Loading...
HomeMy WebLinkAbout0017 CYRUS DRIVE - Health 17 Cyrus Drive Centerville A = 172 - 149 S M E A D No.H163OR UPC 10259 smead.com • Made in USA Ja'�Y� TOWN OF BARNSTABLE LOCATION v-VS d r )vJ SEWAGE# a( VILLAGE 6!!L�3}f�j� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.D, SEPTIC TANK CAPACITY f- LEACHING FACILITY:(type)_> S-00 Gjjt-061W (size) NO.OF BEDROOMS—,?, OWNERs�®c.J PERMIT DATE: COMPLIANCE DATE: .©20 Separation Distance Between the: J()pN� �1CQvN t19'c� Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Ck L'fC Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �3eIc J� ! A 13 cp i Town of Barnstable Barnstable ft Regulatory Services Department `ca # ' `Er Public Health Division1619. ' I 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A. McKean,CHO • i CERTIFIED MAIL #7012 1010 0000 2843 1914 February 13, 2013 Jason Haskell All Clear Septic and Wastewater Service, Inc 30 Cedar Hill Drive .Acushnet, MA 02743 The septic system located at 17 Cyrus Drive, Centerville, MA was last inspected on 1/07/2013, by Jason Haskell, a certified septic inspector for the State of • Massachusetts. The inspection report submitted by you, showed that the system "Needed further evaluation", under the guidelines of the 1995 TITLE 5 (310 CMR, 15.00) due to the following: • You stated "that a soil evaluation needed to be done to establish the water table depth The Barnstable Health Department considers this a part of the Title 5 inspection, therefore the inspection filed with the department is incomplete The department requires you to determine the groundwater depth relative to the bottom of the SAB as part of this inspection; at which time you will submit an amended inspection report to the Health Department. Thomas McKean, R.S. CHO �- Agent of the Board of Health _ cc: Kathy Tucillo �. Assessment Management Specialist 311 Sinclair Road I Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\17 Cyrus Dr Cent Feb 2013.doc SENDER:,COMPLETE,THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. g, ived by(Printed Name C. Qa to f Delivery ■ Attach this card to the back of the mailpiece, ./1 �� J 5 � of on the front if space permits. '� F�^ D. Is delivery address diffe pt from item 1 es 1. ArticleAddressed.to: p vFe_a„ro.delivery iHd ess beloo�,: o John Haskell > All Clear'Septic and Wastewater S 'irces, Ind .�.. 30 Cedar'wHihl Drive ' J �`'' Acushnet,M^*A 02743 a I#Vlail ❑Mess M ❑Registered ❑Return Receipt for Merchandise ❑insured Mall ❑Q.QD. 4. Restricted Delivery?(Extra Fee) era O Yes i• ,,j 2. Article Number _ 7.012 1gl q ��',n4 2`6g4 191,4 (Transfer from service label) I Ps Form 3811,February 2004 Domestic Return Receipt .102595-02-M-1540 I I I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid I LISPS Permit No.G-10 I' • Sender: Please print your name, address, and ZIP+4 in this box • , I ` Town of Barnstable Public Health Division 200 Main Streety i Hyannis, MA 02601 I E lid,III!'l1ll1ii-1i'l1l11�1i'fiji'��iiiii�li�i111iiliii i f ' f i eQ S tg �� Commonwealth of-Magsachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name _ information is Centerville �- -MA 02632 1/7/13 ` required for every page. Cityrrown 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: ►�' .. key to move your cursor-do not Jason Haskell _ use the return key. Name of Inspector All Clear Septic and Wastewater Service Inc. C Company Name 30 Cedar Hill Dr Company Address Acushnet Ma 02743 CityrFown State Zip Code 508-763-4431 Sl 13520 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this ad"is and thhe information reported below is true, accurate and complete as of the time of the inspection.Tq inspeC:tion wa s performed based on m training and experience in the proper function o e and-,alntenance:� f on�siie Y 9 P P P „ 4 sewage disposal systems. I am a DEP approved system inspector pursuantlo Section 1 340 Title 5(310 CMR 15.000).The system: ❑ Passes �❑ Conditionally Passes ❑ Fails ® Needs Further Eval tion by the