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HomeMy WebLinkAbout0034 CAP'N JAC'S ROAD - Health 34 Cap'n Jac's Road_ V Centerville P A = 194 052 �bO CA s©.&u, I UPC 12543 w' No 3L R err 'J HASTINGS, MN t COMMONWEALTH OF MASSACHUSETTS ID EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS � a DEPARTMENT OF ENVIRONMENTAL PROTECTION r A/ V� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 34 Cap'n Jac's Road Centerville Owner's Name: Penny&Chris Fusco Owner's Address: Date of Inspection: 10/27/2005 Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O.Box 371 Sandwich,MA 02563 Telephone Number: (508) 888-6055 e CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The System: —fzPasses Conditionally Passes Needs Further Evaluation by the Local Authority Fails Inspector's Signature: _� `r 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 appjoving, authority. , —3 Notes and Comments of This report only describes conditions at the time of inspection and under the condition' usethat time.This inspection does not address how the system will perform in the future under the ame or"fercM conditions of use. I Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: 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 Pas section need to be replaced or repaired.The system,upon completion of the replacement or repair, as appy6ved by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank'failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): f settled .pi pipe(s)are replaced obstruction is removed _distribution box is leveled or replaced f ND explain: f The system required pu�fiping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with apprg4al of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 C. Further Evaluation is Required by the Board of Ialth: Conditions exist which require further evaluao6n by the Board of Health in order to determine if the system is failing to protect public health,safety or the en�onment. 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 man er which will protect public health,safety and the environment: _Cesspool or privy is within 0 feet of a surface water _Cesspool or privy is wit ' 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Watei 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. r _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'io determine distance "This system passes if the well water.Znalysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: ' Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 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 _Z Static liquid level in the distribution box above outlet invert due to and overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. =� Any portion of a cesspool or privy is within a Zone 1 of a public well. 7 Any portion of a cesspool or privy is 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] Yes/No)The system fails. I have determined that one or more of the above 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 facilit with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no r' the system is within 400 feet of a surface drinking water supply r,. the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 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 V/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 than owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No ✓ _ Existing information.For example, a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)J Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): —�,— Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3(!