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0036 CAMP OPECHEE ROAD - Health
36 Camp Opechee Centerville A= 209—097 r__ i I SMEAEfl Wo.24531.OR MUM smead com • Made In USA No. / ' 1(/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Bispo9al 6pstem Construction Permit Application for a Permit to Construct( ) Repair A Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.3(, 6444P®j)6CH6_E kt> Owner's Name,Addr�ess,,and Tel.No. Assessor'sMap/Parcel 209 �`Vf 3(` e*&( G cC4625 Wo Installer's Name,Address,and Tel.No. SO$" P7-1-$Fs?7 Designer's Name,Address,and Tel.No.670 FS-a7 3—037 7 CAPC—WL*0g; (-t-C- _TG &.11t1A)6WJ)JG, 2111G Type of Building: DwellingNo.of Bedrooms Lot Size 4 QQy — sq.ft. Garbage Grinder( ) Other Type of Building P%G;Q n QQ- T7 r44. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 340,9 gpd Plan Date Oe_, (S. A01 5 Number of sheets ( Revision Date Title �-?6, dAx4> QP6cHe P®4l> Size of Septic Tank t,`SQQ G�{, Type of S.A.S.��� ;3Uo eg,4L Description of Soil $AL16? 4� tJ Nature of Repairs or Alterations(Answer when applicable) U :)C (:-C(ST(060 1SCO ESL LO SST tC__JA1 k� N ! - ao - 3O 3-00 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in 'accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date I L) ;)o15 Application Approved by Date (0- Application Disapproved by Date for the following reasons Permit No. OQ 0 1 / �f Date Issued /��7- '�" I V. vell { .4. M_ No. t /' Fee ( y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION ,- TOWN OF BARNSTABLE, MASSACHUSETTS application for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.3(0 PD Owner's Name,Address,and Tel.No. C`V1 U.(: EWAS µ 0RF_1RA Assessor's Map/Parcel 209 3G *Afp O �5CM25 POD <14 �A.9 Installer's Name,Address,and Tel.No. S O$ �7 7,.$$'l7 Designer's Name,Address,and Tel.No. SO F$ X7 3 0371 C4P EW cD 1g; U-G. -'c. Et41A)E'WA QGr XVCG 15 L'to k t.,U Q(01#4C__'9r s456E AEA' ;)L8 S C.ii I J cl2R RW Ey,kJ14;k-Q c4/4A4 Type of Building: � Dwelling No.of Bedrooms Lot Size 1 5, QQV sq.ft.. Garbage Grinder( ) Other Type of Building R�(���pq�, ` No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow prov .3ided Td. 1 gpd Plan Date 0d;r 175. AQ(5 Number of sheets Revision Date Title .3�2 dAmi'> (oPgci f et POs'l> Size of Septic Tank 1,500 e*(,,. Type of S.A.S. ;o _,%OO ery- cek U � Description of Soil dc.)AZSE S. XAQk? YA S4ZC— pC.4&/ Nature of Repairs or Alterations(Answer when applicable) U 5C- C-C(_5Tc 1JGc 150o 694 L40 Sq>DC _1A0K iD N t1,y H- ao 5'oo ec,4 Oat C �t�J� 41o41�ch�-S W 1'M P&P, P(, J 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 ) L) Application Approved by ` `�f Date (0 a —63�0(� Application Disapproved by Date for the following reasons Permit No. a 0 ( � ' 3 �� � Date Issued 10 t --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired Upgraded( ) Abandoned( )by G t�( G �i�JZ� R�i�l�; ( Lc- ato (4{[7 O PECEt5 PD4D d'VILLA51has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. G(, 1�j dated 'j o -2 1 - / Installer 4C_APGW(1* EFLTT P t� ;� C.C.C. Designer �C �{. IIJ Rl1C)Gt S #bedrooms 3 Approved design flow _ 33<) gpd The issuance o this permit shall not be construed as a guarantee that the system will notio�n�/as designe . Date j 2. I Inspector / ---------------------------------------------------------------------------------------------------------------------------- No. AC (� > V Fee l W. THE COMMONWEALTH OF MASSACHUSETTS - PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 36 < Aai(7 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date �! Approved by J KO 11/13/2015 07 :47 5082730367 N4385 P. 001/001 Ica % Tow of Barnstable --- --=Rei gulatory Services Thomas F. Geiler,Director BARN9TAaL = Public Health Division MASS-Thomas McKean,Director 200 Main Street, Hyanais,MA 02601 Office: 508-862-4644 Fax; 508-790-6304 Date: 11 13-15 Sewage Permit# J 015 -3�5 Assessor's Map/Parcel 201 l 1-7 Installer& Designer Certification Form Designer: ZC, Et28t0ee;(Qc), 106 Installer: Ca�e�: �d2 Lnterects�5t LLL Address: 2h5y Cconbecry N���w�y Address: l53 Go�MmercrGl S�(ee East wcreham , 11ft o�`38 NashPEe, Y1R 62-641 9 OnGaptwcde_ Co ereasetS was issued a permit to install a , (date) (instal ler) septic system at 3 G Cam D Ue6ee. �"4 based on a design drawn by (address) — dated 1° - 15- 15 (designer) � l 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 and/or septic tank. Stripout (if required) was inspected and the soils were fOLInd satisfactory. I cenify 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 of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if req ' nspected and the soils were found satisfactory. '"O° JGt-!N L. CHUFCNI,-L s JR. GIVIL ( taller'i Sign tire) No 4W7 esigner s Signatur (A ix est er s mp Here) LEASE RETURN O BARNSTABLE PUBLIC I �'.ALTH DIVISION. CERTIFICATE OF COMPLIANCE WILLNOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOt!. i al'I'icC Iium,;Jrsign�rcerlilicAtitm rann.doc TOWN OF BARNSTABLE LOCATION, (@ -P oprxktz��n SEWAGE# A01 _ PILLAGE ���2T �It.cl� ASSESSOR'S MAP&PARCEL C INSTALLER'S NAME&PHONE NO.y4QlculcbcG EgMW&SES SEPTIC TANK CAPACITY LEACHING FACILITY.(type)(-X) 500 GA CAe&t kU (size) 4&no *? S o-Cr NO.OF BEDROOMS 2) 5 iZc I V LAtJ OWNER_ G u dg l "I`�lZ P I?.A PERMIT DATE: `__. _, 10—1l•,LO t COMPLIANCE DATE: Separation Distance Between the: N 0 CT.0 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 0(6E?-V EZ) Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) W(A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) A Feet FURNISHED BY C..alewn�6LJ ,eP P a LL C ti A-z 3 A-3 5�9� IQ�.� =56,`�` ® ® I' B"A o 5 Li 5®.