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0153 CAP'N CROSBY ROAD - Health
153 Captain Crosby Road Centerville A= 193 — 169 i S M E A D _" smead_com • Made in USA J�p�CYC(� { t Commonwealth of Massachusetts � I Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 153 Capn Crosby Roady Property Address tom« Orrin J Eaton 'T`n Owner Owner's Name t� information is F—A required for every Centerville MA 02632 05/27/15 rat page. City/Town State Zip Code Date of.Inspection C:.] �a 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. Important:When filling out forms A General Information on the computer, yU5 use only the tab 1. Inspector: key to move your cursor-do not Trevor Kellett use the return Name of Inspector key. TK Septic e5 Company Name 38 Vacation Lane Company Address F--A West Yarmouth ma 02673 City/Town State Zip Code 5085795502 S113744 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site " sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5/31/15 Inspectors 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. t5ins•3113 Tite 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ��! Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w ' 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is Centerville MA 02632 05/27/15 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D I A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 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 t5ins•X13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town 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 0 ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 153 Capri Crosby Road Property Address Orrin J Eaton Owner Owners Name information is required for every Centerville MA 02632 05/27/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No El ® Required pumping more than 4 times in the last year NOTdue to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or`'no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone It 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. t5ins.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 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. 0 ❑ 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): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Mrs•3113 Title 5 OtBdal Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information fr every is requiequireddfor Centerville MA 02632 06/27/15 page. City/Town State Zip Code Date of Inspection D. System Information Description: This system consists of a Tank D box and two 500g leaching chambers Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a'separate sewage system?(Include laundry system inspection ❑ 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)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): GalJons per day(gpd) Basis of design flow(seats/persons/scl t:, 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•3/13 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,y 153_Caen Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 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: 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): t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's.Name information is Centerville MA 02632 05/27/15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 7/28/07 per DOC Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.8 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.): Septic Tank(locate on site plan): Depth below grade: 1.9 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 g Sludge depth: 2 t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is Centerville MA 02632 05/27/15 required for every page. City/Town 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 30 Scum thickness 1" 7„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16 How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic Tank is water tight and structurally sound with both tees intact and water at the outlet invert, no sign of back up or failure 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 t5ins•3/13 Title 6 