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HomeMy WebLinkAbout0072 DONEGAL CIRCLE - Health 72 Donegal Circle Centerville A = 169 074 0 i� I� 4 �►.��ry�Il�nry �RECYCIfOC UPC 12543 No.53LOR HASTINGS, MN TOWN OF BA_RNSTABLE. LOCATION w L 6v-cLe. SEWAGE # VILLAGE IV[ ASSESSOR' & LOT =-L� INSTALLER'S NAME&PHONE NO.y Sic-'TIC TANK CAPACITY 1 LEACHING FACILITY: (size) NO.OF BEDROOMS J BUILDER OR OWNER 1—tr f M4 1 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet L Furnished by I - o� hl 44 Al, AA Q01 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , M 72 Donegal Circle w Property Address ~' Steve & Linda White Owner Owner's Name information is ✓ Ma 02632 4-5-16, required for every Centerville page. City/Town State Zip Code Date of Inspection �yD co 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 Matthew Gilfoy use the return Name of Inspector key. B&B Excavation ,Q Company Name 374 Route 130 ILA Company Address �) Sandwich Ma 02563 Cify/Town State Zip Code (508)477-0653 S113640 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 4-5-16 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System was in working order at time of inspection. 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °w 72 Donegal Circle M g Property Address P Y Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 72 Donegal Circle M Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow (Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s)..Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® El available as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 -Number of bedrooms (Actual) 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 331 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2014-40,000gallons 2015-59,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: NA 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: l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-.5-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner- last pump possibly 3 years ago. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000gallons Sludge depth: 7 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 72 Donegal Circle M Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 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 28 Scum thickness 12 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 6 How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is in need of pumping as solid layers are high and carry over is present in d-box. Grease Trap (locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ — Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up but carry over was present. 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.): NA If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: El leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 37'x10'x1' ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 72 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)-. I t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 12 Donegal Circle Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 page. Cityrrown 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 72 Donegal Circle M Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 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: No GW 144" 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: 4-8-04 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water.elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist.on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 72 Donegal Circle M Property Address Steve & Linda White Owner Owner's Name information is required for every Centerville Ma 02632 4-5-16 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. 3 FEE 50 COMMONWEALTH Of MASSACHUSETIS—. Board of Health, �mn�t� -, MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair IV Upgrade( Abandon( ) - ❑Complete System�<ndividual Components Location 'L r. Owner's Name Map/Parcel# 10 O Address l Y Lot# . S'}„ Telephone# 3Q01 Installer's NameSoD�,-r ; Designer's Name Address -e--s Sk Address ?Q,,-6O Telephone# _ Telephone# Type of Building Lot Size �i (p`.1 sq.ft. Dwelling-No.of Bedrooms ^C1nC`!�. 