� a � Town of Barnstable Barnstable Regulatory Services Department ANWRINCft 1ARNSTABNAM LE ' , ' Public Health Division m 200 Main Street Hyannis MA 02601 2007 Office: 508-8624644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO September 22, 2015, 2015 Betty Brown, TR 19101 Mystic Pointe Drive#1908 Aventura, FL 33180 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 36 Camp Road, Centerville,MA was last inspected on August 15,2015,by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level,<12" below inlet (per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BO OF HEALTH an, S., CHO Agent of the Board of Health • QASEPTIC\I,etters Septic Inspection Failures or Future Evl\36 Camp Opechee Rd.Cent.Sept 2015.doc Parcel Detail Page 1 of 3 eJ rs€ nr � 5 MASS, t e - _ Logged In As: Parcel Detail Monday,September 21 2015 Parcel Lookup Parcel Info Parcel ID i209-097 � Developer SLOT 1 � w Location, AM AD 36 CP OPECHEE RO � Pri Frontage,103 � �) Sec Road_ Sec Frontage Village ICENTERVILLE ; Fire District 1C-O-MM g Town sewer exists at this address No Road Index 10220 Asbuilt Septic Scan: Interactive , Map 209097_1 ly n y Owner Info Owner BROWN, BETTY TR ' Co ownerBETTY BROWN REVOCABLE TRUST � Streetl 19101 MYSTIC POINTE DR#1908 F__ u.ro._ Street2 City sAVENTURA �� State FL zip33180 Country Acres'0�35 use jSingle Fam MDL-01 Zoning'RC Nghbd 0105 Topography Level � � Road IVYved Utilities jPublic Water,Gas,Septic I Location Construction Info Building 1 of i Year RoofRoof Gable/Hip Ext Wood Shingle Built Struct wall Living 1101 Roof FAsph/F GIs/Cmp� AC None Area Cover Type 4l Int _" Bed ,. —M Style Conventional Drywall 13 Bedr0000ms �® Wall Rooms Model Residential Int iC rpet � Bath 2 Full-0 Half �� r FR;;.. Floor Rooms' Grade Average Heat,Hot Aire Total 5 Rooms �� 17 Type Rooms Heat '" Found-r Stories1 1/2 Stories Fuel Gas ation Poured Conc. Gross 063 Area Permit http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=14954 9/21/2015 Town of Barnstable a�xtvsr�at.E, 0391 ,�� Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 7/6/15 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. o Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑Amy portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA o Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc ep 14,,15 07:47a p.1 commonwealth of Massachusetts = Title 5 Official Inspection Form �1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r..0 rz .. 36 Camp Opechee Road Property-Address - !-- Beth Brown Trust Owner _ Owners Name a, information is required for every Centerville _ MA_ 02632 _ 9-9-15 F page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way- Please see completeness checklist at the end of the form. Imng out forms A. General Information filling out forms �� //�� ��u�uunanrn use onlyon the he pute tabr 6 0``�� �(W OF ���ii���i y 1. Inspector: ��r9 '' ' - q •�. key to move your •'cyG's cursor-do not James D.Sears JA M ES N use the return key. Name of Inspector SEARS Ca ewideEnterprises,LLC ,y Company Narne �l' R T{�`O 153 Commercial Street ���'F 5 INsP��'�.�`��� Company Address -�ip+ttnnuu�����a - -!Mash et _ MA 02649 CityfTown State Zip Code 508-477-8877 _ S1623 Telephone Number License Number B. Certification 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 16.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority _ 9-12-15 Aspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. "`*'"This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. (Sins-3113 / `�&rn US Title 5 Official;nsaeciion Form:Subsurface Sewage Dispcsala 1 of 17 Sep 14,15 07:47a p.2 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is MA 02632 9-9-15 Centerville required for every _ _ page. Cityrrown State Zip Code Date of Inspection B. Certification (Cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Failed system -leaching. The system is a 1000 Gal. Tank D Box and pit. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old`or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exFiltration or tank failure is imminent..System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): l5ins-3113 Title Official Inspectiol Form:Subsurface Sewage Disoo<_al System•Page 2 of'7 Sep 14 15 07:48a p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form - yyy Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Camp Opechee Road y A _ Propertddress Beth Brown Trust Owner _. _... - Owner's Name information is required for every Centerville MA 02632 9-9-15 _.... __ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3113 Title 5 Official Inspection Form:Subsurfaco Sewage Dlspo<al Sjsfem•Pane 3 of 17 Sep 14.15 07:48a p.4 Commonwealth of Massachusetts s Title 5 Official Inspection Form " -- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust - Owner Owner's Name information is Centerville required for every' _MA 02632 9-9-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool t ® ❑ Liquid depth in ee2spmW is less than 6"below invert or available volume is less than '/z day flow /0i7— c5ins•X13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pape 4 of 17 Sep 14,1507:48a p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form _ - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments N tea. 36 Camp Opechee_Road_ _____ Property Address Beth Brown Trust Owner Owner's Name information is required for every Centerville MA 02632 9-9-15 page. City/Town State Zip Code Date of Inspection B. Certification (cant.) Yes No ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ �I Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or 'no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply a ❑ 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. l5ir.•3113 Title 5 OHidal!nspedio^Form:.SubSLflaCe Sewage Disposal Svstem•Page 5 of 17 Sep 14.15 07:49a p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is required for every Centerville MA _02632 9-9-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the'SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. El ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Tille 5 Official his ection Form'Subsurface Sewage Disposal S stem-Page 6 of 17 P A P Y 9 Sep 14.15 07:49a p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is Centerville _ MA 02632 9-9-15 required for every _ page_ Citylrown State Zip Code Date of Inspection D. System Information Description: The s stem is a 1000 Gal Tank D Box and pit Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): 2013-160,000Gal 2014-145,000Gal Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: - --- Design flow(based on 310 CMR 15.203): Canons per day(gpd) Basis of design flow (seats/personsfsq.ft., etc.): — Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 Title 5 Offic.al Inspection Form:Subsurface Sewage Disoosal System•Page 7 of 7 Sep 14.15 07:49a p.8 Commonwealth of Massachusetts __- Title 5 Official Inspection Form JA Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner __... .. ...._. Owner's Name information is Centerville MA 026.32 9-9-15 required for every __. _...._ __. