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HomeMy WebLinkAbout0007 CAP'N LIJAH'S ROAD - Health 7 Captain Lijah's Road Centerville A= 192— 156 S M E A®® No.2•153LOR UPC 12534 smead com 9 Made In USA Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments rti�t � 7 Captain Elijah's Rd. Property Address — - — ----- -----—-- w�,; Fred Sullivan Owner Owner's Name information is required for every Centerville - MA 02632 7/8/2015 page City/Town State Zip Code Date of Inspection fti7 r.> 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. -nportant:When A. General Information `illing out forms G/on the computer, cJ/# //O/`�,[�y! use only the tab 1. Inspector: key to move your cursor-do not Paul Martin _ --___— use the return Name of Inspector key. Cape Cod Septic Services r� Company Name 350 Main St Company Address W.Yarmouth MA 02673 City/Town State Zip Code 508-775-2825 S15016 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. I 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 _..� 7/15/2015 _ Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. V t5.ns•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 1 of 17�' Commonwealth of Massachusetts �F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 7 Captain Elijah's Rd, Property Address Fred Sullivan Owner Owner's Name information is Centerville MA 02632 7/8/2015 required for every _ page. CityrTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System in working condition. 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): t51ns•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Captain Eli ah's Rd. P 1 Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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•3/13 TiUe 5 Olfiaal Inspection Form.Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form JV, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Captain Elijah's Rd. �f Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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 ❑ ® 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 '/2 day flow t5,ns•3113 Title 5 Offidal Inspection Form.Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 7 Captain Elijah's Rd. Property Address Fred Sullivan _ Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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 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. t51ns•3/13 Title 5 Offidal 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 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is Centerville MA 02632 7/8/2015 required for every _ _ 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. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 - DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110x3= 330gpd t5ins•3/13 Title 5 Official 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 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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 ears usage d 2013=96gpd g ( y g (gp )) 2014=96gpd Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspectlon 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 7 Captain Elijah's Rd. Property Address Owner Fred Sullivan -- Owner's Name information is required for every Centerville MA 02632 7/8/2015 page. CitylTown 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: No Records Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume um ed: - - p p 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 Form.Subsurface Sewage Disposal System•Page 8 of 17 1 Commonwealth of Massachusetts W� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is Centerville MA 02632 7/8/2015 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: 2009 Per BOH records. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: +10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): Line checked with sewer camera and was found to be clean, properly pitched with no sign of root intrusion. Septic Tank (locate on site plan): Depth below grade: 10"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal H-10 Sludge depth: 8-101, t51ns•3/13 Tille 5 Official Inspection Form Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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 Scum thickness 5-6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estimated Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1000 Gal H-10 tank in good structural condition. PVC tees in place. Tank at normal operating level. Inlet cover 1' below grade with outlet 8" below grade. 