HomeMy WebLinkAbout0031 CHILDS STREET - Health 31 Childs Street
249-001 Hyannis
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UPC 12534
No. 2153LOR
HASTINGS, MN,
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'COMMONWLALT14 ®f MASSAC14USETTS
Board of Health, BARNSTABLE MA.
APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair(X) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components
Location 31 Childs Street Centerville Owner's Name
Map/Parcel# Map 249/Parcel 001 Address
Lot# Telephone# 617-434-2711
Installer's Name South Shore Site & Septic Designer's Name Christopher Costa & Associates
Address 565 Carriage Shop Rd, E. Falmouth Address Box 128/465 East Falmouth Hwy, E. FAl
Telephone# 508-540-3462 Telephone#
Type of Building Residential Lot Size .sq.ft.
Dwelling-No.of Bedrooms 'I Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.required) 330 gpd Calculated design flow Design flow provided gpd
Plan: Date Number of sheets Revision Date
Title
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluatorpon Desmaris Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS Use of existing tank, new D—Box —5. 500 Gallon chambers
The undersigned es to install�the above es 'bed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees t of a te on until a Certificate of Compliance has been issued by the Board of Health.
Signe `� Date "110✓
M c
Inspections
NcH/�'' FEE 1160
Board of Health BARNSTAAE
MA.
APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT
� f 5.
Application for a Permit to Construct( ) RepairoO Upgrade( Abandon( ❑Complete System ❑Individual Components
Location 31 Childs .Street Centerville Owner's NameEstate of Susi Ohrin er
Map/Parcel# Map 249 Parcel 001 Address C 0 Timothy Hannon Bank of America
Lot# Telephone# 617-434-2711
Installer's Name South Shore Site & Septic Designer's Name Christopher Costa & Associates
Address565 Carriage Shop Rd, E. Falmouth Address Box 128/465 East Falmouth Hwy, E. FAl
Telephone# 508-540-3462 Telephone# 508-548-6424
Residential
Typejof Building Lot Size sq.ft.
,,;WiDwelling-No.of Bedrooms 3 Garbage grinder ( )
Other-Type of Building No. of persons Showers ( ),Cafeteria ( )
Other Fixtures,
Design Flow (min.required) 33q gpd Calculated design flow Design flow provided gpd
Plan: Date Number of sheets Revision Date
A Title
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluatorpon Desmaris Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS Use of existing tank, new D-Box -5, 500 Gallon chambers
The undersigned aPees to install the abov es 'bed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
furthe(r�agreeess Zhotto ce"the system' es
until a Certificate o`f omp ance has been issued by the Board of Health.
Signet Da
Date L/�1I e 7
Inspections
N FEE
Board of Health, BARNSTABLE� MA
CERTIFICATE Of C'®MPLIANQE
t
Description of Work: ❑Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed (�),Repaired �),Upgraded ( ),Abandoned ( )
by:
South Shore Site & Septic
at 31 Childs -Street, Centerville, MA
has been installed in pr accor ance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application Noa��—�S�, dated `� 'V; 01 . Approved Design Flow 30 (gpd) /
Installer y >9 . /I �l ,r•�
Designer:l_,k\'' t 5`(-b Aa V7— Cd 5� Inspector: /! (` /�
—Date: 01Z�1/ ,
IT VK1
The issuance of this permit shall not be construed as a guarantee that the systbfi will function as designed.
NQ7�` / i FEE
COMMONWEALTH Of MASSACHUSETTS
Board of Health, BARNSTABLE MA
r
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( yj Upgrade( ) Abandon( ) an individual sewage disposal system
at- 31 Childs Street, Centerville, MA as described in the application for
Disposal System-Construction Permit No. ,dated
Provided: Construction shall be completed within three years of the date.o his pertfiiN 1 local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board Of N ralth
a
Christopher Costa & Associates, Inc.
Land Surveyors a Civil Engineers • Environmental Consultants
(508)548-6424
ON—SITE REVIEW
Excavator: William Bonito/Bonito Construction
Location Address and/or Lot No. Lot 2, 31 Childs Street, Centerville, MA
Deep Hole Number: 1 &2 Date: 02-21-07 Time: 10:00 AM Weather: Sunny
Location (Identify on Site Plan) Right side of Lot
Land Use: Residential Slope(%): 0-1 Surface Stones: None
Vegetation: Pine Trees/I awn
Landform: Glacial Oijtwash Plain
Position on landscape(Sketch on the Back):
Distances From:
Open Water Body: 200+ Feet Drainage Way: 200+ Feet
Possible Wet Area: 200+ Feet Property Line: 15+ Feet
Drinking Water Well: 200+ Feet Other:
Deep lisle Number: 1 &2
DEEP OBSERVATION HOLE LOG
Soil Soil Matrix: Redoximorphic.Features Soil Texture Coarse Fragments Soil Soil
Horizon/ Color-Moist (mottles) (USDA) %by Volume Structure Consistence
Depth Layer Munsell (Moist)
(In.) Depth Color Percen Grav Cobbles
t el &Stones
0"-4" AP 10Y 5/2 Loam
4"-24" B 10YR 5/6 us
24"-120" C 2.5Y 7/3 Med. Sand t
24"-132" C 2.5 Y 7/3 Med. Sand .