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: _.... -- Date Other(describe below): General Information Pumping Records: Source of information: 6/5/15 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? - - Reason for pumping: -..... - -- - Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): .1.5ins 3113 Title 5 Official inspoct:on Form Subsurface Sewage Disposal System-Page 8 of 17 Sep 1415 07:50a p.9 Commonwealth of Massachusetts zi _ Title 5 Official Inspection Form _- ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments ia, y 36 Camp Cipechee Road Property Address Beth Brown Trust Owner Owner's Name information is required for every Centerville MA 02632 9-9-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components; date installed (if known)and source of information: 1986 Permit #86-681. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 22"feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Pipeinq is 4" PVC SCH 40. Septic Tank(locate on site plan).- Depth below grade: 22- ------ feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal. Precast H-10 Sludge depth: 1" c5ins•3/13 Title 5 Cfficial Inspecion Form:Sutsurface sewage Disposal System-Page 9 of 17 -Sep 14 15 07:50a p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1y . 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owners Name -- — -- information is Centerville MA 02632 9-9-15 requireequifed for every -----..... . ... .. ._ .. ._-.-- -. ---._..__.. page. CitylT'own State Zip Code Date of Inspection D. System Information (cont-) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 29 Scum thickness Distance from top of scum to top of outlet tee or baffle 12" --- Distance from bottom of scum to bottom of outlet tee or baffle 17" AsbuHow were dimensions determined? Sludge -Tape _Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level.Tank and covers at 1' below grade. Inlet tee,outlet baffle. No sign of leakage. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness - - Distance from top of scum to top of outlet tee or baffle -- Distance from bottom of scum to bottom of outlet tee or baffle --- Date of last pumping: Date 15•ns•W 3 Title 5 Official Inspection.Form:Subsvrace Sewage Disposal System-Page 10 of 17 -Sep 1415 07:50a p.11 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is required for every Centerville MA _ 02632 9-9-15 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: --- Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: -- -- Capacity: — gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required), Is copy attached? ❑ Yes ❑ No Bins•3n3 Title 5 ofriciar Inspection Form:Subsurface Sewage Disposal System•Page 11 of t7 J f Sep 141507:51a p,12 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is required for every Centerville MA 02632 9-9-15 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x16"-34" Below grade w/one line out.Wall Gone, need to replace D Box. PumpChamber locate on siteplan).- Pumps ( t in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances. etc.): ` If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ins-3i13 T tie 5 Officia.Inspection Fow:Subsurface Sewage DisFosal System-Page 12 of 17 1 'Sep 1,4 15 07:51 a p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a \ 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is Centerville MA 02632 9-9-15 required for every — — - — — - page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions.- overflow cesspool number: — ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is a 1000 Gal. Precast Pit. w/1' stone. Pit and cover at 35" below grade. Level in pit at 1" below inlet line. Failed pit. Need to replace leaching. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert - Depth of solids layer Depth of scum layer Dimensions of cesspool — - Materials of construction - Indication of groundwater inflow ❑ Yes ❑ No 15ins-3113 Title 5 Official Inspection Form:Sutsur ace Sewage Dlspcsal System•?age 13 or 17 'Sep 14 1507:51a p.14, Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments — 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is Centerville MA 02632 9-9-15 required for every _-_.._..._. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: --- Dimensions -- Depth of solids - - - - Comments (note condition of soil; signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Isins•Y13 Trlle 5 Official I-speztionForm:Subsurface Sewage Disposal System-Page 14 of 17 Sep 14 15 07:52a p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments i 36 Cam- O echee Road Property Address Beth Brown Trust Owner Owner's Name information is Centerville MA 02632 9-9-15 required for every _ _...... page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately F/t u Nr 151ns•3I13 TAIc 5 Official Inspector Form:Subsurface Sewage Disposa System•Pag315 of 17 Sep 1415 07:52a p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4y 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owners Name information is required for every Centerville MA 02632 9-9-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 6 Estimated depth to high ground water. e0t+ Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting propertylobservation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Ck Abutting area no G.W. at 20'+. _ Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15ins•3113 Tille 5 Offida.Inspeclicr Fo-m:Subsuface Sewage Disposal Systern•Page 16 of i7 Sep.1415 07:52a p.17 Commonwealth of Massachusetts = Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Camp Opechee Road Property Address Beth Brown Trust Owner Owner's Name information is Centerville MA 02632 9-9-15 required for every .. page. CityrTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/73 Title 5 Official Inspection Form:Subsurface Sewage DispowI System•Page 17 or 17 Town of Barnstable P 0 Department of Regulatory Services Public Health Division MASS. Date• .