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �a 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name . information is required for every Centerville MA 02632 05/27/15 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 t5ins•3113 - Title 5 Ofidal Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts OF Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments iFP 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town 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 even 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.): The d box is down 49"with a riser down only 16"level and structurally sound with no signs of carryover 1 inlet,2 outlet Pump Chamber(locate on site plan): Pumps 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): This leaching consists of 2 leaching chambers that are dry with no visible staining the bottom of leaching reaches 6.5 feet, pits are down 47", 13"to riser 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 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.),. f5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,r 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town 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, A C B Deck 1 2 3 A1)37 A2)48 A3)51.5 B1)7 C2)48 C3)46 t5ins•3/13 TiVe 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 90+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS shows groundwater at about 90 feet Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 THIe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s 153 Capn Crosby Road Property Address Orrin J Eaton Owner Owner's Name information is required for every Centerville MA 02632 05/27/15 page. City/Town 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 I t5ins•3113 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 o Barnstable P�QFt � Re�atary Services Thomas-K Geiler Director.. BABNseAaM • xAss. PubUc Readth DivisioII Thomas McKean -Director 200 Main Street,Hymads,MA 02601 Office: 508-9624644 Fax: 508-790-6304_ Installer&Designer Certification Farm Date: Sewage Permit#1. Assessor's MaplParcel19 3/16 9 toes igner: .... .....Eco-Tech ins imler: Wm E Robinson Sr Septic Address:.. 43 Triangle-.Circle Ades: PO Box 1089 - Sandwich Centerville Wm-.E .Robinson Sr Sept iCwaS issued apermit to install a (date). (installer). septic system0._:163 Cap:'-n Crosby Rd,: .Centerw lb -on a design drawn-by (address) Eco-Tech dated 07/26/07. . .: (designer):. I certify that the septic.system-refereed 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 tA&.- I_certify that-the septic system referenced above,was installed with major changes (i.e. greater thaw 0' lateral relocation of the SAS or any vertical relocation of any component. of the gep& syst6nij but ih arcordaartce-with State&Local tte ons: Plan revision or certified-as built by designer to follow. N of M,gss DAVtC) COUGHANOWR. ! (Installer's'Si tore No. 1093 l GISTS s4NITAR�F ' .,. ��.• `inn V�"`� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE: RETURN--TO .BARNSTABLE. PUBLIC :HEALTH DWISION.. .. CERTIFICATE OF COMPLIANCE WILL.NOT:BE--ISSUED UNTIL BOTH THIS FORK AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PZIBLIC HEALTH DIVISION.,THANK YOU. Q:HeaftWSeptic/Designer CenS4, on Form 3-26-04:doc t _ r - of Town of Barnstable P a � l '6+� Department of Regulatory Services Public Health Division �Y Hate V l 200 Main Street,Hyannis MA 02601 v Date Scheduled - '/l-1 2 ?J00 ,P� a Time� Fee Pd. i V0 6 Soil Suitability Assessment or Sew ' .f age Disposal �-S Performed By- N b I d' b+ VrAq 110kYY Witnessed By: D014d14 (iJ r(� c VK,1 1 LOCATION& GENERAL INFORMATION [NW n Address ► 3 �tpn C,I�sb y ��J Owner's Name t�rri Ceyf-eu U �l /I �b� Address ,s Cal p tl C",h�, " r's Map/Parcel: CGj G� ,J �� ��h�el'V Engineer's Name ONSTRUCTION REPAIR O�1 v d IJ. .Co v�ha npw t Telephone# 0 Land Use Res t d P% j oI j j 4„ Slopes(%) ,7D Surface Stones Q . Distances from: Open Water Body©� ft Possible Wet-Area 100-f --.__ft Drinking Water Well J f7� ft ' Drainage Way ® t ft Pro ert Line P Y I--_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands ds?n proximity to holes) 101.95 F't 33.'