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0131 ELIJAH CHILDS LANE - Health
(131 Elijahs Childs Lane Centerville P A = 171 247 I UPC 12534 No.2_153L_OR HASTINGS,MN Fee_ f " THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.r ' "— PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for I is oBal 6pstem Construction 3pPrmit Application pp tcation for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) El Complete System �dividual Components LocIti n Address r Lot No.1- 1 z;- i j(7 G Owner's Name,Address,and Tel.No. Assessor's Map/Parcel d rL,I'�le 141j j Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. L&�V/ I T)rpe of Building: zz / Dwelling No.of Bedrooms �/ Lot Size �✓�7 sq.ft. Garbage Grinder(610 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Z Design Flow(min.required) gpd Design flow provided gpd Plan Date Z4 Number of sheets Revision Date Title ,,F _1�ilC iglClil Z12 3 ,�/ In' / Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He -- Signed A Date Application Approved by IfrDate Application Disapproved by Date for the following reasons Permit No._� '�j Date Issued 1 ._�- ..a,,...n+-........,.-,,,,r+'•,t,:.,".sr.�'6W'c'r-•Ji�:.fl7.i""�:frtKey.. ..«...w...-.-.'+'-."'--.......--_._..-...-...��__.,. r _-• .� .. „ s ..hw.a-dkwurw+..*,- ,_ ,,,,�. ...,..... --. .. .. 1 C Fee THE.COMMONWEALTH.OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS /Yes ftpliLatlon for Disposal opstem Constfuction permit Application for a Permit to Construct(-) Repair(V) Upgrade( ) Abandon( ) El Complete System .. ndividual Components Location Address or Lot No./3/ f l)O /M5 A, Owner's Name,Address,and Tel.No. Assessor's p/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size __/�77 sq.ft. Garbage Grinder 41�) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ? Design Flow(min.required) zj,2j gpd Design flow provided gpd Plan Date Z0 Number of sheets Revision Date ,!:::9 9 - Title .5 _ 0 ow 3/ / "�`f � //� _ l Gl,Gv Size of Septic Tank /159,19,�W Type of S.A.S. Z S�Q %/�>/ C a."g, S Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: A The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed �2-—� Date Application Approved by / Cj Date ( � _ Application Disapproved by Date for the following reasons Permit No. b Date Issued - G� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS eeftificate, of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by l � S/ . at l 3i� ,��'j/�J� J��� rJ has been constructed i/n,,accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�)( "i- dated I _ 1 y_ CCj Installer Z Designer #bedrooms Approved design flowf\7 A gpd The issuance of this ermit shaal�l not be construed as a guarantee that the system will funccAgn as designtd. Date I t0�;i-I Inspector _ No. �V�Vt � j�� � ---------•-------------------------•-•-----�--._-3__-------------=Fee =f=U�=c-------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal &pste/ Construction i9efmlt Permission is hereby granted to Construct( ) Repair ,V) Upgr de( ) Abandon( ) System located at / ljf /J � / and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construct' f must be completed within three years of the date of this permit. C q` Date , t " 1 lJ Approved by 1/V\ ��t ;(l,� Jt I , CITY/TOWN: G ! 1 APPLICANT: ��2TU two 1�1 Gr n1�-'T � 1-1 TTt� ADDRESS: H DESIGN FLOW: gpd REVIEWED BY: DATE: N/A OK NO ,',lr rx?�r..r.,i, r.•i,�',��a�i«;�1�rx..�°, '�',TG+,'i'�r�`::'ti,. .��:';Ai?'a3u, ' �� t_ �•-' +fy�,;r'Y U r'?i�..:<;F;Pair.;"�'� ,.