� �,, i431ti 200 Main Sheet,Hyannis MA 02601 TEl)MA'1 A Date Scheduled �!� /( �_ - - n Time-.] 1 I A4 Fee Pd. k/0 a 0 "o 4- Soil Suitability .Assessment for Sew ge .Disposal Performed By! MlChoieI p1/Y1Pii EZr CSC . WitnessedEy: . LOCATION& GENERAL INFORMATION Location Address t Owner's Name `7i✓TT 3(o..C_At�P C��L:G�{�� ��. CVIG(L p y szoe�sce.I q Address (-1 I O1 I\A45T i C_ PT DIL A%j ukA V: � Assessor's Map/Parcel: ® 1 �U q CA�.)(De �T GIs Li Engineer's Name NEW CONSTRUCTION REPAIR _ Telephone 77-1✓2Z'77 08-2-73-0377 Land Use-�Estde/} Iaiei�(v1� Slopes(96) $ Surface Stones . AIA /�- Distances from: Open Water Body �77 l 50 tt Possible Wet Area 7I5 O ft Drinking Water Well �i�0 ft Dralhago Way / S ft Property Line _ft Other r ft SKETCH:(Street name,dimensions of lot,exact locations of teat holes&perc tests,locate wetlands in proximity to holes) Sew a}+ached P`oft) Parent material(geologic) Q(/7 (,J05A P f a lA Depth tq Bedroc>t 7 86S Depth to Groundwater. Standing Water in Hole: ` 4 G Weeping from Pit Fpee 7l Estimated Seasonal High Groundwater / Zb 8 GS DETERMINATION FOR SEASONAL*HIGH WATER TABLE Method Used: D/Lec•f p hSeLve;flo n / Depth Observed standing in obs.hole: 7 f�b __�In. Depth to soli mottles: Depth 7 G to weeping from side of obs.hole: Index Wellli _ ll� - ---It), Groundwater Adjustment fr, Reading Date: Index Well letiol Adj,}hCtor _ T Adj,Groundwater Level Observation PERCOLATION TEST Dfli 1D-?-i.5_rrinra it'►tc�w� Hole# tr Time at 9" i� Depth of Pere Time at 6" _ Start Pre-soak Time / a ill Time(9"-611) End Pre-soak Rate Mio./Iuch . �^ Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N)_AJ Original: Public Health Division Observation Hole Data To Be Completed on Back--------; ***If percolation test is to be conducted within 100 of Wetland, must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:IS EPTIC\PERCFORM.DOC �0 vs DEEP.OBSER`6TATION MOLE LOG Mole# r-f 2 Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsistency,%drityen o- Zy - _ ^ . FULL 2 - Z 6 ALQPr1 Sal?d 0 P 3 , Z6—yZ Q Locimy Sanj o l 5115 — qZ.- 66 e- 1 coArse sA � . l oyr 5 6 - jo-2o '/. 6-ar6kveI 66 - i26 _Z fned- Co rseSCIA6 616 - DEEP OBSERVATION HOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% ra ]DEEP OBSERVATION BOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%O DEEP OBSERVATION HOLE LOG: Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Con ' to Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes ._ Within 500 year boundary No V+ Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? -e If not,what is the depth of naturally occurring pervious material? Ceftifiication I certify that on /0'27"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 required training,expertise and ex ence described in I10 CNM 15.017. Signature Date Q:\S EPTIC\PERCFORM.DOC ASSESSORS MAP NO: 209 No.--•---•....-••_..... g� 6 t . PARCEL NO.: 97 Fes$... .S ._� .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.. ..............O F.........Barnstable..........-------------------------------.-..-----._.- Appliration for Biovoottl Workii Tomitrnr#ion ramit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: 36 Camp -0-pechee„Road _„___,__Lot 1 Loc 'on-Address or Lot No. Sandra Realty Trust --,,,,.. 36 Camp•,- Opecheea•Centerville,,,MA,_,,,-„ _........ ................................................... ..... W 5EGL�P Oyer � Address a ...........................................................W / 'v` ---------- --- -------------------------- ---....... ..... .......... ..-•-•---------- Installer Address dType of Building Size Lot....1.5,.QQQ..........Sq. feet Dwelling—No. of Bedrooms....three.•(3)...................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building ..... No. of persons............................ Showers — Cafeteria 44 Other fixtures --------------------------------- W Design Flow.............................................gallons per person per day. Total daily flow__..........Q30_........................gallons. WSeptic Tank—Liquid capacity1.00.O.•gallons Length...$'........ Width-;:4. ........ Diameter................ Depth..4........... x Disposal Trench—No. .................... Width.............._..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------.............. Diameter._8............... Depth below inlet....... Total leaching area.....202......sq. ft. Z Other Distribution box ( x) Dosing tank ( ) '-' Percolation Test Results Performed by..CBI_.E.NGINEERIXG.,...Garrge..Lombar-dcDate....��10/86............... `�a Test Pit No. 1.....2........minutes per inch Depth of Test Pit___1-2............ Depth to ground water........nGQe-_-__-- 44 Test Pit No. 2................minutes per inch Depth of Test Pit----1.3............ Depth-to ground water--------none..-___. . 0, _..�.s...T'opsoi2-...............................................O.T._I.,...T'opsoi_T.................................................... O Description of Soll...I.,_-.__.4.F._.L'oainy""saiicT""sii�soil"""""""""""""""""""""T� = l+t Loamy sand siiTisoT....•.......... x . U ---•------------------••-•--------V--._--6+...EM--sanc?---•-•--..--..-•---------•-•---•---------4+••_ IZ, coarse'sancT..... UW ------------------6-t-••_ tTv..-Goa--se--sari Nature of Repairs or Alterations— rAnswer wLen applicable............................................................................................... ..............................--------•-••-----------•----•------••--------•-----------•----...--•---•-•---•------------••-------------•-•••-••-•---•-•-•------------...