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 5 Official Inspection Form.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 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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 0 11 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.): H-10 DB-3 with 1 line in and 1 line out in good condition. Box is clean and level with minimal solids carryover. No sign of overloading or hydraulic failure. Cover 29" below grade. 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: t51ns•3/13 Tide 5 Offiaal 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 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: -- - ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 1-10'x30'x2' ❑ 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.): 6-3050 Infiltrators in a 10'x30'x2'Trench configuration. Units checked with camera and were found dry at time of inspection. Soil inside units found to be clean. No sign of overloading or hydraulic failure. 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 t5ms•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts �l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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.): i t5ins•3/13 Title 5 Offaal Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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 t5ins•3/13 Title 5 Official 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 7 Captain Elijah's Rd. Property Address Fred Sullivan Owner Owner's Name information is required for every Centerville MA 02632 7/8/2015 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: +11'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: Hand auger near leaching to 11'with no water encountered. Max bottom of leaching at 4'6". Minimum of 66" Separation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Offiaal Inspection Form.Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts F� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Captain Elijah's Rd. _ Property Address Fred Sullivan Owner Owner's Name — information is required for every Centerville _ MA 02632 7/8/2015 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 t51ns•3/13 Title 5 Ofrical Inspection Form.Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION '� ,'rt L;¢.�ti SEWAGE# 00 9 VILLAGE Ce-%¢r v.zk ASSESSOR'S MAP&PARCEL /qoT /SG INSTALLERS NAME&PHONE NO. 5C, A-i M0 SEPTIC TANK CAPACITY __ /OOOy LEACHING FACILrrY:(type) '30So K�i..l ylsize) /O X 30 X.Z NO.OFBEDROOMS 3 OWNER Fri P ✓//, PERMIT DATE: f-.2 O-O 1/ COMPLIANCE DATE: • Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility- Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY A /3 f� ;z a 3 31' 33' T y ,o. http://www.town.barnstable.ma.us/assessing/HMdisplay.asp?mappar=192156&seq=1 7/7/2015 No.C�" FEE l D COMMONWEALTH OF MASSACHUSITTS Board of Health, IA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair(/pgrade( ) Abandon( ) - ❑Complete System ❑Individual Components Location Owner's Name Map/Parcel# •2 Address7(a `�-�' S'�L {� _ Lh Lot# Telephone#STEPHEN'J.DONIT Installer's Name J �, AG `�,� �- `� ���� esigner's Na a 42 CANTERBURY"4€ Address p�/f �aX 3 3 -7 Address 50B/fi�3 91 Telephone# g! 'lag- --r 5 S Telephone# Type of 'ng Lot Size sq.ft. r ) Dwellin - of Bedrooms arbage grinder ( ) er-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures J Design Flow(min.required) -3-3 ()_gpd Calculated design flow Design flow provided '!:3*Q gpd Plan: Date v 0 Number of SIWCts 1 Revision Date Title s" Description of Soils) is, Soil Evaluator Form No. Name of Soil Evaluator t L.J:ri, Date of Evaluation ' l DESCRIPTION OF REPAIRS OR ALTERATIONS The undersiawd agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a (.ego�to ce th sys m in operation until a Certificate of Complianc�ey has been issued by the Board of Health. Si Date Inspections No.`J� -! �} I I FEE l D �4. M4t � • `b 1 (1 COMMONWEALTH OF MASSACHUATIS Board of Health,: 1�gz .,i ,;11A. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair(/Upgrade( Abandon( ) - ❑Complete System ❑Individual Components [rAddress tion Owner's Name /Parcel# Address�(o y-1 g (� (� /� LLB(�• Telephone# ller's Name J. C AG ! J �/� Designer's Name 42 CANTEPTURY LADE Address �:� x �5 � ��� :��`.f /��! 