_2_��--- -- -- — Z W 59.00 f Lt1 WLLJ m CO JZO Lnn m mN L�l m emu q3 zI N E 'CID 1 ® < < W (Li0 Oc�Nn- I ra_ LLCr MWU-)"T"M \JI 7A..2 I ti LL. Z Z 3 TZ el IN W 53z UJ < z CD ^^ 1 m OUZ pW p WU )' Irk 3 U~� ~3 _z_z~~ ` / co co V I I ❑ 00< UXWOODD O 1 I ! Z z W Wz<<-)� rn I z �0W °OOWWO❑ 3 m I i ❑ L� N��« 1 I 1 X<- ''r W m C9 —071 Parent material(geologic) ®u+wa5 Depth to Bedrock 11L h Q Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face p Vb Q Estimated Seasonal High Groundwater-'see (l bo U 2 DETERNIINATION FOR SEASONAL Method Used: HIGH WATER TABLE S e� of b&V e Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: in. Depth to soli mottle$: In Index Well# Reading Date.' Index Well level q_ In, Groundwater Adjustment ft. Adl,lhetor— Adj.droundwaterLevel, PERCOLATION TEST bate 7 z5 v Thne Observation 1 Hole# Time at 9" °I Depth of Perc .109 AL Time at 6" 6 Start Pre-soak Time @ 6,' ALL— End M 'p - Time(9"-6") i Pre-soak Rate Min./Inch `ZVq Q i Site Suitability Assessment:` Site Passed- Site,Failed: Additional Testing Needed(YIN) . Iy Original: Public Health Di - vision Observation Hole Data To Be Completed on Back----------- ' ***If percolation test is to be conducted within 100'of wetland,you must first notify the �Barnstable Conselrvatioli Division at least one(1) week prior to beginning. Q:SEPTICIPERCFORM.DOC ' SOIL TEST LOG ! DATE OF TEST: JULY 25, 2007 SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. PERC NUMBER: X TEST PIT 1 NO GRNDWATERNCOUNTERE PAARENOTUMAATERI A EPROGLACA LD OUTWASH PERC AT 72 in - 2 MIN/INCH IN C SOILS � ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 95.50 0-16 FILL 16-19 O LOAMY SAND 10 YR 2/1 NONE FRIABLE 19-20 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 20-24 A LOAMY SAND 10 YR 4/4 NONE FRIABLE 9150 24-48 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 85.00 46-126 C MEDUIM SAND 10 YR 6/3 NONE LOOSE NO _ I TEST PIT 2 PAARENOTUNDWATEMAATERIAL:ENCOUNTE PROGLACALD OUTWASH 2 MIN/INCH IN C SOILS f ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 95.95 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 0-4 A LOAMY SAND 10 YR 4/6 NONE FRIABLE 4-36 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 92.95 36-136 C MEDUIM SAND 10 YR 6/3 NONE LOOSE e4.45 Depth from Soil Horizon Soil Texture Soil Color — Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones Boulders. r sistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Co si n Flood Insurance Rate Map: Above,500 year flood boundary No— Yes V Within 500 year boundary No Yeses - Within 100 year flood boundary No Z 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? eS _— " "`If not,what'is the depth of naturally occurring pervious material?,.. Certification t 'I certify that on o� 1lu (date)I have passed the soil evaluator examination approved by the is was performed by me consisten �•� Protection and that the above analysis pe jH OF M .Department of Environmental Prot � �ss9c le required training,expertise and experience described in 310 CMR 15.017. DAVID yG� Signature Date S�\.�25 �AD7 o D. in COUGHANOWR `r0 �'CENSE� p� EVALUP� Q:WEP cr pERCFORM.DOC No. 4OO-7 /' r $e10 0 .0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 01pprication for Migpogal 6pgtem Congtruction Permit Application for a Permit to Construct( ) Repair(X) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 5 0 8—7 3 7—0 9 8 3 153 Cap' n Crosby Rd, Centerville Orrin Eaton Assessor'sMap/Parcel 1 93/1 69 153 Cap' n Crosby Rd, Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville 143 Triangle Cir, Sandwich Type of Building: jg�) A1d+- �ri Za G. Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) INstall a new Title 5 leach system to plans of Eco-Tech, ETE-2694 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 o eal . • Sgge � Date Application Approved b Date Application Disapproved by: Date the following reasons it No. d 7 Date Issued -----------------------— s THE COIMMONWEALTH OF MASSA`Ctiy§U E,TS Entered in computer: PUBLIC HEALTH DI!