> Number of current residents: Does residence have a garbage grinder(yes or no):.k3r=, Is laundry on a separate sewage system(yes or no):v2s----�[if yes separate inspection required] Laundry system inspected(yes or no):— Seasonal use: (yes or no):��� 1< 3 _ �.F;? P. \C)z Water meter readings, if available(last 2 years usage(gpd)): ? � , Sump Pump(yes or no): j Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.2.03): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings, if available: Last date of occupancy/9se: OTHER(describe):f �/ GENERAL INFORMATION Pumping Records Source of information:(:I",, Was system pumped as part of the inspection(yes or no):_,2y:2> If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPEOF SYSTEM ptic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance.contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if kno )and source of information: r J -+ c `_ r �-4 LYi ���7 �. -l.N� �.a r G-e./— d��� F''�� ���� '-'\.� ,tiK.'� .4�n„��.C►�Vl Q, �"l�(.. �A�j`t�. c-� `.•..„:two. Were sewage odors detected when arriving at the site(yes or no): p�'-� f Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 BUILDING SEWER(locate on site plan) Depth below grade:�4 Materials of construction:_cast iron_Z40 PVC other(explain): Distance from private water supply well or suction line: a A Comments(on condition of joints,venting, evidence of leakage,etc.): SEPTIC TANK:y,!!�-(locate on site plan) Depth below grade: 3 j& Material of construction:—L—/Concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: Sludge depth: Distance from the top of sludge to bottom of outlet tee or baffle: ' Scum thickness: —,=�> ;' Distance from top of scum to top of outlet tee or baffle: Co" Distance from bottom of scum to bottom of outlet tee or baffle: j y" How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condi ion, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): 'i" Va �v GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fib 7rg ass_polyethylene_other (explain): f Dimensions: f Scum thickness: Distance from top of scum to top of outlet tee o baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendation.'inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): i Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 TIGHT or HOLDING TANK: (tank must pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_ tal_fiberglass_polyethylene_other(explain): Dimensions: �j Capacity: �Eral(lons/day ns Design Flow: Alarm present(yes or no): Alarm level: Ala n working order(yes or no): Date of last pumping: Comments(condition ofalarm and float switches,etc.): DISTRIBUTION BOX: -le!!"'(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): `�— *;!) Kx `—.0-5 dl.---- r vim\ ^\ t �U,``�r�S �=.da.r-r�,1 c`�L,a �✓'� �.J� �v..'u=�l.r..� * ti ./^ :�ia.��\n.' �� �tJ'�.f'"� PUMP CHAMBER: (locate on site/plan)Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamb of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: _leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): C C" CESSPOOLS: (cesspool must be pump ps part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: i Depth of scum layer: —�— Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(y s or no):. Comments(note condition of soil signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: , Dimensions: Depth of solids: Comments(note condition of soil, signs o ydraulic failure, level of ponding, condition of vegetation,etc.): • y Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. Lj 4-11 � � ,1 LL i I O O { 9 r Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 34 Cap'n Jac's Road Centerville Owner: Penny&Chris Fusco Date of Inspection: 10/27/2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 7L feet Please indicate(check)all methods used to determine the high ground water elevation: _IZObtained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the 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: -• ���'� t. --4 ..��-.,�, r� .��1 �..-cam:.�.� `' r r, FEE COMMONWEALT14 ®F MASSACHUSETTS Board of Health,arxm S"\-:9 , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repairg Upgrade( ) Abandon( ) - ❑Complete SystemAndividual Components Location Z4 Cppt4 ', Owner's Name6D Map/Parcel# Iq Lf WO Address S'lC- Lot# ® Telephone# Installer's Name S CO Designer's Name f8n 1 Address `3't� Address M� Telephone# S 3` ) Telephone# 62 S-X Type of Building ``�a5l a� Lot Size �0150 sq.ft. Dwelling-No.of Bedrooms Garbage grinder Other-Type of Building ®n n - No.