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HomeMy WebLinkAbout0078 ELIJAH CHILDS LANE - Health c(,mtei-v1110 A== t7:i.-252 S M E A D No.2-153LOR UPC 12534 amead.com • Made In USA 1�IJi�N iNi iYtntX►l!E SFI �D* SM14dNDWOWSPROMAMAM �MSR POOMM CER71fiED Existing House French Door Brick step ............ 91,................. CA Existing 5' Slidin O�db door r"7 --J C) CD Pathway Existing Conditions 3 Season Room/Slab on grade .................... .......... ........................................................... 13' 9",. .......... Existing Carpet finish 78 Elijah Childs Lane Centerville, MA i Existing House **new floor elevation and existing transition Open walkthrough/archway to main house. _..............1 3. ........ _............_ .......... In-Wall-custom build TV equipment shelves Re-Used DoubleFrench Door location (2) New Window CD Locations N i New Carpet ew Stairs (4) New window locations *floor elevation will be raised to match existing house floor elevation. constrcution will consist of 2"x6" wood joist system. 3/4" plywood and carpet for floor finish. 78 Elijah Childs Lane Centerville, MA i Window Existing Grey Cedar Shingle House Roof Window IP House 78 Elijah Childs Lane Centerville,MA Slab on grade Existing 5'Sliding door(x6) EL. 4ff Ch ® i,Ps A iv F �J 3r� -1- ............... ........................................................ -62'6, ................. ............... House 2 . .......... .......... ................ .......... ................: ............. aistlng,,Brick Path n Y, 3 Season Room -410 Or .................. 14'T ...... ys� _ __ 78 Elijah Childs Lane Centerville,MA 4 0* �-orn S e-r S��,s No. v 3 � Fee I00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_LL PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicotiou for Tigponl *pgtem Cougtructiort Permit Application for a Permit to Connss^truct( ) Repair(Upgrade( ) Abandon( ) El Complete System El Individual Components Location Address or Lot No. O ��/�. .9 j4 14/p 3'4 Owner's Name,Addresspnd Tel..�ro. IC Assessor's Map/Parcel ?I— A07 ZJ41 C,4(/%OS Installer's N me,Address,and Tel.Nq�f e*P7,A4 Designer's Name,Address and Tel.No. Type of Building: Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re utred) 3�c� gpd Design flow provided 3(0. F0 gpd Plan Date ? Z6 10 Number of sheets Revision Date Title Size of Septic Tank (QtC> 4 'Al. Type of S.A.S. Description of Soil e Nature of Repairs or Alterations(Answer when applicable) A6 �`� Date last inspected: Agreement: The undersigned agrees to ensure the constructi and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title of the Env' in Code and not to place the system in operation until a Certificate of Compliance has been issued by th' Bo rd of Signed Date Application Approved by L Date Application Disapproved by: Date for the following reasons Permit No. Date'issued -too , FeeNo THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1� t 1 1' �- Yes PUBLIC HEALTH DIVISION - TOWN_OF BARNSTABLE, MASSACHUSETTS Rpplication for Mi.5po.5al i§paem Cowaruction Permit „ I Application for a Permit to Construct( ) Repair(` _Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. ��/� /.�,� � �,�,$/ )wner's Name,Address, nd Tel. o. Assessor's Map/Parcel 171- 4' S ��' /'�'�Q� C,C�/��S I n ' g Installer's Name,Address,and Tel. Desi N ` nerea's Name,Address and Tel.No. Type of Building: Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re uired) gpd Design flow provided y7. �a gpd Plan ,,Date 2'�f Zo 10 Number ofisheets 2 Revision Date Title Size of Septic Tank &X-A-_-, 6'A�. Type of S.A.S. _ � ,y Sue Description of Soil /' 7 Nature of Repairs or Alterations(Answer when applicable) ,��� X,' . `D) 1�� 4 a,pqr,1,'n� Date last inspected: Agreement: The undersigned agrees to ensure the constructiMoi and maintenance of the afore described on-site sewage disposal system in accordance with the provisions hthlBo le of the Env' mental Code and not to place the system in operation until a Certificate of *,.Compliance has been issued by rd of He Signed Date � Z�/ Zo!U ' ) Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Dateassued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE IFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (V) Upgraded ( ) Abandoned( )by �� /,fir( ��,� at r L k �'All �d i'/1 5 1A has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer <dY7` Designer "A�CIR #bedrooms _3> Approved design flow z gpd The issuance of tth§permit shall not be construed as a guarantee that the system w.ii f nc/ti,11i as desig ed.. Date 1 f l/;; Inspector No.r l/� I Fee i 0 0 �—• --THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwigoml *pmem Construction Permit Permission is hereby granted to Construct ( ) Repair (V-" Upgrade ( ) Abandon ( ) System located at (Ac, �vt