/ISIONI -.TOWN-OF--BARNSTABLE, MASSACHUSETTS ke 2pprication for Migogal *p5tetri Construction Permit Application for Permit to Construct O Repair�) Upgrade( } Abandon-( ) ❑Complete System ❑Individual Components 1 Location Address or Lot No. Owner's Name,Address,and Tel.No. 5 0 8—7 3 7—0 9 8 3 153 Cap' n Crosby Rd, Cellervillee Orrin Eaton Assessor'sMap/Parcel 193/169 153 Cap'n Crosby Rd, Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 1 6 Designer's Name,Address and Tel.No.3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: 1Vdr- l'r\ �Z_a C_ Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder {10) Other Type of Building No.of Persons Showers( ) Cafeteria Other_Faxtures_. Design Flow(min.required) gpd Design flow provided gpd Plan Date r Number of sheets Revision Date r Title'' Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) INStall a new Title 5 leach - i system to plans of Edo-Tech, #ET-E-2694 f Date last inspected: Agreem� ent: ! ice'/"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 �PHeal, . O ✓ry w - (ate ,"' Date �- ✓�'`� Application Approved Date Application Disapproved by: Date for the following reasons Permit No.�©U + — 3 9--a— Date Issued —————————="———————————————————————— �y'- 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Eaton Certificate of Compliance y THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (X ) Upgraded ( ) Abandoned( )by Wm E Robinson Sr'A Septic at 153 Cap'n Crosby Rd, Centerville has been constructed in accordance with the provision of Title 5 and the for Disposal System Construction Permit No. a00-7 dated 7/A& Installer y �ti n5 0 VN Designer Coj4)ka e)o j r- 11.1 #bedrooms Approved design flow �� gpd The issuance of this�p^}er/miitt shall got be construed as a guarantee that the syste wil`' f n ion de i}tied. Date 1/ cam/ __ Inspector _ 1ti No. f_-'X A 77 73G)-p1 $0600.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Eaton x1i6po.5ar *pztem Construction Vermit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at 153 Cap'n Crosby Road, Centerville and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction //must be completed within three years of the date oft rt. Date / b '� Approved b TOWN OF BARNSTABLE LOCATION SEWAGE# 200-7-3.02 VILLA GE ASSESSOR'S MAP& `PARCEL 193 a /G9 INSTALLERS NAME&PHONE NO. Ro ,'N Sn - pfi C SEPTIC TANK CAPACITY 1 ,o o LEACHING FACILITY.(type) 'Z lEAcv1rNq &,41JeN (size) 13XaS -it 2- NO.OF BEDROOMS OWNER 6 Rk,i 1,3 J . CA+o VJ 11 L PERMIT DATE: .?/a-(-/!U 7 COMPLIANCE DATE: 7 C14 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Dt. k.. t, 3191 -7 -7A O' O 2. 99/ s U 8-1Iz y5' 3 L4-7 ..� No.`......� - Fes$..- ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH e J ' ....Town.........................oF............Barnstable g., 1 ApplirFatilan for Di"oii al Workii Tnnitrnrtion runfit Application is hereby made for a Permit to Construct ( yj or Repair ( ) an Individual Sewage Disposal System at: -Lot # 66A Captain Crosby Road Gei� eville...... -- .......... . ..........................••--•-•-•--•---••............ --------••-••-•.......••-•-......-- Location-Address or Lot No. Suffolk Realty Trust P.O. Box 308 Centerville„•,--•_-,----- _- ......................_................... Kevin Hickey Owner Address 1W4. •----- ................................................... ......_Carr. �e...&iMe.....Barnstable................... Installer Address 18 345 Q Type of Building Size Lot_____.._r..................Sq. feet Dwelling—No. of Bedrooms.........2................................Expansion Attic ( ) Garbage Grinder (nep p`4 Other—Type of Building ---ranch No. of persons....two_______________ Showers (2 ) — Cafeteria ( no) Q' Other fixtures -----------------------,-----------•. . W Design Flow.... 10................................gallons per person per day. Total daily flow--------330---__---_.._____-----------gallons. WSeptic Tank—Liquid capacity_l OOOgallons Length__$__'.6"... Width__5........._ Diameter................ Depth-.54........ x Disposal Trench—No. .................... Width.........._......... Total Length.................... Total leaching area-------:------------sq. ft. Seepage Pit No.___l___-_---_-_--- Diameter.__..6x6...... Depth below inlet_.6.............. Total leaching area._1DIIfI....sq. ft. Z Other Distribution box (3� ) Dosing tank ( ) '-' Percolation Test Results Performed by---------------Ronald..JG!fEC)rd.................. Date...OCtober 26J 1978 p p p .� Test Pit No. 1._...2....._..minutes per inch Depth of Test Pit_.__._14.4"_.. Depth to ground water.......none................. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C+ ---- •--------------------------------------•---------------•---...---------------------------------- ---------------- •---------------------------------------- O Description of Soil-------•----------..''_24"........o ain-- C?_ (xj ---------------------------------------------------24.".-144".......mad uM...t.jD1e_._,a Md-------------•---------------•--------.....---•--•-------- W 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 iI'i 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 heal h. ned-- -- ........ ...... ..... .. .. ..... ..•-----------•---•----- �Q'3 = Date Application Approved BY l r/✓I . •-•------------------------ ---- 7 : a Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- -------------------------------------------•------------•---------------....-----------...._ Date Permit No.................................... -` - Issued........................................................ Date yt� No.._...V/-.. � ...... Fss............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w r� - R Town.........................O F............Barnstable. Appliratiou for Uh4pasal i9orhi Tomitratrtinn ramit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: • -- -Lot # 66A..:Captain Crosby Road ....Centerville......................................................... Location-Address or Lot No. .....Suffolk Realty Trust._.......... P.O. Box 30$......Q CY.x�. ................... Owner Address .....Kevin_..... ...................... ......................•----•--•... .......0 r.r.i g :•_.Lane.._..Barnstable...._........-•---- Installer Address Type of Building. Size Lot_.1$_,.34.5.........Sq. feet U Dwelling—No. of Bedrooms.........2................................Expansion Attic ( ) Garbage Grinder (nd Other—Type of Building ---ranch.......... No. of persons....two............... Showers (2 ) — Cafeteria (n6 a Other fixtures -----------------------•---•---•----•--••----•---- - W Design Flow....(}.:.............:................gallons per person per day. Total daily flow________330---------------------------gallons. WSeptic Tank—Liquid'capacityl-COogallons Length_$!$!!... Width__-5.!......... Diameter________________ Depth_.54.e1---_-- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----}--------------- Diameter.....6x€y...... Depth below inlet.16.9............. Total leaching area._I.3Q(y....sq. ft. Z Other Distribution box (E ) Dosing tank ( ) Percolation Test Results Performed by................. E_._._ ...._.._.....__.... Date__Geteber----2b-y-•-1978 Test Pit No. 1-----2--------minutes per inch Deptfi of-Test Pit-----144,f__. Depth to ground water-none-___---___. �T4 Test Pit No. 2................minutes per inch Depth of Test Pit____-____.--__-_.__. Depth to ground water........................ a ...................................•••--••--•-•-•-••-•--••-•-•-••-•--•..._........_......--•-•............................................................... 0 Description of Soil................... �r Tr.... ----- --------------------------------------•---------------------------------xloam & su soII v -------------------------------------------------- „-_ - „----- -- -- ----------- - -- ---------------- • me ium fZne san - ---------------- ------------- ------------------------ -----•-•-••-•--•-...-- •-----------......-:--•--------••---------------•-----•-------•----••--••---•--•-•-•--••----•-•---------•••---......•-- 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 TITS E 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. --,/ ned.. ............. ...... ....