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HomeMy WebLinkAbout0895 BUMPS RIVER ROAD - Health 395 Bumps River Road Centerville A= 167—036 ' 4 i S M E A D® No.H163OR UPC 10259 smead.com • Made In USA i� COMMONWEALTH OF AtkSSACHtiSETTS EXECLTIVE OFFICE OF ENV1ROT'ZIENT'_aZ:AFF AI .S ` DEPARTMENT OF ENVIRONMENTTA N L PROTECTIO �C 4 ' TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A C CERTIIFICATION Property-Address: 99' 4'`' S 14lW,►^ Ad eln , 4 o01(-3a S� � �t Owner's Name: f 7—wr dro,-,i Owner's Address: s r1 1ve, iqd , .e oab 3� Date of Inspection: oZ D Name of Inspector lease print) Ar� oZSe-1�i . Company Name: � VI p —TEC-H Mailing Address: fJ d�1( Telephone Numbev'�o-d 17 2-Y— 7 �f CERTIFICATION STATEMENT I,certify that I have personally inspected the sewage disposal system at this address and that the inforrnation 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 afn a DEP-,, approved system inspector pursuant to Sec ' n.340 of Title 5(310 CVIR 15.000). The system: Passes ' „._ ` Conditionally Passes -- Needs Further Evaluation by the Local Approving--Auttw.L, Fails -� Inspector's Signature: Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health orb DEP)within 30 days of completing this inspection.If the system is a shared system or has a design o b=of 10,000 + gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional o=lice of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the appre-.�n7 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 I nspection Form 6/15/2000 page 1 14 Page 2 of 11 OFFICIAL INTSPECTION FORM—NOT FOR VOLUNTARY ASSESSI'IENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM E SPECTION FOR 1 PART A Q CERTIFICATION(continued) Property Address: /� �t/'^P S X l� /�ono oa 3� Owner: /Y/IVL-10 Date of Inspection: a/ O Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D I� A. S em Passes: I have not found any information which indicates that any of the failure criteria described in 310 CNIR 15.303 or in 310 C M 15304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: /1/ 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,-�vzll pass. Answer ves,no or not determined(Y,N,\D)in the for the followina statements. If"not determined"nlease explain. �l The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is struct ally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent System Mll 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(:vith approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: I� The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system r.�L pass inspection if(,Mth approval of the Board of Health): broken pipe(s)are replaced obstruction is removed N`D explain: Page 3 of 11 OFFICIAL ENTSPECTIONFORM-NOT FOR VOLUNTARY ASSESSATE.NITS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTI0- FOIZAf PART A �CERTIFIC�ATION(continued) Property Address: 9d /� � ✓1 �, G�zG 3.2. Owner: /c5ro(NNI i$ Date of Inspection: SY.21149 q C. Further Evaluation is Required by the Board of Health: 41 Conditions exist which require finther 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 C1II215.303(l)(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 I of a public eater supp'_y. 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 deternune distance *This system passes if the well water analysis,performed at a DEP ceriified laboratory- coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that faciliz=and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprr_,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form 3. Other: Page 4 of 11 OFFICI_AL INSPECTION FORM-NOT FOR VOLUNTARY ASSESS NT NTS SU13SURFACE SEWAGE DISPOSAL SYSTEM E ISPECTION FORIT PART A I; CERTIFICATION(continued) Property Address: Owner: Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate "yes"or"no"to each of the following for all inspections: Yes \To/ _ .v ackup 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 �l cesspool ,---I Liquid depth in cesspool is less than 6"below invert or available volume is less than? day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).\umber I� f times pumped v portion of the SAS, cesspool or privy is below high ground water elevation. i� Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface ✓ater supply. t/_- any portion of a cesspool or privy is within a Zone 1 of a public well. _ t/ y 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,pro-vided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] / (Yes/Ivo)The system fails.I have determined that one or more of the above failure criteria e-xist as described in 310 C_-MMR 15.303,therefore the s�-stem fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. I# E. Large Systems: �3 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) es no th stem 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-I,',-?