Local pproving Authority m„ 1/14/13 /Inibctor's Signaturcr Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. "This report only describes conditions at the time of inspection and under the conditions of use, at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Offiaal Inspe on F :Subsurface Sewage Disposal System-Page 1 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water.levelIn 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 5Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 � Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 filling out forms A. General Information `t` on the computer, use only the tab 1. Inspector: key to move your cursor-do not Jason Haskell use the return Name of Inspector key. All Clear Septic and Wastewater Service Inc. Company Name 30 Cedar Hill Dr Company Address .Acushnet - Ma 02743 City/Town State Zip Code 508-763-4431 SI 13520 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ❑ Fails ® Needs Further Evaluation by the Local Approving Authority II' 1/14/13 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 tank, leach pit. Septic tank outlet baffle missing needs replacing, bottom of leaching pit is 120" from grade near by water table from across the street has a watertable @ 120". Soil evaluation needs to be done to find watertable for this address. NEEDS FURTHER EVALUATION 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 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 Titie 5 Official Inspection Fonn:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments lug 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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: Soil evaluation needs to be done to find watertable. Needs outlet tee in septic tank. D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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: f`4' ❑ ® 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 privyis within 50 feet of a private water supply well. P PP Y ❑ ® 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- 10,0009P d. ❑ ® 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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. ® ❑ 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): Unknown 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 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 page. City(rown State Zip Code Date of Inspection D. System Information Description: Number of current residents: None 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 ears usage 6.85 gpd 9 ( Y 9 (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown 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: 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is Centerville MA 02632 i required for every /7/13 page. Cityrrown 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: None per BOH 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): Septic tank, leaching pit t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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: Unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 32"feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town water feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joints in good condition, no evidence of leakage,vented. Septic Tank(locate on site plan): Depth below grade: 23"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: year Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8'3"x4'3"x5' Sludge depth: 4" 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 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 No baffle/tee Scum thickness 0" Distance from top of scum to top of outlet tee or baffle No baffle/tee Distance from bottom of scum to bottom of outlet tee or baffle No baffle/tee How were dimensions determined? Rod and tape measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not required, inlet baffle in good condition, outlet baffle has fallen off needs to be fixed, liquid is @ outlet invert, no evidence of leakage. 