-of tpersons 3 Showers (,.YCafeteria (✓f Other Fixtures Q s C6 5,01Z, lcJf Design Flow (min.required) gpd Calculated design flow3 %esign flow provided s1 gPd Plan: Date Number of sheets nn � Revision Date Title a CfZ�IJa�QC si UC<L'QA ffi Vi5Gt9�� ` tt�i�dT� Description of Soil(s) � pkcc) Soil Evaluator Form No. Name of Soil Evaluator ';RDA QC Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS -yl P'1nG_ENGINEER MUST S''-- ..'CE TO PLAMThe undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a ees to not t pl a 7� �Ttejnmration until a Certificate of Compliance has been issued by the Board of Health. Sig Date S'VA-03 Inspections. ..,Fy•l�y\.�r�"�'M`J�Yy.r �- ...,• '1 ld...\.-."Tti...r+•.-'L'.r' .lrrw��;�,...+•-+...-.l`.r'k��' ...i».�„N' .,�,. 4%.:.-«.^-rSf. � .. .1..-y`+.c.,,.w'bt�..:�,a"l'&""Y7Y`'-'�i,z'��"'s` Board of Health, rn cam , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT ; Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( - ❑Complete System ndividual Components Location [4 Cppr, ,1 'S � 1�L Owner's Name tj S5 CJ/V Map/Parcel# 'q L4 6 52- /TECtWO A i (, Address �qM Lot# Telephone#' Installer's Name Designer's Name b �tS C s fob, < k, u�ronn,anj Address S --T'�� SA. 7 �0 Lt Address M� Telephone# I �. rg 1(� `Jl Telephone# (D7 6-V S j(- Type of Building s-1��-�2(1`�1G� Lot Size r1 (!90 sq.ft. Dwelling No.of Bedrooms 1 n�tQ Garbage grinder Other-Type of Building Qne No.of tpersons 3 Showers (%�'Cafeteria Other Fixtures e Design Flow(min.required) 50 gpd Calculated design flow esign flow provided gPd Plan: Date (L4 -A-, Number of sheets C Revision Date Title Nt ��CZ)fro Sell JS u( Qc-cP -R,JC' �Q m�v \ 514 Skin t Description of Soil(s) --�Zca 1pkco !'� -1. Soil Evaluator Form No. Name of Soil Evaluator CRbn l CAt )I O-C Date of Evaluation R 1 DESCRIPTION OF REPAIRS OR ALTERATIONS � =Q{ 'm '�Cl x The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further grees to not t pl ce4lhe system in operation until a Certificate of Compliance has been issued by the Board of Health. Sig •�d Date z`^5'1 --03 Inspections , No. r � COMMONWEALTH V'V' EALTH OF MASSA 141 SETTS FEE Board of Health A P 1\1.SC 17 , MA. i CERTIFICATE OF C®MPLIANC E`\ Description of Work: XPkidividual Component(s) ❑Complete System The undersigned hereby`certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgred (I��Abancj ned O by: 1 PT L /J at CIA►0' l �� l= 1h 1,o ",►. has been installed in accordance with the�jrovisions of 310 CMR 15.00 (Title 5) and the approved designlans/as-built plans relating to application No. dated Approved,Dsjign Flow (gpd) Installer /� Designer: Inspector: /1 (f Date: V f� 6 The issuance of this permit shall not be construed as a guarantee that the system will function as designyd. r No. Q4� 3 \ + .. FEE COMMONWEALTH Of MASSACHUSETTS , Board of Health, �� � DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade(L-) Abandon( ) an individual sewage disposal system at �_ (f�I�/t �_ fn _ r�e�P 5 as described in the application for Disposal System Construction Permit No. dated S Provided: Construction shall be completed within th ee years of the d tte of is-p 't. All loca�conqdi i'ons must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date G Board of Healt Jl TOWN OF BARNSTABLE LOCATION A l �°' � S SEWAGE #— VILLAGE ASSESSOR'S MAP& LOT�� f2, 0 INSTALLER'S NAME dt PHONE NO. IL 6—M SEPTIC TANK CAPACITY I LEACHING FACILITY: (type). S (size) ?Co/ NO.OF BEDROOMS 3 i BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: A?