_. i or a_.�:�uee Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a siani�caut i�reat; or aSr+,-zre "yes"in Section D above the large system has failed. The owner or operator of any large s;�stem con_cid..red a r significant threat under Section E or failed under Section D shaIl upgrade the system in accorda?ce.With;i C C1 15.304. The system owner should contact the appropriate regional office of the DeIR partment. �l Page 5 of 11 I� OFFICIAL INSPECTION FORM—NOT FOR VOLUNT_4RY ASSESSMENTS SUBSURFACE SELVAGE DISPOSAL SYSTEIvi INSDECTTON FORM PART B CHECKLIST Property Address: 6Q/ ) doev�__ lei ve, /�ew �: ' 6 63� Owner: &0 wV^ Date of Inspection: a 09 Check if the following have been done.You must indicate`yes"or"no''as to each of the following: I; Ye�No Pumping information was provided by the owner,occupant.or Board of Health �l 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 l\!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? !1 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*he proper I maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been dete=I died based on: Yes o 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 appro7i-3aLioD of distance is unacceptable) [310 CTMR 15.302(3)(b)] I1 Page 6 of 11 OFFICI_AL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORTNI PART C SYSTEM INFORMATION Q n Property Address: /� 4 Owner go Date of Inspection: 0 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 41C Number of bedrooms(actual): /! DESIGN flow based on 310 CI M 15.203 (for example: 110 gpd x#of bedrooms): T Number of current residents: 0. Does residence have a garbage grinder(yes or no): /0 Is laundry on a separate sewage system(yes or no):Aj,[if yes separate inspection required] Laundry system inspected(yes or no):&4 Seasonal use: (yes or no): ; Water meter readings,if available(last 2 years usage'(gpd)): Sump pump(yes or no): y0 Last date of occupancy: COMMERCIA-UINDUSTRIAL +.'• Type of establishment: Design flow(based on 310 CMR 15.203): am 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 LNTFORMATION Pumping Records Source of information: Was system pumped as part of the inspecti(n(yes or no): If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: T�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 T�o a 1 components,date installed(if known)and source f informa n: oQ�9►�tL tiel 1,9-qG a oo� 10f/ Were sewage odors detected when arriving at the site(yes or no):� G1 A-, i+. Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSTN'IENTS SUBSITRFACE SEWAGE DISPOSAL SYSTEM L\7SPECTION FORRIZ PART C SYSTEMpINFORINt-kTION(continued) Property Address: +"9 /t�✓wll K� Owner: WV1 Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron i-1_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: 1'� ocate on site plan) —( p ) Depth below grade: / Material of construction:_vconcrete_metal_fiberglass_polyethylene —other(explain) �3 If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(a<iach a copy of certificate) .p Dimensions: 0 Sludge depth: 02 e" Distance from top9f sludge to bottom of outlet tee or baffle:30 Scum thickness: "5S_ / " Distance from top of scum to top of outlet tee or baffle: g Distance from bottom of scum to botto of outlet to or baffle: 8�G How were dimensions determined: le Kos d2!/lG�. i s Comments(on pumping recommendations,inlet and ei tee or baffle condition,structural inte-n _.liquid levels as re ed to outlet invert,/evidence ojletage,etc.): ' / / v�J /vt ✓!o 17 Q T�'�tf 71/4tzei Q•• �✓ av� GREASE TRAP:`/ (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass__polyethylene_other �t (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 rote=-iit_. _?quid lei els as related to outlet invert, evidence of leakage;etc.): f Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLU'--'N-T:ARY ASSESS11TE\TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTTO�T FORAM ► P_A RT C Q o SYSTEM IINFORMnATION(continued) Property Address: Owner: O(�►-✓� Date of Inspection: p TIGHT or HOLDING T_A-N'K: /�' (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of censtruction: concrete metal_fiberglass_polyethylene other(exolain): 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: y Comments(condition of alarm and float switches, etc.): �# DISTRIBUTION BOX:� (if-present must be opened)(locate