I i-e—, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date �_��c _ _ - 1 Approved by �(� �('t` i Y Town of Barnstalble Op1HE � Regulatory Services Thomas F. Geiler, Director • HAM L& 9�A1, STABs� Public Health Division Ea " Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-362-4644 Fax: 503-790-6304 Installer & Designer Certification Form Date: i Sewage Permit# Assessor's Map\Parcel 7 2S Designer: aarye,4. / V Mel (-I' Installer: Address: � � Address:.5r-- On was issued a permit to install a (date) (installer) septic system at 79 `A� based on a design drawn by (address) 2)a Krleeo dated l & (designer) 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. OF Mq o DAR N `� �. � M staller's %—Bkze) 114 l SANITAO 9 -7- Ifs (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSrEPUBLIC HEALTH DIVISION. CERTIFICATE OF CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-26-adoc TOWN OF BARNSTABLE LOCATION a-49S I XA SEWAGE#o70/0 ',/7 9 VILLAG e,e— d� ASSESSOR'S MAP&PARCEL 1-71 INSTALLER'S NAME&PHONE NO,; T SEPTIC TANK CAPACITY lezo LEACHING FACILITY.(type 11—Co (size)9 57 iK 11-: e NO.OF BEDROOMS 3 OWNER, 'k 171 C per !n PERMIT DATE: Z4010 COMPLIAN DATE: Zjf(} Separation Distance Between'the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY f i � .. �, rt s, � ,�,� . .,. ,Y , .� 7, 1 { � 3a .;�.� ,, I F ,� Town of BArnstabie P# Department of Rekalatory Services Public Health Division Date Mesa 200 Main Stree4 Hyannis MA 02601 s6Jy. � 1 Date Scheduled ° Time 0 Fee Pd. I it Suitabili Assessment fop Sewage isposaI p Performed By: _ Witnessed By: i LOCATION & GENERAL INFORMATION Location Address U� Owner's Name F ��/p0N 7� Lt.t;llart=l Ctiri`��� l�N •CC. .F�CU t t..t.—t_ I Address Assessor's Map/P4rcel: 1-7 l �S I Engineer's Name l Air� k 9-�e- i. NEW CONS1RUt ,ON REPAIR Telephone* �b y 3 Z ZS Z Land Use AA Slopes(go) 1( Surface Stones ft Drinking Water Well I ft Distances from: Open Water Body ILft Possible Wei Area Pf Drainage Way 9 J ft Property Line / y ft Other ft SKETCH:($treet name,dimensioos'of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) �y D CS, day � o0 ss•012 �O i y rin I16�~ —-.- EE L S6'61 Z Z I rn Parent material(geologic) I Depth to Bedrock Depth to GroundwaKdr. Standing Water in Hole:* 1A, i Weeping from Pit fte :: Estimated Seasonal Nigh Groundwater ! DtTERMIN j`TION FOR SEASONAL FIIG.H wATEIt TOLE Method Used: ! . • i in. Depth observed standing',n obs.hole: in. Depth to soil mottles: ! in, ©roundwater Adjustment Depth toiweeping from side of obs.hole: i Adj.Ihctor,,,,.,.�.. Adj.0roundwnterLevoi.,,,,e, index Well# Reading Date Index Well level - . I PERCOLATION TESTDale. Observation 1 I Tittle at 9" -- Hole# Time at 6" -- Depth of Pere Time(9"-6') Start Pre-soak Time.@ -- • End Pre-soak Rate MinJinch Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed Site Failed: Original:,Public l�e$lth Division Observation Hole Data To B e Completed on Back------ ***If percolali6n test is to be conducted within 100' of wetland,you must first notify the Barnstable C44servation Division at least one (1)week prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION HOLE LOG Hole#1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) 2 Y DEEP OBS RVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cons istencv.%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon SbkTexture Soil Color Soil Other Surface(in.) (US (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ra I E Flood Insurance Rate May: / Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pery us material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required t ' in expertis4 and experience described in 3.10 CMR 15.017.. Signature Date Q:\SEPTICIPERCFORM.DOC I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ..°"y 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 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. Impotent: A. General Information When filling out forms on the computer,use 1 Inspector: only the tab key to move your Patrick M. O'Connell c cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. ` Company Name 189 Cammett Road Company Address Marstons Mllls MA .02648f- �"�" Cityrrown State Zip Code 508.428.1779 S112855 Telephone Number License Number B. Certification I certify that 1 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 July 15, 2010 Job# 10-177 spector's Sig u 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. _ (� To - _l t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage D s sal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every 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 informattcn which indicates,that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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. Systeml. 