-------••-•-----------••-•---•. Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE, 5 of the State Sanitary Code—The undersigned fu ther agrees not to place the system in operation until a Certificate of Compliance has been " ued by the board of h th. Signed --- �---------- ...••.......... ................. ----------- -- - =�------ Apphcarion Approved BY---••-----------•�•� -•-------- _.__...-• ------•----•--- --� ��•• Date Application Disapproved for the following reasons---------------•-----•-----------------------•-------------------•---------------•-----------•--...........---•-- Date Permit No......................................................... Issued-.................................... ......................... Date Map no: 209 Parcel no. 97 No. Fss�S_..`.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD .OF HEALTH ...............Town.................OF.......; BrnS.table...... Appliration for Displial Workii Tunutrur#inn Prrutit Application is hereby made for a Permit to Construct (g ) or Repair ( ) an Individual Sewage Disposal System at: .....36_ Camp Qp.g heo_Road Lo .. .................... ---------------------------•--••--------• -----....._...---------•-•---•--....................... Sandra Real tyLalatlgt's]address 36 Camp Opech�;°6i� terville, MA ......-•..............-----•---•-----.......--•--:.....-------•---------.........------.......... . ..........----------._...---...........••----•-----...................._......__.___-_._________-- W Sc Qwney/i_,(jly Address a ._._....... Installer :_... ................ Address 1 5 000 Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...._.threk__(3)________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures ..---•--•-•-•-•-•---•----------`:................. d ---.-. :.-•.............. .........••... W Design Flow............................................gallons per person per day. Total daily flow.............330.......___._......._.._.gallons' WSeptic Tank—Liquid capacity.lOOQ.gallons Length___.$.......... Width.....4......... Diameter................ Depth.... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........1......... Diameter._... ............ Depth below inlet..... ........... Total leaching area...200........sq. ft. Z Other Distribution box ( X) Dosing tank ( ) '-' Percolation Test Results Performed byQ .•ENGINEERING,__George_Lombrdo Date.....� __________________a a TAst Pit No. I......... .....minutes per inch Depth of Test Pit._12.............. Depth to ground water, none.......... 93, Test Pit No. 2................minutes per inch Depth of Test Pit.la........... Depth to ground water----none.......... � . p4 G� - 1� Topsoil -0' - 1' Topsoil ...............•-•-. .......................................... 0 Description of Soil....................1_' - 4' oamy sand subsoil 1' - 4' Loamy..sand subsoil .....----•-•.... ......-.......... 4' 6.....fine sand ......... 4' 13' coarse sand U Nature 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 TITIE 5 of the State Sanitary de—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be sue b the boardealth. ,� �� Signed .... _---- Application Approved B �_G_= .................................... 15 D tg L Date Application Disapproved for the following reasons:................................ --....----•-•-•-•---•----•----•........................•-----•-•----.....:•---.---_=................................................................_................................................. F Date PermitNo................................................... --- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................OF...........C�-Ns..IYZ.�......................... Trrtifirate of Toutphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............. ........................ -•------------•-•-----...---•----------•=------•-•-----------------------------------•---•-------... ---•-- r Installer at--. �?.._.._. f:h'.`'.�...Q.t'_.�. has been installed in accordance with the provisions of TITLE 5.-oflh State Sanita Co a described in the `'/ application for Disposal Works Construction Permit No`` -.`�'r'._......"�'"5...�._....... dated ...��........_��'............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F tCCTIC?",SATISFACTORY. DATE.... . ....-•.................•---........................-•---- Inspector.................................................................................... Z,b� f q-7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH __— s�Z� .......................OF........� ...................................................... DiupolialFflr4A Tnnotrurtion Uprrutit Permission i hereby granted......_.....5 .. to Construct ) or Repair a iv . Sewage D sp at No.......3_b-•---62.A?.1e....0 A--__L .-a -� u-) ...... as shown on the application for Disposal Works Construction..Per-mit Street mil-...... Dated.............A..................... _.._ � ` X Board of Health DATE........ . ....... ....... t... .............................. FORM§I255 A. M. SULKIN, INC., BOSTON . t , �j TOWN OF BARNSTABLE ma- LOCATION / ,4�w,4 /�'�.ECl1�.�' SEWAGE # 7 ,:QrS r. Pt 3if�j �2 VILLAGE C 17,Y7 2/Z y i LL X ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 04or, /3 A,&Z SEPTIC TANK CAPACITY LEACHING FACILITY:(type)T�i� (Size) e/,NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ism% DATE PERMIT ISSUED: Q!/.9gcf DATE COMPLIANCE ISSUED (/���/�0 VARIANCE GRANTED: Yes No �w� a �' �u���P�� _,. S'� 40 • 4� 4 G`/ ASSESSOR'S MAP NO. ZUq t/7" PARCEL_I LOCATION SEWAGE PERMIT NO. VI-LLAGE 21 INSTALLER'S ( NAME i ADDRESS d U I L D E R OR OWNER D DATE PERMIT ISSUED DATE COMPLIANCE ISSUEDlz:- � (� A fJ���c�r�� ►?zi .` cam' %"3�1 ,.,, _ .d�''v'�'- "' ,/�` � ,.r. ``� �J ..tea:, - — •--.»..i:� - *.o . No...........�. . .. '�'4, .. F $... . . fir..... a!e` THE COMMONWEALTH OF A SACHU `^..M S SETTS '3 ',�-"'. BOA RD F•"iH BALTH .... ..........OF......... .. `...�t/d�. .................................................. .Y ApplirFatinn for Big aii al Vorkg Tonotrnr#inn Famit , Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ; C System t: ---• l::• ice• � �� ...