on site plan) Depth of liquid level above outlet invert: two Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover;any evidence of leakage into or o f box, etc.) PUMP CHAI-NIBER:A (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.): li T41. : T.......,...i___ I Page 9 of 11 } OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSIIENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C Q SYSTEM INFORMATION(continued) Property Address: �/s lJvl v'7 S /e/V4, �d Owner: /c5/fJL✓✓� q Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type / 2�0 (rG l/0 k1 CAC- -h �Q ys I leaching pits,number: 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.): dH it �l S'�a Z1✓X G �oke— 0 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: l Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation; etc.): PRIVY: A—/(locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding, condition ofvegetaion, etc.): �l F Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR V"OLUNARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR>g PART C SYSTEM INFORMATION(continued) Property Address: U 2S Kt Rd- Owner: /Ow✓1 I Date of Inspection: .� 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. o i i� T:al,. G T..._�.. r Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSANTENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORRNI PART C I ' SYSTEM INFOR LATION(continued) Property Address: O 9� l ItJ /f 4oZ6 j�L Owner: ��w� Date of Inspection: / 0 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water /0 feet Ale, 14 S O t.'l 7' , Please indicate(check)all methods used to determine the high ground water elevation: ����C/// 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: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must des 'be h w you established,the •gh round yjatler eleva P� �l� e # I i THE COMMONWEALTH OF MASSACHUSETTS. Entered Fee in comouter. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIpPtication for Mis;MgaI 84PSUM Con!6truction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon O ❑Complete Sysren �In ii iduat CauiWncns Location Address or Lot No.j�#S 1-, t 5 z.",A. (�� - . Owner's Name,Address,and Tel.No. Assessor's Map/Parcel r�1(t'� 3 t+i t(' Installer's Name,Address,and Tel.po. ej Designer's Name,Address and Tel.No.L-t SC ? Type of Building: ,,`` Dwelling No.of Bedrooms y - Lot Size J` (W<< sq.ft. Garbage Grinder p Other Type of Building _ No,of Persons ( ) Other Fixtures Showers( ) Cafeteria( ) Design Flow(min,required) U y D gpd Desist flow provided w,{ Plan Date -a 1I u o Number of sheets Z 5 t 5 Title —�— - Revision Date Size of Septic Tank JZIC'0 �t t Type of S.A.S. y Description of Soil [k2;,( Nature of Repairs or Alterations(Answer when applicable) t r H L1 a �- C(k"uutr 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 ffiis Board of I—atlth. Signe Application Approved by �. Date C, , Application Disapproved by: 1 Date J O '-) for the following reasons Date Permit No. aQC'2 7 ------------------------Date Issued V' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of (Eompriance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Abandoned ( ) Repaired ( ) Upgraded {�) JN 1 i G•' at with the provisions of Title 5 and the for Disposal System Construction Permit No has been constructed in accordance -��"7 J< J I Installer�f,,L r•/ i� Y c 7 dated ,r 4 �./ci.�J<<L�„S1"Designer / ;c., L1Dtt7v15 m bedrooms L r Approved design flow it 1 C The issuance of this permit shall qot be construed as a guarantee that the systern-wall-fmo Date tinA as.designed. �d /!G Inspect. ——— �)vet -7� -------------------------/------ THE COMMONWEALTH OF MASSACHUSETTS Fee f JG I . PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS i teM Con$trUrtion permit Permission is hereby granted to Construct LRepair (r ) Upgrade ( ) Abandon System located at { t 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 6f this permit..-"\ Date Approved ' TOWn of]Wnstable iy� of Regulatory Services • .gARNSTilBLE, - Thomas F. Geiler,Director y MASS 1;. ,� Public Health Division, Ep hfA'��` (� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 9ffica: 508-8 62-4644 ' Fax:.508-79(k6304 Installer & Desi zter Certification Form Date: G Designer: �i yc Installer: Address: Ci L_. Address: i LO �Vc 5&L'C was issued a permit to install a (date) (installer) septic system atJ �� ,:J`yL ��( c� ��' ?� �Pased on a design drawn by (address) dated_ 24 I Z-1 0 7 / .