** MINIMUM OF TWO(2) HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA**
Parent Material (Geologic): Glacial Outwash Depth to Bedrock: N/A
Depth to Groundwater: N/A
Standing Water in the Hole: None Weeping From Pit Face:: N/A
Estimated Season High Ground Water: N/A
04/14/11Jb/ l :4LJ 151J8/b8b4JJ bUHNEiDEH_ASbUUiA1ES HA6E IJ1/U1
04(25i07 11.00 z LGR.tFIG P_01
Town of Barnstable
Regulatory Services
Thomas F.G eilcr,Director
Public Healtb DIAS110"
Thomas McKean,Director
200 Main Stre4 Ityanaft,MA 07601
Of ea. 508-862-4644 rag: 508-790-6304
In r D i ner flcat arm
Dane: c" O S gc PelrMit#,;)do?—('SI-Aaslessor's Map1NA1reel_2_Ja__�b 41
Designer: ( [y` ,Y �c>F :► # . A.-Installer: Z—Ove l
Address: r7 _,..., Address: / rCctvre ��?e`o
On off . _. was issued a permit to install a t
(d ) iosta ler) o ,
sieptio system at based on a design drawn b
r� �,f dated •` �< ",� � �,.- . a ,�(}�� N
de9ignor) -Q�.
-ir''l oertif'y tihat the"septi;z system rcfercnc d above was installed substantially a Ong tP
the design, which way include tninor approved changes such as lateral rroloca n of the
distribution box and/or septio tank. _
- „ ,,..-. .._ .
1 certify that the septic a stein referenced above was installed with major changes (i.e.
greater then 101 lateral relocation of tbc-'SAS 6r aoy vertical relocation of any oomponent
of the septic eystem)but in accordance with State&c Lopal�^}l bnlh>r"s. Plan revis>Ion or
r...
certified aq-built by igncr to follnw. � \> - 'qs�c
q a N DOUGLAS �»
.1 sc4 p\EIOER
" '��� CkViL
(Install s igna re) No s6546
r
esigner's sign , re) gner'S,,tamp I ere
1C��CAi9I.°. R1L"I:i] 1� �Al 1V A � BLIC_••LEALT-I� ION, CER [CA _• UR
A1VCB WIIJ E tJtC]) U '' 1t07`}I 'N4ltM 3-t31J1 '' f:'Alti� 1rit�C
�L ELYED OV TIIE IltAlli3VsTAEI,IC t'1J 1C 1�EA -H D1VIS1( s THANK YOiJ�
c q t.`- 1 .':1!tI( }• i,. 7?t^tl. r:l.'. �?�x�l,f„ti t�`ag�".FSc .. _ . .. . .; ...'l4:K.°`"• .•
Ci:`Hesil{i/$epti�li :ligixr OcrlifiCdiaan kortn 3��G-0t\doC;tS ti+i s.::c:a,t:,`t5. .,.:; IK ' ] '?t•,. :4$(>_ , Tri
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME-in town (which
you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
DATE�11a 1 Fill in lease:
� P
APPLICANT'S YOUR NAME/S:
BUSINESS YOUR HOME ADDRESS: S
arm M,
s0aZ I
TELEPHONE # Home Telephone Number S,08 S3
NAME.OF CORPORATION: r
NAME OF NEW,BUSINESS 40oA G C TYPE OF BUSINESS Qt �a htZLh CoY��ai2
IS THIS:A HOME`OCCUPATION? t YES O '.
ADDRESS OF'.BUSINESS �i ':G 4. 1 S� . C4r4,2(vi t IA n2cP32, MAP/PARCEL NUMBER [Assessing]
.When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
2. BOARD OF HEALTH
This individual ha ee in r eftot� ermi requi ement t pertain to this type of business.
Authorized Signature"
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
UNITED STATES POSTALE♦VIC�
r. s: m ,re,.'+:•r,,,..•.ro ,?+a� F,f►'3t�Cla$$'I�I"dll"" yv
' 3 JAI
• Sender: Please print your name, address, and ZIP+4in this box •
PUBLIC HEALTH DIVISION
TOWN OF BARNSTABLE
200 MAIN STREET
HYANNIS, MASSACHUSSk'TS 02601
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Sig ture
item 4 if Restricted Delivery is desired. .®"Agent
■ Print your name and address on the reverse X .171f Ak '0 Addressee
so that we can return the card to you. B. eive by(Printed Name) C. Da of D ivery
■ Attach this card to the back of the mailpiece, D �v S d 7
or on the front if space permits. J l
D. Is delivery address different from item 1 ❑Y s
1. Article Addressed to: If YES,enter delivery address below: ❑No
F
s Susi Obringer
11 Childs Street
" 3. Service Type
Ce-d rville MA 0.2632
h• � ❑Certified Mail ❑Express Mail
❑Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2.. Article Numbe.r
(Fransfer from servicelabjji++++�i+�+��++++i� ti+i+i+e11JR21R.M11RAiMAN,i 0191 2649
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
Postal
I Q" . �.
