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HomeMy WebLinkAbout0036 CENTER LANE - Health 36 Center Lane, Centerville A=251-055 S M EAD® Ido.2-153LOIt UPC 12M smead.com • Made In USA f Commonwealth of Massachusetts Title 5 Official InspectionForm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name Information is Centerville Ma 02632 1/29/2013 required for awry - page. City/Town state Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer. use only the tab 1. Inspector v key to move your cursor-do not Sean-M. Jones use the return Name of Inspector key. Capewide Enterprises Company Name 153 Commercial'St. Company Address Mashpee - Ma - 02649 Citylrawn state Zip Code 508-477-8877 S14522 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 diSDosal 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 1/29/2013 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. •n"This report only describes conditions at the time of inspection and under the conditions of use at that time.This Inspection does not address how the system will perform in the future under the same or different conditions of use. Title S orfiwl vepectlon Foam Subewwe sewage Disposal system•Page 1 or 17 t5ina•11//0 . 5' 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D \, Y A) System Passes: ® 1 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: The dwelling located at 36 CenterLane Centerville is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 2 500 gallon leaching chambers. This system was installed 9/18/2008 per town records and found to be in proper 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): t5ins•11/10 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , ° 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma, 02632 1/29/2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner - Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water.analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm; provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or. clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS orcesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown 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. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 r Commonwealth of Massachusetts Title 50ffiaI i Inspection Form c Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 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): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 gpd t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2011 18,000 total=49 gpd 2012 23,000 total =63 gpd Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System 6 Page 7 of 17 Commonwealth of Massachusetts W - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD.F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 1 feet Comments (on condition of joints, venting, evidence of leakage, etc.): - Joints ok, no leakage, vented through roof Septic Tank(locate on site plan): Depth below grade: 2 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: 1500 gallons Sludge depth: 611 t5ins•11/10 Title 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 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown 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 3 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? opened covers, took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. Inlet and outlet tees intact, water level was even with outlet invert, tank was not leaking and was structurally sound. Covers are on risers. 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form Not for Voluntary Assessments M •'" 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown 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): 9 9 ( p P p ) ( P ) 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•11/10 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 ,M 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was in good condition, water level was even with outlet invert. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK; DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® g leachin chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching chambers were found to be dry with a stain approx 6"from bottom indicating that the s.a.s has never beem hydraulically overloaded. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown 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.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 36 Center Lane Property Address DIETRIM DONALD F Owner Owner's Name information is Centerville Ma 02632 1/29/2013 required for every Centerville page State Zip Code Date of inspection D. System Information (cost.) 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 Oro 3 � (;•Z 20 C'� I $ C, 0-L/ l 7.Y' Title 5 omciel Inspection Form:6ubsurlace Sewage D18posel System•Pegs 15 of V t5ins•11110 Ed WdSO:T T 210E 6E •uef 'ON Xtid SdNOf'W s: Wod a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown 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: 20+ 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: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour maps. Before filing this Inspection Report, please see Report Completeness Checklist on next page. C t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 iJ Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address DIETRICK, DONALD F Owner Owner's Name information is required for every Centerville Ma 02632 1/29/2013 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 B k 23162 P s 2 6 d7 DEED RESTRICTION WHEREAS, �. -e.4n �' ro �, (ownul a name) of 3(O C ATE tzmA (,a-�►e C��, ; (address) is the owner of 3 C,4,Y)C- at ��address) located � MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in MA, Property of_�el T et al, ounty Re duly recorded in Barnstable C Registry g ry Deeds in Plan Book L4 Page l l Qt Or on Land Court Plan Number WHEREAS, _ I-�e,( 'C f as the owner of said 'lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the number.of bedrooms which can be included in any home built on said lot as a pre-condition toobtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; . WHEREAS, the Town of Barnstable Board of Health, as a pre-condition-to tranting a disposal-works construction.permit fora septic system in compliance with 310 CMR 15.200' State Environmental Code, Title V,. Minimum Requirements for the Subsurface:'Disposal of Sanitary Sewage, and authorizing the"issuance of a banding permit for the construction of a-singlefamily home on this property, Is requiring that the agreement for the,restriction on the number of bedrooms in any house constructed on the lot be put-on.record with the Barnstable County Registry of Deeds by recording this document, deedr r ' f • /. NOW, THEREFORE, lweo Z" 17, i does hereby place the (owners name) following restriction cn his above-referenced land in accordance with his agree ent with ffi,e Touch , whie Het'!on-sh�lt run with the-land and be binding upon all.successors in title: 3� C:'e'vitle R a-✓� L l _may have constructed (address) upon the lot a house containing no more than I Ljj t. (-z-) bedrooms. MeA'A T. Xo S,.-,V. agrees that this shall be-permanent deed (ownees name). restriction affecting IX17 53 located on. MA, and . being shown on the plan recorded in Plan-Book 14-7 , Paged 119 .t).q1ess A jA on+;l.�c Or on Land Court Plan r3 eF ,�_Altl For title of Pe-l4C.1 X-. 7(o.i'n seethe following deed: Book i5Z47. , Page Zoe . Or Land Court Certificate of Title Number Exec t d as a sealed instrument day of e o Owner's signature Owner's signature Owner's signature COMMONWEALTH OF MASSACHUSETTS ss Zed Then pers ally appeared the above-named • �-1�� � ��ul r1 • known to me to be the person who executed the foregoing Instrumentzrid . , acknowled -the same to be free t and deed, before me, Notary Publ' My commission expires: (date) USA M.oaTORA,No"PuWic. My commission Mou Aftich r3 2oi o No. Fee d U t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z[ppricotiou for Migo!ml *pgtemc Cous;truction Vermtt Application for a Permit to Construct( )`_RepairwUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3u C e(%k er l-4n e Owner's Name,Address,and Tel.No. A C\e tR 1\ Assessor's Map/Parcel Ceri�•e,C a•``\Q (j 36 C4AN-e c 2.N V>e r J.