®3 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 3T 'T 9 i 1 0% a s�O t.y A A A Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: APhI \1 ACI-s lCP_(� �,�p Lot No. Owner: � S� � C— s L )a � Address:_ � MF— Contractor: 5Y)GX. 2n\.)kt��1(�.On�t\ Address:—TYy! z—— Notes: r yPATC�C ���c� III STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OAppropriate index well.................................................... OB Water-level range zone ..................................................... C STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to e water level for index well ?IUD A montnn/Year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 213) determine water-level adjustment ..............................................:........................................... STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water �tl� level at site (STEP 1) ................................................. ' (D .......................................................... Ir Figure 13.--Reproducible computation form. 15 Sep - 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304 �' • U2 s�2s;o� NOTICE: This Form Is To Be Used For tLe Repair Of Failed Septic Systems Only. PERCOLATION TEST AXD SOIL EVALUATION EXEMPTION FORM �4emrk-,\ s9ey , hereby certify that the engineered pian signed by me uetec 1 b3 concerning the property located at e3�- AP�,4 ZAP-'S meets all of the ir:l:o��•,ng c-tteria: 7�-, • This failed system is connected to a residen(ial dwelling only. There are no .ornmercis; cr business uses associated with the dwelling. T�.e $oil is ciass:tied as CLASS I and the percolation rate is less than Or equa to -r>:autes per inch. The applicant may use histoncal data to conclude this f3ct or may :onduc:t pre:imic,ar; tests at the site without a health agent present • There .s no cncre:,se in flow and/or change in use proposed • There are :to variances requested or needed. The bottom of the proposed leaching facility will not be located less than fourteen I Feet aonve the maximum adjusted groundwater table elevation. fAdiust the Ounc!wwer table using the Frimptor method when applicable) Please complete the following: i Ground Surface Elevation (using GIS information) g` G Vr' E;ev at:or, � ad;ustment for high G.W. ' . = ' (Q �CFTTREHNCF 6ETWEEN and �L•� S G.IWE D _ L D ATE NOTICE 3asec; jpon. !tie above rformauon, a repair permit wil! be issued for oedrocros Ta .,r.0 r: bedrooms are authorized to the future without engineerec ept c syaem plans. s .ctun!r,Aci T0'W1 e �J::° 5 ARNSTABLLE s iU ."^CAI'JION C— o SEWAGE # ViLT AGE—C .r' ti�l,l, ASSESSOR'S MAP & LOT 't STALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.ITY: (type) r� '. 'r�T6.rZ (size) Z ,�.�-�� 5 NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:v� S "a, COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility l �'� 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 ® �a� h5- G.S .. ✓ O El 4� �\ � n TO/} WN OF BARNSTABLE LOCATION C�1°' y N �r�� SEWAGE# 3 � �VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY `,67rD LEACHING FACILITY: (type) �6COs (size) NO.OF BEDROOMS r BUILDER OR OWNER A-156 D 0 PERMTTDATE: 'I S`C, COMPLIANCE DATE: ®3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of beaching 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 y 6 0 a� t _ G w a. ' r- Ga. J TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE i ASSE OR'S MAP & LOT 6V00 2�is�c7z;+l�S ^ G AME&PHONE NO' Grz4 V/ SEPTIC TANK CAPACITY D U l::7 e 't`lG — LEACHING FACILITY: (type) �i >< /J (size) _ /6D0 NO.OF BEDROOMS BUILDER O OWNE ✓y�� A-, PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 et of];aching faci / ` Feet Furnished by. i t F-R- d)v �n `e o � CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES, INC. P.O. Box 627,East Falmouth,MA 02536 August 18, 2003 RE: Certification of Title V Septic System Installation: Residential Property 34 Cap'n Jac's Road, Centerville, MA Dear Sir or Madam: On August 15, 2003, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 34 Cap'n Jac's Road, Osterville, MA, based on