I �
.D (Domestic Mail Only;No Insurance Coverage Provided)
I MAILT. RECEIPT
Ir
OO Postage $ (474V0O Certified Fee 0 P
OReturnReceipt Fee 1/� Here
(Endorsement Required) �Y
Restricted Delivery Fee P$
—0 (Endorsement Required)
Total Postage&Fees
�/.
Ln
O ent To c D�C3
�n J
V
Street,APE No.;
or PO Box No.
Citj State,ZIP+4
• ,I�Q U�63a-
Certified Mail Provides:■ A mailing receipt (asiana a)aooa eunr'ooge wjod Sd
e A unique identifier for your mailpiece
■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First-Class Maile or Priority Maile.
■ Certified Mail Is notavailable for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
e For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a ReturnReceipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPSO postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".-
■ If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed to APOs and FPOs.
Town of Barnstable
CF tHE Tp�
do Regulatory Services
,STAB Thomas F. Geiler, Director
MASS.BAR9$A •��' Public Health Division
tEp�'l A
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 10 2007.
Ms.Susi Obringer
31.Childs.Street
Centerville, MA.02632
ORDER TO COMPLY.WITH STATE ENVIRONMENTAL CODE, Title.5 --
The septic.system owned by you located at 31 Childs Street, Centerville, MA was.last
inspected November loth 2006 by Michael T..Bisienere a certified septic inspector for
the State.of Massachusetts.
The inspection of your septic system showed that your system"Fails" under.the
guidelines of 1995 TITLE 5.(310 CMR 15.00)-due to.the following: _
System is in hydraulic failure
You have 2 years,from the date of the system failure to.bring the system into compliance...
If there are any questions.about this reminder,.please feel free to contact the.Barnstable
Health Department..
BARNSTABLE HEALTH DEPARTMENT -
Thomas.A. McKean,�RS.�, C.H.0
Agent of the Board of Health
COMMONWEALTH OF MASSACHUSETTS
Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
h
I�
C
`OW
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A D /
CERTIFICATION pg
Property Address:31 Childs St.,Centerville,MA 02632 �jj(j 9'
Owner's Name: Susi Ohringer
Owner's Address: 31 Childs St.,Centerville,MA 02632
Date of Inspection: 11/10/2006
Name of Inspector:Michael T.Bisienere
Company Name: A&K Septic Systems Plus
Mailing Address: 565 Carriage Shop Road,East Falmouth,MA 02536
Telephone Number: 508-540-6706
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reportl-,d --
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my i
training and experience in the proper function and maintenance of on site sewage disposal systems.1*arn a DEP• >
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system_D '
Passes
Conditionally Passes ° , r-
Needs Further Evaluation by the Local Approving Authorityt r-r' M
X Fails
Inspector's Signature: Date: 11/15/2006
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.
Notes and Comments: Evidence of hydraulic failure.
****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 5 Inspection Form 6/15/2000 page 1
Page 2 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
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:
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
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:
Title 5 Inspection Form 6/15/2000 2
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date'of Inspection: 11/10/2006
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Heaith 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.
_ 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 and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other:
�I
Title 5 Inspection Form 6/15/2000 3
f
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
X _ 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 '/z day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the SAS,cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
_ Any portion of a cesspool or privy is within a Zone 1 of a public well.
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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
YES (Yes/No)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.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
_ 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 11 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.
Title 5 Inspection Form 6/15/2000 4
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
X _ Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out?
X _ Were all system components,excluding the SAS,located on site?
X _ 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?
X _ 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:
Yes no
Existing information.For example,a plan at the Board of Health.
X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)]
Title 5 Inspection Form 6/15/2000 5
Page 6 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):
Number of current residents:0
Does residence have a garbage grinder(yes or no): No.
Is laundry on a separate sewage system.(yes or no):No. [if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use:(yes or no): No.
Water meter readings,if available(last 2 years usage(gpd)):Town 096726
Sump pump(yes or no): No
Last date of occupancy: August 2006
COMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information:
Was system pumped as part of the inspection(yes or no):
If yes,volume pumped:,How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
X 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/Altemative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no):
Title 5 Inspection Form 6/15/2000 6
Page 7ofII
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
BUILDING SEWER(locate on site plan)
Depth below grade: 6"
Materials of construction: _cast iron _ X 40 PVC _other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints;venting,evidence of leakage,etc.):
SEPTIC TANK (locate on site plan)
Depth below grade: P
Material of construction: X concrete_metal_fiberglass_polyethylene
_other'(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): No_(attach a copy of
certificate)
Dimensions:
Sludge depth: 1"
Distance from top of sludge to bottom of outlet tee or baffle:23"
Scum thickness:2"
Distance from top of scum to top of outlet tee or baffle: 10"
Distance from bottom of scum to bottom of outlet tee or baffle:20"
How were dimensions determined:field instruments
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):Recommend pumping every two years.