(designer) V I certify that-the septic system referenced above w the design, as installed substantially according to gn, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. —_ I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component _ h of the septic system)but in accordance with State-& Local Regulations. Plan revision or certified as-built by designer to follow. r OF M4SS�IJJJ�, •. arl is Signature) L 1 t-A C. ao LYONS n' #1143 • �i (_/'(Design�r',s Suture) (Affix Designer s Stamp Here) PLEASE RETURN TO 13ARNSTABLE PUBLIC QF COMP:I,IANCE WILL NOS' BE �SS[TED ITNTIL Bp B�Vi�ION. .CERTIFICATE BST CARD ARE RECEI`�ED B�.'THE BARNS'I'ABI.,E PI7BL C �EALTH� AND AS- THA,�YOU. DIVISIQI4. Q:Health/Septic/Designer Certification Form 0 No. . Fee (� r THE COMMONWEALTH OF MASSACHUSETTS . Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 3 Zipprtcatiou for Mis;pozar 4potem Cott.5tructton permtt Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.,jWs 1etQM 5 . ;e U Owner's Name,Address,and Tel.No. 3QE j+afZ /11&,", Assessor's Map/Parcel jA i I Installer's Name,Address,and Tel.gNo. .`A3,N d(�rMS c-A, JMG Designer's Name,Address and Tel.No.L I SGA. c , L1 on S 5'" cIm, Type of Building: Dwelling No.of Bedrooms LA Lot Size :HL 9digs sq. ft. Garbage Grinder ( ) Other Type of Building 5,aj1,e, 1, A A No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow min.required) "4 d Design flow provided � � l�Sales g ( q ) gP g P �'"� l t7 Z. .5 �f'�:�S/� gpd Plan Date Number of sheets Z Revision Date Title Size of Septic Tank /D.00 i Type of S.A.S. L4 0j ao Description of Soil k."I 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 f Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by ° is Board of Ht Ith. Signe , / Date 7 Application Approved by 1 Date s: Application Disapproved by: Date for the following reasons Permit No. `r LW 7 O Date Issued 7 � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for �Digpogal 6pgtem Conotruction Permit , Application for a Permit to Construct O Repair O Upgrade O Abandon O ❑Complete System ❑Individual Components ` Location Address or Lot Noels 130MP5 U Owner's Name,Address,and Tel.No. B(t8 Z !i U-5+4 1 em )A , Assessor's Map/Parcel,v 1 1477 R 3 Installer's Name,Address,and Tel No�,�� �t��250 kNG Designer's Name,Address and Tel.No.(..ls� C LyOh S , Type of Building: Dwelling No.of Bedrooms L Lot Size Q(a Q sq. ft. Garbage Grinder Other Type of Building jjAw�4—11,0 No.of Persons ' Showers( ) Cafeteria( ) Other Fixtures / �!� @I rt 5.des Design Flow(min.required) V y 17 gpd Design flow provided W 4l 0 z ,S ,,,, /2 gpd Plan Date of tlfi Number of sheets 2_ Revision Date Title Size of Septic Tank /DOD e� I Type of S.A.S. y 60 L,C , Description of Soil (IA,,o( f Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: ) The undersigned agrees to ensure the construction and maintenance of the�afofe described on-site sewage disposal system in accordance with the provisions f Title 5 of the environmental Code and�not'lo place the system in operation until a Certificate of Compliance has been issued by his Board of Health. Signed / Date A� r Application Approved by i. Date _ 3 Q Application Disapproved by: Date for the following reasons ; r Permit No. 'a('X0-7 © - Date Issued S 7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance ` THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ) l Abandoned( )bY.I? 2 ve 4 C rlcc a4' rr :Lo, Ly, at RK j �S �; Q n �G� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. :-9-7—G� dated 3 5 Installer":�4kJeti + C.&,24- j 6r,). n)-6 15-'Designer 1, ;�� C LW ow; #bedrooms Y Approved design flow L-A H O gpd The issuance of this permit shall not be construed as a guarantee that the system_wi.11 funct'on as designed. Date Ins ector -------------------------------------------- No. -900 -7 G 7 / Fee f THE COMMONWEALTH OF MASSACHUSETTS PUBLIC-HEALTH-DIVISION -BARNSTABLE, MASSACHUSETTS lwigpogar *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at ,C(� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date btoyf.this _Qer"fiZijt �)Date Approved ��� IN T6wn of Barnstable �� , NAP o� Regulatory Services enfeivsr�si�, ; Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,Na 02601 4ffwe: 508-8624644 ' Fax: 508-790-6304 Installer& Designer Certification Form Date: a Designer: Ll A )ly S Installer: ,Cj, Address: � Address: t�.r . YATi fviS m-A 02-60 On -' (date) w � L (ay was issued a permit to install a . . (ins taller) . septic system at �based on a design drawn by (address) i—` a uoS dated_ ?