4J Garbage grinder Off, Other-Type of Building NAf1Q No.of persons_43 Showers (►rCafeteria(f� Other Fixtures Design Flow (min.required) 7d gpd Calculated design flow 33o Design flow provided 3 I r gpd Plan: Date Ate I O A _ Number of sheets Revision Date Title r;��[� Description of Soil(s) �pro(\ Soil Evaluator Form No. Name of Soil Evaluator r o-w-N ate of Evaluation 4�S 6 Q� DESCRIPTION OF REPAIRS OR ALTERATIONS '�CQ Qbr-, The undersigned agrees to install ove described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a Wt to p ce a syste er lion-until a Certificate of Compliance has been issued by the Board of Health. Signed Date 7 Inspections .,M.,r..t..,,.rr.,,�. -•f.,'��'Y1r.--n^i�-^'"""'"•.n-�,�`'��"S�""+T"•^"."�.".r'YL""-�'�'tr�ri.s�+.+�....N a - X�•..-�.,:-+,.•-.-�u�.,,i'�r• .^" fir"'_" � /'^' ":k^ .SF�-'*-'"V4�'—+'..:r,rT.i.•yr,.'rr.v+ .�'r�....,..� r 4. - , ♦rr .--'.Y6' f. No. �� FEE —_ COMMONWEALTH OF MASSACHUSET.S,-; BoardofHealth, cer,� r�� MA. APPLICATION FOP DISPOSAL SYSTEM C®NSTRV.J�TION PERMIT a A'pplio�n for.a Permit to Construct( Repair Upgrade( Abandon( ❑Complete S stem individual Components � Location Owner's Name Map/Parcel# ' nS Q 4 non, 41 lie Address v C 1 we` ut Lot# _4:�5'� + Telephone# 390 I Installer's Name Designer's Name t)( n�cA �CS Address Jam' ^�� S\ . yoxcnov , Address Q �x n U V C r 1 Telephone# („t -572 Telephone# (- _�_+9 Type of Building \ �"�C2`'a 1C 1� ` Lot Size S, (£,. sq.ft. / T Dwelling-No.of Bedrooms -vn1Z,P . C 1J Garbage grinder O A _ .. Other-Type of Building 1Q\tL17)Q No.of persons Showers Oe)'`Cafeteria (P/ Other Fixtures 1- 6,. Q k-t"6w . 1�,,kC L--, S n 1.04101rk-1 i- Design Flow (min.required) :J,7y gpd Calculated design flow 330 Design flow provided 33 t I Pgpd Plan: Date 40 1 Q fit" Number of sheets ' Revision Date Title �� YCt�C:C7 1� � Ak�c Description of Soil(s) Q -Soil Evaluator Form No. Name of Soil Evaluator G(CyVf) Date of Evaluation 4/3 I b 2, DESCRIPTION OF REPAIRS OR ALTERATIONS Q. (' "tt) (Db(-,) The undersigned agrees to install the-al�ove'described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree's_to _of to p, ce theessyste m operation until a Certificate of Compliance has been issued by the Board of Health. Signeii /aU. Y-SA.m 1 ../ � Date a ' Inspections NoO`''0 /10.3 COMMONWEALTH `-- �T��r (� T ¶' FEE S Q TTS Board of Health, ?_>M1r1Q5TP-.01 C_ , DIq. CERTIFICATE OF COMPLIANCE Description of Work: tlApdividual Component(s) ❑Complete System I The undersigned-hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (V/,Abandoned ( ) ` by: ?�P✓ 5FY6 t \ (, _ at �f�` �l #nJUCG,rr1`.. G.lo'c.eY_. ��».'Cc�✓V� �. E' has been installed in inn accordance with the,��gvyisi ns of 310 CMR 15.00 (Title 5)•and the approved design plans/as-built plans relating to application No. t y�, dated ' /i Approved Design Flow (gpd) o, Installer Designer: Inspector: Date: 4 d o T The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. c::;kjJq ! (D 3 FEE R © ..- 'L_OMMON V'V'FA LT14 OF MASSA'1.HUSETTS Board of Health, ✓n JS1tib , NM. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade(✓rAbandon( ) an individual sewage disposal system at '� r� �� �.. �o r-��r-e � 'v�Zz'w�� as described in the application for Disposal System Construction Permit No.�, 7Vb3, dated / 4 Provided: Construction shall be completed within)three years of the date of tth-is p•f- irk'I Vocal conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ki /�/U� Board of Health ..►�..� �^^----3 Sep - 20-0'1 13 : 52 BARNSTABLE HEALTH DEPT 5087906;3U4 1 1 . .XOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION 'PEST ANJJ SOIL EVALUATION EXEMPTION FORM QC�Ce1� hereby certify that. the engineered plan signed by me aatec 0 5 c oncerning the property located at meets all of the iCilow;n; ^terra • This failed system-is connected to a residential dwelling only. There are no :orvner;ia! or business uses associated with the dwelling, TF.e soil is cidsstf:ed as CLASS l and the percolation rase is less than or equai to -Ti.nut:s per inch. 