GREASE TRAP:NA(locate on site plan)
Depth below grade:_
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:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
Title 5 Inspection Form 6/15/2000 7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
TIGHT or HOLDING TANK: NA (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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
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.): Liquid level is normal in D-box.
D-Box is not Structurally sound.
PUMP CHAMBER: NA(locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Title 5 Inspection Form 6/15/2000 8
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Type
X leaching pits,number: One
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.):
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 or no):
Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY: NA (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.):
it
Title 5 Inspection Form 6/15/2000 9
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
SKETCH OF SEWAGE DISPOSAL SYSTEM.
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.Locate all wells within. 100 feet.Locate where public water supply enters the building.
J
f
o
Title 5 Inspection Form 6/15/2000 10
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 31 Childs St.,Centerville,MA 02632
Owner: Susi Ohringer
Date of Inspection: 11/10/2006
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water: Undetermined.Engineered plans needed for upgrade.
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators, installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the
Title 5 Inspection Form 6/15/2000 11
565 Carriage Shop Rd.
A&K SEPTIC SYSTEMS East Falmouth, MA 02536
Division of Kerrigan&Axon, Inc.
(508) 540-6706
FAX (508) 540-6934
November 30,2006
Town of Barnstable
Board of Health
367 Main Street
Hyannis, MA 02601
RE: 31 Childs Street, Centerville,MA
To Whom It May Concern,
I am enclosing a Title V Inspection report regarding the above mentioned property for
your files along with a check in the amount of$25.00 to file. Do not hesitate to call if
other information is required.
Sincerely,
Carol J. P�letier
Secretary
Enc.
NSVSSORS MAP NO:
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Appluatton for Dtspnsal Wlaxks Tonfitrusttun Frrmit
Applica ' s hereb m for a Permit to Construct (✓S or Repair ( ) an Individual Sewage Disposal
SysteM at• J� l
---.L..7---- . --------ST.......--•--•---•--........ C'�N7�A-_!✓/...............................................................[
,C3f1 y�l� Lo ;Aaar �, = ..1 ___ d JC. r•�t ....................................t ...--
]� /� / /Owner (� G Address
f-�c./ Y.firr"'--•---•--------------------------'----....--'--- ---• ...............................
Installer Address O O��
Type of Building Size Lot---_----1________ -------Sq. feet
U Dwelling—No. of Bedrooms___.... ................................Expansion Attic ( ) Garbage Grinder WjO
04 Other—Type of Building U100_15100P, No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures --------------------------------- -
......:.............S� ��
._.._..___..__gallons per person per day. Total daily flow____....___.. J_�.................
W -.,Design Flow
Q; Septic Tank—Liquid capacity./VOD.gallons Length................ Width................ Diameter---------------- Depth................
Disposal Trench No..................... Width....`.............. Total Length.................... Total leaching area-_______-r•-___--_-.-sq. ft.
Seepage Pit No--------I.......... Diameter-------�U_.___..._ Depth below inlet......7..�....... Total leaching area.4.1......sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1---!I ._..minutes per inch Depth of Test Pit-------1.Aa:_._. Depth to ground water.../_ 12N
(i Test Pit No. 2__ .. `.._minutes per inch Depth of Test Pit........ ...... Depth to ground water._/0 ___
----------•----....•.............. •-••--•-----•.... •-----•......-----------.....----------_...... -•-•-----•----•----•-•----•-••-----•..........---•-
O Description of Soil.....0- . 3......7 ll� �} I` ,S N P
U
W -•--------••-------------------------------•----•--------•-•------------...........----•-----•-.....-----•--••-------•-•••--•-•-----••••----•-••--•••-•-•••--•-•------.............•--•••......-----••--
UNature 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 p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Sin --�--/- -------- - ..........................................
1 .. Y�..._
ApplicationApproved BY ----•----- ':_....................................................... 1................................
Date
Application Disapproved for the following reasons:................................................................................................................
..-•-----------------•--••---.....----•--•--•----------•-----.....--•-•--------•------...............--•-••---------•-•--•-•-----•-•--•-----•-----•---•--•--•---•••••-••••-----•••••-----•-••-----------
Date
PermitNo...... Issued.......................................................
Date
07
No�... (p Fes$ "
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-.-------... As-----------OF...... 9".��s -57./9 .LE"� ...
Applira#ion for Uispoiial Works Tonstrudion Prrutit
Application is hereby made for a Permit to Construct (W-11) or Repair ( ) an Individual Sewage Disposal
System at:
T ...I.._..C A+��:_� ....... .......•--•-•--............... ._ / :
.----....__ ..........
Loc tro -Ad ss �St or Lot To
el,
a '9i W\J` � €.._U� .G...caner --. ....P.:_:_.� /fi A A s�..........................._---------'- ----'-- _......_.._......................_.............................