�((Z�'2J / (d signer) V I certify that-the septic system referenced above to the design, which may include minor approved chang changes such as lateral relocation talled substantially accor'ofgthe distribution box and/or septic tank. 0 I certify that the septic system referenced above was installed with major changes i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any co onent of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. ; ..4:;ss4,,i �'�sSignature) '.V : L I L A C. LYONS N� LIC. f1141� (DeSl rjTFRED gn r S' attire) (Affix Designers Stamp Here) PLEASE RETURN TO BAIINST'ABLE PUBLIC H�.ALTH DIVISION. .CERTIFICATE OF COMP�,IANCE WILL NOT' BE ISSUED UNTIL BOT THIS FORM AND AS- �I BUILT CARD ARE RECETt�D B�' THE T� BARNS'TABI,E P .LIC $EAI,T'H DIVISION. Q:Health/Septic/Designer Certification Form No. J " 3_2 Fee (/v THE COMMONWEALTH OF MAS ACHUSETTS . Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPrication for Migpogar bpgtem Construction j3ermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No145 Jpyt�6R� Owner's Name,Address,and Tel.No. 3Uu--V,,1.eWL J il ,1 Assessor's Map/ParceI(A 1411 P,3 UI Installer's Name,Address,and Tel. Designer's Name,Address and Tel.No.L—I$(k C• L J OVI r Lk Type of Building: Dwelling No.of Bedrooms Lot Size W(s !Mk sq.ft. Garbage Grinder ( ) Other Type of Building %p Other Fixtures No.of Persons Showers ( ) Cafeteria( )Design Flow(min.required) L44 0 gpd Design flow provided _ i L? "q 0 Plan Date - o� {'Its d� Number of sheets Zgpd Revision Date Title Size of Septic Tank /VV0 �e I Type of S.A.S. Description of Soil (11,ea ,{ _ Nature of Repairs or Alterations(Answer when applicable) l e��hL ?el'L aQtuce�, 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 f Title 5 of the vironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by is Board of Ith. Sig' ne Date 7 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 'Z1Q0 7^ O Date Issued ° --- D THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE;MASSACHUSETTS Certificate of Compliance _ THIS IS TO CERTIFY,that the On-site Sewage Dis1-1% posal System Constructed.( ) Repaired ( ) Upgraded (�) ¢ Abandoned( )by 2 tl C r -� f 2�. / 'u✓ rr at Y�`f L; >�e d) n z —� ►> � has been constructed in accordance rr f r< with the provisions of Title 5 and the for Disposal System Construction Permit No. -7-0-7 � dated 5/- c Installer,S49-ye-n , C/ ",�,� u.) 4).�61.2 5 ' a r c o 'Designer�;�, � („„�q/�„�S' #bedrooms- Approved design flow V La O gpd The issuance of this permit shall t be. oitstrued as a guarantee that the syste c designed: Date Ins rr -———————— v r� /�-7 r< No. 0 �G, Fee a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS ig ogaY pgterrt Congtruction permit Permission is hereby granted to Construct ( . ) Repair ( ). . Upgrade ( ) Abandon System located at FRS Uw.a C RW A It QrIA and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction mu757-7 bempleted within three.years of the date this Date Approved b a t. TOWN OFBARNSTABLE LOCATION 016' SEWAGE# Z007,-,c-2 —2 VILLAGE C QAAt V t(Z ASSESSOR'S MAP&PARCEL 7 0,3 V INSTALLERS NAME&PHONE NO.54.J-t-)``-C I.ae 7,W.►N,c L-4Sv, We-S'oq 1432-►logo SEPTIC TANK CAPACITY 1®tap o, LEACHING FACILITY:(type)Ll 4'o01(11 It4dA a (size) NO.OF BEDROOMS L4 OWNER S G A2 U.)C4 PERMIT DATE: ION, 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 aching facility) Feet e,, FURNISHED BY - 6 A q. 4� 3a Z 31 35 a 3 U� �J VA �031 -. P Fps......-�..:5 ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -- ---------------- ......OF.......................................................................................... ApplirFation for Uhipvii al Works Tumtrurtion ami# Application is hereby made for a Permit to Construct (VI or Repair ( ) an Individua),,Sewag/ D' sal System at: nP�w �`' Location-Address or Lot No. Y_-----i����19/. rl --..1 . .....-----•.....................•-_... .............----•-••----------•-•-=---....•----.... Owner�jc Address a •--•......-••••-•.•..../� �,� y----------------•------........----- ----------.•---•------•------ ...---------.......-•-•-------------------- Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............. . Attic ( ) Garbage Grinder ,Vo) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•--. W Design Flow.............................gallons per person per day. Total daily flow_____. c ...........................gallons. --------------------- WSeptic Tank L Liquid"capacity./_600..gallons Length................ Width................ Diameter__-____-.___--_- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--../------------- Diameter.f�_ .4_..... Depth below inlet.................... Total leaching area...�! lafE-._....