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 i Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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): 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 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 No d-box 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 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 0 ' Commonwealth of Massachusetts _ - Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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.): Soil and vegetation normal, no signs of hydraulic failure Ample available volume 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-11110 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 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 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 o Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information is required for every Centerville MA 02632 1/7/13 page. City/Town State Zip Code Date of inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 NN Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 17 Cyrus Drive Property Address HUD Owner Owner's Name information isrequied or every Centerville tVIA 02632 1/7/13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 120" 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: Info from# 18 Cyrus Dr done on 4/9/12 ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: No groundwater encountered @ 120" at#18 Cyrus Dr, bottom of leach pit on this property is 120" below grade. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 17 Cyrus Drive Property Address HUD Owner Owner's Name information isequired for every very Centerville MA 02632 1/7/13 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ®System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 i Septic & l asten-ater Sez-vices 30 Cedar Hill Dr. Acushnet, MA 02743 Office: (508) 763-4431 Fax: (508) 763-4168 http://www.aliclearseptic.com/ i l United Siatss Environmental rrOiaViOn Agency A Homeowner ' s G., - - _ to ^� IL ems ..... ... .. �=�^:� � ;•_7._r_"��'y:�y=��4'.- �'-S:.-�Y +'Sirr'"»:�r:�� 'mac.�,ai�' ,rr..l •''-�3��Tr•'••i-'Iv:''�:nc�-*� �y�yNr'� w-"•�''�-"r•. ;ET�i`..:'. - 'a`i� r r'E'-ram rr,�'rar.,`,}tr�� ._ •"•.-. '^`' it2L f'�-3��3:f�t:?-i i--r"qi;.•,. •.7-i":.ti-:.tV SOIL hq:i/W�rw.epa.gov/�w�/Septicipubs/h_cmeowner_guide to _ _ ng.pn :1P�,r,/i�1J 1�Ir•�Sul:���� Cal LONG The Impact of Septic Systems t, ISLAND IUTUDY on the Environment SOUND proper operation,used only for the purposes for which they S were designed, and given periodic maintenance. Even a properly operating system will discharge nutrients (phosphates and nitrates; and some bacteria or viruses to the Nearly half of the homes and businesses in the Long groundwater. An improperly maintained or failing system Island Sound watershed have septic tank waste disposal will discharge even more contaminants to the groundwater. systems. When properly sited and maintained on a routine Domestic wastewater can contain bacteria and basis, septic systems are an excellent waste management viruses that cause dysentery,hepatitis, and typhoid fever.To alternative. However, when not properly sited or protect public health,it is important to minimize the amount maintained, they can cause contamination of surface and of these organisms that reach surface or groundwater. groundwater resources, which leads to public health and Fortunately, soil and soil bacteria can effectively remove pollution problems. most pathogens (disease--causing microorganisms) from wastewater treated in a properly functioning septic system. How Septic Systems Work When nutrients such as nitrogen and phosphorus Septic systems have two key components, a are discharged from septic systems into the groundwater, receiving tank and a leaching system. A sewage line they contaminate drinking water supplies,and also represent carries wastewater from the