Installer Address g�bry
Type of Building Size Lot........_......................Sq. feet
Dwelling—No. of Bedrooms.......3................................Expansion Attic ( ) Garbage Grinder I've)
aOther—Type of Building 4#00J No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures ------------------------------------------------•----.•-•-----------------•-•--------•--•-••----............------
W Design Flow.................... ...............gallons per person er day. Total daily flow............ .I.. ..........gallons.
WSeptic Tank—Liquid capacity/.000..gallons Length................ Width................ Diameter................ Depth................
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area____.___ ft.
Seepage Pit NO-------I----------- Diameter......&"_.-______- Depth below inlet....._r'�_..____... Total leaching area..?..®__.�_.__...sq. ft.
Z Other Distribution box ( •) Dosing tank ( )
Percolation Test Results Performed b Date.................................
,4 Test Pit No. .____minutes per inch Depth of Test Pit...../_�._..__ Depth to ground water__ O�� .__-
i, Test Pit No. 2__ __ `__-_minutes per inch Depth of-Test Pit....... ......_... Depth to ground water--VfVV '__
P1 •-••-----•••-•--•---•-----•••---•-•-•-••-•---•-•-•------'-•....................•--..........---•-•-'•--•------....._........_
D Description of Soil_. , ; . ? /�. � ,d�� - ...............................a _b -����a-
U
W
UNature 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 TIT 4 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a.Certincate of Compliance has been issued by the board of health.
S_greedy_ = .........................................
......------•---=r _.:I .. .'--'----�=�r"':............................ -_APPlication Approved BY
Date
Application Disapproved for the following reasons:................................................................................................................
--------------------
••---•-••-•----------------•-•---•------...------------------•-------------------....---'--•--•--•------•..---------------------------------------------------•----------•-----------
Date
PermitNo.... ................................ ���4p Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS '
BOARD OF HEALTH
f ..................OF..........
'wa{At` ........................
�rrtif irtttr of Totnplionrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (L) or Repaired ( )
by_..a 7 ---. O ff Q.-'-•----...----•-----.•.........................•-------.....--------••----............-----------'--.......--•-•---
nstaller
has been installed in accordance with the provisions of ,Ti T E j of The State Sanitary Code as d scribed in the
application for Disposal Works Construction Permit iNo ...�2- ..... dated------ .................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................... ..--�'- --- .�............................. Inspector - -------------
•---------•-------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. 0.....................OF........... .. : C
No.-- F -�
Disposal � orkii Tonptrwttion rrnttt
Permission is hereby granted......:.................................` b .51-1
-._.....-------••---------•-•-------•----•--••-•--•-••-•••-•.......••-••...........---......_...
to Construct (i j) or Re air ( ) an Individual Sewa a Disposal System
._._.....•-_.
Street
as shown on the application for Disposal Works Construction Permit No .._�i��(_:Dated--__ ___-_-_
7 -------•- -•-•-------------------•.---'
Board of Health
DATE------------- '•-----'---------•-----------•-•-•••-----•.----
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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1 CERTIFY THAT THE PROPOSED BUILDING
SHOWN ON'THIS PLAN CONFORMS .TO THE I'
ZONING LAW OF f4e&s LE, MA.
LE
DATE: 3 .
EXISTING SPOT ELEVATION 0�Q_
PROPOSED SPOT ELEVATION 1�� ' h�M1
EXISTING CONTOUR
9 PAt1L A.
PROPOSED CONTOUR 0 "�R. DAVID P. �r6.
LEVY +� 5
MARIANO tx NOTE- THE LOCATION OF ANY UNDERGROUND s tit; No. I0517
SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON CIVIL CIF;,
THIS PLAN IS APPROXIMATE ONLY AS DETERMINED No.31115 gal, <' e
'T��iy� 'V�* 1 y v J 1
FROM RECORDS AND/OR VERBAL INFORMATION, v .ems ,V
THE CONTRACTOR IS RESPONSIBLE FOR THE ��s'si `���, v <.. ,a
VERIFICATION OF THE EXISTING LOCATIONS IN
THE ,FIELD. s t
NIN TR
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VY & ELDREDGE ASSOCIATES,INC. r. "r � .'
CLIENT I 1
ENGINEERS - LANDSCAPE .ARCHITECTS JOB I1I0. L 07- rG•, �> �, wTi��
.PLANNERS - LAND SURVEYORS ®R. BY
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889 WEST MAIN STREET CHKD.BY, nvJ//-j �
CMERV I LL E, TWA. 02632 EnT,..LOF SOLE ='` _:,9�T I.
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EITNER TNESEPTIC TANK OR �
20 FT. MIN. 1--xr,4C 11VG P!T ARE MORe TNA/V /2"SELOW
GRAl3Ej A 24"OIA14E7 COtyC.P�TE COMER •.
toll SCNSOuLB 40: .S/JA/-L &.= aAro sN r T® GRA Off.�AN E�t'7'�f'i4
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!i1lLE7' .s P?/C TANK 9 ./6 FT, F7 O/.�!►�. C(SSE T�U<.AT1®/�/�
ev?,4ET SEPTIC TANK ,96 FT. .