�\Q Installer's Name,Address,and Tel.No. C(\e e"Jam'X& ' Designer's Name,Address and Tel.No. )C- 'Po 7-IN 0-4 -143 2$sy u'L�• �-lo Z�6 •I k a 13' O 3� . LA-) h TI pe of Building: r J� J j-Y Dwelling No.of Bedrooms (f( �{ J"L.of Size X-6' 6p 6(n} sq.8. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)_gpd Design flow provided O�L,n $ gpd Plan Date C)% ` _ 'Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil t-A G r, C, CW ` Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board h. Signed Date Application Approved by DateV Ili Application Disapproved by: Date for the following reasons Permit No. 2-ac i-,- 3�� —————————Date Issued - - 1,; 7 A No. ook — Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Mi5po5al *p!gtem Construction Permit Application for a Permit to Construct Repair( Upgrade Abandon Complete System ❑Individual Components Location Address or Lot No. L Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. \11A Type of Building: Dwelling No.of Bedrooms Other Type of Building 5, Lot Size sq.ft. Garbage Grinder No.of Persons Showers Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired Upgraded Abandoned by at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector - ------------------------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION —BARNSTABLE, MASSACHUSETTS Miqonl *pg;tem Construction Permit Permission is hereby granted to Construct Repair Upgrade Abandon System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date Approved by own of �ardStaq� r .RQglalatQr3 SerViCes s � I I PAR �� j I`hvmas F. Geller,iDirector, Y MAIL Public!Health Dfvi ion '1711omas McKean,Director:I �! 200,Main Street,Hyattnils,IVIA 02601 1 ! Offiu..: :508-862-4644f Fax; 508.790 G304 j Iustx ter Desi er Ce flc "A" Date. , ` Desigper: C' � :'��e�rc' �..C. _ In alley; _�� e�.idtz ���org2itf���_a E Address:- �N� `� Cccxtilr�e�f Imo. ' A►ddr'es _ p:; a' E , I Wof e_VC;W1 5&t 1 On + 2. - was i,ssued�a re ti E - tati� " .� X rtitit to install a t ;! { ) (ins'l,aller) ! I r Septic system at k_e:rabased ' by Y' i - -- - _ ��n a design drawn -rt16J`1ZY I a dated ; ! , (des gner) j l certify that the septic sign system;referemeed abd►ve was�irtstall��d s`,ubstantialiy according cc� the de , which may include miner ,approved changes such a's lateral relocation of the ?� distribution box and/or septic tanle, j I I certify that the septio s ten• rcfecenced lab i ys avewas installed iwith major Changes (ix', F greater than 10 lateral relocatio' n!of the SA:S of any v.ertit,al relaxation of any componi;t�t .` of the septic systein) but inlacl ordance with S6te & Local Re latieni. Plan revision :7i certifie8 f►s-built by.designer to;follow.! I I ! _ (lnsta er€s Signature;) I „ 1 �IV11.i 1 (ve61g21EY S 1 E) 1( i 1g,1C1@T.6 t3lllf here) f 1 . ! P PLEASE RETU O BARNST '1 PU IC T D `VI CERTIFICATF i O IP CO ,E; ILL f B c if Tl D (JLI. , Q Realth/Septic/Desi8nsr CertificationFgtm 10 'd Z920 2.LZ 80S ! DNIN33NI ]N38t Wd 90: 20 800Z-S2 -d38j i�. ( , TOWN OF BAaRNSTABLE LOCATION ��(� eeol l{t'- L,r12 SEWAGE# ` 00% ' 3%�3 VILLAGE 6pil f(r U/ I Cr ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. twf� (��► �/Z9 �/U SEPTIC TANK CAPACITY_ _ Z10e) LEACHING FACILITY:(type) 1J—r6 4 LC (size) NO.OF BEDROOMS OWNER PERMIT DATE: 00 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4V 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 L`-aching Facility(if any wetlands exist within 300 feet of leaching:facility). �Cre feet FURNISHED BY It(�e, Ujl G� (1 (\i SeS A' C Li (p A 37 c•s 33,ko OI2 c�c � C( 31. 0 91 93 1s.v 6'L Zv U P14 f 7 o y c 3 1-1.8 D5 cq v 3D x . of� Town of Barnstable P# Department of Regulatory Services : BAMSTAEM : Public Health Division Date 200 Main Street,Hyannis ML6O� Arm�►Date Scheduled �O OD t T'meFee Pd. Soil Suitability Assessment for Sewage D' osal Perform 171CSIffe- lW Witnessed By: LOCATION& GENERAL INFORMATION / Location Address 3(., ����� � � Owner's Name L•�v,.