�t��' � --------------••-- Date Application Approved By.... � l t/t!1 • ---- �.5_.�D T ...... .........•.._ $ V Date Application Disapproved for the following reasons:................................................................................................................ t.: ! * t 7 Date PermitI\I,o........ - - -•--- ------ --- -------. Issued....................................................... 'SFk` Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.......... BA r ig C�rr#if irtt#r iff TantAtaatre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ................................ -•--•:.....................................•-•-••-•--•-•----•.X•-•--••----...•-••.....-•-----•-••- �{�`f�11`1 I��Ckey-•-------•------.---.-Installer at.._..._ - - ----------------'------------------------------------------------------- Lat:#k �jg.-C,apt 'i'n"CY bV Roaa------ erv� has been mstalfed in accordance wltli ze provis>ons of Y o3 e State Sanitary Code as described in the application for Disposal Works Construction Permit N �a.__:' Q�._ 3,P:'.7 *............... ' dated_-_. THE ISSUANCE OF THIS-CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. P DATE.....t.12....... O'`�� -----...... Inspector-- _____ -------------- ----•--•-•-....................................... s t' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable 7� ..........................O F..---•............................_.._......-------•--...•--•-............._......... No. ...� ....... FEE......,d' ...... Disposal Workii Toamtrudiart rIrmit - Kevin Hickey Permissionis hereby granted.............................................................................................................................................. to Construct (X) or Repair ( ) an Individual Sewage Disposal System Lot # 66 Captain Cros ` .Ro e?at No................... __ ._ . _ . . Y. d .%te.ryjlle--------------------------------•------•-•--.....-•-- Street /° as shown on the application fair Disposal Works Construction Pe t No Dated../ "_✓.. ... . .... ,Iry / Boar�a th s DATE r 1�~.�©' � "' •-•-••......-••-•-............. , FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS -, - LO,.ZATION nF �j / SEWAG�E�-PERMIT NO. V11�'LAG E INSTALLER'S NAME & ADDRESS CA BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i .��-1 t , � �� �� r 3 � 1 (� � i . r 7-- i La',- L /- E� /o�tt�• .�I T p!N `A, , N I. ���� od TEST 14 L.E /42 E T5 PC-,e Tv L✓n/ ,e E i20R DS TO L./A/ k/A T E P /-s V),Q /` L R 8 L_ E •, f A.4 'P Nf//V//\IUPI 80/1- DIA-16 5ET51:�C ,;� .eEQu P-,E/"7EAyT5 R O A/7- 00 45/,D E. / N07- -r-ca 8E tee, a PPOPDSED BEDROOMS 3 SE t /E �Q� SSl,STI�!"l UlVLE55 Z�aES/C.v FLAW .33v �/3L /IJI�y Vie• H-.20 ZEES! /V LOf� Z�fN I USE.Z� . pR01--'OS,E'D L E/ 0H ,qRE,,9 Zoo .�9T/0AJ TES T CoA,r,=�ORM 7-0 1111SS. 6A.1VIP_ 0AJME/V7-91 �� '• C'0-Z) E .I' Z7 ?97'EIJ 77 6A.1-b 7-OJ^IAIO ASA?RA-2 .5 °�4 r'G. H EA L T 5/LL. ELEV. 70 f3E —` FT. 900VE PD. I . �� a Y2 �o _r' oP, 011C ST/N I I IL.. �,2f37�E f��C�vE GEf3CK �'G> U NT�RTi ptti/ /N d �' L I A�Ef� i� MANHOL e0W E'f+ 7© X7"_;:r A/.b 7o To . f . _ f►9/N/M1JM FROM --- e a v ,e D s7otvE �9 t3 :z/" iin �9.L ,9RO UtUD r kj� ^`Y a !"lla+V//y(jft7 _ �"'MIl+l, ...�X• -G'�^•K1�1.. � ��s�f. A7'�� d8 �, _ 4' i 7 Rr to"nth% / r '' �"c3b�^ �" 4V- ?>tr� / o0 "�FQcT �` " wf3 f/,E p /�3 /jA L L Q 5 �?' /004 x ,��/v��r 5� � s rn tv� CF3� L Oti/ f+Sf �'T i' P/T .R f f Nd/ERT G'A-7 f3f 'a✓ _ ,2 4 lJnrb - I - - n - } /�.�'+} `�,5���p , /?•�f�+,v'I•�Z?'>��/-��.`y��+•Tr� ,x ` .A {�/•` f f • � 1iwIM. t nP. r 4,J `V`ivr Ml✓/'T I G". Y r A Of •r � � ��.� �..� ;j'�1'Q•,!�t.,y.� C°I�'rC1 7"r�i�!/'/��`.�'• f "r�w -�- � ��`�� -. » � , a w `. 4.. ,. #1RTN60 , ', 134f,Ov ',. GIFF0Rf}r "' r 7{'1� �,a� f�•. L » ``s � ` -s .s, -', r - n •• M1 yQp�///! F'�� ��' �'A'7� � J ..}•�-,ram • �j �,,ry � ( ,`g� �cr > F', ,.. �ri'�.` .+! a +. - ,.. F.. w i.. �{ f fl�.� .. tV- f. V.- ��� r l.�- !-�F/1\(.-•:`- . ( t7 • r 4 '/ /p' A ^ � � � C.�/ 'i.-+r � '�+�'�. e • - r • !V 4.r .oar E:J'9�-T�i !