/N._ET D/STYE/�IITIDN BOX';-'-'•7o FT GROUND NLi4TER TX&LE
FT.OC/TLaE'TD/STHlB1PTlON BOX9�SSA •SE'C7"/®/V OF"
/NLET 1.rACHIMG I�/7- FT, aSEJ�VVAG� ®/eS/po'r SA .SY•���/�'P 'TA8(1leATl0/V
LEACH1NCB a/T D/MENS/ON A,4-2- R'T
SCALE Y4
DES/GN CR17WMA DImx-NSION 0-4 FT.
!VL Af8--R OF®FDROOMS `g D/MENS/®N C1 F7:
GA�e�AG.�v/,�Po.�4L UNIr�✓o SOIL LOB S®ll. 'YE57'
TOTAL E5rT/AlA7-ED SOIL 7-EST#I SOIL TEST#,?
Num'gER OF LEAcx/NG P/rs / fELEY. 99'-3 ��-ELz-K , ,DATE d," S®!L TEST 8�
SIDE LEACHING PER P/T 2�5--so.
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3, T /
®OrrOM LEy9Ci!/NG PLR P!T13 - 4• FT + PEmCOdA7'/ON @.4-re Af,/ -2 I`9!n�I/NCH
TOTAL l EAC'H/NG,AREA `� SQ• FT. f 5 v:�/G `'``j `'o ',�-.PFRCOLr4TYON RA7E l�2 �— mim.11NCH
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'd., � No.31115 �
LEVY & ELDREDGE ASSOCIATES. INC
NA 889 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 02632
a ND GI�Ot/ND YYATL"R �NCOlJNT�REO CL/ENT $g S/j!� DATE'/2
GI�DCINO y✓.4TER AT £Lg!/, JOB N® / O Ct Sf,IEET F
OWN OF
ATIO CAS STSEWAGE #
VILLAGE Ce � l/! ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. .� , e �l ?
;.SEPTIC TANK CAPACITY
LEACHING FACILITY:(type} �2Q'C �(� (size) Q C�ccA�'S
PRIVATE WELL OR UBLIE
�O. OF BEDROOMS C WATp
BUILDER OR OWNER OftY 9 C D E Lb C-7 �� C
DATE PERMIT ISSUED: `
DATE ,COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No c/
,
i
I
i
Yo
-77 SCHEDULE OF ELEVATIONS SEWAGE, SYSTEM ROFILE DETAILS GENERAL NOTES
NOTE:ND NOT TO SCALE LONG PO 1 FIRST� FLOOR 1. RISERS AND COVERS TO FINISH GRADE 1. ALL CONSTRUCTION AND MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL 2 100.79 -FOUNDATION , 1 101.79 2. H-10 COMPONENTS AND CODE (310 CMR 15.00,TITLE 5), AND THE LOCAL BOARD OF HEALTH.
TION 3 98.56 3 PIPE INV. AT FOUNDA SCHEDULE 40 PVC 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN 2 1 LOCL J SO- 4 INV. ,,OF PIPE AT SEPTIC TANK INLET - : 4 PERMISSION OF THE LOCAL BOARD OF HEALTH.S=2% MINIMUM 5 ' INV. , OF PIPE AT SEPTIC TANK OUTLET 5 98.10 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL D-BOX INLET 6 97.87 13 99.90 OBSERVATION PORTS-T 6 INV., OF,PIPE AT TTENTION OF THE ENGINEER PRIOR TO PERFORMING THE 12 99.81 P1 7 INV. OF PIPE AT, D-BOX OUTLET 7 97.70 RELATED WORK.8, 8 4 98.35 INV. � OF PIPE AT.START OF LEACHING FIELD 11 9 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND 9 BOTTOM OF LEACHING FIELD 9 95.47 10 9 'I'S NOT TO BE USED TO ESTABLISH PROPERTY LINES OR BUILDING SETBACKS.
' BREAKOUT MINI.ISTONE 10 98.30 I1 50 NOT HAVING BEEN VERIFIED. NO REPRESENTATION
11 FINISHED GRADE OVER LEACHING FACILITY 99.80 ACCURACY OF THOSE SHOWN IS IMPLIED OR INTENDED.
-BOX 12 99.81 OUTLLET - �-i rl�...........FINISHED, GRADE: OVER D 12 6 OUTLET 99.90 "D- 50X 5
13 NISH GRADE OVE TH ALL DISTURBED AREAS ARE TO BE LOAMED, SEEDED AND MAINTAINED
I14 100.10 tLL IR SEPTIC ANK 13,1 BACK FILL W MIN. 'S=O 02 ICLEAN FI TO PREVENT EROSION.
tMIN. S=0.01 LOCU 3 MAP 15 BOTTOM OF SEPTIC TANK 15 93.85 L=1 11, R.- 6. FOR PROPER PERFORMANCE, SEPTIC TANK SHOULD BE INSPECTED AT LEAST 0.50 I01 0I 4 FINISH GRADE AT FOUNDATION MIN. 'S=0.02--NOT TO 7 3 CM 92 I16 0 SCHD. 40 TEE5 L 11,3" cm 0 0 =CM SCUM AND SOLIDS EXCEEDS
16 CELLAR FLOOR VARIABLE C51 C2 C5 C2 0 92 IIII1/3 THE LIQUID DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED.
_zl I, -T- 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED
II4' OF,NATURALLY OCCURRING BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH; AND
BAFFLE 7 197.70 C: CONFORMS WITH THE REQUIREMENTS OF rTITLE 5 OF THE MASS. SANITARY CODE.