---.....-•-----•.............. •----••---------•-------................. a� -•-••- Locatio -rlddress - -----------------•••--••or Lot No. J �1.------•--1-------------•................. ............................. • wner Address a •• •-•- Installer Address Q Type of Buildin Size Lot--_-----_-----------------Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—T e 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—No..................... Width.................... Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No----------------_-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test 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........................ ------------------------------- ••----•-••---•--------------.--•-...---.--•--••-----------•-----...---•-------....-....-.-------•----•--------•--•---•-••-- 0 Description of Soil------------------•----•-•--------------.......---....-----•---•------•------------------------------•-------•---------------------...............•-•----------------- x c, ......................................................... ----•-----•------• ------......------•------•------- . --------- . .......................• — U Nature of Repai Alterati s—Answer when applicable_- - - ,1 -- --- -------� ��e!� ..--•--•----------••-------- •--' -------------------------------------------------------------------- ..................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT:..x; p 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. Sied--.................................................................................... ............................... Date Application Approved B .......� Date Application Disapproved for the following reasons:-----------•---------------••-•----•-•-------•---•-•---•---•-••----•-•--•-•-----••--------•-•---•.............-- Date Permit No.. .. Issued._. Date `T olk No................�V ..... f FEs............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH ......OF........ ... .. ........... Appfiration for Diipnsaf Vorkg Tnnitrnrivan Prrutit Application is hereby made.for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System t• ....... :.....................................•---------......._••----...........---_.. LocatioiT-Address or Lot No. • v �..... ........................................... ...............------....----------..........................-----•-----•-•---.........._..---•--. ��r�G- wn2r Address .................. . . -•--•--•---•---•-----•------••---•-••---•----------• ••-•--••-•-------------••-----•--•----••-----•-••-••••--•-••••--•-----•----•-•-•••--------•••----- CQ Installer � Address 14 Type of Building' Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pk Other fixtures ---•-------•----•----------------------------- ----------- --------------- -------------- tll W Design Flow..............................................gallons per person per day. Total daily flow..._................_.................._....gallons. WSeptic Tank-Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ xDisposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-------------------------------------------------•-------••--••-••-------------•-----------•--------•--------__............_._.__-___............ 0 Description of Soil........................................... --------•--------------------•--------------------------- W U .-----------------------•...-•---------•-•--•---...........-----......._..............---•-...-•---.._....------•---------- --- . W --•--------------------------------------------•----- -------------------------------------•-------------. "ram"-- �A�f� ----------- -- / ---•- UNature of Repai Alterati s—Answer when applicable_."- _ ------/,/"9a -- .��i+� f-----•`-'--------------•----._..............---•----•---------------------------••-•----•-- -----•--------------------------------....-•--•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 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. Sie --_-•... ......................................•--------.....•-••---------------- �� % Date Application Approved By----- Date Application Disapproved for the following ..reasons:................................................................................................................. , Date PermitNo.....................................................--- Issued•............................ ....................... Date THE COMMONWEALTH O`F MASSACHUSETTS r BOARD HEALTH ... ..OF....... c < '2.........................:......................... Trrtifirttte of Tnutpfianrr T IS� TP CER '1 Y, T, at the- Individual Sewage Di1-11------sposal System constructed ( ) or Repaired (� b .......... .......... � .......................... ,✓�� " sEallerZy at...........bt has been mstalled�in accordance with the provisions of ' of The State Sanitary Coe as described in the j ,�application for Disposal Works Construction Permit No,�.____________ __________________ _ dated-. . . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS UE® ARANTEE THAT THE SYSTEM WILL, FUNCTION SATISFACTORY. DATE....:...Z•.....>,3-------••-=-• ............................................ Inspector..... .............._.._ ........................................--------•---•-- TH-E_CO-MMONWEALTH OF MASSACHUSETTS BOARD .19• , HEALTH tf' ,. ► v .�� ..........O F........ ... .. . ...;.'........ �--U �-.- N FEE........................ in I nrk `n Ilan rruti# Permission is hereby grante __._, ,-.. - ........- .__.Ftr; _44'a/ ..._._. �.� ;.... to Const-act ) Zepait (''r)"an nduuale�rage,Disosal Syst �� at No.- _ 1> ....... F` - l � �% �-a �r j � ?_.. -------•--•--•--•-......--- + /Street as shown on the application for Disposal Works Construction P It No.._�_�____::._._.__ Dated_.��_.... i .................. --- . ... !. ± ._ _...-•..................... .• �,. „ _...