�,r, ::• Legal boundaries denoted [310 CMR 15.220(4)(a)] �i Street, Lot, tax parcel number and lot number noted on plan [310 ✓� `1 0 CMR 15.220(4)(u)] L ocus Provided [310 CMR 15.2204(t)] VIV Plan proper scale? (1"=40' for plot plans, I"=20' or fewer for components) [310 CNR 15.220(4)] Easements shown [310 CNR 15.220(4)(b)] ./ System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CNR 15220(4)(d)] Location all buildings existing and proposed 310 CNR 15.220(4)(c)] Location and dimensions of system components and reserve areas. J [310 CMR 15.220(4)(e)] System Calculations [310 CNR 15.220(4)(f)] daily flow septic tank capacity(required and provided) soil absorption system(required and provided) ✓ whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CNM 15.220(4)(g)] Location and log of deep observation holes (existing grade el. on V/✓ each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CNR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(1)] Percolation test results match loading rate? [310 CMR 15.2421 Certification statement by Soil Evaluator [310 CNR 15.220(4)0)] Observed and Adjusted groundwater (method for adjustment / given or indicated) [310 CMR 15.103(3) and 310 CNR 15.220(4)(n)] , Address Sheet 1 of 7 N/A. OK NO Location of every water supply,public and private, [310 CMR ✓ / 15.220(4)(k)] ✓ within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 3 10 CMR 15211d an catch basins. any Y located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located[310 CNM 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[11) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor (required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? / [310 CMR 15.103(4)] ✓ '� Test Holes adequate.to confirm adequate groundwater separation? ✓�` �;� [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR / 15.000] System components not> 36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] Address Sheet 2 of 7 N/A OKq NO ._10 Size OK? [310 CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] i Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [31.0 CMR ✓ l 15.228(1)] / Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] V Het/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have users on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] ; Access to within 6 " of grade - one port for systems<1000gpd, two for systems>1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.2111 .,...F �, .,..a�rae�ae9:wr:+r�.�art^ „►r. �r q. "T )a �yM1�� rl�aH„��.r"r"�� I�Iultl �orxapay,��e� .�;aflhcs '�"�'�: ��.�:1 �� ;.p � •�,.. Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address Sheet 3 of 7 t N/A OK NO Located at least ten feet from any water line? [310 CMR ✓ / 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts required/provided? [310 CMM 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/fi) 0.02 preferable ✓` [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/ (leachfreld below pump chamber) Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller / than 3/8" not larger than 5/8") [310 CMM 15.251(8) and 310 ,/ w CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) ------------------ Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 �✓' CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMM 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] v Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] Capacity(emergency storage above working---design flow)? [310 CMR 231(2)1 f Proper setbacks [310 CMR. 15.211 (salve as septic tanks)] lo Watertight 20-in minium access manhole at least 20" MUST BE -7 TO GRADE [310 CMR 15.231(5)] Service components accessible (not too deep with piping, discomiects accessible) Alarm floats - alarm on circuit separate from pumps specified? , Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)] Address Sheet 4 of 7 ,�, ' � '(. ) G�J'���A�� r�. .'� �'�.'•t�d Jed 'r r.;�; N/A OK NO r Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.2411 . Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and ✓,/ Guidance Document] �� '� <SPI7['S9�.:._� �1�,5, 31®��l�A�2��:��253 . • , . , . t.•`�; ' ,, .,,: ��� '�` n � Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate I'minimum- 4'maximum. [310 CMR 15.253(1)(b)]. 2' sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet-maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater (3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] lti minimum 2 distribution lines [310 CMR�15.252(2)(a)] Maximum separation between lines 6' [310 CM RI5.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] j Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only [310 CMR 15.252(2)(1)] Address Sheet 5 of 7 N/A OK NO a r aire Dosed Systein ? Provided pump and piping lations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] ——/——— If used in gravelless system-make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year (systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fall -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CIAR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR I-.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] "Graa�elless s I ro�cal e tees ` � Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge -' to scour soil interface �te�,�i�sfay epfr.' �5"se�ri Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance [ trZCe Are the variances listed on the plan? [310 CIVIR 15.220 (4)(q)] d RLS Stamp necessary on plan if a component is within nve feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CNIR 15.4141 Address Sheet 6 of 7 N/A OK NO Is the system in a Designated Nitrogen Sensitive Area (Zone 11 for a public supply well)? [310 Cl lM 15.214, 310 CMR 15.215 and 310 CN1R 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CNR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CNIR 15 216(l)] Pr y� i t i t a f �1 �` t ;�d d � t � R�ya :Y���'�.�r°�i:, °F•. P'�. y S x,��{ J t, IITlSCL'ZICZ PeDZZS nu t{. t±',i �,�'q�5 t s r,h:��" Pumping to septic tank ? [ 310 CNa 15.229] Shared System [310 CMR 15.2901 Address Sheet 7 of 7 FROM :down cape engineering inc FAX NO. :150836213880 Dec. 21 20013 01:41PM P1 ih, 1`pI5 -A1a8' 6y�rC"� a' 1'-honnaa.s Them as McKean, 3A.iroretm. Office: %S-Y6'2-i15 d Fax: .S03-790-630 4 DiStsull PT ek Desig—mer•Q.''ertiiifnea i g n Form Date: 41d &env age,PeirIMR4 �Uo �— �.ssa ssor�'; I�YIIKaDe1�'ta�a.t if I�/ �ta0 ICDe's ib>r er.. p vil vl P. � er1 A nnQit l.lear: �Q r' U lt44u ►-� a1.d�.u�ss� / J CJ L• Add)rmq-. / • ,�, 13ox 74 ----- 4 �' l /� G® — 61� ._ was issued a perulit to install a septic sysi a.-t at �c3� �. 1li�j g� �� � tG� l arip- based on a desikm drawn by , AY1 I e_�. (Cfesi. 'ierj 1 T ufTtily tllat the septic sys eim referenced above was jnsialled stIbSU01tiltlly according to IL-he design, wlueli may inclaade minor approvcd chu ges si.a.cli .as I,;ater;a,l. reloultioll of[lie distribution box and/or sct)tic tanl f certily (1.tiat 11C SCPtiC. sysTeR.1 refc:.•ellccd a.bow.. was .inSUJ.11--d 176lh ii).nj0.r ch a� ;es (j.e e rc ter tban 10, lateral relocation ol: the. �l1�', or. any vt:,Y[ietal rcloc:�tioll of ally co:t poo.,►1t of tlic, f.)tj.c system) but in ac(,np"dWnce Wi:lt 'St`nte& T,cac.,a.l RegUhtLiOl-IS. FILU"1 <rT Cc ti icci as-bililt: by desi1Jne.r to foll.m. DANIEL/1. s (11 ` c:l.''S :�i.CTllrTt11n"E OJAIA CIViL m No.46502 Q G ---Me*signeT' ;1i 11att�t - {.A.fkz� i. �._.,l.��r's LS np Hti-e) PLEASE, 117) HE 8 A?E�LNSTA)3LE 1BLV�' A!L'1.'ii.Q Q W18 _.,..-•---------rU .......__.�___. ttbLal. (_:DrfI+4:Q..V.Qi:Q4:A'I'k+, Or WILL �T(-)T .iiE_4S`gL1l;,+L-3�_,U1°TIL BOTH. 'rm,,, POIt i iANJD AS-13LJ �,T e_:AJU) AKRI ... . . _.... .... .... ......_....... .... ... ...... _.._._.._._.. - --- -- IL� BY TRF BARN.,?6'ABlj.IL 14lUlfLl:(;I- E AljTHi DIVI:;RON. 'rIlAN.1 YQDv. C}:lir„�4thfSrpli.�:T�r.;;itr rr('e,tiiicatikvi Form 3-26 U4.doc t TOWN OF BARNSTABLE LOCATION /'3'1 ��6�� C�`c� �a„� SEWAGE# &-J�,-7-,37/ VILLAGE ASSESSOR'S MAP&PARCEL /711,Pe-r INSTALLER'S NAME&PHONE NO. ����oi� �iy� �,�J� y SEPTIC TANK CAPACITY aoG 4 �7.