PERVIOUS MATERIAL 1 8 197.47 E
NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED.
I1 9 195.47 In
0.47 i TED TO SOIL CONDITIONS FOUND
8. TEST HOLE INFORMATION SHOWN HEREON IS LIMI
1000 GALLON SEPIC,TANK I � , - t 9 'AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN
EXISTING TANK TO BE NO GROUNDWATER ENCOUNTERED IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF USE 2 GALLEYS WITH: SUCH TEST HOLES.KEPT IN SEWCE 5 T93.85 38" STONE''ALON G 'Sl DES;6" MIN'r E 9. ALL ORGANIC AND UNSUITABLE MATERIAL MUST BE REMOVED FROM THE AREA
116 ITBD- BETWEEN; Ir DIRECTLY UNDER AND 5 FEET BEYOND 'THE PROPOSED LEACHING FACILITY. THIS
S r 48" ENDS., AREA MUST BE BACK FILLED TO THE ELEVATIONS INDICATED ON THESE PLAN
GTH 30' -SITE OR IMPORTED SOIL MATERIAL CONSISTING OF CLEAN 0 WITH SELECT ON TOTAL WIDTH 11' ERIAL, FREE FROM ORGANIC MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS
SHALL NOT BE USED. THE FILL MATERIAL SHALL CONFORM TO MA STATE HEALTH CODE TITLE 5 - 310 CMR SECTION 15.225(3) AND SHALL HAVE DESIGN DATA PERCOLATION RATE OF BETWEEN TWO AND FIVE MIN. PER INCH, BEFORE AND AFTER PLACEMENT.T. BUILDING TYPE: 3 BEDROOM HOUSE 10. ALL STONE MUST BE DOUBLE W M FINES AND ANY
ORGANIC MATERIAL AND MUST HAVE LESS THAN 0.2 PERCENT MATERIAL 2. DESIGN FLOW: 110111GPD 'PER .BEDROOM 110 x 3. = '330 GPD FINER THAN A NUMBER 200 SIEVE.DESIGN PERCOLATION RATE: 2 min/inch�3. 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCTOR:4. r GARBAGE DISPOSAL: IS NOT DESIGNED FOR A GARBAGE DISPOSAL SUPERVISE THE CONSTRUCTION OF THE SYSTEM. THE CONTRACTOR IS 5, SEPTIC ANK DESIGN REQUIREMENT: 200% DESIGN FLOW RESPONSIBLE FOR MAKING ARRANGEMENTS FOR INSPECTION OF INSTALLATION 330 X 2 = 660 GAL. (USE 1,500 GAL. MIN. PER TI TLE 5) OF THE SYSTEM WITH THE LOCAL BOARD OF HEALTH.6. TOTAL LEACH AREA REQUIRED: 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND TITLE 5: r 330' GPD /, (0.74 GPD/SQ.FT.) 446 SQ.FT. (CLASS I SOIL) VERTICAL CONTROL OF ALL SYSTEM COMPONENTS.:7. TOTAL AREA PROVIDED: 13. TIGHT JOINT PIPING TO CONSIST OF POLYVINYL CHLORIDE (P.V.C.) tSCHEDULE 40, UNLESS OTHERWISE NOTED 11' X 30' LEACHING TRENCH (SEE DETAIL) DE 14. THE CONTRACTOR SHALL NOTIFY THE SIGN ENGINEER FOR CONSTRUCTION EFFECTIVE DEPTH = 20; ENGTH 30% WIDTH 1 1.O' INSPECTION AFTER EXCAVATION FOR THE LEACHING BED (PRIOR TO THE
E) AND ALSO AFTER PLACEMENT OF PIPE & STONE
SIDE WALL AREA (2x3O)(2) SQ.FT. PRIOR TO BACKFILLING.BOTTOM"AREA = 11x30 330 'SQ.FT�ENCHMARK 15. DESIGN ENGINEER SHALL CERTIFY CONSTRUCTION OF AND MATERIALS
(2xl,l)(2) 44, SQ.FT., CH I LD S :,STR EETI END WALL AREA�TOP OF CONCRETE BOUND ., INSTALLED. THE CONTRACTOR SHALL PROVIDE A SIEVE ANALYSIS OF THE FILL
EL. 100.67' ITOTAL AREA PROVIDED I 20 + 330 + 44 494 SQ.FT. MATERIAL__REQUIRED� AN-.,.AS-R-UILT,.-PLAN-,,SHAL.L..,-BE-,SUBMI-TTED TO THE LOCAL 0 ON ---COMPLt'li ON.r---HEALTH OP V I D� B ARD OF'
I C GD PUB , 0 FT_1� E 494 SQ.FT. x 0.74 SQ.FT./GPD .= �365 -CONSTRUCTION MACHINERY SHALLr DRIVE OVER THE PROPOSED 16. NO RUBBERTIRE