-ri'.,f'v�l,`'e Address `�j� C..P�,.i,R-� L✓�.v�� Assessor's Map/Parcel: ZS(f ri j + Engineer's Name GaP�.� NEW CONSTRUCTION F REPAIR v Telephone# 576 `{Lb Y a L% Land Use /ctS,Jen6 t Slopes(%) (—2 Surface Stones Distances from: Open Water Body Possible Wet.Area 7 f 00 ft Drinking Water Well ft Drainage Way — ft Property Line t 0 ft Other _ g SKETCH:(Street name,dimensions of IoL exact locations of test holes&perc tests,locate wetlands in proximity to holes) se- 00n S60MI Parent material(geologic) ®U V-J05k n Depth to Bedrock 7 13 2 _vim Depth to Groundwater. Standing Water in Hole: 7 (3 Zip b55 Weeping from Pit Face 7 t 3 2 �° S Estimated Seasonal High Groundwater 13 2yS DETERMINATION FOR SEASONAL HIGH WATER TABLE . - Method Used: DiIFCA 605etuln"a Depth Observed standing in obs.hole: 7 13 2. in. Depth to soil mottles: -7 t 3 z in. Depth to weeping from side of obs.hole: 7 t.3. in. Groundwater Adjustment ft. Index Well# — Reading Date: — Index Well level Ad{,factor, Ems_ Adj.Oroundwater level„ PERCOLATION TEST Date 9-0-0b Thee /A) Observation Hole# Time at 4" Depth of Perc 36"5y i Time at 6" 1 Start Pre-soak Time @ I( 0$�.N _ Time(9"-6") End Pre-soak �.i I V A H Rate Min./Inch Site Suitability Assessment: Site Passed y e 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:\SEPfIC1PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,,Boulders. o iste ravel _ <<11 •10 10yrS , 15A- gCPQ-k 36- M5 2-5y4- A 24.st�e1` many ° s6-132 1'C`-2, �f S 2.5 Y�/� — Loos DEEP OBSERVATION HOLE LOG Hole# 2- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.% 67 g - Fttl $ -IS A L S io i� l iV Y i 5/4 ti 15% 3 rctle.l 3b-5� e-1 MS 'A ew eatp\al e3 Zo/5•Pa�el �1,o�^y s16-132 G-2 }4 S 2, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling. (Structure,Stones Boulders. onsi n Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on 1 y-2 -�9 (date)I.have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise experience described in 310 CMR 15.017. Signature Date Q:\S.EPTIOPERCFORM.DOC Town of Barnstable Barnstable Regulatory Services Department ea j saanrsrnai:£, 9 MASS 1659. , ' Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO August 14, 2008 Helen Drouin 36 Center Lane Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 36 Center Lane, Centerville,MA was last inspected on August 2, 2008,by Robert Paolini, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Septic system needs to be upgraded to Title V. Overflow cesspool is not on owner's property. You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER O ER THE BOARD OF HEALTH David Stanton, R.S. Agent of the Board of Health CERTIFIED MAIL#7006 2150 0002 1041 7729 Q:\SEPTIC\Letters Septic Inspection Failures\36 Center Lane.doc i Commonwealth of Massachusetts L W Title 5 Official _Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 36 Center LaneV� Property Address Helen Drouin �25 1 _05, Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any 1 waY. s �, Important:When filling out A. General Information I forms on the computer, use Inspector: CID ��� 1. only the tab key cn W to move y our Robert Paolini cursor-do not Name of Inspector nZ use the return key. Capewide Enterprises,LLC. 77 Company Name P.O.Box 763 PQ Company Address Centerville Ma. 02632 r"O City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and.complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 8/02/2008 Ins or'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. 36.Center Lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth &Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Septic system needs to be upgraded to Title V.Overflow cesspool is not on owners property. 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. 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): ❑ broken pipe(s)are replaced ❑ obstruction is removed 36 Center Lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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. 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. 