�i�i r LEACHING FACILITY.(type) g2 a 46l464,-1(�� (size) 44- Id NO.OF BEDROOMS OWNER PERMIT DATE: I1-/1Ej COMPLIANCE DATE: OLN t/a 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 / 4'/3J ` lb • (12 3 ° _ s� O Town of Barnstabk Department of Regulatory Services e nnxr!arnnce, +F Public Health Division Date 200 Main Street,Hyannis MA 02601 7 Date Scheduled d Time ]fee�°d t(t� va Foil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION'& GENERAL J[WORIVAATION /,3 1 �6/Q'a ( Gk C Owner's Name Location Address ! )I t �Qw —r ✓� I Address Assessor's Map/Parcel: � Engineer's Name �QW A_ NEW CONSTRUCTION REPAIR Telephone It. d Land Use Slopes(%) 0 Surface Stones Distances from: Open Water Body �—� ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Properly Line _ft Oilier it SKETCH' (Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands In proxinuty to holes) r- �` l� g71 ' 7 jai nt� /00 7 u�iC I�� Parent material(geologic) Depth to Bodrock Depth to Groundwater: Standing Water in I-tole: gvv N Weeping Cron)Pit Nor�v _ —_Estimated Seasonal High Groundwater DETERAUNA ION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _ _ In, Depth to 5011 Itto[tlev: Depth to weeping from side of obs.hole: e In, Orouadwater Adjuslment,•a _ ,.�ft. Index Well# Reading Dale: Index Well level _ y 4 AdJ,factor Atli.0rl' Llndwater Level P PERCOLATION'IO TEST---- Mate f0 2 d7'711 #11Observation Hole# I Time at 9"Depth of PeruTime at 6' Start Pre-soak Time @ A),© Time(9"-6") i End Pre-soak Rate Min./Inch c& ✓y 'z Site Suitability Assessment: Site Passed X SiLg Failed: Additional Testing Needed(YIN) Original: Public Health Division — Observation Hole Data To Be Completed on Back----------- ***If percolation testis to be conducted Within I00' of Weiland, you nituSt fllrSlt notify t➢tc. Barnstable Conservation Division at least one'(]) Week prior to beginuingo QASEPTIC\PERCFORM.DOC DEEP-OBSERVATIOWHOL + I.GG --- Depth from Soil Horizon Mole# Soil Texture :Sdil Color Soil Surface(in.) (USDA). 'Other (Munsell) Mottling (Structure,Stones;Boulders, Con istenc % ravel ram' L 5 �Gyn�t G S lOr2s� a/oA14,_ AC I�EEP,OBsERVATI®N HOLE LOG Depth from Soil Horizon Soil Texture Mole# Surface(in.) Soil Color Soil (USDA) (Munsell) Moulin Other g (Structure,Stones,Boulders. C�.- Consis ncy.%Gravel L6 r12V Y1r, Depth fro • m DEEP®RSE RVATI®N HOLE LOG Surface(in,) Soil Horizon .I��It~# Soil Texture Sail Colo[ � —'-- (USDA) Soil Other (Munsell) Mottling (Structure,Stones,boulders. Co siste c Graven DEE1P OBSERVATION HOLE LOG _ Depth from Soil Horizon Soil Texture # Surface(in.) Soil Color Soil Other r (USDA) (Munsell) Mottlln g (Structure,Stones;Boulders, Consi ten a I Fllood Insurance Rate 1bla P. Above 500 year flood boundary No— Yes Within 500 year boundary No Yes ' Within I00year flood boundary No Yes Depth of Naturals OcC�vious IVlateriai Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system$ �j If not,what is the depth of naturally occurring pervious material? C'e¢tn---�catiorn I certify that on P z (date)I have passed the soil evaluator examination, approved by the Department of Environmental.Protection and that the above analysis.was performed by me consistent with the required training,expertise and experience described in�10 CMR 15.017. Signature ebb �. � Date Q:\SE?T'lCU'ERCFO R M.DOC r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AF ECEIVED Z w DEPARTMENT OF ENVIRONMENTAL PROT CTION d MAR 1 8 2004 F TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A 17 f CERTIFICATION MAP �----�---�`�" PARCEL ' 'L 41 Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 LOT Owner's Name: JACK FERRIS Owner's Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Date of Inspection: 2/11/04 n COPY Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET, MA. 02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT 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: X Passes f _ Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority Fails - i Inspector's Signature: i Date: 2/11/04 The system inspector shall submit a co of thisns ection report to the Approving Authority Board of Health or DEP within Y P PY 1 P P Pp g Y( ) 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title. 