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by-------------------------------------------------------------------------- Date........1.-_��:27........... aTest Pit No. 1_ .�-..____minutes per inch Depth of Test Pit____________________ Depth to ground water_-___________-__.-_____- Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.------------........... ----/-----**-'?7... .......................... Descr>ptio Soil •---- ------� U -• ----`� . &-- --- - �I� f/`st/ t�C�VinG ----------•---------------------•--- --•--------------------------------------------------•-•----------------...........-------------•----------. W -•-•------ ------------------------------------------------------------••--•-•----••----------•----••------------------------........-----•----•---•••-••••-•--•-----••••........................•- UNature of Repairs or Alterations—Answer when applicable._.......................................................:...................................... ....................................... -•-------•----•-•-••-•••-•-•-••-•••-••-••..................•-•-•••-•--•---•••----•-----------•-•---••••--...---•--------------•--•-•----••............-----•---- Agreement: t The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ITLh: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed------- -•-- -----------------------------•-------------------• ................................ ! Date Application Approved By...... r• �/�� '2 ��- ja_ 7� Date Application Disapproved for the following reasons:....................................... --------•------------•............................. -----------._. ..................•.......--------------...--•--...------------------------------......----•-•-------------•-----------••-------•---------------•--•-•----•----•-••-- •_.------------------------- l' Date PermitNo......................................................... Issued_- ......................... Date � s No. ._ .� F>c$............._...... THE COMMONWEALTH OF MASSACHUSETTS `y BOARD OF HEALTH ............................ ............OF....................................... --------------- .......................... Appliration for Diipnsal Workii Tomitxnrtinn Errant `Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: '` 4140M .............•-•-•»------•..... .. .--•-- ........-----•--•-•---.............. .......--_.. .- r CI�d/�yL/occa/ra�tion �y� t '`'01 1 or Lot 1{�.[f W'f�. /Y Q�f-��GVt.. ......................» .._._.:.Z... ..................................................... _.._..................................._... ............_.......' ........... wn r Address w 0jr 1� �y -----------------------------•-....... ---•----•••--•-••••--•----.....--•••••-•--•••-•---•----•••-•-.......--•-----------•-..........---• , Installer Address Type of Building . q.Size Lot............................S feet ,., Dwelling—No. of Bedrooms................ ...........................Expansion Attic ( ) Garbage Grinder eo) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .-}--------------------•--------•-•-------------------------------------I'll------------------k...--•••••-••••----........------•----••....._------ d W Design Flow.g? _. i......................gallons per person per day. Total daily flow.....a. `s .__._ ..............gallons. WSeptic Tank 4-Liquid capacity./.0..gallons Length-------_------- Width---------------- Diameter.................Depth................ x Disposal Trench—No. .................... Width_...__ ._.._....... Total Length.................... Total leaching area-----•...._...._ sq. ft. Seepage Pit No...... ........... Diameter../ �t--__ Depth below inlet.................... Total leaching area....... ...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------------------------- ----------------------------------------- Date........................................ aTest Pit No. 1........ 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........................ W ................................ •..... -•-•-•--•••••-•----••••-••---••••-•••-••---•......................................................... Description of Soil_________________ � .__ r........ 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 the provisions of TITI.;,,. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complianpe has been issued by the board of health. `',. Signed.........................................-............................................ ' Date ApplicationApproved By.............. - =•• • •............................ ....................................... 0 t Date Application Disapproved for the ollowing reasons:---_............... _._. -------------------- .