a design drawn by Shay Environmental Services on August 14, 2003. XX I Certify That The Septic System Referenced Was Installed Substantially According to the Plan I Certify That the Referenced Above Septic System Was Installed With Changes but in Accordance With State and Local Regulations, Revisions or As-Built Plans/Sketch will Follow. The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is Required. If you have any questions, please do not hesitate to call the undersigned at(508)-548-0796. Sincerely, CARMEN E. SHAY ENVIRONMENTAL SERVICES,INC. N OF•iygss9 �o CARMEN cyGN E. SHAY N Carmen E. Shay, R.S., C. No. 1181 President or S T E V' S4NITARO'N 1 No........ .. _... ,... Fm3.............................. w -w� THE COMMONWEALTH OF MASSACHUSETTS G�/'_ 2631 BOAR® OF HEALTH 4.- - ----\ov?c�.................oF......... ns c lb\c......................................... ApplirFation for Mipviial Workii Tomitrnrtinn rani# Application is hereby made for a Permit to Construct (JJ or Repair ( ) an Individual Sewage Disposal System at: pp ` .............. .......................•..................•••• ••-•••....-•----------••.......•-•..........-••---.............................•.................. Location-Address or Lot No. Owner Address Installer Address �053 U Type of Building Size Lot_._.a�_..�....................Sq feet Dwelling—No. of Bedrooms.__.......�..............................Expansion Attic (P 9 Garbage Grinder (U cq aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------------------------•------------------------•--------------------....------------........._... W Design Flow............�A o........................gallons per person per day. Total daily flow----------- 3.9......................gallons. WSeptic Tank—Liquid capacity0 0°...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 ( ) a Percolation Test Results Performed by..._$�:�........ ...ti._. ._.. Date.__.9."'1'.8 .................. ---...... 1.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lr. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •---•-•----------------------•--------------------------------. ......................................................................................... xDescription of Soil.....52---J.Z. `...---... . C30.....l'ne...:....... a n `n ........ ------ U ---•-----•.....................•-------•--•----......----------...--------------------•------------------•-----------------•--------•---------...------------....•-------............------•-----.------ 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 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. Signed--- 1�'hR.�..• -•- .......l - ....,..�------•--------•--. .... p Date _ Application Approved By............................ ,1 - ..... -�_-f 1 Date Application Disapproved for the following reasons:..................... -•-----------•...............................................•------.. ........----•- ----------------------------------•-------------...----------...-----------•--------------•---------......__....--•--------------------------------------------------------------------------------•-•-•- Date PermitNo......................................................... Issued.-----------------------------------------------........ Date No..-•---•---f-.-._..f} THE COMMONWEALTH OF MASSACHUSETTS Fps............................_ i �..: BOARD OF HEALTH ^.................OF........a(Arns b\.. Appliration for Disposal Works Tonstrurtion amit Application is hereby made for a Permit to Construct (<s) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. _.V ..........: uc 1 C \ -••--•-----------------------••-••--------•-•• Owner __..... W \j C ,"''. ``,J't-.._....._. U�n ` LL C. Address a ....... ........................ ..........__... .....__.._......_...--•-•--••�-•--•-•._........_......•...._.._.. Installer Address Type of Building Size Lot...__.`D...3........