508/540-2534 phone# 5 pg wg, 5 C Telephone# Type of Building Lot Size 1-t Z y + sq.ft. Dwelling,hlo.of Bedrooms 3 Garbage grinder ( ) Other Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow(min.required) 3 (� gpd Calculated design flow Design flow provided gpd Plan: Date Z21 Number of shects Revision Date Title Description of Soils) GTE r2r � �C L Soil Evaluator Form No. Name of Soil Evaluator `, . TIx 1 Lr�� Date of Evaluation l DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections No.— FEE COMMONWLALT14 OF MASSACHUSETTS i l Board of Health, ,�Gr,-, S f�i,�>° , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: �� G. �u &-0 at '1' cUp '� Z. ';�, ti '1 has been installed in accordance with the pr sions' of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 2�✓��''/� , dated Approved Design Flow (gpd) Installer c 7 �� _ ) e , 1 Designer: S ` '5SOe_ Inspector: ` Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. �CJCJ I ( FEE / COMMONWEALTH OF MASSACHUSETTS Board of Health, ��- % t f�,��r , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. .' ,dated Provided: Construction shall be completed within three years of the date of this emit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date G Board of Health t r Town of Barnstable j"E Regulatory Services • Thomas F, Geiler,Director • BAIMsreaz.e. AS Public Health Division ArfO"��' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Dk — 11' - l Sewage Permit# 9009' —// Assessor's Map\Parcel N 2 ' i'& Designer: �•���Ly 5.7, i_: Installer• Address: �' �>'zt��3 1 Address: eO 13o,c 3 3 9 t1 filar 5 to�•s mil. //s /�I/� O� � -4 On 1 IAA AA l_YJ was issued a permit to install a (date) (installer) septic system at C-o y-`" , t A a S - J based on a design drawn by (address P►a r dated N n 13, ,7 ooy (desi ner) I ertify that the septic system referenced above was installed substantially according to he design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & LocaI Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. o CP j e o STEFHEN -(Installer's s Signature) PIIF+S� N n g � y �J No.1 t186 � DOYLE p �C, Z 4 a 375 N e ccG18TyP a O� a` A sAAtiTAAN�`� Ae•��`o suFv0Vaaa ( esi n s S is re) (Affix Designer's Stamp Here) .•�� PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- I3UILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rey 03-09-06.doc TOWN OF BARNSTABLE L6cATION !7 C,,r'a I l L ;4A SEWAGE# c 009 VILLAGE Ce-i- rev, ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY /00& LEACHING FACILITY:(type) NO.OF BEDROOMS 3 OWNERr�� PERMIT DATE: r/.-a 0- 0 �/ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY � f✓vnf �3 ,4 /3 3 .37 33 T i �o' Town of Barnstable P# Department of Regulatory Services AM : Public Health Division Date t z 200 Main Street,Hyannis MA 02601 �— Date Scheduled r 1 � 1 Time ' Aw, Fee Pd. l o V Soil Suitability Assessment for Sewage Disposal t Performed By 1 v �.tv Witnessed By:. a if 1Ji r'_Z r LOCATION & GENERAL INFORMATION Location Address Owner's Name 'I ( 9 Address Assessor's Map/Parcel )q' "- / Engineer's Name NEW CONSTRUC11ON REPAIR Telephone# ­341 Land Use Slopes(%) -4�- 41 Surface Stones '� /01 Distances from: Open Water Body 4 L;.' ft Possible Wet Are ft ft Drinking Water Well _ft Drainage Way t'J ft Property Line >> i�ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) ZC1 2 t� Ac Z c L��` 1 �1: 1.= Parent material(geologic) �„A Depth to Bedrock Depth to Groundwater. Standing Water in Hole: 'f Weeping from Pit Pace Estimated Seasonal High Groundwater V) 6'11� Llya, /ltloot 1 DETERMI AT 3FOR SEASONAL HIGH WATER TABLE Method Used: ---tom i.` Depth Observed standing in obs.hole: —in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Act),faetor— Adj.Oroundwater Level .n PERCOLATION TEST bate Observation Hole# �_ Time at 9" Depth of Pere Tim/6" Start Pre-soak Time® Tim End Pre-soak / Rate Min./Inch � -' �` �3.Zd+r t•L> Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTI0PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole#L1' ._' Depth from Soil Horizon Soil Texture Soil Color Soil er Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con n avel �.� � 't-� r%17. "� , � !.� to � u C •,tom DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil er Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. CoDsistencv.