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-09108 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 y< 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityrrown 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��tilith-ar.proval 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 15ins•09108 Title.5 Official Inspection Form: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 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centervilley MA 02632 Jul 15, 2010 every 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 coliforrn 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_day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 or 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 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-09108 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 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ pumping information was provided by the,owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information.. For example, a plan at the Board of Health. ® ❑ 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): 330 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centervilley MA 02632 Jul 15, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): N/A IrrigationSystem. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 I - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityfrown 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: Tank last pumped 6/26/08 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15 2010 every 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: 28 years. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' Depth below grade: 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): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. Sludge depth: 3" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 iCommonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is Centerville MA 02632 Jul 15 2010 required for Y every page. Cityfrown 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 27" Scum thickness 2" 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 12" 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.): Liquid level currently at bottom of outlet invert, tank is structurally sound. Observed solids on top of outlet baffle indicating hydraulic failure. 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•09108 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 y( 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is y Centerville MA 02632 Jul 15 2010 required for , every page. City/rown 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.): 6 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 t5uts-09/08 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 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is Centerville MA 02632 Jul 15 2010 required for y every page. City/rown 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 01. 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.): Previously full to top. 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °y 78_Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: One 6x6 pit. El 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.): Leaching pit shows evidence of hydraulic failure. Observed staining and exposed aggregate to top of structure and solids deposits on top of inlet pipe. 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 l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ..' 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15,2010 every page. City1rown 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 ' Commonwealth of Massachusetts - j Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y� 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. CitylTown 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 - .- - -- / / . .%. / / f \% J / % J / / / f / f J ! J / ! / / / J / / J /%/ / / / / / / /%I / 25 11 22 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is Centerville MA 02632 Jul 15, 2010 required for y every page. Cityfrown 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: N/A feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form co Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Elijah Childs Road Property Address Margurite Heffernan Owner Owner's Name information is required for Centerville MA 02632 July 15, 2010 every page. Cityfrown 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 No.d/-,61_98.. ,< Fes$.....310........... ` HE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH J. ...... ........OF........ 0a� ....1 ...... ----------•.................................. ApplirFation for BhipmFal Works Tomitrur#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sysem at: 1/1_5'... '` r� ......................... ................. ....................