36 Center Lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address Helen Drouin r Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 EJ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/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. 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth'of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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. 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 L Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If.they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® El approximation 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)] 36 Center Lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes Z No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage unavailable 9 ( Y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: 8/02/2008Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 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: Last date of occupancy/use: Date Other(describe): 36 Center Lane-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection M System Information (cont.) General Information Pumping Records: Source of information: Capewide Enterprises,LLC. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1000 gallons How was quantity pumped determined? measured Reason for pumping: Check for groundwater. 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): Approximate age of all components, date installed (if known) and source of information: 1950 Were sewage odors detected when arriving at the site? ❑ Yes ® No 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2' feet Material of construction: ® cast iron ❑ 40 PVC orangeberg pipe ® other(explain): Distance from private water supply well or suction line: feet feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 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: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown 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.): 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 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): 36 Center Lane-03/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 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.): 36 Center Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma., 02632 8/02/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Main and 1 Overflow Depth—top of liquid to inlet invert Main CP 6" Overflow 2' Depth of solids layer 1' 811 Depth of scum layer Dimensions of cesspool both 6'x8' Materials of construction Concrete Block Indication of groundwater inflow ❑ Yes ® No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Main cesspool had roots in sidewalls.Overflow water to invert was 2'.NOTE:OVERFLOW CESSPOOL IS NOT ON OWNERS PROPERTY! 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.): 36 Center Lane•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size ® zoom�outjjj ill 11 jIn A K IC)d Fn— . ,..... P♦ 1, qP f,,.. _ s J s. . Al IN .♦ k kt S �.:. F f; 1 •k' \ - I:: /1 .O R h . f !il % f J n ' m «> I / I• Set Scale 1' = 20 I Aerial Photos I MAP DISCLAIMER (.nnurinhf)nnF_9nnR Tnum of Rarnefohln KAA All rinhfe meant. http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=251055&mapp... 8/9/2008 Commonwealth'of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 36 Center Lane Property Address Helen Drouin Owner Owner's Name information is required for Centerville Ma. 02632 8/02/2008 every page. Cityrrown 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: Bottom of Cesspool 50' 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: USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 plate#2 annual ranges of groundwater elevations. 36 Center Lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 PROVIDE PRECAST CONCRETE EXTENSION FINISH GRADE OVER D-BOX= 71 .0'± FINISH GRADE OVER CHAMBERS = 71 .08' - 70.80' GENERAL NOTES TOP OF FOUNDATION = 72.4 RISER WITH CONCRETE COVER TO WITHIN SLOPE @ 2% MIN. OVER SYSTEM 6" OF F.G. OVER INLET AND OUTLET COVER CONCRETE RISER AND COVER 3/4"TO 1-1/2" DOUBLE WASHED STONE TO 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISHED GRADE TO WITHIN 6"OF GRADE 4"SCHEDULE 40 PVC MIN SLOPE 1% FINISH GRADE OVER TANK EL.