%Gravel) A, i? L IT DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, oGravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No l Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervi us material exist in all areas observed throughout the area proposed for the soil absorption system? - If not, what is the depth of naturally occurring per ious material? Certification I certify that on `" (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date Q:\SF-PTIC\PERCFORM.DOC r aim i I P', r. �r f i, vl ;;12 (1 � Ire ✓T C� 1'd t �S/LL f..C-E✓ T ABOVE PO.aD � F'L. U T' RL A /V 1 L O CA T"/ON SCALE - _ � _D..QT& I PLAN 2EF2E�/C,� : /Nu LOT _Z 74 TA G E .5,: ,F,-1 t=/v571oF, d�� I NEleESY CEL71F THAT THE EXIST- r':,, S -/NG FOUA/DA 7 ION LOG L!TiONS Q / 7Z YJ;tFkn :., F. %^ _Jam:=_� __CO.v.-O,2^.f WirN TAYLi:k r Tf-/E SU/L D1 A/G SE Tl3AC�PEQUiPE r-1 �Fre ADO OF THE TOWN OF �8►T E �9`1 GV/GLO�t/,3T. >:42MOUT3/"R�PT MA. OC,QTIOK'. 7 EW6,61E PERMITrr MO. — LD t-2 — — - _\ p t.�• ALL WSTaLLER 5 U&ME: � ADDRESS — — —R Qb-ezt, s Qur BUILDER 5 Q &V AE ADDRESS David Tellegen Dennis Mass DATE PER" T ISSUED 10/6/75 — — — — 10/9/75 D ATE COMPLI &&ICE ISSUED : — — i SiD� �--- A � ao' A 8' �3�,b,, �ay� I� r.• 7 ASSESSORS MAP PARCF1N FE$. ................. THE COMMONWEALTH O Ciiij. , X`�j BOARD OF HEALTH _ TOWN .......OF...........B .R.NSTABLE...................... ...................... Appliratiun -fur M-4posal 10orku Tatuitrurtinn Prrntit Application is hereby made for a Permit to Constr ( r Repair ( ) an Individual Sewage Disposal System at: !(,f Loc lion-Address or Lot No. m h e -F e.r.r an Q.a.y.i,d Q .T..�.l.,� erg. 2 ranr at i.a�n...Rs�s. .... ennis•----•-•--•-•-•-- Owner Address ------------------------------------------------------------- ----Gr aa.t---A!a a.t s-rn..._ ........... Installer Address QType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..................._..__..._..._.._.__-_..__Expansion Attic (x ) Garbage Grinder1-1 ( ) a4 Other—Type of Building QW!1_l n.g..... No. of persons.......... ............... Showers ( ) — Cafeteria ( ) P4 Other fixtures ...................................................... W Design Flow...............5_Q------------------------gallons per person per day. Total daily flow........30------------------------- 0 .....gallons. WSeptic lank—Liquid capacit.1_}2Q-0gallons Length................ Width................ Diameter................ Depth-_--_-_______... x Disposal Trench—No..................... Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.......... ......... Diameter... ...X...5... Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by------- -- ......................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ CT, Test Pit No. 2................minutes per inch Depth of "Test Pit.................... Depth to ground water........................ et.. - -- --- - O Description of Soil ---�­ • J� �.._• `- �1 fk:t.... i _�.17 �.__ x Sand -------- c.� y •-- ��/-1 j W ••••---••••-----------------•--- •----••-•---------------------------•----••••--•••--•--•••-•••••----•-------•------------•------•--------------------• .......... . VNature 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed-----"/`� . .. ._._------- I---------- .../4._- -6 -7- ----- te Application Approved By____. .. ate 21 j :.._._.__ .. ----------------------- Application Disapproved for the following reasons___________________________________________________________________________________________ D ._......___._. --------•--•-•..............••...•--•-------------------------------------•-•-•-•--••-••---•-•-•------ .•.-•-•••...•.•----•-••-•-•-•----•- / Date +- PermitNo......................................................... Issued.......�F Date 1 7 sC Al Nth J-.......1.�. Fss. .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T Q;.:', _.... .. ..........R RNSTA BL.E..... Appliration -for Bi,ipooal Works Tonotrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Lot il . Old _Stage Road, Cent_e.>~.Vil,19 -........ -------- ----- - •------.. ---•- -••-•-•••-........ .......... IMichael...FerrQne�t�QgjLj.d.-A T-p.1.1���n. 22.._�or�_Q.r�tiAar..�ra��l�._.a.snni�..... ---- Owner Address aRob•ert.... qu-T.............................................................. ....G.r-e-gLt_._A1.g.s.te_ra...Rd—.,....N.----Ha.rwiah--•--...._. Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No, of Bedrooms______________3 ............................Expansion Attic (x ) Garbage Grinder ( ) Other—Type of Building Owe 11..n o_____. No. of persons.......... ________________ Showers ( ) — Cafeteria ( ) QI Other fixtures .......................................... W Design Flow______________5�______._.._..____..______gallons per person per day. Total daily flow._.._._3 �_._.._.___._.____..._...._..gallons. W Septic Tank—Liquid capacitka-U Q .. .gallons Length________________ Width.._............. Diameter_.............._ Depth....._..__._.. x Disposal Trench—No...................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........i.......... Diameter__5••-•x 8---- Depth below inlet____________________ Total leaching area__-_._-._----_.___Sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date...................................... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.-.___._--_--__-_-__-. G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ M ,� j.. -- zejO Description of Soil.--..._. _.....---- ._._.: n.--"°t-..� _.. __ __ _____ - -- �. _ A t 0' J ,L v -------------------------------------•-..---------•-Sandy----------- '�1�- L�,[.- �/ W --------------- -----------------------------------•-•••••••--••••-•••--••-.._..----.............................................................................. ------------------------- VNature 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. S ned...__ -•• ate�1 y Date Approved By- ..--•-------------------- --�&4� Application Disapproved for the following reasons---------.......................................................................................................____--_----•__ ..-----•-•--•------------------------------------------------------------•---------.-.-..-----------•---•.--------------•--•---------------------------------------------------------- ................. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL H I...... ..........OF...... . .... .. . .. ......... ......................... Ulertifirate of Tontphatta ' / T S TO CE IF hat the Individual Sewage Disposal System constructed (®r Repaired ( ) by..... ...e ....... 1 ' -----------------------------------•--- ----- �-a--_ ......"--•---------- � st ler has been installed in accd dance wi he provisions of A XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. _._._ --- dated,/D....... _. ........... THE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARDJ HEALTH ...... _. � FEE_ (! 01- Di-spa ork , L trnrtion Pt ermit Perm' sion�reby granted---• . -4 -----' -------------------------------------------------•••••-•-•••-.........----- to on c ( ) or p i nvidyal age tsposa] Systat N fr` (.� ���F= ' -- CI�'��? s�QJ2,1 ,�_)�._—i--!"r�_.� Street / as shown on the application for Disposal Works Construction P it No. ___._ ___!___.: ated...�11-�.'_7 . - -•-•--- _______ ____ mil . -----•---•-------------•-------- oard f.Health DATE............["' f ------------ ................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS � II O � o w FINISHED GRADE EL. 64'f J � U 6" 6„ 20" RISER 20" 1/8" TO 1/2" DOUBLE WASHED STONE © 2" THICK OR GEOTEXTILE FABRIC O U) : z Dia. Dia. FINISHED GRADE EL. 62.5'f MAX. Q J 0-)< � m O INV EL EXISTING 6 FIN. GRADE EL. 61.6f' MAX. o —1 Q O TO REMAIN RISER FIN. GRADE EL. 61.6f' MAX. ® 07 N x Min. 1� Mi._; 3/4" TO 1 1/2" DOUBLE WASHED — OBSERVATION co �_ Z Z Lrj INV EL --� li INV EL STONE AT SIDES AND ENDS PORT OBSERVATION < 3/4" TO 1 1/2" DOUBLE WASHED � Q � < Aelow Flow Line (TWO-SEE PLAN MEW) PORT STONE AT SIDES AND ENDS INV E INV EL Min. 6" (TWO-SEE PLAN VIEW) 3 a L�J Q m Liquid Level 48" Sum L a � U 58.5�' 58.30' -- --- - - - o < n • ' l 6 Stone INV EL ,'. HIGH DENSITY a F= z EXISTING 1000 GALLON TANK TO REMAIN DISTRIBUTION BOX 58.10' ,' POLY INFILTRATOR < .. S ! 24" 30" p� W Eff. Depth MODEL 3050 a cn LEACHING CAMBER s� w 1 < 2.5'�- .. I 6.10' F 36" � < Tees shall be constructed of Schedule 40 PVC and shall extend a PRECAST REINFORCED CONCRETE DISTRIBUTION BOX 30' 10' p0 Locus O minimum of 6' above the flow line of the septic tank and be on Install on a level base USE FOUR INFILTRATORS PROPOSED HIGH DENSITY the centerline of the septic tank located directly under the Minimum wall thickness = 2" clean-out manhole. 