kitchen, bathroom and laundry a potentially important nonpoint source of pollution to room to the underground septic tank, where heavy particles ponds, streams, and the Sound (see LISS Fact Sheet #7, settle out of the liquid, forming a layer of sludge on the Nonnoint Source Pollution in Long Island Sound). The bottom of the tank. Light materials float, forming a layer of connection between ground and surface water pollution is scum on top of the water in the tank(see Figure 1).Bacteria closely linked since the base flow of streams draining to use the solid materials, liquefying these waste products. To Long Island Sound comes primarily from groundwater allow sufficient time for particles to settle and for bacteria to contributions. (see Figure 2). break down the sludge, a septic tank should be large enough to.hold at least one day's flow of wastewater from the home, a and to provide storage for sludge and scum. j-0-I J ACCESS COVERS flO JO�pIY EIY11914�+: SEPTIC SYSTEM SCUM _W;R WATER TABLE LET .:::>_:> FROM 11TLET l HOUSE =: TO • WATER LEVEL LEACHING SYST EM :::::: Figure 2. Groundwater can transport biological, Figure 1. Cross section of a typical septic tank. chemical and nutrient contaminants to nearby surface waters. Each addition of wastewater to the septic tank In freshwater systems, phosphorus causes excessive - displaces an equal amount of liquid into the leaching system. aquatic weed growth that can limit the uses of ponds and This may consist of a large perforated ring,leaching pit,or a lakes. In the Sound, nitrogen fuels massive algae blooms, series of absorption trenches, depending on the regulations which in turn die,using up oxygen as they decompose.This in effect in your area.when your system was installed. The causes hypoxia, a loss of oxygen in the bottom waters, leaching system is designed to allow the liquid from the which has serious ecological implications for Long Island septic tank (called effluent) to be released into and filtered Sound (see LISS Hyooxia Management Update). by the surrounding soil. Bacteria in the soil further degrade Infectious diseases and nutrients are not the only the waste,removing harmful organisms, organic matter, and concern. The improper use of septic systems has been shown some nutrients. Ultimately, some of the effluent enters the to contribute to contamination of groundwater by toxic groundwater. chemicals. Contaminants that may enter groundwater through septic systems include heavy, metals and toxic Groundwater Contamination chemicals from small commercial establishments, toxic household products, and organic chemicals typically found Septic systems will operate effectively if,and only if, in septic tank cleaning products. Given that over 50 percent they are designed properly, situated in areas that allow of all drinking water used in the United States is groundwater. improper use and failure of septic systems worth the price. Maintain records of system maintenance should not be taken lightly. and know the location of the system's components. In order to improve the level of wastewater treatment Watch what you put down the drain.The use of a garbage and minimize the `amount of disease organisms, nutrients, grinder will add SO percent more solids to the system, and and chemicals that enter ground and surface waters, you result in the need for more frequent pumping out of the septic should make sure your system is in proper working order, tank. Don't put grease or cooking oil down the drain—it follow simple maintenance procedures, and conserve water. congeals and can clog your pipes, septic tank, and leaching system. Dispose of unwanted household chemicals SIGNS OF SEPTIC SYSTEM FAILURE properly- do not pour them down the drain where they can . Slow drainage or sewage backup in drains or contaminate groundwater, instead save them for the next toilets. household hazardous waste collection day in your * Excessive lush grass growth in the system area, community.Remember,the