'Fhe applicant mayuse histoncal data to conclude this fac: or may :onduct tests at the site without a health agent present • �here :s no increase to flow and/or change. in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than fourteen 1,) fee; aonve the maximum adjusted groundwater table elevation. (Adjust the ;rnuridwater cable using the Fdmp(or method when applicable) Please complete the following: �. -rop of Ground Surface Elevation (using GIS intormauon) 'a•�d _ B; G VY, E Icvat:or, _ i. ad;ustment for 'nigh G.W. '...._... = o�'�• [�8 '�CFTEREt�c F.. BETWEEN and Bar•UO S:t,'rE D --- D ATE: —_ VOTiCE 3asec aron tine above r.formaucin, a repair permit wil! be issued for 'uedmorrs r2,v irr.0 r No bedrooms ase authorized to (he future without engtncerec -n plans. ° I 1r.uh:C:Oc� �c Kc.tm7 5 r. Permit Number:Y Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Loclation: ^t2 �QQ l t d^s �� V1('Q Lot No. S Owner: �t``�Q CvcC`e!1 Address; /(j'� f-'�IlitC[� p�Rlnn� Lt'L� .T1J� Contractor: 6hQ.— Address:_ Notes: I STEP 1 I Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date month/day/year STEP 2, Using Water-Level Range Zone and Index Well Map.locate site and determine: ' OA Appropriate index well.................................................... Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ,,,,,,,,,,,,,,,,,,,,,,, r �a4 •�, i monthhh/yy§.ar STEP 4 ! Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ....................... 7-,;� STEP 5 Estimate depth to high water by subtracting the water•level adjustment (STEP 4) from measured depth to water level at site (STEP 1) %........................... 1; Figure 13,—ReproduCible computation form, 15 07/10/2014 19:29 FAX [6 0011001 Town of Barnstable r Regulatory Services t Thomas F. Geiler, Director 6'� � Public Health Division '► °i Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 4/12/04 Designer: __Shay Environmental Services Installer: Roberts Septic Service Address: 34 Thatchers Lane Address: 5 Trenton Street _ East Falmouth, MA 02536 Yarmouth, MA On 4/9/04 Roberts Septic Service was issued a permit to install a (date) (installer) septic system at 72 Donegal Circle, lA annis based on a design drawn by (address) Shay Environmental Services dated 4/8/04 (designer) XX I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. { 10F kIS, (Installer's Si ature) pc CAI , 4J EN�n�G� a S 4,41' No. 1181 � o esigner's Signature) (Affi x1 TV e s Here) NrTAa« PLEASE RETURN TO BARNSTA,BLE PUBLIC HEALTH N. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:14e411h/5eptic/Designer Ccrtification Form APR-13-2004 TUE 07:02AM ID: PACE:1 `� OWN OF BARNSTABLE � �-C. LOCATION SEWAGE# VILLAGE ASSESSOR'S MAP & LO /' ,V INSTALLER'S NAME&PHONE NO. 1we a r A g2 e- Vf,0�"C. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) //V/ /L 712CrO S(size) NO.OF BEDROOMS BUILDER OR OWNER PERMI'TDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of beaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ' e y 3 A 3-i2L-33 s 1� /o 7 y No.. Y 9 Fmc.....:20 G... � --..--•. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH T=e.vn:........... .......OF.........Barnat.aUe................................................ Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....72......Donegal;:Circle Center�ville -------------•---.........._..........----------------._....--------------.._..__......----------- ...... -- Location-Address or Lot No. jKta- Vi 111 am Curran ..........-...................................................................................... - Owner Address '-----•-----------••--•-------•--•........................... ........•--•-•-•-----------.....--•--------•----•----.....------------------..................... Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling-XNo. of Bedrooms......-3...................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ----------------------_---. No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures ............................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. R: Septic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--____-._--_--.-._•sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet....---.-.------.-. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) PercolationTest Results Performed by..................•-•-•---.......----•-----------------...._........•----• Date........................................ aTest Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water...................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground watel........................ -------------------------•--•-----•-•----••------•-----•---•--...............-•-•-------------_.............................................................. 