- 71 ,5'± INSPECTION PORT w/ACCESS BOX WITH CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FOUNDATION = 71 .7'± - - 5" DIA. OUTLET(S) COVER TO GRADE (SEE NOTE#21) 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE CODE AND ANY APPLICABLE LOCAL RULES. 20" MIN. ACCESS COVER g" MIN. - } -- - -- --1/8 - -------- ----- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE f PLACE RISERS ON ALL (TYPICAL FOR 3) 36" MAX. 9"MIN. TOP OF SAS = 68.08' CHAMBERS WITH DESIGN ENGINEER. PROPOSED 4" 36"MAX. 67 25' 36'IN. INLET PIPES TO 6"OF 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SCHEDULE 40 PVC PROPOSED 4" BREAKOUT EL = 67.75 FINISHED GRADE SYSTEM UNLESS OTHERWISE NOTED. 2" DROP MIN. SCHEDULE 40 PVC MIN.SLOPE@1% 6" 3" „ 3.� g�� PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 3 DROP MAX. MIN.SLOPE@ 1% JOINTS (TYP.) o o ELEVATION =67.75' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A o ' S4" PVC IN EPT C TA F OM 4" PVC OUT TO o 0 0 Q ��� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" 68.25 0 0 0 0 0 0 0o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. . LEACHING FACILITY zC, 0i o o 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 12" oo °° 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 68.50� 48„ OUTLET TEE 67.G0' MIN. 67.43' 2� � � � � � � � � � 00 � � � 0 0 � o� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 22"ZABEL FILTER 0000 0 0 oo ' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS � j, �,6" CRUSHED STONE 11.3'TO FND. MODEL#A1801-4x22 OVER MECHANICALLY o0 0 0 0 0 o - NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH COMPACTED BASE AND DESIGN ENGINEER. 5 2.0' 8.5' (TYP) 2.0 2.0' 4.9' I 2.0' 6"CRUSHED STONE OUTLET DISTRIBUTION BOX �,P ! 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 72.00' ESTABLISHED OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE 21.0 < 59.90' ( ) ON A NAIL SET IN AN OAK TREE AS SHOWN ON PLAN. COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET 65.25' GROUND WATER ELEV.= 8 g' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION *PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT -- 2 - 500 GALLON CHAMBERS CHAMBER END VIEWLENGTH 10.5� WIDTH 5.67� DEPTH 5.67� CROSS SECTION VIEW 5 MIN. 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES 'OPTION TO CONTRACTOR TO PROVIDE A 1,500 TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. GALLON PLASTIC TANK BY FRALO,IF NECESSARY, SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL CHAMBER DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE IN ORDER T FEASIBLY NOT TO SCALE NOT TO SCALE NOT TO SCALE STRUCTURES SHALL BE MADE WATERTIGHT. NOTE: PORTION OF LOCUS PROPERTY IS LOCATED WITHIN BARNSTABLE'S +�, TEt 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING GROUNDWATER PROTECTION OVERLAY DISTRICT. ALSO, LOCUS PROPERTY • # TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM + . � + l IS LOCATED WITHIN THE ESTUARY ZONE OF CONTRIBUTION. NO INCREASE APPROPRIATE AUTHORITY.+�. OF FLOW PROPOSED FOR THIS PROJECT. i+ INSPECTOR: Donna Miorandi 12• ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE « EVALUATOR: Michael Pimentel, E.I.T. THEY SHALL WITHSTAND H-20 LOADING. DATE: September 11, 2008 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. TEST PIT#: 1 (Pere. No. 12352) +r• • * i �` + ELEV TOP - 70.90' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE Gooseberry '� ti • MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. + ELEV WATER= < 59.90' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, {�Islant • .• rn - • •• � FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PERC RATE _ <2 Min/In f Ull@f 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN • DEPTH OF PERC = 36"-54" SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. • ' • • 16. TEXTURAL CLASS: 1 PROPOSED PROJECT IS LOCATED WITHIN: • on LOCU ASSESSOR'S MAP 251 PARCEL 55 OWNER OF RECORD: HELEN T. DROUIN + � ' • 0 Fill 70.90 ADDRESS: 36 CENTER LANE Litt� • i • 8" 70.23' CENTERVILLE, MA 02632 1 i ` • Loamy Sand Benchmark * ' �; ` • • A 10 Yr 3/1 Nail in Tree . 