V. TOP I
NDATION
isting) i
55.28 -� F.G.EL: 55.0-52.0 F.G.EL• 53.0 F.G. EL: 52.0 t. FINISH GRADE=53.0-52.0
I` a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA
COVERS TO WITHIN 6 OF GRADE
2" OF 3/8" DOUBLE 3/4" - 1-1/2" DOUBLE
. L = 25 WASHED STONE
WASHED STONE
A s" 4" SCH 40 PVC
L = 5' 4" SCH 40 PVC
1o"I S= 1� MIN. ®®®®- 0 ®®®®
(MIN.) 14" ( ) 6• S= 1 (MIN.) rE ® ®®®TEE'S ARE TO BE EgO I®®®®®4' SCH 4o PVC 2 EFF: DEPTH ®®®®®®E.INV.50.25INV. 50.05 1 INV.49.854 2 X 8.5 4J ,
STING OUTLET GAS PROPOSED DB-3
BAFFLE EFFECTIVE LENGTH = 25'
H-10 DISTRIBUTION BOX
INV. 50.50 EXISTING 1,000 GALLON SEPTIC TANK
i
GAS BAFFLE TO BE INSTALLED ON NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING BREAKOUT
OUTLET TEE AS MANUFACTURED BY PIPE INVERTS PRIOR TO CONSTRUCTION 1 ELEV.= 50.70
TUF-TITE, ZABEL, OR EQUAL 2) D-BOX SHALL BE SET LEVEL AND TRUE TO
GRADE ON A MECHANICALL COMPACTED SIX INV, ELEV.= 49.70 ®� •E3
INCH CRUSHED STONE BASE, AS SPECIFIED IN ®®®®®®®
310 CMR 15.221(2) E3E3E3 ®
3) REPLACE EXISTING 1,000 GALLON SEPTIC ®®®®®®
BOTTOM EL.= 47.70 ®E3 ®E3
TANK WITH 1500 GALLON SEPTIC TANK FIF1 5 FT. 4'
IF FAILED, DAMAGED, OR UNDERSIZED.
4) INSTALL INLET & OUTLET TEES AS REQUIRED
SEPARATION 8.6 FT. EFFECTIVE WIDTH = 13'
I
SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: 39.1 SOIL ABSORPTION SYSTEM (SECTION)
N.T.S. (500 GALLON LEACH CHAMBER (H-10) LOADING)
SOIL LOGS a DESIGN CRITERIA
NUMBER OF BEDROOMS: 3 BEDROOM
DATE: APRIL 2, 2007 SOIL TEXTURAL CLASS: CLASS I (See Attached Sieve Analysis)
SOIL EVALUATOR: DARREN MEYER, R.S., CSE DESIGN PERCOLATION RATE: <2 MIN/IN LTAR: 0.74 GPD/SQ. FT.
WITNESS: DONALD DESMARAIS, BARNS BOARD OF HEALTH DAILY FLOW: 110 G.P.D.
PERC TEST #: 11694 DESIGN FLOW: 330 G.P.D.
GARBAGE GRINDER: NO (DESIGN DOES NOT ACCOMODATE A GARBAGE GRINDER)
Elev. TH=1 Depth Elev. TH-2 Depth LEACHING AREA REQUIRED:
53.10 0" 52.0 0"
A SANDY LOAM A SANDY LOAM (330) = 445.94 S.F.
10YR 4/ 10YR 4/1 74
52.27 B loll51.17 e 10" USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS (H-10 LOADING)
SANDY LOAM SANDY LOAM ,
10YR 6/8 10YR 6/8 WITH. 4 FT. ON ALL SIDES: 25 L x 13 W x 2 D
50.02 C1 37" 49.0 C1 36" BOTTOM AREA: 25 X 13 = 325 SF
FINE - MED. SAND FINE - MED. SAND SIDE AREA: (25 + 13) X 2 X 2 = 152 SF
2.5Y 7/3 2.5Y 7/3 1 OTAL SQUARE FEET PROVIDED = 477 vs. 445.94 REQ'D
46.94 C2 74" 46.59 C2 65 �1 QF
SILT LOAM SILT
os�4 2��P� y� PROPOSED SEPTIC SYSTEM UPGRADE PLAN
10YR 6/4
43.27 118" 44.0 96'� DA M. n
C3 C3 EYER 319 BUCKSKIN PATH, CENTERVILLE, MA
MED. SAND MED. SAND No. 1140 f r)U -
2.5Y 7/3 2.5Y 7/3 Prepared for: James S. Peacock & Scott E. Crosby
39.10 168" 39.5 150" iQ£C�S�E(�F� Engineering by: Surveying by: SCALE DRAWN JOB. NO.
DARRENM.MEYER,R.S. Eco-Tech Environmental N.T.S. DMM
PERC RATE <2 MIN IN. C" HORIZON PERC RATE <2 MIN IN. C" HORIZON SANITAR�P PO BOX981
/ ( ) / ( ) 1 �(j' (�" EASTSANOWICH,MA02537 (508) 364-0894 DATE CHECKED SHEET NO.
NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED 6
508-362-2922 04/08/07 DMM 2 of 2