_Sq. feet Dwelling—No. of Bedrooms.......... ...............................Expansion Attic (J Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ;-; W Design Flow........... .. ...................-:....gallons per person per day. Total daily flow..........-% `�...___........-........gallons. WSeptic Tank—Liquid capacitylt_.�."___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....ACY'"".:,_....... p`"......................... Date..............._ ". a Test Pit No. I................minutes per inch Depth of Test Pit..____.............. Depth to ground water--__---______-_-•----.-- ' 4� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-._---____------__-___- a ...................................................................... D Description of Soil..._.�L-_ Tr_ .• t�_.o r n e c�• .n �� yA ......................... . . 1 c a n d dr u V ••-•••-•-----•--------................................................................................................................................................................................. 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 TITLI: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.... _..--�----...•.-�-��`i-:..:E 1^----------------•----------- l � 1 Application Approved By................................... _'_ - 9- 2-�t� Application Disapproved for the following reasons:............... Date --......----•-•-•--••••--•-----------•--•---•------•---------••---------•-•---•-----•----•-•-••------....--••••••------...••-------------••----.-•----•--------•-•-•------.----•----•-•-•--•--_...------ Date PermitNo......................................................... Issued.............................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................................OF...... -........................................................................... Trrtifiratr of Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ,,,.} or Repaired ( ) r:; a •y-. at. ....................................��� `- . F ; c, 1' 1 -------1 caller-----Cj(} `� f,1` - has been installed in accordance with the provisions of TITLE �.of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. 51 _._._..___0.___'€E �_._ _ dated__..___..._.................................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................... C1•r 2. el - f�i- t� ........-••-•--------•------•--_... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH yt/ 9 S ..........................................OF.........:.: ................................................................... SU No...._ i' _.... FEE........................ Uhipsal nrk� Haan #rttr#uan prnti# Permission is hereby granted.....v.g.- r = `a 6ti? = to Construct ( ) or Repair ( ) an Individuals"Sewage isposal Sy tern { a� Q LA r1 � , \ C-vt' at No.••---.._.. - Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... J .................................X..... =..-------•---•---•••---•---•----------------•••--...._.. Board of Health DATE............................................. FORM 1255 A. M. SULKIN, INC., BOSTON ►.Jo GAtiOc.G� Gcz,r.iDEcz- DI� �Ow Ilv x 3 33oG Pc� t 3 A►LY F f,EPTtG TANK = a3PX 154>% :A9 5;G.P o U5E 1000 GAL. I'po(' PIr < "'Id•G fi -r o15Po5A1- PI'T vSE I v o0 6At_. S j VCWA« AtZGIa a 1 JC s.� o - 150 5.>= X 2.5 e 375 G.Po T�I- �' -� iM. Q BOTTOM �- �- �r� a o 5.P c i� 3 rJ' 2 I 1 -,roec --TCTAl- DESIGN = .42-K G. -- � -. \ } O -TOTAL TDA 11-Y Flow! = 33o G.Po /O f'E2Co�ATioN RATE = V'iN 2MIN or,.l-E55 i '2O P[TC RiCHARD�(lr d(r / _ - .•'[ t �SMT RAXTER Nu 24019 '�'� '�• - Z q ,, �ND R.VE'j i LovHZ Top FNDt ll5 9 G= Ion -ra��-- NV• '�iZ ca,c. e.