5 Incnertinn Fnrm F/l 5000f) 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 3 10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. n/a 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 irruninent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMEN TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ 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 n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant, or Board of Health X Were any of the system components pumped out in the previous two weeks X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? _ X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facilityor dwelling inspected for signs of sewage back up `? g P X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site`? X _ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems`? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X _ Existing information.For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] S Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE, MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 1 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO f` Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): ttt7p `� � <'l� Sump pump(yes or no): NO rr N Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes, attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: APPROX.23 YEARS PER OWNER Were sewage odors detected when arriving at the site(yes or no): NO F Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 ELIJAH CHILDS LANE CENTERV➢LLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 BUILDING SEWER(locate on site plan) Depth below grade: 22" Materials of construction:_cast iron _40 PVC Xother(explain): 20 PVC Distance from private water supply well or suction line: n/a Comments(on condition of joints, venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 16" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: L 8' 6" H 5' 7" W 4' 10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" 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: 16" 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.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFUL LIFE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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 STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' OCTAGON leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: nla n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. SYSTEM SHOWS NO SIGNS OF FAILURE.PIT WAS HALF FULL AT TIME OF INSPECTION.STAIN LINES INDICATE PIT HAS NEVER BEEN MORE THAN HALF FULL.BOTTOM IS AT 8 FT. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE,MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.Locate where public water supply enters the building. W gca. noA 0 10 I D 0 �n Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 ELIJAH CHILDS LANE CENTERVILLE, MA 02632 Owner: JACK FERRIS Date of Inspection: 2/11/04 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12 FT. tt .: TOWN OF BARNSTABLE 1261 LWATION 51hSEWAGE # VILLAGE C Ju n2 ASSESSOR'S MAP & LOT 12 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY `O D LEACHING FACILITY: (type) 10 ze) NO. OF BEDROOMS BUILDER OR OWNER S PERMTTDATE: 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 Furnished by � R A C, 2, 60 l,O.tkTION ZL SEWAGE PERMIT _N0• VILLAGE INSTA LLE 'S NAME R ADDRESS 5U1LDEIII OR OVINE i. J �3� ��r?.rru�c%__► �' GATE PERMIT ISSUED DAT E ' COMPLIANCE ISSUED � �� � . s� _ _ . _ 4 � '��t' .' ,� i, �Eq�. . .. � � ��1. � � ��� , � � �. t ..