0 Description of Soil------------ --•-----------••--•---------•-••----------.............---•-----------------------------------------------------------------------------•••--•••-•--------- W ........................... .and..A...Gr.Bv.el�----------------------------------------------------------•------------•---------•---...._....--------.....--------•----------------•-- W ----•-----------------------•--------- ------------••--------••••-----------•---•-•-------•--•---•---------•--••------•--•--------••--•-•-•---•-•••--•---•-----•--••----•-•--•--------•-----•--•-------- UNature of Repairs or Alterations—Answer when applicable.------------------l-?Z000_-_.&110I.._P t• --------------------------------------------------------------------------------------------••----•-•-----••--------••-----------••••-•-•-•-----•...----............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI _5' ; of the State Sanitary Code— Th ndersigned further rees not to place the system in operation until a Certificate of Compliance has b n issue b rd of heal/. Signed. L 7� 16l$7------ Application Approved BY ..I. .. --.�-�`--•-•-.......... -•--- -•-------- - . ate Application Disapproved for the follow reasons-----------------------------•-----------•-----------------------•-----------------•---------•••-..._......------ ee�, Date PermitNo.........5_7.P...1 5_---.19...--- ------ Issued....................................................... Date Fxs zs............� o•`j��r No.. -...__..........•. ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .�' i­ ................................. OF n, r . r k ApVltratiou for Disposal Works Toostrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (,,�) an Individual Sewage Disposal System at: .t... i'1 1... E' Location-Address or Lot No. "•.. r....... t, Owner Address W '.•e Y Ott Installer Address Type of Building Size Lot----------------------------Sq. feet U Dwelling No. of Bedrooms_____ ____________________________________Expansion Attic ( ) Garbage Grinder ( ) p`�•1 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures __________________________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid cap acity............gallons Length................ Width................ Diameter________________ Depth................ x Disposal Trench—No_ ____________________ Width......._............ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water..................... rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_.:_____________________ P4 ----•--------------------------------•......................................................................................:............................... 0 Description of Soil......................................................................................................................................................................... W �• W ...............-----------------_---------•-••---•--•----------..•..------•---•-••-------•----------------------------•-•------•••----.(...--tt-----•-------------•-..y.�.........•-----••--....--••-••••- on U Nature of Repairs or Alterations—Answer when applicable______________________________________ __._.__.._______.._..__...._.___.__._______.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ('1T t'1•'a•. the provisions of l _ of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has by/een issued by.Ahe bgard of healih./' -Pi-•____________________ -- Signed s 1`�� ._ ,� /� -Da Application Approved By_______ __ _�_:1.__.:_, r____ � 1 ate Application Disapproved for the f ollo • reasons:--.-•..----------•-•----------------------------•-••---•------•----------------•. a..e............ .......................••••--------•-••••••-•--••-••-------•-----••--•-----------•---•-•••••---....•----...-•----•-•----------•-•---------•••-•-•••--------------------------------......•-----•-•---••. Date PermitNo--------------------------------------------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................� ,`" OF.......: .............................................................. Trrtifiratr of Tootpliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 3} y9" c t.a CJ' ••••__._..... M by---`�-°---•--•----��--'--•---==-:- ...........................•-----...------------•--------...