��� a INv 113 0 I 11211 z rz PTIC �6 Lxy,25 TA►dK ' ��. O loot F o � o ��n� .t✓ GP r [NV. iu`i• Mir i Lr= r� Pr j lmz lm�. u 1 ,- l �PCiIv I I W 1 FT v 5�u� wA,Pei> 8; GaWrIFIGD pLoT P1_A►J e _ L o L 4'T I O N 6:-w tt_[_V 9d. �jGO'1'E Ilr-C GO �AT'c q-(o•Fyl1 1,0 �U►�T�- P 6QEN Grc 1 GE QTIFY 'TV4AT "iNE T--cv r r;,fv ro/J 5HoWN 1' HEREON GOMPI-Y5 WITH T VAS Za Auto s>^Te�►GK R.6QVIR-EMENT> QF 'tN� TovVN o F ' ,A r-rJ�,T �-c3ANv � LOCNTED WITNIW THE Ft-OOD PLAIN 1A Aim IL, 1►NIr14 II /I-1'417 1 DAT L gAKTE 2 e W'Yt- INC. R.EG 1 SZ tGV-rw D'►AAN o S u ZY EYoe'S Tt115 P�L�r�l I�j N� E's��>c r� oa AN o�-rEczvlu�E • MAss• lu5�-RuM�1.IT �ueve-y e -TWF: n SE"f5 Suovl.D / L Wo•T Pt1= u5EoTa pETER.�^1►J� t o-r- �.�NE.c� AP9LICA►`IT /�k.��S I`' AA ITS M UO CATION SE E PERMIT NO. Lp f dv S � `VILLAGE INSTALLER'S NAME i ADDRESS 8 I L D E R/ WR OWNER d DATE PERMIT ISSUED C �7 _..-�� DATE COMPLIANCE ISSUED /'h -L � 7 i I (7 37 . a7 _y D VENT PIPE (0 Lenst 24 Inches tall) Schedule 40 PVC w/Chorcoal Odor Filter 110' min. from 2-le DIAM. AOCtSS MANHOLES a h;�se to'septic tank *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. Existing Foundation, !Septic tank covwi must be e T.O.F, slov. 100.00 within 6 in. of finished grade SITE Grade over Septic Tank- 100.00 Grade over D-Box 100.00 do over SAS ELIEV- varies From 100.00 to 96.00 SECTION A -A )K :I-4N1114. PROFILE VIEWOF LEACHING SYSTEA[ 4v S 0.02 HOLE Not to Scale S-001 DIST. Box THE ACCESS COVERS FOR THE SEPTIC TAW, 17' (H-20� 0. W.10", INLET DISTRIBUTION BOX AND LEACHING COMPONE14T Top o f SAS-Etev--93,00 OUrn ET SET DEEPER THAN 6 INCHES BELOW FINISHED 22' PIPE 0 XI$T. 1,000 GA t' 0.010* Der foot FROH FDUNIIATION SEPTIC TANK to 0 I/V roh"C"Ww AN" GRADE SHALL BE RAISED TO WITHIN S' OF a) (6 Q H-10 PVC TEE 20?1 Effoctlw Depth FINISHED GRADE 0.10% or Ch r� CONCRrt FULL FOUNDAITION'y > REQUIRED C� C14 INSTALL TUF-TITE GAS BAFFLES OR EQUALS TO REDUCE 0) 03 > IN D-Box 2' WATER VELOCITY STEEL REINFORCED PRECASt CONCRETE 11 2000, Not to Scale Effe SYSILM EROFILE >: 0 1 '0 otive PLAN �'VIE TD Effoctly* Wldthi ;1; S-idewall 0 3 Units 7' 21, 3-24' REMOVABLE COVERS c: GENERAL NOTES S ln.of 3/4"-1 1/2' compacted stone 0 1. Contractor is responsible fo Digsofe 'notification 4- .41 . I . and protection of all underground utilities and pipes. e-9 In. cWorance 4JTST, G* Ef f ectlye Lengtli INLET -,E-= 12' min. Inlet to outlet 2. The septic tank orij, distr�i lion box shall be set OUTLET level on 6* of .2 stone. SOIL ABSORPtiON 'SYSTEM (SAS) 3. Bockfill-,should be 'clean sand or gravel with no '- 5! -7* stones over 3" in stze. INFILTRATOR 'MODEL 3050 (H-20 LdADING)/ SUMNER DUNBAR 4. This system is subject to inspection during installation 4'-0* mIn. LIWId depth (OR. EQUWALENT) by Carmen E. Shay - Environmental Services, Inc, NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE 5.1 The contractor shall install this system in,accordance NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30- /EFFECTIVE HEIGHT IS 24- 1 1 with Title V of the Massachusetts state code, the approved plan and Local -Regulations. f 4' -101-- 6. If, during installation the contractor encounters any CROSS SECTIQN END-SECTIO soil conditions or site conditions that are different 'PIP, from those shown' on'the' soil log'or in our design installation must .holt & immediate notification be ode to Ca rmen E. Shay Environmental Services, Inc. m U ANK , SE EXISTING 1000 GALLON 'H- 10 SEPTI T 7. No vehicle or heavy machinery sh FOUNDATION fol SEPTIC TANK __�_221 D-BOX 20' LEACHING FACILITY all drive over the NOT TO SCALE -H-20 septic components. septic system unless noted as S. Install Tuf-Tite gas 'baffles or equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Sch. 140 NSF PVC pipes. VARIANCE REQUESTED: 10. All'-sblid piping, tees & fittings shall be 4" diameter PERCOLATION TES Schedule 40 NSF PVC pipes with water, tight' joints. Reduce Distance from Tank to Foundation from 20 Feet to 11.6' f eet, 'V 11. SITE and Surrounding Properties are Connected Date of Percolation Test: August 4. 