18" 69.40' j FEMA FLOOD ZONE C Elev. = 72.00' PROPOSED INSPECTION PORT • # ' • GravellyLoamy Y COMMUNITY PANEL# 250001 0005C B Sand A rox. M.S.L._\ /I ri `+_ ''^ to ---, w - • 17. REFERENCE: / PROPOSED 2-500 GALLON `�� , t • 10Yr 5/6 DEED • \� 36 67.90' BOOK 8247, PAGE 208 LEACHING CHAMBERS • . Pere -PROPOSED DISTRIBUTION BOX ©.* `• • «_ Medium Sand 54" 66.40' 18. PLAN REFERENCE: •o+ • ,1� • `a/ . •• •i « C'1 2.(Few Scobbles; PLAN BOOK 47, PAGE 119 j� ..a • « « ll It + 20% Gravel; "bony") 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Q� �1 � Q � O ..-_ � • "` • I! � 0 w• � � 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY MAP 251 � -- - FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY J vP TP 2 p LOT 54 Med.-Coarse Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. (9 Q6 op 71.2'� �j - t C-2 2.5Y 6/6 �� �\ ��' TP 1 ss ° LOCUS PLAN (Loose) 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A 70.9' 7p �� DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A SCALE: 1" = 1000' REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. " PROPOSED 1500 GALLON SEPTIC TANK 132 59.90' �. moo^ (EITHER PLASTIC OR CONCRETE TANK No Mottling, Standing or Weeping Observed GARAGE - ACCEPTABLE) - --- -- - -- - LEGEND MAP 251 CESSPOOL TO BE PUMPED AND DESIGN DATA - LOT 55 C ✓ / 8� j FILLED WITH CLEAN SAND TEST PIT DATA - 50 - - EXISTING CONTOUR 13,800 S.F. ± l O r1 PROPOSED CONTOUR ) -C 72 NUMBER OF BEDROOMS (DESIGN) 2* INSPECTOR: Donna Miorandi;! ` � D/H/W - EXISTING OVERHEAD WIRES - R. >>/ PAVED EVALUATOR: Michael Pimentel, E.I.T. t � DRIVE DESIGN FLOW 110 GAUDAY/BEDROOM TOTAL DESIGN FLOW 220 GAUDAY DATE: September 11, 2008 W W- EXISTING WATERLINE _ PATIO LP (FND) DESIGN FLOW X 200 % = 440 GAL/DAY TEST PIT#: 2 (Pere. No. 12352)DAY GAS EXISTING GASLINE = UP 33� ❑/H/W DOH � M� ELEV TOP 71.20' ° W _ DOH/ D�H�W #36 - � USE PROPOSED 1500 GALLON SEPTIC TANK (4) cc S2mow'- EX G ELEV WATER= <60.20' EXISTING FENCELINE �'ti'�✓ OG,�` �9�, / 2-BEDROOM -X-X-X-X-X- O `S-p /} DWELLING *DEED RESTRICTION TO BE FILED PERC RATE _ _ �-`�- 0 �- TEST PIT LOCATION O (3) ti'w F'�iF �2,q MAP 251 DEPTH OF PERC = (5) O LOT 128 TEXTURAL CLASS: 1 EXISTING CESSPOOL � / S E GC J �� INSTALL 2 - 500 GALLON CHAMBERS _ (6) PROPOSED 1500 GALLON SEPTIC TANK SIDEWALL CAPACITY 011 ,� O�h`��✓ ' vP £ (LENGTH + WIDTH 2 SIDES) (2' HIGH) (0.74 GPD/S.F. Fill ( PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE ( ) = GAL/DAY GARAGE GC 1 �O� �Z2T (21'+8.9')(2 ) (2' ) (0.74 GPD/S.F.) - 88.5 GAUDAY 8" 70.53' GC 3 A Loamy Sand D PROPOSED DISTRIBUTION BOX OGT ti�w �P BOTTOM CAPACITY 10 Yr 3/1 (2) 18 69.70 Q PROPOSED 500 GAL. LEACHING CHAMBER (1) \p l (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY Gravelly Loamy O ti'w (21'x 8.9') (0.74 GPD/S.F.) = 138.3 GAUDAY B Sand 10Yr 5/6 REV. DATE BY APP'D. DESCRIPTION HC 36" 68.20' TOTALS: Medium Sand LP (FND) UP 337/3 2 C_1 2.5Y 6/6(Few cobbles; PROPOSED SEPTIC SYSTEM UPGRADE #36 _ TOTAL NUMBER OF CHAMBERS PREPARED FOR: TOTAL LEACHING AREA 306.5 SQ.FT. 20% Gravel; "bony") CAPEWIDE ENTERPRISES EXISTING TOTAL LEACHING CAPACITY 226.8 GAL./DAY DWELLING 56" 66.53' LOCATED AT SWING-TIES c 2 Med.2 5Yr6/6�nd 36 CENTER LANE SCALE: 1" =20' (Loose) CENTERVILLE, MA DESCRIPTION HC GC 1 GC 2 GC 3 I SCALE: 1 INCH = 20 FT. DATE: SEPTEMBER 16, 2008 SEPTIC COVER IN (1) 27.2' 32.3' - - 132" 60.20' j 1 o 10 Zo 40 ao FEET No Mottling, Standing or Weaping Observed SHOE - ��- SEPTIC COVER OUT(2) 22.3' 24.2' - - �" JOHN L. 1�1, PREPARED BY: RESERVED FOR BOARD OF HEALTH USE C4YRCH1U_ JC ENGINEERING, INC. LEACHING CORNER (3) - - 10.6' 26.2' JR. NI LEACHING CORNER(4) - - 31.5' 39.6' N° Al 7 , 2854 CRANBERRY HIGHWAY NOTE: EAST WAREHAM MA 02538 LEACHING CORNER(5) - - 32.3' 34.9' 1.) MAGNETIC MARKING TAPE SHALL BE 508.273 0377 SITE PLAN PLACED ALONG THE TOP EDGE OF EACH LEACHING CORNER(6) - - 12.8 18.4 -- -_ i SCALE: 1" =20' SEPTIC SYSTEM COMPONENT. Drawn By: BSM Designed By:MCP Checked By: JLC JOB No.1479