less you put into the system,the even during dry weather. longer it will function properly. . Unpleasant odors around your home. Avoid Additives. There is no scientific evidence that . Excessive growth of aquatic weeds or algae in demonstrates the effectiveness of any additive. Various lakes or ponds adjacent to your home. products marketed for that purpose do not improve the performance of the septic tank, nor do they reduce the need HEALTH EFFECTS OF A FAILING SYSTEM for routine maintenance. Organic chemicals, such as . Improperly treated wastewater can contaminate chloroform and trichloroethylene, are typically found in drinking water supplies, causing disease. septic tank cleaning products. Some of these chemicals are . Infectious diseases are spread by mosquitoes suspected of causing cancer, and they are generally and flies that breed in areas where liquid wastewa- ineffective as septic tank cleaners. ter reaches the surface. Conserve Water. Conservin . Risk to the public, especiallyg water b y installing low flow children and animals who come into contact with surface flows and may fixtures in your home and by adopting more conservative drink contaminated groundwater. water use practices can extend the life of the system, delay the need for repair, and lessen the likelihood of contaminating local surface and groundwater. Distribute What You Can Do laundry chores throughout the week to avoid overloading Maintenance is the single most important factor that the system on any given day. Don't connect downspouts determines the length of time a septic system will function from roofs or basement sumps to the system; in heavy rain properly. Too often homeowners forget that whatever goes they will quickly overload its capacity. Instead, make sure down the drain or toilet ultimately finds its way into the soil such drainage is diverted away from the leaching system (and possibly the groundwater) or remains in the septic tank area. Minimizing water usage during periods of heavy until it is pumped out.The following maintenance practices rainfall will reduce the potential for system malfunction. will help keep your system functioning well and help minimize its impact on the environment. FOR MORE INFORMATION: Pump out your septic tank. When a system is poorly For more information about septic systems, a maintained(not pumped out on a regular basis),solids build comprehensive series of fact sheets titled "Your .Septic up in the septic tank, then flow into the leaching system, System" is available through Cornell Cooperative clogging:it beyond repair. Since it may cost$5,000 or more Extension. If you have a question about your septic system, to replace a septic system, having a reputable contractor call your local Department of Health or Cooperative pump out your septic tank every two to three years is well Extension office. The Long Island Sound Study The Long Island Sound Study (LISS) is a multi-year research and management project that began in 1985 as part of the National Estuary Program, a recent addition to the federal Clean Water Act created to protect estuaries of national impor- tance.The LISS is a cooperative effort involving research institutions, regulatory agencies, marine user groups, and other concerned organizations and individuals. The purpose of the Study is to produce a management plan for the Sound that will be administered by the three major LISS partners, the U.S. Environmental Protection Agency and the states of Connecti- cut and New York. To learn more about or become involved with the Study, contact the New York Sea Grant Extension Pro- gram, 125 Nassau Hall, SUNY at Stony Brook, Stony Brook, NY 11794-5002, (516) 632-8730; or the Connecticut Sea Grant Marine Advisory Program, 43 Mame St.,Hamden, CT 06514, (203) 789-7865. This fact sheet was produced by the New York Sea Grant Extension Program and the Connecticut Sea Grant Marine Advisory Program. Graphics, layout and text by Trent R. �404 0 S�� A •,� SE4 GiGNT Schneider. Funding provided by the Long Island Sound Study. Cooperating Agencies: the U.S. Environmental Protection Agency, Connecticut Department of Environmental Protection, New York Department of Environmental Conservation. 