---DATE.. --------------------•----••-••••--•----••-------- � Board of Health v • FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ,. ' LOCATION SEW A- PERMIT N0. --3 .,y VIt;LA pod /-/©v�� IN.STA LLER'S NAME & ADDRESS �' E®E0R®S trucking 0 wulldv,sng Hyannis, Mon. 775-0628 BUILDER OR OWNER DATE PERMIT ISSUED DAT E. COMPLIANCE ISSUED \ i 'moo. 0 77 .�.+ " rJ a, re f"- r • SOIL TEST DATA DESI N DATAi'T S _ b h r of rooms Numbe Bed 3 Date of Test b, 1 i !♦ Total Design Flaw �. �? Spd Tested by Pe c8 4 Witnessed b Y JANrS COnlLonl R S '\� 1 Septic Tank Required 1.5x3 0 5 g J � � - p �1 3 4� gal. Fl c. ti Se tic Tank Provided /oeav ® Percolation Test o � 4Depth , K, of test s o 4 ti � g �, Leaching Facility Provided: Rate LEss TRW min./in. o g Z s o d ti T 1"4 pi7 sb ti Type LfAGfE / Data Pit Test• Y 1,�ax �' Number T ;,. / •e • /. D]JT1erLS10nS 6 r( ��AIgL �jh1AQj" sd -*Test Pit 1 # Test Pit. #2 !yk ►► Garbage Grinder Wfl/hll Not Be Used Elev.:'30, Elev. ttlt 40 pyC d"� (5C1% area increase is req d with grinder) /f[ .. ir of Leaching Provided: TGPSoIL +� in Pso/l ; s y „ Bottom S 0 ft y �a�.+ i LoA Y s n1 �■ n � 9Q LOAM S �. /r A O ; .+T r 0 Septic 'dank . .ti id 1 i S ft syaaarl; sKas 1�. � P . *, � S ewal � sq �� ti 211 layer ooD al. •6 Y -Total a t� ft y ��. S Dist. 3/4 to 1 i/ ;• � s9 t 4 8to14Aff $ Box Stone / / - . _ chin t 1 a- 0 / ► ;r ':"y •- ,a•, :.--:- ..�� � Stone " Capacity.Provided. - �br • d Pit .� 8 P� Y S( Bottom ,�sgft x gpd/sgft 50 gpd • zo, a c dA41st• sAa6 8 ti j Sidewall l50 ft x b / ft Total t 5 r� i — P Bottom a Bot o 0f Pit Breakout Calculation: �._ ! �w i 8 T� PROFL4f _.__ NOTES E.S.G.W.L. 1. Allinstallations shall conform to the minimum Observed water No45 Observed water woNr requirements of The State Envirarental Code E.S.H.W.L. E.S.H.W.L. b T f 13'1�'usrABL..Title 5, and the own o Board of Health. is not a 1 survey. Benctmark IIev. 3 0. � , 2..Ttus property line y. Bamdry ® Q ASSU _O c ti information from a P t�r n:T"PI-AA/A/ o fi a s � inf S ca�r t�M , 0 , 3 A !_A►/l�7 IN G'�'it17F.R✓1l.LE Hq FOR CLV µ, P W AT�R nAx[B��e� r+ArecM �G1 ih7G Pic A2F0 , i m r /SZ1M� ooTo t r ��+c. w�s7 yo-��r�a�t�N t-�fk .� 3v -t"X C� C +R.1 3, Tot:.f1,3 WATER a ,_ _30 P�toPasFo caw�act,��, 43 tL ! � r I 1 I _. 3 J P t d t ri O G { HARSN Q. r I. FJ 4 , J• s J o F ! � tp1 LOCUS ` -,.. { �. � i U S 3 � � I o fl AD D)T1 SEWAGE DISPOSAL SYSTEM DESIGN IGN - �ESFpvE" /oo y 1 o u S � on. CAMP Rp for : SaND� � ��r?Ru s r- Septc TavK i CF',vTwt✓lLl.E C'AHP O/,ECNEE RD I � 6 s ryA 3 G gx -rPz \ t�acN1 P,9,TC FJ. a O 7 c T Vi L y � � 'N R 1. Pt T r ; l I L 0 8 Q f.J • o i 703 �20 E"--r- /y0, 8 .. engineering H� OF. M i /-Yfi ,. •. A q s o �I GREOGE G. ti, G � LOMBA RDO , c, SANITARY -+ PLAN _ ARY - I Na 32533 o G R STE e , sr hnvirnomental Consultants 24 Forsyth Avenue South Yarmouth # MA 617# ( ) 348 5215 i T.O.F. EL.= 51 .8�± FINISH GRADE OVER D-BOX= 51 .7 PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE± FINISH GRADE OVER CHAMBERS= 51 .4' - 52.3' GENERAL NOTES PROVIDE H.D.P.E. RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION w/COVER TO WITHIN 6" RISER TO WITHIN 6"OF FINISHED GRADE 7 OF F.G. (TYP OF 2) 4" SCHEDULE 40 PVC INSPECTION PORT w/ACCESS BOX WITH - METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 50.7'± F.G. OVER TANK EL. 51 .0'± 5"DIA. OUTLET(S) COVER TO GRADE (SEE NOTE#21) STONE OR GEOTEXTILE FILTER FABRIC FINISH GRADE MIN SLOPE 1% 2" OF 1/8"TO 1/2"DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. r= _ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS COVER(TYP.OF 3) 1 TOP OF SAS= 48,80' PLACE H-20 RISERS ON DESIGN ENGINEER. EXISTING 4" PROPOSED 4" 9"MIN. ,% 3.50'MAX. ALL CHAMBERS WITH 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE PVC SEWER PIPE 36"MAX. 47.80' SEE NOTE 22 BREAKOUT EL= 48.30� INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. FINISHED GRADE 6 3"DROP MAX L-25'+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 3 3 9 PROVIDE WATERTIGHT ELEVATION =48.30' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 2" DROP MIN MIN.SLOPE@1 040 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF jj,,_�- JOINTS (TYP.) THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. I! 13" 14„ * , SEPTIC TANK4" PVC IN 4" PVC OUT TO o0 0 0 0 0 0 0 0 0 0 0 0�� 0 0 0 O o -� 48.5 ± O LEACHING FACILITY po 0 0 o0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 12" 6" oo = = = = o o 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. CONTSHALLRVE IIFR I FYY SIZE 48" VERIFY CONDITION OF TOR SHALL OUTLET TEE 48.17' MIN. 4$,OO' 2 0 00 oppo 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONE o 0 0 0 oo NOT TO BE BACK FILLED WITHOUT FIRST OBTAIAND READY NING APPROVAL FROM BOARD OF HEALTH INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY po 0° o TANK NECESSARY COMPACTED BASE AND DESIGN ENGINEER. 2.0' 8.5' (TYP) 2.0 2.0' 2.0' 5 OUTLET DISTRIBUTION BOX (4.83.83' 8. ELEVATIONS BASED ON APPROXIMATE MEAN SEA LEVEL DATUM. BENCHMARK ELEVATION TO BE INSTALLED ON A LEVEL STABLE VARIES (SEE PLAN) OF 50.00'ESTABLISHED ON TOP OF A NAIL SET IN UTILITY POLE#100/5 AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 45.80, GROUND WATER ELEV= < 40.50' VARIES (SEE PLAN) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. I THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 2 - 500 GALLON H-20 CHAMBERS 5' MIN. CHAMMBER EINU VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILE TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. `CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR H-20 Di b i " b U �I ON BOX DETAIL H-20 CHAMBER DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE _ NOT TO SCALE DATA /� 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING SWING-TIES ;�.. :� : • • �' /� Hayes �� TEST PIT DATA, REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM Y 14857 APPROPRIATE AUTHORITY. + • • • ��♦ PERC NO. ' • ' : ' ' t ' Pt ` ` 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS DESCRIPTION HG1 HC-2 • . • , • i 1 INSPECTOR: David W. Stanton., R.S" LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE CORNER OF STONE (1) 56.2' 59.6' • -� �!" ! EVALUATOR: Michael Pimentel, EIT, CSE rea t THEY SHALL WITHSTAND H-20 LOADING. ' Pt C.S.E. APPROVAL DATE: Oct. 1999 CORNER OF STONE (2) 45.T 49.6' 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. � ,. '. , ;DATE: October 9,2015 r • " i •" • ��' +• • `' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE CORNER OF STONE (3) 43.6' 50.2' I ' P ---- - u � '� , ';` TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. r�' . ' ^`'!