—"� /..A! {.I M 0,t= ' C t P - / .. . �: / / f -ram -"T,R-•t /a`.�` ' ',. f e7 C�,s 4s� �.�•, 1 S, ` . ,r�'tt/'+,f Z� 3' / /`' GrJ+t ✓ `f1� r to - a {j. «- �/yam. /�I..w•1�yy.�yj�'�j' ��."(•� 4 aQ` �f l �' � IG,fJt '..[�llk.t -.t .,- °��C./f,lM,�.•,•• � • �i kl T ' 'C r ,i E � y% + `4 j 1�! ef.,'3 T1019 .. � Y - . is �. L • ,-. SOIL TEST LOG . DESIGN CALCULATIONS DATE OF TEST: JULY 25._2007, DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL PERC NUMBER: 11860 CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) TEST PIT 1 NO GROUNDWATER ENCOUNTERED DISTRIBUTION BOX: USE 3 OUTLET D-•BOX. PARENT MATERIAL: PROGLACIAL OUTWASH SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft. x 2 ft LEACHING GALLERY CAN LEACH PERC AT 72 In - 2 MIN/INCH IN C SOILS Abot = ( 24 x 12.5 ) = 300 sf Asdw = ( 24 + 24 + 12.5 + 12.5 ) x 2 = 146 sf ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER At.ot_ = 446 sf (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING Vt 0.74 x 446 = 330.04 GPD 95.50 0-16 FILL USE A 24 Ft. x 12.5 Ft x 2 ft GALLERY. Vt = 330.04 GPD > 330 GPD REQUIRED 16-19 O LOAMY SAND 10 YR 2/1 NONE FRIABLE 19-20 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 20-24 A LOAMY SAND 10 YR 4/4 NONE FRIABLE L EA CHI N G GA L L ER Y 1000 GALLON SEPTIC TANK 24-48-126 48 B LOAMY SAND 10 YR 5/6 NONE FRIABLE .USE SHOREY PRECAST 500 GALLON NOT TO DIMENSIONS AND DETAIL NO T TO USE EXISTING H-10 UNIT SCALE 91.50 C MEDUIM SAND 10 YR 6/3 NONE LOOSE LEACHING DRYWELL (H-10 LOADING) SCALE 85.00 CONSTRUCTION DETAIL SEPTIC TANK IS TO BE PUMPED DRY AT TIME OF INSTALLATION AND IS TO NO GROUNDWATER ENCOUNTERED DRYWELL UNIT BE EXAMINED FOR STRUCTURAL TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH STONE INTEGRITY. INSTALL NEW PVC OUTLET 2 MIN/INCH IN C SOILS 24.0 Ft TEE EOUIPPED WITH A GAS BAFFLE. ELEVATION n Q DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER m 1 E (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING ri 4- TAPER 95.95 0-4 A LOAMY SAND 10 YR 4/6 NONE FRIABLE � L::§::1lD::1 m+ LO (' 4-36 B LOAMY SAND 10 YR 5/6 NONE FRIABLE N m N o c 92.95 36-136 C MEDUIM SAND 10 YR 6/3 NONE LOOSE �'4 ri 64.45 3.5 24.0 f t GROUNDWATER ADJUSTMENT EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE 500 GALLON DRYWELL GIS DEPARTMENT RECORDS. DIMENSIONS AND DETAIL INLET OUTLET COVER COVER INDICATED GW 36.00 USE H-10 UNIT INDEX WELL SDW-252 INSTALL ONE INSPECTION 3 IN DROP RISER TO WITHIN THREE —*> �l FLOW LINELh ZONE C INCHES OF FINAL GRADE — —� READING DATE DUNE. 200Z AND INDICATE LOCATION FROM 10 to _ !4 TO BUILDING _Sox READING READING 46.5 ON AS-BUILT PLAN in ADJUSTMENT 1.2 LIQUID GAS ADJUSTED GW 37.20 LEVEL BAFFLE NOTES Op 33 000o p 1n 0 00 0 000000o DOOpp 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 0000aooaao CROSS SECTION VIEW 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED Gj0 FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. la? 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES CROSS SECTION VIEW BEFORE EXCAVATING FOR SYSTEM. 2 to PEASTONE 2 to PEASTONE SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING ,LEACH PIT TO BE .PUMPED. COLLAPSED... AND FILLEp' i1, 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON:' FINES AND, DUST*&IN PLACE. 24 in TO SERVE EXISTING DWELLING t t ,. by 28 3/4!n TO EFFECTIVE /4 in TO 26 Z) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION 'OF''LOW''FL:OW FIXTURES 1n -I/2u,p7AVEL DEPTH 1-1121n�^"� 1n ORRIN J. EATON III AND APPLIANCES. AND BIANNUAL PUMPING OF% THE SEPTIC iTANK. 6) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR L'OADING?iiDO,sNOT/fd 46 1n 58 1n 46 1n 153 CAPN CROSBY ROAD CENTERVILLE. MA PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM., EEO-TECH ENVIRONMENTAL 150 1n 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE°ON"A LEVEL INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED' AND ON TO WHICH FABRIC IN PLACE OF THE 2 ,,,. PEASTONE LAYER SPECIFIED. 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED. TO MINIMIZE 'UNEVEN SETTLING. 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