2003 to Municipal Water. Test Performed By. RON CADILLAC- R.S,, C.S.E. Results Witnessed By: Waiver per Barnstable BOH Excavator: Unknown. Percolation Rate: Less Than 2 mIn./inch 0 42" BELOW GRADE. H ROPERTY LINES ARE APPROXIMATE AND Test Hole Test Hole Test Hole No. 1 No. 2 No., 3 OMPILED FROM THE SURVEY PLAN GENERATED BY DEPTH SOILS ELEV, DEPTH , SOILS ELEV. DEPTH SOILS RONALD J. CADILLAC, R.S., P.L.S.' OF YARMOUTH, MA,' DATED 8/5/03 0\ ENTITLED - SITE PLAN FOR SUSAN ASSELIN OF 34 CAP'N JAC'S RD, 68.00 0 �78.00 0 400 CENTERVILLE, MA" AND IS NOT 'INTENDED TO BE A SURVEY PLOT PLAN 0 LAyer LAyer 11_00my 1 1 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN 0 S, tOYR 4v THE SEPTIC SYSTEM INSTALLATION. 0.-12* 67.001 0'-2- 0 6 A,7 97-501 Loom Sand Loamy Sand LXm,,,Sanc y IOYR 4/1 10YR 4/`1 THERE ARE NO WETLANDS LOCATED WITHIN A 200' RADIUS OF THE SITE. 00 E 66.33 2-- 11 42 Ir- 20"1 4 E 93.50 IN,- A Sandy Loom Sandy Loam Xoamy Fine 10 YR 5/6 2.5 Y 6/6 y 1.3 NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE 20'-64' 62.661 4*-42" Be 74.501 42'/44- Cla FROM THE EXISTING SEPTIC SYSTEM TO BE DISPOSED 1 95.00 i Sandy Sandy OF AS PER BOARD OF HEALTH SPECIFICATIONS. Loam Loom 10 YR 6/6 10 YR 6/6 64"-84* C1 42*-844 C, 71.00 "'EXISTING LEACH PIT TO BE PUMPED DRY, & FILLED IN PLACE Sandy Fine 61-00 Sandy Fine OR REMOVED TO FACILITATE 'NEW SEPTIC SYSTEM INSTALLATION. Loom Loam PROJECT BENCH MARK TOP OF FOUNDATION 2.5 �y 6/1 -2,5 Y 8/3 84"-132* cl 157,00 1 84'-144- , 64.00 ELEV. 100.00 (Assumed) F ine as Sand Sand ASSESSORS MAP - 194 LOT 052-TOO 10 YR 6/4 54.00 144"-1 21 ,2.5 :Y 6/3 62.00 C3 1 1 C., ZONING - RESIDENTIAL 4- FLOOD ZONE C ----Perc #1 0 Test +�ole­#3 Depth to Perc: 42", to 62" Perc Rate=<2 m1n./Inch 6 Groundwater Not Observed THERE ARE NO WETLANDS LOCATED WITHIN A 200' RADIUS OF THE SITE. BOTTOM .OF TEST HOLE Elev. 144* Failed No Adibstment Required. ADkSTED H20 Elev. Leach Pit EXIST. 1000 gal'-\ Septic Tank 0 ALL OUTLET PIPES FROM 'ME L�1.�N DISTRIBUTION BOX SHALL BE LEGEND SET LEVEL FOR AT LEAST 2 FT. 12'-VICONCRETE COYM 00 10, - 98 3 5' OUTLET 2' GARAGE 1�p e, MOCKOUTS 94- V�8xo 0 DENOTES PROPOSED ou W INLET EXISTINC 96 711� SPOT GRADE 92--__1 BOX 2 BEDROOM jo HOUSE 2 DENOTES EXISTING X 104.46 3A 4' - SCH. 40 Tee�/ SPOT GRADE & ___92 64 90�i TEST HOLE #34 PLAN SECTION \ELEV.= 97.00 -------- CROSS-SECTION PL PROPERTY LINE EXIST. DECK __86 3 HOLE DISTRIBUTION BOX - H-10� LOADING PROPOSED CONTOUR -- ------------ 84 NOT TO SCALE __82 97 -- - -97 EXISTING CONTOUR Design CoIgulojign§ i - 14.) ------------------- Number of Bedrooms: 2 Equivalent to 220 Gal./Day (330 Gal./Doy Min. per Title V) DEEP TEST HOLE & 40 MIL Rubber Liner 9� Garbage Grinder: No PERCOLATION TEST LOCATION FROM ELEV. 93.00 To Etev.90.00 & 10 Feet 110 Leaching Capacity Proposed: 330 Gal,/Day Mini �um (Min. Per Title V) Beyond Each End of SAS/or Dwelling -------- m Septic Tank 2 x 330 Gall./Day = 660 USE 1,500 GAL Septic Tank. FENCE HOLE #2 ro SOIL ABSORPTION AREA: Using percolation rate'of <2 min./inch ELEV. �_YA_00------ Bottom Area: 0.74 gal/sq. ft. x 290sq. ft. = 214.60 gallons PRIVATE DRINKING WATER WELL Sidewall Area: 0.74 gal./sq. ft. x 1156 sq. ft. - 115,44 gallons 86 (6 Providing: ­o 330.04 gallons Use: (3) HIGH CAPACI TY'INFIL TRATOR CHAMBERS, H I A"NG A 2' EFFECTIVE DEPTH, 8 4 (4' W x 7' L) TO BE USED WITH 2' OF WASHEO STONE ON THE SIDES AND LOT #20 4' OF WASHED STONE ON THE ENDS. 27,650 Square Feet 80 ------------------------------ ro PR, EPARED FO R cc TEST HOLE #1 PROPO SE D ELEV." 68.00 SUSAN L. ASSELIN SUBSURFACE SEWAGE DISPOSAL SYSTEM OF ro ro #34,­ CAP ) N JAC 'S ROAD #34 CAP" N JAC ' S ROAD oad CENTERVILLE, MA OC689 64--_ CENTERVILLE, MA 02632 vtttttv PREPARED BY: REVISIONS rA M N t_/."RHEY , E. SHA Y jo ' No. DATE: 31 DEFINITION SH EIV VIR ONMENTA L SER VICES, INC -t ro 0. 34 THATCHERS, LANE CIO T EAST FALMOUTH', MA 02536 0 20, �40 50 j4t�t,�tg 0 NITAR\ TEL/FAX 508-548-0796 I r 2' ,!71 - 211 110 I;OZTnLl",11� SCALE:. 1"=20 DRAWN_8Y: CES . DATE: AUGUST 14, 2003 PROJECT#SD-462 FILENAME: SD462PP.DWG SHEET -I OF 1