3ON,kDURING CONSTRUCTION.365 Gpb SEPTIC BED EXCAVA;14
TOTAL FLOW PROVIDED, TIES SHALL BE NOTIFIEIJ�,,,FOR
17. DIG-SAFE AND OTHER, NECESSARY AUTHORI C,!B0 THE PROPER LOCATION OF EXISTING UTILITIES PRIOR TO ANY EXCAVATION.
NOT - SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER.lb tq E:N04*17'50"W , I0 98'1�r kA SOIL EVALUATOR'S LOG 22 tC1130 Soil Depth from Soil Soil r Other C 'To O:ture Color Mott EXISTING :, PARCEL Surface Hor. tive STe Relo SEPTI ELEVATION (Inches) (USDA) (ML Factors BE REMOVED t -f F 20, 027 , 2 E S LKWAy S1. F'. DEEP OBSERVATION HOLE ' #1 EL. 99.75 04/19/07 DESIGN PERC RATE DF Mc 7 00 ttK 1 04/17/07 PLAN REVISED DF MC
99.42 0"-4" Ap LOAM 10YR 5/2 I I I I I : I I 1.�� REVISION DATE DESCRIPTION BY APPR Uj 97.75 4"-24- B L/S 1 OYR 5/6 10.5!.-- -30.0' U I �,r_ 1 16 116 1 .- APPLICANT.- SUSI OHRINGER+ PARCEL 013 7-4"-1 32" C M/ 2.5YR 7/3 qG 88.75 CIO FLEET PRIVATE , CLIENTS GROUP
+ + SAND C) `C6 86 WILLOW STREET PARCEL 002 z PERC. 01 48- < 2 MINLANCH co, YARMOUTHPORT, MA. 02675 FF=1 01.79 N DEEP OBSERVATION HOLE #2r EL.L', 99.53 PROJECT,99.20 0"-4" Apt LOAM , 1 bYR .5/2 E ISTING XISTING �1000 GAL 97.63 B 4"-24" L/S I OYR 5/6 SEWAGE DISPOSAL SYSTEM DESIGN TANK TO BE KEPT IN SERVICE 89.53 -1 20" C M/24" 2.5YR 7/3 f I 31 CHILD S S TREE T SAND LO ro 3 IN"E E3 CENTER VILLE, MASSACHUSETTS S06�5��4O 13 209.88', PERCOLATION RATE- < 2 MIN./INCH TER = NONE ENCOUNTERED i SHEE T NO.: I OF �1 DA TE: 212 1/0 7 So Y..8*38 22"E. OBSERVATIONS B DON DESMARIS SOIL EVALUATOR: CHRISTOPHER COSTA, PLS SCALE: As Noted PRG FILE, CHILDS-31-OHRINGER 8.07, PARCEL 124 DATE TESTED: 02/21/07 CHRISTOPHER COSTA, FLS DESIGN BY. WILLI" DONOHOE FHECKED BY.LEGEND INOTES PREPARED BY.EXISTING PROPOSED 1.1 THIS LOT IS NOT IN A FLOOD HAZARD ZONE AS SHOWN ,ON FIRM FLOOD INSURANCE RATE MAP. Christopher Costa & Associates Inc.CONTOUR ELEVATION t2. WATER SERVICE LINE SHALL BE LOCATED AND MARKED CIVIL ENGINEERING LAND SURVEYING ENVIRONMENTAL CONSULTING 50.5 5Ox5 SPOT GRADE 14 OF PRIOR , TO ANY EXCAVATING AND 0' MIN. SETBACK TP N��A OF 44,9 DISTANCE FROM SAID SERVICE TO THE SEPTIC SYSTEM SHALL BE MAINTAINED. P.O. Box 128 465 East Falmouth Hwy. 508.548.0350 FAX TEST PIT (TP) LAYOU T WUGLAS SCN�EOER IN 4" PVC East Falmouth, MA 02536 508.548.6424 PHONE El CONCRETE BOUND (CB) CHRI P R CIVIL 3. ALL WATER LINES SHALL BE SLEEVED ,WITH NO, 3&U0 zi 0 SCH 40 PIPE FOR 10' ON EACH SIDE OF SOIL ABSORPTION SYSFEM. DRA WING TITLE:GRAPHIC SCALE N 30 SPIKE (SPK) 4. GROUND ELEVATIONS ARE BASED ON AN "ON THE GROUND"I20 0 10 20 40 80 INSTRUMENT SURVEY. IUTILITY POLE (UP) SEPTIC REPAIR PLAN LIG IN FEET *7'WATER GATE (WG) , I inch'= 20 ft Aso WATER SERVICE (WS) SORS INFORMATION. MAP 249 PARCEL 001 tL 17
IS