9/91 '•,..,�.� t No. r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicatiou for Misposal 6pstrm Coustruction Vermit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Loto. /7 Gy/vs 'j�41 p0_ Owner's Name,Address,and Tel.No. G6vif f t1[ P Assessor's Map/Parcel ,2 !A� 6CAftoccC ,J Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms\_ ` Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �(jK1c IC c ) No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 30 gpd Design flow provided � gpd Plan Date 73-S'9-O R0 Number of sheets t Revision Date Title �"`"-,� Size of Septic Tank 1�-7�5}��N< Type of S.A.S. 31,5-0o ��)) j(0 dy y11 t.j,A glsbac Description of Soil Nature of Repairs or Alterations(Answer when applicable) ~ JN �Qb "D CsAl 1 �' / 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. Sign Date Signed Application Approved by I JQ2 A j Date Application Disapproved by Date for the following reasons Permit No. Date Issued ?j G a ww a,e� ��•,. No. . A " Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.,,' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Disposal 6pstrm Construction'Vermit Application for a Permit to Construct( ) Repair(p)Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. 17 C'y/0S "0i l I)E Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ! .2 Y? t-*f rJ o'c o Innsstlaller's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: F'Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) 1, Other Type of Building �4'5X(YVTIQ) No.of Persons Showers( ) Cafeteria( ) kb P Other Fixtures �t % sign Flow(min.required) 30 gpd Design flow provided gpd Plan Date 3-'S-9LO RQ Number of sheets(AA t V_)' Re sion,Date Title `-_ _� Size f Septic Tankiyyt7t�d �n9s, , �, Type o S'A Sv z C�,Apll j (y1Ct✓�'li[X1tS fj N�; _''mt �r {' 4�`"3!'h�4�^u•..1 9+.� }�..�- ��,»> �,�. '�w,3t''*,.r7` � �, e�� Description of Soil J r r Nature of Repairs or Alterations(Answer when applicable) l l r A)V,n &s t lYlttir-ft \DOX cuk�) 3 sm G.VCYn,7 �t°(S Lj l�b 41 5+tom ,1 n) Q 13,'`IX kleb 04, 00/ 1 ) a Date last inspected: t f t 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 °7� * �� Application Approved by Date�3`.QD Application Disapproved by Date for the following reasons Permit No. _ � Date Issued ?� V _ - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( V)� Upgraded( ) - _Abandoned_(, -)by e /rU s A9 Tnf r at I- ` (v JO has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NN dated !'-'�j Installer D A ,1'ry 1"%A)N Designers 1 J(A01r) J tm/\ #bedrooms `� Approved deli flow _ (� gpd The issuance of this permit shall'' of be construed as a guarantee that the system will func ion rI design°d. ° Date �°1 t� Inspector Jrl� s' No. 'o ;?a-'� ' Fee /( � THE COMMONWEALTH OF MASSACHUSETTS : � STABLE,MASSACHUSETTS ;1- PUBLIC HEALTH DIVISION-BARN , 4i �ts�osal �pstetn,;�oustructton �ermtt �a a ,:� ��, ,; � �° Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) Y✓ System-located at 1 7 � f�T ; and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special condition's. Provided:Construction must be completed within three years of the date of this permit. Date / '" �' �CQ Approved by r j d a # r r lLi' �, � , 1. 4.11 ,LII 9 ±-s. yJi� ' io. ..,, r T YI-.�1 9 !'�l' °' `t� � � -I;r �: s' � ": -- ■ trttl q t i i .w ar n o a.■ c.i_�'q : _ '�. 't■ .-l: i ! :-d d F nei`�N!- t•d I i 1 i -.. x o ! n.- F-o c .� 1.�1 �Kati iir%�g -1 a-1,' •.'�.. s n-f, � 9 . _ .._ ! _ > • � z�.• � i ".".: 1,yr..!� P? A' P ..1, `, '-i i , t,, 't1 .,_ _. i � p�'i• ,i ' r°t i ill"!t.■c� ! - .!.' ,i. c, :c � �..�•;>. �!-1= I i L : ,■ t �-i ��! N'.. e',- 1 p��, n, �i c ti P 1 ,_ `t F ... v'+� ra . �N 11'-l- i•, d •� i•-- ,!,: Lei.. 17 ti 1•:-• �" -n o u � -e a is � ,� _ .