---•--------•----•----•--••---•-----•--------•-•---•---..._.....---------....._..---- - a ' — Installer a...................•----.......------......•----•-----------._...----------------...----------•----•--'-•-•--------------------••-----•---------•---------•-_- ----------•------•------------- has been installed in accordance with the provisions of L-rrnAt r of - e State Sanitary Code as descri�e n the application for Disposal Works Construction Permit No.- ........... dated_--...--.?.�_..C'y THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------•----�-••---./_G._..-:...S.-f.)................ Inspector--- ----- ................... THE COMMONWEALTH OF MASSACHUSETTS �4 h BOARD OF HEALTH ,L-lc 1 ..........................................OF. .............................._..._.__._.............._............. 1\I 0..0............. FEE._...................... Disposal Works TUoatotrttrttiort prrutit Permission is hereby granted-_._" `'= -'G _: f r•••-••-••-••--•------•--••...--•••--•••--... to Construct ( ) or Repair (f ) an Individual Sewage Disposal System t a No lL .,or.` o.q1_ 1 rc ,- :�t r� --•...............................•--.....-•--------------------•-•----------••--•----•---.._______.____.__..._..-••--•-••-•-••••-•------•---•--•---•---••--_... Street ___ 1 as shown on the application for Disposal Works Construction P rmit No.�_}_ G Dated__.__71716........................ Board of Health DATE......... ................................................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS :' TOWN OF BARNSTABLE LOCATION —SEWAGE lc/ VILLAGE r 1//� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO, r SI. PTIC TANK CAPACITY 0 8 `T "LEACHING FACILITY:(type) (size) NO. OF BEDROOMS-1 WELL OR PUBLIC WATER. BUILDER OR OWNER DATE PERMIT ISSUED: '7 "l G 7 DATE .COMPLIANCE ISSUED__ VARIANCE GRANTED: Yes No , 72- - - -- - - - - SECTION A -A �---10 min. from NOTE: ALL PIPES ARE TO BE 4 SCHEDULE 40 P.V.C. PMounfr r FROM THE VENT PIPE o Least 24 Inches too) PROFILE IEW OF ADDITION. TO LEACHING 'SYS EM mwnuroi,am sHALL sE Existing Foundation I house to septic tank Schedule 4d PVC w/Charcoal Odor Filter Y T sEr LEVEL FOR AT LEAs1 2 FT. 12' ,E mVEa +` ( TOP OF FOUNDATION ELEV. 100.00 (Assumed) Septic tank cows trait be 3' of 1/8" - 1/2' Washed P.astone + ~_ i within 6 On. of fins~ grade Grode ow Septic Tank - 97.00 !)rods over D Box 97 00 over SAS- 97.00 / / Stone ,r-•- r r c - t':c (fir T 3 4 td 1 i 2 " Washed Crushed 5KNOCK0 FRET ,*-` 1i fi r Ol1AET ' `� t12� METmom 010% 4,S 0.02we = z � 3 HOLE H-10 Y Noxbnurrs Cover TOP Load -E1ev. -93.75 - \ ,✓ 6' DIST- BOX ! ,r EXIST. s:o.o, or Greater i NEW PIPE X 1,000 GAL 5. s- 0.01' per foot • o"...Effective Depth PSs•.. 4" - SCH. 40 Te - s,7s• �. `a t .....t: ,;:`�:,,. s; •._ FR[?I EXIST. FouNnATIDN ,,, X SEPTIC TANK cV W H-10 0 5 Units a 6.25' 30• PLAN SECTION CROSS-SECTION �,Y.rts°�°�� ), Al CONCRETE nu FOl1N0A u > n 'n 0.83' (10 ir, has) 3 ;: 3, o > m N 31.25 $ c, O ' 3 HOLE H-10 DISTRIBUTION BOX ' SYSTEM PROFILE -6 In.ofmpa led stone ,/Y � � � x � 37.25' erortspocted atone i u u o rn Effective length NOT TO SCALE ,� ` Not to Scale - c o ' 4' 4' ° S❑IL ABSORPTION SYSTEM (SAS) ' C - aw "-Dawa rvieM...rww�.,.eaw CIR�Ir "'P•Prj y C c - t2.5 > 6 in.of 3/4'-1 1/2' � 10' v INFILTATROR HIGH CAPACITY (H-10 LOADING)/ GEORGE ❑'BRIEN GENERAL NOTES compacted atone Effectivt viath OR EQUIVALENT Not to Scale NOTE ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE o NOTE: OVERALL HEIGHT OF INFILTRATOR 15 18' CTI 1. Contractor is responsible for Digsafe notification o Bottom of Teat Oba 1 Elev.=85.00 m ( ) VE HEIGHT IS 10" and protection of all underground utilities andpipes. No Groundvroter Observed O 144' �FFE P g - �" 2. The septic tank anq distribution`box shall be set level on 6 of .3/4 -1 1/2 stone. 3. Backfill should be clean sand or gravel with no stones over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this`system in accordance PERCOLATION TEST # LOT so LOT #s> with Title V of the Massachusetts state code, the approved plan LOT 59 # and Local Regulations. 