--------------------- •-----••----••••--••----••---•--•...-•••••...••-•.....--•-•----•--•-•-•--••----•-•-••---•----•-----•••••--•-----•---••-----•-•••------•••--•••-••---•-•---•-------------•••---••-••--------- -------- Date PermitNo...................................................=----- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tntifirab of Tamplianrr THIS IS TO CERWIL,That the Individual Se Disposal System constructed ( ) or, Repaired ( ) 1 by .. J''l!�'?1..... ......-•----•--••-. ` G .................................................... .� Installer at........ ............................. has'been ins e In cor ce w' �1 provi ns of TITLE S of Th - t e Sa ry o e as described in the appll atf n f rks" 10tPfleton �� '1 �- THE ISSUANCE OF THIS CERTIFICATE SHAL T B CONSTRUED AS A GU� IV.TEF.�,THAT THE SYSTEM-1111 Cr I. FUNCTION SATISFACTORY. +� too �� ` ' �— DATE...-::_. .... � U -. Inspector.... _ ._..., ! ... ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F..........................................._.._...................................... No. = ---------- FEE.__... .... -:0: j �� 1 n�k� nr�ttinn rrnti# a s-=°- Permissionis hereby granted.............................................................................. .............................................................. to Construct ( ) or Repair ( ) an I l ivi�juA Se rage Disposal System atNo,-••---•-•-••-• p ............. -------------------ii--•--••---•---------•--•••-•-••-------•---••--••--•••••-•-•••-••--••------•••_...........--••-- as shown n t li n for 1�V��r tru strut / d ..................................................... - -----•-_-- f B rd ealth DATE•_-.--7.... ......................................... � �t .a FORM 1255 HOBBS & WARREN. INC,, PUBLISHERS E/b III EXISTING 1000 GAL TANK DISTRIBUTION BOX 500 GAL DRY WELLS CROSS SECTION LOCUS PLAN ADD GAS BAFFLE NOT TO SCALE NOT TO SCALE NOT TO SCALE NOT TO SCALE BM 100.0 0 97.5 a / / / / / / / / / \>\\\�\\�\��\\�\\ �\COVER sE\wr�rl�r\6�oF\>�\ �\ �\ - :,11 MAX.36 COVER 2 1/8 -,L, u1iLSIIID S ONE 3"AffNIlN[IM " 4"SM.40 P.V.0 ::;::<•: 4"SCH.40 P.V.C. .:. 11 311 :.::::::::::::: �:: o o o o o ......:::•:. . ::::::..:...... .:....... .. �sboe t 97.16 9 95•0 95.3 ii;ii:>::?s:'i'ii: o _l [Eil 0 0' EHI F__l 0• Eil [��0 1 7 / t= O O O O O t� C'� Gr. ... I� I� I� C� �! ii.':::'i:::e::"..:i':: ':i:4:ii.::ii:•iii:iii Ri..�::i.:::'.::.•::i:: I� I� I� :'i:::::•e:i'::::::�:i:::':::::::::i:::is 4.0 95.1 92. ... , .. � 0 � � (� � MIN 2. 34' L 1 2 8' 4.83 2.8' ro i 39 * a°oPs8.5 vl acSANK 3/4"-1 1/2"DOUBLE WASHED STONE H 8.5' BOTTOM OBS 86.26 SITE SPECIFIC NOTES R p N DESIGN CALCULATIONS GENERAL NOTES FLOOR PLAN LAB ALL PIPING TO BE SCHEDULE 40 P.V.C. PIT TO BE PUMPED AND FILLED EXISTING BEDROOMS 4 ® 1t0 G.P.D. ALL LOCATIONS OF UTILITIES SHOWN ARE AS FIRST FLUOR 440 G.P.D. MARKED BY DIG-SAFE AND ARE TO BE INSTALLER TO NOTIFY DESIGNER 24 HOURS M167 P36 VERIFIED BYTI INSTALLER PRIOR To - NO. OF UNITS 4 CONSTRUCTION PRIOR TO BEGINNING OF JOB TO P # 11�617 DEPTH BELOW INV. 2' THERE ARE NO KNOWN WETLANDS WITHIN COORDINATE INSPECTIONS ENc H 395, UNLESS SHOWN.PROPOSED LEACHING FACILITY THERE 46 ACRES • BOTTOM AREA 409.5 0 ' OF TH N KNOWN A HI EPROO D L LEACHING FACILITY SIDEWALL AREA 198 a TOTAL SQUARE FEET 607.5 SF THERE ARE NO KNOWN IRRIGATION WELLS WITHIN 50' OF THE PROPOSED LEACHING CAPACITY SIDEWALL 00.74 146.5 G.P.D. FACILITY CAPACITY BOTTOM 0 0.74 303.1 G.P.D. THIS PROPERTY DOES NOT FALL WITHIN A BEDROOM KrTCHEN FAMILY ROOM CAPACITY TOTAL 449.6 G.P.D. FLOOD ZONE AS SHOWN ON FIRM MAP 125.5 1 IS DESIGN DOES NOT REQUIRE VARIANCES T TITLE 5 (310 C.M.R. 15.00 OR BARNSTABLE THIS SYSTEM NOT .DESIGNED TO SUPPLEMENTAL REGULATIONS. ACCOMODATE A GARBAGE ALL CONSTRUCTION SHALL BE IN ACCORDANCE DISPOSAL TH TITLE 5 AND BARNSTABLE SUPPLEMENTAL REGULATIONS. PLAY AREA - i BEDROOM LIVING ROOM IN-LINE ELEVATIONS PROPOSED AS-BUILT SURVEY INFORMATION i Ll.l INV. ® HOUSE EXISTING cc 97 PROPERTY LINE DATA FROM .,__,. 77 NV O TANK 97.41 Q J. P. Doyle, RLS NOV 1977 Q PR INV OUT OF TANK 97.16 (� BASEMENT INV INTO D-BOX 95.3 PLAN TO BE USED FOR INSTALLATION L1J INV OUT OF D-BOX 95.1 OF SEPTIC SYSTEM ONLY 9 ^f , INV INTO CHAMBER. 9 .7 BOTTOM OF CHAMBER 92.7 NOT FOR DETERMINING PROPERTY LINES 99 r TH 2 A _.... ._...., .,._ Q...,. -: - TTfnl� nr na^, uni r 86 F, --::_._ _ �_.� _. _._ :-- BENCH MARK rcf OFFICE BEDROOM WATER TABLE NONE ENCOUNTERED Corn Of Shower Deck 100.0 (ASSUMED) BENCHMARK SET p N `�- UNFINISHED Shower decking. -- _..__.�..__..._ por SAS - 4 DRY WELLS , , 7DATE: OBSERVED BY: WITNESSED BY: E(.