`•_i ad r:i li �. E a M ,1 ■ . .. ,• ??!,°:- '.1 ",.4s1® „�-R -Y �! 1 P '+ ei� e-' �,;�.:a _.,� •� `- _I � 8.. -r I fl t. o hiK�1 L, • t �'-� '� tt_'■' @� �, l��.■Ja 14� IY,�p �� �iE ■ ►1_ J i]o ."I u �—OU C a_41-19 4431�,�r1;' '�1E ��'r�'aI Rd�1 t.•.+ni•+.^'Fe�.r•<vYstl./.•Is54Ya fit..• _ ^_- ..- .r:-�:-..f.r o.,--.,.....-wC+x.�-w.7•a•wn-R.'e.Ma._. ...:ls^.:.+ Y.:.;.._ -•c++:•v.,v-.s'o.P.'=•v..,. .�.s- .- .�1.-'i,:.i_��,..,mss'r�eGJ�^.n. :. ._ .. -. a .. .... .-+,._ewaca .. •st "•,+.Lr>•w.•� rr• :M AR. '.w• � :•O �,, ,.-.,w.-.ro�•ntas++<�mv .. as..U-:-.•s•.,s.—'.' ,,. ..+*wvwt+rewmn.t+..ar�a,w.�s-. - - rrvn_wsseaa.�•ma�:.s.-. 'eae'-•.r x.:•a .. ,. s .. . y ! 7cJ f iJOL�..- + .._ �Y:� inSt.d',rajr r t n o f O� 4- -�, . sha€i caii;iv rdi_h tote S;.at�r. Lironrr..r?tal Codr:'f ic�� :�: ,7wn o. �' � !�� :trc: ;�f!•seafih i?c�gt+ 'tio'ls. 'l,zW ZC ,' v�ll: 1Q1�� l �• �5 � septic_systen- as proposed or t T Wan shait rt:)'. :.e frs;.al!eri unril a licensed town instatler �C oO € 6 ��!✓�V� �:JeS oval ar,d :rrtst3%€aticlr; permit reran 9 8 t_4 Zbc� ----- ---- - f !'tl a } 4Q ,•� ' rti't ''2 is r'+3ti c sewer ?!-v...' ------- _ _ `,a to tn,.al�ar .t th craacl£t tfl3t)1 r•_r EV 1,. t. t'±L, sewe' - - —_ existing r. components prior t . a i rr. � 1�, ( t ..;, t tc; nit r� St n5 sNpt �tomt. a avt l�J✓ r 'r A':gravity sewer piping is to oe 4 incti s,_hedule 41)PVC at ,i6' , c F � � � _ c - h . first Z feet au`c • V t distr ibution box shall b, level, All 1-ping connertions to be !"t,is septic_desil;n vlm, is n,.-it to tie it ! for t resperty ling da`� ryri�,,:...., r.for any other r` U, eyI t,;:,pose -*)thv: th_.;t�-e propO5,21i : ':;: ysterr: insta!!atinn. W � � +,: != k'V�-Ompo,:ent_'are ?Oue. \J soecifieations. CP) y ....+a.ac n•r»--,aresc,-.r.+e .•.n.r-a. aasr+r�r.w '! ' a q, 1 c. ilafl h l.,'o litt `le. 1 ill p . b C/ ki*1P S ' tail: ` f{ =� "i 3t �% -0'rt t)t1L''1tS UnrE'i () r; ''1� aFf_ HZtJ SOddG . �' — �o s}j i',�existing teaching cr tess{,c�r:is s#taf! he periZ �fPd and tiltr:t ,nrtk?� ,T;a;ariat r)er Titie IV z v i alsardonn.ent nr•7cP(tr.;'2.:. lca[hir;� :'d cessprcl(s;and c��rrtarniraatecl s0il '•uithin the ? Gc 5 SAS=h:4t! he :ern-wed arts re;:iaced with,.:ear. sa:ui =,+�: ,"itle V specificat ,ns. jO f f �J,j ` � :Tc'')i!L CC.r11GL ls'nts ar•: r _ t`.d`E't' S$rViCe Brie. 3t'N'ef:r i@5 Lrossing n wdtE'f Iit1e f) `u ri/r11 b sleeved v�irf; ar ata,;. . ;: �ttedule 40 P1`C with ends grouter,. The water sere?cc= or the Sept.c l:r., lithe sleeve being d distance ^,t the line. "t�_�-C'`^Y_�"_ ::^•` t� g;;rbage grindP:ex:;i -Ye,it is to be removed if the sepi 4 ;�:tF::� is Ic:! a f sa , �aV V1 L Ci �i�rZoG� tit 31 t[IrtlrTlC' r�!j?r, ` '.installer is rr�or� J - . �,avatior ar�ur.:: a'. ;•�� ::`tti� , �ert'y apt',: • I tCClir'Jthe Stt'rJCTt< �' :•tr'�:t,rrGs C1,r R t. :lilhn process of the. :,t'.(l!' ;,' ; rater=-rip I itie V w '' _ prr.;perfy owner thai: r •riti^v de;:;.., rrite •r. to approvo jj,e total nurnt)e? of bedrooms 2nr: IU t f un flow. tnstallatic;c of the septic tee as ro osed and receipt of payment for the desipi, r U a;l be ciee Tied?Pp+cu3:t:f tt;e d .;gr, '_riter'ia by the property owner o?'agerrt of. iD !.u?validity of This plat)5( all expir'2 watt* the e pirat!oh of the town installation permit issue.-; ,' , 1 O O 0 / t t` �. )f�� plan Or'he validit' 'iZt;' p!al' 5"�eiil P llirP r,r� t;lr','xpiratri�re Ql i�?N Cf?r'P'�fCi�tf' ofr:Urn11`iF4tl( 20 IJ�JLJ A� :✓ T'' ed for t„f_ "- fliA - 437 N SSG D a 31t k 137 .wIr5 - - ✓ SPTR C 5L(5TEMN Sit"( Ott - sky �27 SEPTIC-rK Sty _. ; S L 7 �ot��oF -(ems �V, 3� -- — B. ti' ; I G 05 iyE � DAVO � MASON 41 7. t - ," _ /i •'. r �7w�,L9IID���._YfifiOl,s.>s•r•.bT.+'� .'V ^:Vw<Ni1.+�..�..caeew.n.._ .. ... ..a v._...y�n7 ."-..._+.�. .. _ _ .. .-.. :�•G_ .�T. ..iw0.::.. •-r.. ..r -. i. .. ...:.��'RMMYI.M.M"-��i:•1eV:w✓a-b r . •a'Mf.•'. i+M� S:b+:I:T-tW'Y!3'.:++H.�.M H!�HefVq�i.1��Vr t':."..�Y::A:T r.s.•r:�-.c.n.. , -2se_s.. <a..�s.sw:�I>..-•r.. � .... saa.. ._,