• . +: * CORNER OF STONE(4) 49.2' 61.3' � I ' PROPOSED 4" PVC VENT PIPE; { • - .� 1" I •• ELEV TOP = 51.00 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, . FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255 3 EXACT LOCATION PER OWNER • j ( ) CORNER OF STONE (5) 60.8' 71.1' I �' _ • ' "'• • •s /�// O . ' > ELEV WATER= < 40.50' . ,, !//� • • . 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN / I PROPOSED 2-500 GALLON H-20 �, . -" + +• • '+� f + •' " rR r� + PERC RATE _ <2 min./inch I SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. � I LEACHING CHAMBERS WITH AGGREGATE O +. •+'. � � LOCUS r • + + +++ • I o_ • + ' ''� ' + + • 42" -60" ' 16. PROPOSED PROJECT IS LOCATED WITHIN: • • . . DEPTH OF PERC= I _ N PROPOSED • +` • r f4 +'•.*. . ASSESSOR'S MAP 209 LOT 97 - ` INSPECTION PORT •, •, . / •• f. o , •• TEXTURAL CLASS: 1 / . ! 04 T 16 • 4 OWNER OF RECORD: ELIAS MOREIRA EXISTING LEACHING PIT TO BED 5C1 _ ��• ` PUMPED, FILLED WITH CLEAN COARSE 1 '• d _ SAND &ABANDONED. •• .• : t� • 11 0" 51.00' ADDRESS: 36 CAMP OPECHEE ROAD • 51x9' MAP 209 " •• p• % Fill BARNSTABLE, MA 02601 � - - � • / �� �� Loamy Sand 49.00' FEMA FLOOD ZONE X 10.0' ` X LOT 153 • � B M E)0 � -. •� • • ♦ � 24„ 25.0' \ X X� ! �� A COMMUNITY PANEL# 25001CO561J \ X�- �- ` G t + 10 Yr 3/1 48.83' JRIVEL (5) (1) FEN -�X 1V7 11g 67, �Q .. r , Beechwood //;'''�� 26' t�i \ E(Typ 8°01 a • ��`"' ; �j 4(,Cf j 1 17. DEED REFERENCE. BOOK 29182, PAGE 231 59 W -� �• B Loamy Sand C\f �-_ - MAP 209 i 10 Yr 5/6 Q �y- 18. PLAN REFERENCE: PLAN BOOK 305, PAGE 13 I 'Q LOT 152 • . tl ! • •• ' o " " / / •• ' • // �. ++ / © ;•ter 42" 47.50' 1 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Pe Benchmark ;' -- ._� (3) / , > _ ' ;: .. • iJ + . 60" t`"'n Coarse Sand 46.00'rc 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY Nail In U.P.#100/5 18.6 / `°+v � •,.*�` • • 10 Yr 5/6 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY • . . Elev. - 50.00 . ' ! FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. o I� / 8n erry • , f � C-1 (10-20% gravel) Approx. M.S.L. T\_ �- 2 (\ / /' .t.. - \'j) 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A ' 45.50' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A DTP 1 PROPOSED _ 0 5 ��• 66,. _111\/ DISTRIBUTION i REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.51.0 P 2 2.SY 6/6 BOX / / Med. to Coarse Sand 22. IN ACCORDANCE WITH 310 CM 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE i" C-2 APPROVAL IS REQUESTED FROM 310 CMR 15.221 (7): oM S? \ / LOCUS U P L,./1N (1.) A 0.50'WAIVER(3.00'-3.50') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. a 51. \ MAP 209 SCALE: 1"= 1000' / \ \ � LOT 97 OF WAY 126" 40.50' "^ \ �t�` 15,000±S.F. CO- RIGHT \ .51 O <2� NEW F PER PLAN TI BV(3 5'PAGE 13 No Mottling, Standing or Weeping Observed \ .�� �, o (6o'wIDE) DESIGN DATA i LS'i tj1T DATA LEGEND 12" 50x9' O \ \ \ \ PERC NO. 14857 EXISTING 1,500 GALLON `s J / 3 INSPECTOR: David W. R.S. � / NUMBER OF BEDROOMS (DESIGN) _ Stanton., SOxO' EXISTING SPOT GRADE Q \ LSA SEPTIC TANK TO BE \ DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pimentel, EIT, CSE 50 - EXISTING CONTOUR Iv 6" UTILIZED IN THIS DESIGN O yi - - / `s� C9 Z TOTAL DESIGN FLOW 330 GAUDAY C.S.E. APPROVAL DATE: Oct. 1999 41- U`r p„ 16" 50x6' BUSH �'O o r`^ PROPOSED CONTOUR x \ F�`s w GAUDAY DESIGN FLOW X 200 % = 660 DATE: October 9,2015 V J 1 7 � BUSH 9 TEST PIT#: 1 EXISTING OVERHEAD UTILITIES USE EXISTING 1,500 GALLON SEPTIC TANK �C/ Q x 16„ ` ` ELEV TOP= 51.00' W/ W a EXISTING WATER LINE Q d a >-� BUSH �' O a� W ELEV WATER= <40.50' Q HC-1 \ PERC RATE EXISTING GAS SERVICE LINE � O `�'N Q / _ HC-2 S '-� TEST PIT LOCATION V � % - -W _ W W-mow �- 51- _- DEPTH OF PERC INSTALL 2 - 500 GALLON H-20 CHAMBERS w/ STONE = TEXTURAL CLASS: 1 O O O EXISTING 1,500 GALLON H-10 SEPTIC TANK k � #36 SIDEWALL CAPACITY EXISTING --�- -" - - PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE _..---�- (PERIMETER) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY N 3-BEDROOM ----'"` (73.7') (2') (0.74 GPD/S.F.) = 109.1 GAUDAY 0" 51.00'DWELLING PROPOSED H-20 DISTRIBUTION BOX I �----- TOF = 51.8'± J.� Fill / BOTTOM CAPACITY 24" 49.00' Q PROPOSED 500 GAL. H-20 LEACHING CHAMBER (BOTTOM AREA) (0.74 GPD/S.F.) = GAUDAY A Loamy Sand (313"3 S.F.) (0.74 GPD/S.F.) = 231.8 GAUDAY 26" 10 Yr 3/1 48.83' B Loamy Sand NOTES: TOTALS: 10 Yr 5/6-�- 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF REV. DATE BY APP1 D. DESCRIPTION -� TOTAL NUMBER OF CHAMBERS 2 42" 47.50' EACH SEPTIC SYSTEM COMPONENT. TOTAL LEACHING AREA 460.7 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE 2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE TOTAL LEACHING CAPACITY 340.9 GAL./DAY Coarse Sand �H or^,;as`; 10 Yr 5/6 c. PREPARED FOR: PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT C-1 10-20% ravel) JOHN L. DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF ( g CHURCHILL JR CAPEWIDE ENTERPRISES HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 66" CIVIL 45.50' NV 41-1 C LOCATED AT S78° 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2. 'i ��" MAP 209 o1�5g.,E Med. to Coarse Sand C 36 CAMP OPECHEE ROAD 4.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. C-2 2.SY 6/6 ` LOT 12 17o.3s� jf CENTERVILLE, MA 02632 126" SCALE: 1 INCH = 10 FT" DATE: OCTOBER 15, 2015 40.50' 0 5 10 20 40 FEET No Mottling, Standing or Weeping Observed -� PREPARED BY: RESERVED FOR BOARD OF HEALTH USE JC ENGINEERING, INC. 2854 CRANBERRY HIGHWAY EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"= 10' Drawn By: JC Designed By: MCP Checked By: JLC JOB No. 3280