=100.0 (Assumed) DECK lOS X 39 SOIL LOGS DON DESMARAIS OLITD R 2.8' stone on sides; FEB 2, 2007 S ISAOIL E C. L ONS BOARD OF HEALTH _ SHO R 2.5' sto?4)e on ends HVl OBS. HOLE#1 OBS. HOLE #1 -` EL V. DEPTH ELEV. DEPT 11 99.5 0 pCD FILL FILL V �{ppnC � #895 96.5 E MEDIUM SAND 91, 98. ED SA 111 ^-' 2.5Y 6/2 B 2.5Y6//2 p \\ 96.0>< B LOAMY SAND 5 98. 16" y B LOAMY SAND 1 I \\ 94.8 I OYR 4/6 11 10YR 5/6 29 31 I \\ C MEDIUM SAND 96.9 C MEDIUM SAND 11 W 2.5Y 6/8 54.. 2.5Y 6/8 I \\\ Z 86.2 32" 88.5 32" . _ ..___._.._. _.__. i \\ �' NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED \ \\ PERC RATE<2 MIN/INCH LO lk ur i r ;q�yGo�. SEWAGE DISPOSAL SYSTEM t i \ is* C. PLAN SHOWING: j 125.591 =o= 1,i 0 �► ; `n .� ��I b / PROPOSED SEPTIC SYSTEM REPAIR IN BARNSTABLE i i114�� FOR: DRAWN BY: LISA C. LYONS i y,� BREWSTERBROWN DESIGNED & CHECKED BY: ®®9 • sRE61StE YONS LOCATION: LIO C. LDATE BUMPS RIVER ROAD . �® _ REVISIONS:DESCRIPTION: DATE: F i ""''� � �® $95 BUMPS RIVER RD CENTERVILLE �d����FR[D S ®�� LOT#: DATE: - ®�14111l�� SCALE 1 : 20 M16'7 P36 F:EBRUARY 12/07 ISO C. L ONS .S. // o I CERTIFY THAT THIS PLAN CONFORMS TO LI SA C . L Y 0 N S, R . S. lJr8) 790'9270 TITLE 5 AND BARNSTABLE B.O.H. REGULATIONS (774)t}$'7-16$8 (EXCLUDING WAIVERS SPECIFIED) IIYANNIS, MASSACHUSETTS i F, 00 TYPICAL SYSTEM PROFILE AREA PLAN FINISH GRADE= A0Cr FDN TOP NOT TO SCALE zo 0 FINISH Sc ALE : I FINISH GRADE OVER TANK= GRADE OVER P'Tz rl LOT -79- 3 PUMPS R I VER ROAD PVC OR 0 0 :C. I 3�9063 A TEES BSMT 42.00 GAL. 4 FLR L 4 0.00 REINFORCED DIST. BOX;j CONCRETE 8 TOBE I N STA LL E D'ON A LEVEL STABLE BASE FNID. TOP a go+ ST"K, F"D. SEPTIC TANK I 5 7 4,01f W 41 I 0 0 0, 0 .0 I I t 3,3,96, TO BE INSTALLED ON A f LEVEL STABLE BASE 2 1/8'!- 1/2 WASHED PEASTONE ALL PPCAST_CON C RF-TE- BRICK a MORTAR COURSES AS AROUND FREE OF IRONS- FINES P T MQID, REQUIRED TO BRING COVER TO GRADE, ANDDUST IN PLACE leirF: PnAt I- 6r ROM LE A'2.00 LEACHING R1 T. 24 C.1. MANHOLE COVER a 3/4 "TO I-1/2 "WASH ED CRUSHED LEVEL PIT T.F, FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE IRONS, FINES AND DUST, IN DISTP_I6UTIW '1B0y,f-4 1121� PLACE FOR FIN. GRADE I SEE SYSTEM PROFILE S 0 IL AND PERCOLATION P, 4 DATA--+4.5,% ERC.' RATE MIN.J(IN.I : -32-1+ FOR INV.ELEV SEE,4 C. D.' SPOHRCF-D. L,,6,r_1rY) . INLET O\SYSTEMGPROFILE -BY:ut LINE MR PAuL_.,mup_RA'2 -7 313EDROOM ' � 1aARAGE Opr WITNESSED 2�L' _NIN S W/4� 8"Lo I .48.06, OUTER DIA. & 1-3/411 DATE HOUSE 0 4 A C.618' 91 7' INSIDE DIA. TEST PIT-GND�ELE OTAL 3 WOOD LO^M AREA NO ROST + OIL 4 I0 0,m 0 0 0 0 0'LOT -7t 2 6 6 ]1A. BOT PERC. HOLE E F F E,CTIVE DIA. DOWN LEACHING -'P I T�- ' SECTION(r P0 T) NO SCALE DESIGN �`DATA :NO., OF BEDROOMS NOTE:,-DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM ;, ` D I SPOSAL IEST TOTAt"DAILY EFFLUENT :GALS.LEACH ING'�:': PIT NOTES:' SEPTIC TAN K' G A L.CONC TO' BE, 4000 P.S.1 2 8' DAYS 2, REINF W, ,-� 6 6i2 6 GA. W. W. M I -AND 4 SECTIONS ARE AVAILABLE FOR ' ,-STK �T:f.j D 2 M. GENERAL' :NOTES GREATER`.DEPTH REQUIREMENTS�co ALL SYSTEM.COMPON ENTS'SHALL BE INSTALLED: IN H -OF THE STATE�SANITARY CODE I `AtCORDANCE 'VIT ' �TITLt 5 NOTE' LOCAL, RULES APPLICABLE. ATE EXCAVATE TO ELEV.— OR LOWER AS 'D 00 D -j U LY,J�1971'a�A NY 2� ANY�t!­IANG B BY THE 00 REOUIR REMOVE ALL LOAMAND',CLAY CONTAINING ED TO T04TH I S''--PLA N M U ST. E­A PPR D.t�0 'BENEATH PIT-REPLACE EXCAVATED MATERIAL ,,- B A ERIAL D. OF'HE L H M T A T WITH CLEAN,CLAY, FREE GRAVEL MECHAN ICA LLY N'4S COMPLETED -PRIOR70BACKFILLING11 , 'CbNSTRUCT16,NOTIFY'BD. OF HEALTH ��FOR 1INSPECTION.', -c OMPACTED1N PLACE.'S.F. ' 'G'ALS 1,98 -4 S.F.1GAL 8'7 0 F., -,BE,CHECKED "COMPLIETED.�;' I4 ,FbUNbATION "ELEV MUST WH S. @ _0 EN 6' fTOM AREA S 5 THE L 9T nOT�BE CHANGED WITHOUT,'BOARD,,��I .6 S. F/GAI, GALS E_E EVS.1 'LEGENb� BOARD F HE LTH INSPECTION,REQD. WHEN EXCAVATED.(b E -APPROVAL Sum F,� ;, I A I VR 0 TOTAL F�' TOTAL -GAL OF,�HEALTH 0 0, ", 'EX+ 5 IST.' VROUND' ELEV:I .0 FINISH GROUND UNDERLINED.................... ELEV. ",D E -,CR I P DAT S �T I 0 N, ­�ANVERT.�. ELE P I P F -50"47, 'EWA 0 I'S RO S'A .­;`­SYSTE'M' ;S4 T EST: PIT LOCATION L FRL NOTE o E�� TOR SEPT b- "DISTRIBUTION s6' A LGF ,',40MEb IC� iTAW TO A sH m S S 4 _131T. F IGHTJOIN'"'. �-R I IBER PIPE EN T 4 I 'OT-7��` BUIVI R& RIVER OAD L c '_'1PI PE Charles D.,'No. OH DATt''Fp RE' 'U r IRED To B' PVC OR FI C- I- TEE 0 C)7F 0 1 EIN R CO N C E 24 "I GRADE FRA.M PROFILE -,77 D R A-W'[N G N 6 r PROPER TY-.'L I NE ,-,,,:A-r E 6 4::'0\*/"�,,,�,,va 77 r ' DtS:t' Ni,D ,C N E N '-COI ISTA PR S1+ -AS SHOWN D IS t-, CKEP: C �D,I