36'' STONE AT SIDES AND 30 AT ENDS INFILTRATOR TRENCH Minimum inside dimension = 12" The inlet pipe elevation shall be no less than 2 ' nor more than 3>, (10 WIDE X 30 LONG Outlet inverts shall be equal to each other and at kq above the invert elevation of the outlet pipe. 2" minimum below inlet invert. L. U. LENGTH - 6.25' -L,O C Septic tank shall have a minimum cover of 9" The distribution lines from the distribution box shall all have 36 STONE AT SIDES AND 30" AT ENDS Two 20" manholes with readily removable impermeable covers equal inverts as determined by flooding the distribution box to of durable material shall be provided with access ports. the height of the distribution line invert after all lines have Design Da ta: USE FOUR INFILTRATORS The outlet tee shall be equipped with gas baffle. been sealed in place. BOTTOM OF SOIL PIT = EL. 50.5' Invert adjustments shall be made by filling with durable and Three Bedroom Design Flow — No Increased Flow NO GROUND WATER OR nondeformable material permanently fastened to the line or REDOXIMORPHIC FEATURES OBSERVED ASSESSORS MAP 192 PARCEL 156 reconstructing the lines until all inverts are of equal elevation. 3 X 110 GPD = 330 GPD Required Flow STRIPOUT NOTE: REMOVE ALL UNSUITABLE MATERIAL 5' AROUND S.A.S. DEED REFERENCE: 21212-180 No Garbage Disposal Allowed DOWN TO THE "C" LAYER (EL. 56.5f) AND REPLACE WITH CLEAN GRANULAR SAND PER 310 CMR 15.255 (3). PLAN REFERENCE: 275-5 Use: Infiltrator Trench 301 x 10'W x 2' E'ff/Depth ZONING DISTRICT: RC [30 f 30 f 10 f 101 x 2 0 = 160 sf OVERLAY DISTRICT: 30' X 10' = 300 sf AP & MA ESTUARY Z.O.C. GENERAL CONSTRUCTION NOTES 460 x 0. 74 — 340 GPD Total Design Flow LOCUS DOES NOT LIE o 1. All the workmanship and materials shall conform to REP Title 5 IN A FLOOD HAZARD ZONE U, and the Town of Barnstable rules and regulations for the subsurface disposal of sewage. w 64 � 2. Access ports over tank tees shall be accessible cn within 6" of finish grade. STRIPOUT NOTE: z 3. All components of the sanitary system shall be capable of S29S6, REMOVE ALL UNSUITABLE MATERIAL 5' AROUND S.A.S. Cn 0 withstanding H-10 loading unless they are under or within 10 ft 2p4.89 �9'E DOWN TO THE "C" LAYER (EL. 56.5t) AND REPLACE WITH of drives or parking. H-20 loading shall be used under or within w o 10 ft of drives or parking unless noted. Plastic equals may be CLEAN GRANULAR SAND PER 310 CMR 15.255 (3). used in lieu of all precast units. 64 Z 4. The exca va for/contractor shall call dig safe and verify the location of all site utilities prior to any exca va tion, and shall be responsible 1000 G 61 n all 5.r Sewer pipes shall be matters t 4" Schedule 40 PVC laid at a min. 0.02 slope. ACo electric easements. CON TANK To &f 62 60 59 z 6. Any masonry units used to bring covers to grade shall be . 63�N mortared in place. _ 7. Finish grade shall have a minimum slope of 0.02 ft per foot. Shed 8. Existing system components -if any- shall be abandoned 6 CV O EXISTING per Title 5 requirements. Deck 0 ' 0 9. The excavator/contractor shall be responsible to contact DWELLING #7 ° �8 _^\ Doyle Associates 24 hours prior to any required inspections. 64 \ s' \ o b 2 10. All components shall be marked with magnetic tape or / \ \ \ 35 0 �o' co comparable means in order to locate them once buried. / 11. 36" max cover over system components. < \ \ \ \ N lzz:c _ Z L— E C,-- N C� �� \ EX�STrNc GRg EXIST. LEACH PIT °° LP ; 64 TO BE ABANDONED LOT 1 ' -- _ � - OH L OVERHEAD ELEC. 17, 251 ±SF 63 __J 1 BM: TOP OF CB z GRAPHIC SCALE , CZ 31 .6' EXISTING SPOT ELEV. DATUM:5GISf Q 20 '° z° 40 80 x U w 59 EXISTING CONTOUR M 62 ~ ( IN FEET ) O Z 61 PROPOSED CONTOUR - 1 1 1 inch = 20 ft. Z 61 / '�� < EXISTING UTIL/POLE C'01 S38'25'39"E 5982 63.53' EDGE O OF TEST DATE: 01 -07-09 62.76' PAVEMENT ro 6 _ Q N O SOIL EVALUATOR: S. DOYLE U O @� HEALTH AGENT: DONNA MIORANDI OLD S T ��P��N OF#,jqs Cf)O � > T.P. #1 PERC <2 M/INCH T.P. #2 PERC <2 M/INCH t A GE EL. 61.0' �' DAVID s�� (n L i I o y zwcn EL. 61.0' 0 0 4 D a MAgSON y Q a co "A" SL 10YR 3/2 "A" SL lOYR 3/2 6,> 6" — _ W � < (N „B» LS 10YR 5/6 »B„ LS 10YR 5/6 ---- - -- 4 iMi° � m (n � W 53"(EL. 56.5') W 53"(EL. 56.5') —.._ _ LLJ :�E I _ �%,A'~A�� O z - � C MED. Ln C MED. ®� 0 ?a��, �� C) < SAND P " SAND s �c U00 „ ERC 60 o\ �STEPHEN -A ® 0 0 DpYIE ► z < 2.5Y 6/4 2.5Y 6/4 emV� �� _ w '�� - Z EL. 50.5' „ EL. 50.5' „ - m� �w`� ^ O (n Li NOG WATER OR NOG WATER OR U) w Ll26 126CL REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES \ Li I- . N �j