6. If, during installation the contractor encounters any Dote of Percolation Test: APRIL 5, 2004 --- soil conditions or site conditions that are different Test Performed By. CARMEN E. SHAY, R.S., C.S.E. �' N 34d 49' 25" E from those shown on the soil log or in our design Results Witnessed By: WAIVER ( per Barnstable B.O.H.) installation must halt & immediate notification be SHAY ENVIRONMENTAL SERVICES, INC. 125.00 i Percolation Rate: Less Than 2 MPI 0 48" i i Failed made to Carmen E. Shay - Environmental Services, Inc. 15.7$'` Leach Pit � 7. No vehicle or heavy machinery shall drive over,the \\ septic system unless noted as H-20 septic components. co 7.2 ` a� 8. Install Tuf-'rite gas baffles or equals on all outlet tee ends. 9. All Distribution tines shall be 4 diameter Schedule 40 NSF PVC pipes. Test Hole ,' > e ` ' , _ a" pV`ts M 10. All solid piping, tees & fittings shall be 4" diameter NO. 1 / ``� ,s-` •.mot ti_{,, VENT \\ Schedule 40 NSF PVC pipes with water tight joints. --� < , s DEPTH SOILS ELEV. ,n ----___ �' \\ � 11. Municipal Water is Connected to ALL OF The Residence and Abutting 0 97.00 �.''--- D-Box 'TEST HOLE #1 ; Properties Within 150 Feet. Sandy ELEV.= 97.00 \ '� Loam PROJECT BENCH MARK ' \ to T a/z TOP OF FOUNDATION ` O EXIST. 000 gal. THE PROPERTY LINES .ARE APPROXIMATE AND 20.5 1 Ii COMPILED FROM THE SURVEY PLAN GENERATED BY W-10" A 96.12 ELEV. = 100.00 (Assumed) p Septic Tank 9 THOMAS E. KELLEY, R.L.S., ,OF S. YARMOUTH, MA y ENTITLED." SUBDIVISION PLAN OF LAND IN CENTERVILLE. Sand MA", DATED AUGUST 19, 1968 , Loam �/ �\ 1 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN to rR s/e r 1 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN 10'- 30" Be 95so 1 96`, r \\\ i THE SEPTIC SYSTEM INSTALLATION. Fine Silty ty i i EXISTING 1 30"-42" 2.5 G7/4 9a.50 LOT #58 ��\ ,L 3 BEDROOAf /J`` I LOT #56 EXISTING LEACH PIT TO BE `PUMPED OUT AND 1981 -� REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION Cooree ,98 \ ROUSE •ram \96 NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE Sand \\��� l 7.5 r 6/6 \\ 1 #72 ��' FROM THE EXISTING LEACH PIT TO .BE DISPOSED 142'-14e 85.00 i \\ r OF AS PER BOARD OF HEALTH SPECIFICATIONS. NO �`WETLANDS'ARE PRESENT WITHIN 200' OF THE PROPERTY k6 9A ASSESSORS MAP 169, PARCEL 074 L_ - LEGEND ` Pere#1 Depth to Pere: 48" to 66 ,� \ I ,� J04X1 DENOTES PROPOSED Pere Rate= Less Tho 2 MPI 1 , Groundwater Not Observed --- +-- _ LOT #57 , SPOT GRADE No Observed ESHWT . A� ��\\ �. �, i\ 15,625 Square Feet +/- X 4.46 DENOTES EXISTING ADJUSTED H2O Elev. = None 9 i 10 �, , � , SPOT GRADE PL PROPERTY LINE 125. 96P -- PROPOSED CONTOUR S 34d 49' 25 W - - - -97 EXISTING CONTOUR TYPICAL 1000 GALLON SEPTIC TANK DEEP TEST HOLE; & IJ O N.E' GA-E G.IR CL E NOT TO SCALE PERCOLATION TEST LOCATION 2-18' oinks. ACCESS MANHOLES 6 FOOT STOCKADE FENCE e' (40 FOOT RIGHT OF 'WAY) . �� r ? •-L Ali--.t~ '- I -• .. - HET -Wr ET PLOT P LAN THE ACCESS COVERS FOR THE SEPTK; TANK, OF PROPOSED SEPTIC SYSTEM UPGRADE - DISIRIBUTION BOX AND.LEACHING COMPONENT -••• tT�- .-- •-? - "� : SET DEEPER THAN 6 INCHES BELOW FINISED PREPARED FOR s•_• ,� +.; R_h -a �,-- GRADE SHALL BE RAISED TO NIHIN 6' OF STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE W I LLIAM ' M . CUR RAN PLAN `.VIEW INSTALL TUF-TITE GAS BAFFLES OR EQUALS AT 3_24• REMOVABLE��Rs-� #72 DONE GAL CIRCLE min. Clearance E I CENTERVILL MA m1s INLET 2• .:islet to outlet a srdn. - a,nFT Design Calculations ;-;T ;�'OF V PREPARED BY 6'-Y S' -T >� tr E , Number.of Bedrooms: 3 Equivalent to 330 Gal. Da 330 Gal. Do Min. per Title V �" �' E� 4!-Cr rr>an. q / Y ( / Y P � ) am same Garbage Grinder: No "I o h" EI =- >� depth CAR.�i EY E. - SffA Y b LeachingCapacity Proposed: 330 Gal./DayMinimum MIn:'Per Title V Septic Tank -.2 x 330 Gal./pay = 660 USE EXIST. 1,000 GAL Septic Tank. ` c ENVIRONMENTAL SERVICES INC. -SOIL ABSORPTION AREA: Using'percolation rote of"<2 min./inch 0 20 40 50 v . .. .•T. •t a- :. -�.•. .- - - - -� �' -10' Bottom Area: 0.74 gal/sq.-ft. x 370 sq. ft. 273.8 gallons 1 P.O.' BOX ''627 Sidewall Area: 0.74 gal./sq ft. . x 78 sq. ft. 58 gallons s G n 4i h EAST FALMOUTH, MA 02536 - r CROSS SECTION', END-SECTION Providing: _ '331.80 gallons '?�" s ,�, "- �y lrA�� ,:.� TEL/FAX 508-548--0796 Use: (5) 'INFILTRATOR HIGH CAPACITY H-10 UNITS, HAVING A 0,83' (10 INCHES) EFFECTIVE DEPTH, SCALE. 1 -20 a.� TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES AND 3 5' OF WASHED STONE SCALE. 1 - 20 DRAWN BY. CES DATE. APRIL 8, 2004 ON THE ENDS. NO STONE UNDER. PROJECT SD554 FILENAME: SD554PP.DWG SHEET 1 OF 1