• -------•-------------•-----.........---•- L tion•Addre s or t o. � . ... ................................ ........-•... (.�.. ....._...._.. �j ....(� Owner Address ------j Installer Address d Type of Building oS Size Lot../I-z?TJ.....Sq. feet Dwelling—No. of Bedrooms.........`-...............................Expansion Attic ( ) Garbage Grinder (Ayc. aOther—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( ) Pa Other fixtures -----•.................••-----•• . W Design Flow.......` .................................gallons per person per day. Total daily flow.................... ..... ............... 1:4 Septic Tank—Liquid capacity.•3Tx?gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No.___1.U _.. Diameter.__.-__-•___-___:-_- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...........................................................•-................................................................................................ 0 Description of Soil......................................................................................................................................................................... U ---••••-••••••------•-----••••••••-•••---•-•---•-••-•-•••-•-•••--••.....-•--•......•-•------•-•-----••-•...--•-••--••-••....--•-•-•-•----•---•-••--••••-•----...--•-•••-••-•-•--•.................•-•••. W -----••---------------------•------•••--••--•-•-••-•-------------------------......---••------•---••-------------•------------------•----------•----•-•-••••--•-•••-•-----•-••-••-•••-......---•----•-•- UNature of Repairs or Alterations—Answer when applicable.............'.._._.....____._..___.................._._.........................._............. --------------------------•••--••-•---•--•-••••-••••--•-•--•--•--•-•--••-•-••-•-•-•-............................•-•-••---•---•---•---•-•--•-•-••-•••••••••••••-•--••••••••••••••••••-•••••--•-----•••••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of AITTIE 5 of the State Sanitary Code— The undersigied further agrees not to �ace the system in I operation until a Certificate of Compliance has been i by th ar of health. 1 4 Signed ••---- Date Application Approved By......... ................ �/ ,1�/............. Date Application Disapproved for the following reasons----------------•----•-•---------------------------------------------------------•----------•---•......••••..._.. ---------------------•-------•----•-•----....-----...----•-----------------------.........-•--------••---•••--•-••••-•-••-••--•-••••-----------•••--------•----••-••-••••••••••••---•------••••••---•--- Date PermitNo......................................................... Issued....................................................... Date No.L?I=.dj? FEs.............................. 'JTHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.......................................................................................... Applirution for Di-spotittl Marks Tonitrurtion thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: I ................_--.............................................................................. .............................................. ;.Ka.......................................... Location-Address or Lot No. ......................—.......................................................................... ....................•-•---•-••••---.......................---••••................................. owner Address a ••-------••••----------••---•-•....---•••-------••--•.....-•----------. •................................................... `......................................... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................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. 04 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test 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 water........................ a' ----------............................... 0 Description of Soil......................................------------- .._......... W ••-•----------- ---------------------------------------------------•----------------•---•------•-•--------------------•--------------•------------••---.....----•-----••--•----•----••--...._......--- VNature of Repairs or Alterations—Answer when applicable...--........................................................................................... ................ ------•-----------------------••-•--------•--•----•------------------.._.._.......-•--•---•----------••--------•----------............-----•--------•-•-....---•-----------•------•••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI:;w. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.................•-•----•--•----------...--------------._...-----•------••------•-•... ................................ Date Application Approved By......... �----_-----•--..------ /<------------- 111007 Date Application Disapproved for the following reasons:-------•------••-----•---------------•---------•------••-------•------.........-------•---•-•---._....._.----- ................•---•••-....-----•-••------•-------•---•---•--------•-.......----._....................---•-._.......-------•-••----------•----------------•---•-------•--••-•--•••---------------•----- Date PermitNo......................................................... Issued-----•-•------........................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .1 .. .........OF............l yt t� ............................................. C��rr#ifiratr lit Toutpliana THIS IS TO TIFY, That the Individual Sewage Disposal System constructed ( L<01'r Repaired ( ) y .....p � _._..��.b � :-: ; ' I tall -_ has been installed in accordance withwith t isions of TI LE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----�/�.`..Jf............. dated......................._........................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................/:n/�..'-fl ........................... Inspector........ e-&4t------•---•-----------.---•---•-------------------•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH :r�'r-�. .........0 F......' ' .".?,E� •.. d,,,"' No............. ...... FEE....�.�........... �i��la��t1 ork� �on��rttr#ion rrmi� Permission is hereby granted....... ...4 G '......01_..............................................................•----•--•--.............. to Construe` )fir Repair ) an Individual Sevtra e •spo System !r� atNo..............................•....� ... .ee---•---•-•--- d° . as shown on the application for Disposal Works Construction Permit o........... .�.... te ...................................... . ......... .................................. / jAT DATE............... f ==V................................... Boarealth FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS O -�AfZK.�{= bill w1t�EjL � . :,1 • i 5 • USE-'; �-r-t-��c� ,t�et�a.• � Wit=. � � • ` ` ,.� : � =a +r.�. ► ,,: Ir • TOTAL 17E-S t•1 •425 �.• .� 1 Exr'. peon? � F-. ToTA L �Ist t_.�f Ft..ow z 33D 6�1�D.. :'. . ., : � r : • � : I�r4'.Q " �.r Y (�rzCC)L6.TI, Q SZl�Ttr : "tr,.l �.�4t1U•,OIZ �Y�. . _ 00 ;.��#f I.;t-y"d.�� ?ti y•!r ..... 5/`/r.�" � .•r yam\ - r r } ' �. .. , � �C Tar 17-40 ,1 • i •' , � �� ♦ 't����-'`��'ri�I P ` /� K O. , ( f. f LT yTJj�CCT�Y%TV.v'7P P Q �f'Op tool J`+ 4P p . ;r I � a� . iw- _.GAS .; -. 2 ; . . ... : �. . -max �rj:� Sc-vnc 10• ' A� - :. : : ; .: •�. GAL. PIT 7: _._- ... _' ;. .t_' _' _:__ � ��= ._ _.' C.EC'.Tl�lEt7 QL.b`T" •PL.,4t;�• :, t; Pcz -tLt= LoGATto" CEt,I-r ✓,� , �3. . . : ' ; ; s pa-r l� lia�gl 1 A .TN E. C'ov NDATt.o�.� Sc.�owu T -tT i t-if_�Lc�F,l Gc�.tr�P�.�IS W I-rA T I V E Lt►-�� i � �'j�► � fit; UICEME-.WT9,; 0;= CEO T !u.I tb t�L.dsJpS }t�GATcb. 17141 Q T • T--- � o 0' •, r I Q/'1 XTC . � RCGtS'CLRED b-a.NG Su�v�:.`�o1Z<,` LloT ZASCCI 064 AN tW���:JihC=1.1:� !��\�l_�( �• YI�Cr. UGC j�T�1 �-11-�Cil•J�I� I,Nl�l.t�/�M.�T !"ru � _ �LA r� �,M A C.C. 1�J 0 I -� � � L` CATION �v SEW# GE PERMIT ­NO•. _ lot 58 Elijah Childs Lane 81-688 VILLAGE Centerville MA. 02632 I N S T A LLER'S NAME & ADDRESS Robert Our Harwich, MA. 02645 GUILDER OR OWN ER Alan E. Small, Inc. Box - 536 Centerville, MA. DATE PERMIT ISSUED 11/18/81 DAT E COMPLIAN-CE ISSUED .: t r ,r f j E �I !` zo" LEGEND 04o PROPOSED CONTOUR . STq�FRo v ® PROPOSED SPOT GRADE- 5G -98 —— EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE aQ III W— EXISTING WATER SERVICE TEST PIT o,F� SITE O� z LOCUS MAP N.T.S. GENERAL NOTES: I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ ��� 99 BOARD OF HEALTH AND THE DESIGN ENGINEER. \ Insp. P S. 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 55.G+ .f_Q �a OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 40. y "in° LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: -J 310 CMR 15.405 (1) (B): ,?• / 1) A 1.64 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE v ( 4.64 FT BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �C TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTHAND THE O TH-2 DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Y ENGINEER BEFORE CONSTRUCTION CONTINUES. TH-1 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. EXIST. I ,000G 8 THE CONTRACTOR OWNERTTOENOTTIFFYIBHE FOR OOCAL BOARD OF OF SEPTIC TANK HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. t 8• TOLAREAS C NDITTDISTURBED ON AGREED UPON CONSTRUCTION OWNERANAND CONTRACTOR. ELECTRIC COMPANY 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY EX%S Leach Pits EASEMENT - -- - THE LOCATION OF-ALL UNDERGROUND UTILITIES, PRIOR.TO BEGINNING (Note ) -6�, _ . - EASE CONSTRUCTION. y 10. EXISTING LEACH PITS TO BE PUMPED, CRUSHED AND REMOVED PER TITLE V. FILL WITH CLEAN MEDIUM SAND. } 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION ' 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING 54.8+ 14. ALL OF �Ass9 { PIPING OF THIS TB 'SYSTEM DOES NOT ALOW(UNLESS SPEC. OTHERWISE) 15. THE FOR THE USE OF A GARBAGE GRINDER DA N M. yG 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING 17. PROPERTY IS IN ZONE II OR NITROGEN SENSITIVE AREA. o. 114 "' f f 17. INSTALLER TO FIELD VERIFY H2O CERTIFICATION PRIOR TO INSTALLATION. c, NITAR\a� PROPOSED SEPTIC SYSTEM UPGRADE PLAN 5G 78 ELIJAH CHILDS LANE, CENTERVILLE,MA MAP.•171 Prepared for: Scott Campbell LOT.• 252 Engineering by: Surveying by: SCALE DRAWN SURVEY REFERENCE: 1 DEED BOOK: 12679 DARRENM.MEYER,R.S. Feller end Assoc. 1"=30' DMM PAGE., 337 PD BOX 8B1 Route 28 DATE: CHECKED SHEET N0. PLAN OF LAND BY BAXTER & NYE, INC. EA3TSANDWICH,MA02597 Centerville, MA 02832 DATED: FEBRUARY 12, 1980 54 506-8B22922 (508) 775-0735 08/18/10 1 DMM 1 of 2 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:49.86 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED. D-BOX PROPOSED S.A.S. T.O.F. EL.=56.0 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER Uf MAsf OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G.J,� F.G. EL.=55.0± F.G. EL.=54.5f F.G. EL: 54.5f F.G. EL: 54.50(MAX.) VENT QA RR� J+ No. 1140 ," 9" MIN COVER/ L � 10 t 36" MAX COVER L 30° TEE L - 10'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) �� c�0 • S-IX (MIN.) 0 S-1x (MIN.) O S-tx (MIN.) NITAR 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC Sq \Pa 10" a 11.3" TO l& jj 1� INVERT 4B"uouiD INV.=53.17LEVEL PROPOSEDGAS BAFFLE D BOXINV.=50.0 4 ROWS OF 4 UNITS AT 6.25'/UNIT - 25'/ROW _4WINV.=50.20 �� INV.=49.47SOIL ABSORPTION SYSTEM (PROFILETING 1,000 GALLON SEPTIC TANRESTORE VEGETATIVE COVER BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS 75n NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION BREAKOUT=TOP ELEV.=49.86 '• ''r�'�•• � .• '''���•,��' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 49.47 GRADE ON A MECHANICALL COMPACTED SIX MIN INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 48.53 EXISTING SUITABLE 310 CMR 15.221(2) 2.83 MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5'. MIN. ABOVE BOTTOM OF 76" _I TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH 4 x 2.83 = 11. IF FAILED, DAMAGED, OR UNDERSIZED. (7.56 PROVIDED) USE 4 ROWS OF 4-HIGH CAPACITY (H20) PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED ADJ. GROUNDWATER EL.=43.30 = ADS SIODIFFUSER UNITS-NO STONE / 5) PLACE SANITARY TEE IN D-BOX AS SHOWN. SEPTIC SYSTEM PROFILE TYPICAL SECTION � 1s" N.T.S. SOIL LOG � 11 -_ Kr.: P 13022 DESIGN CRITERIA # II NUMBER OF BEDROOMS: 3 BEDROOMS DATE: AUGUST 16, 2010_ I�3400 SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. SECTION END CAP WITNESS: DAVE STANTON, BARNS. BOH DESIGN PERCOLATION RATE: <2 MIN/IN ElevTP-1 Depth Elev. TP-2 De 16"" HIGH CAPACITY (,H-20) BIODIFFUSER UNIT DAILY FLOW: 330 G.P.D. .30 _0. 0. DESIGN FLOW: 330 G.P.D. 54.30 A LOAMY SAND 0" 54.35 A LOOAYMRY SAND 0" MODEL 16" HICAP GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 53.89 a IOYR 5 1 5" 53.94 s LENGTH 76 NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT. PROPOSED SEPTIC TANK: USE EXISTING 1,000 GALLON CAPACITY LOAMY SAND B LOAMY SAND EFFECTIVE LENGTH 7501 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: 330 = 445.94 S.F. C1 IOYR 6/6 10YR 6/6 DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. ( ) 52.30 24" 52.35 C1 24" SIDE WALL HEIGHT 11.2" 74 OVERALL HEIGHT 16" DISTRIBUTION BOX: . 5 OUTLETS MINIMUM LOAMY SAND LOAMY SAND 4640 TRUEMAN BL (MINIMUM) VD IOYR 6/4 10YR 6/4 OVERALL WIDTH 34 HILLIARD, OHIO 43026 t PRIMARY S.A.S. 49.47 58" 13.6 CF M&TS. USE 4 ROWS OF 4 - 16" ADS BIODIFFUSER H-20 UNITS-NO STONE C2 4s.s2 C2 58" CAPACITY (101.7 GAL)j ADVANCED DRA1wu1E srsTEMs, iNc. VA BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIODIFFUSER) VA (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.70 SF/LF = 470 SF MED. SAND PERC 0 48.10 MED. SAND PROPOSED SEPTIC SYSTEM SITE PLAN DESIGN FLOW PROVIDED: 0.74(470 GPD/SF) = 347.80 GPD > 330 GPD req'd 2.5Y6/4 " 2.5Y6/4 78 ELIJAH CHILDS LANE CENTERVILLE MA 43.30 132 43.35 132" Prepared for: Scott Campbell PERC RATE <2 MIN/IN. ("C" HORIZON) NO GROUNDWATER OBSERVED Engineering by: Surveying .by: SCALE DRAWN JOB. NO. DARRENM.MEYER,R.S. Heller and Assoc. NTS D.M.M. • i, Darren M. Mayer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 pO BOX 881 Route 28 to conduct soil evaluations and that the above analysis has been performed by me consistent with the MA 02632 DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. EABTSANDW/CH,MA02S97 Centerville, 508-W2822 (508) 775-0735 08/18/10 D.M.M. 2 Of 2