� � � � � r� � � �r, � z SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR : i SHALL BE NOTES PROVIDE MIN 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. APPPROX. NGVD o Kok Street 1. DATUM IS ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE ASTONE TOP FOUND. EL. 61.17' FILTER FABRIC OOVER OSTONE E 2. MUNICIPAL WATER IS EXISTING Locus Ponds \ 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. o three MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 59.4 Ro e Lone 4. DESIGN LOADING FOR ALL PROPOSED PRECAST fo9P PRECAST H-10 BLOCKS OR UNITS TO BE AASHO H-Q � V RISERS (TYP.) a' 2'0 ' 4"4SCH40 PVC PRECAST RISERS 59.0 PROP. TEE MORTAR ALL H-10 Locu o o, PIPES LEVEL 1 ST 2' 4. COMPONENTS I , 5. PIPE JOINTS TO BE MADE WATERTIGHT. r o F i�ENDS (TYP.) 7 ExIsrlNc SIDES 56.4' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCEc 10" 1000 GAL H-10 14" Do�no1-1.,° 1 000 00 WITH> o 0 0 o e oo Q�o > o 0 0 0 TEE SEPTIC TANK TEE ��00 0 ��0 oo°o o ����-O _mpm 'o°oo° Z ~ \:t*57.6' ° ° °°°° aaoo�o��oor� °°°°°° oo�oaaoaoao310 CMR 15.000 (TITLE V.).* 0 0 0 0 0 0 6" MIN. SUMP _ ° ° ° ° 0000 � o � � 000 ° ° oo � 00000000 m (RE-USE) o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0„ > o 0 0 0 o 0 0 o O o 0 0 0 0 0 O ,°o°o°o°o°o° 12 MIN NT. DIM. >00000000 0 0 0 � � o o � o � �� oo°o°o Q��Q�Q.QQQ�� ,°°°°°°°° GAS BAFFLE:; ��0��[�0�0�1] 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND o " °o ooa�000�a�r� °°o°o° aoao�oao�o� .�o�o�o�o 0 0 f �o°o°o°o° oo°�°o poo°o°o° 55.88 55.71 °°°°°°°° °g°° °°°°°o°° 53.5T NOT TO BE USED FOR LOT LINE STAKING OR ANY o OTHER PURPOSE. H-10 500 GAL LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3/4"-1-1/2" DOUBLE WASHED STONE + (2) UNITS REQUIRED \Locus - 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30' X 9.83' 9. COMPONENTS NOT TO BE BACKFILLED OR a CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 [2]) HEALTH AND PERMISSION OBTAINED FROM BOARD a 5.07' OF HEALTH. 10 SLOPE ( SLOPE) ( 1 ) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR /� FOUNDATION- EXIST. SEPTIC TANK 17' D' BOX 16' LEACHING 4s.5' BOTTOM TH-1 & 2 CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP FACILITY VERIFYING THE LOCATION OF ALL UNDERGROUND & NO'GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT NOT TO SCALE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY,FOR RE-USE. REPLACE WORK. PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 171 PARCEL 268 SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED 'LEACHING FACILITY. T PDISTRICT N TR TI LOCUS IS WITHIN G 0( CONSTRUCTION N 0 12. EXISTING LEACHING FACILITY SHALL BE PUMPED PROPOSED) AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND SAND. 99 - EXISTING CONTOUR X 99.1 EXIST. SPOT ELEV. 99 PROPOSED CONTOUR 102.20' 9.20 [98.4] PROPOSED SPOT EL LARGE OAKS 60.12 TH1 SHED 46 x 08 60.1 SYSTEM DESIGN: 59.10 TEST HOLE 9 19 8.67 TALL SPRINKLER AD P O ° 2% SLOPE OF GROUND 2, GARBAGE DISPOSER IS NOT ALLOWED i 59 4 •59.19 OG g' 60.48 UTILITY POLE I 60.73 DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD FIRE HYDRANT 158.57 DEAD OAK 41 9. 5 USE A 330 GPD DESIGN FLOW Y NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING I LARGE OAKS. it .43 BRICK 60.38 °o. _ SEPTIC TANK: 330 GPD (2) 660 I N 60.47 PATIO **RE-USE EXISTING 1000 GAL. SEPTIC TANK TEST HOLE LOGS 'I 595LP N N LEACHING: NE H. OJALA PE, SE 58.41 "- 6 .6 PORCH .69 AR ENGINEER: ' \ 9.13 .43 .46 (SLAB) ' 60.83 SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD WITNESS: DAVID W. STANTON, RS r 60: 6 BOTTOM 30 x 9.83 (.74) = 218 GPD DATE: OCTOBER 23, 2009 o TOTAL: 454 S.F. 336 GPD BENCH MARK - CORN. OF 6 .1 PERC. RATE _ < 2 MIN/INCH CONC. BULKHEAD EL. = 61.2' EXISTING DWELLING c PAVED 59.49 _.t J TOP FNDN. = 61.17' I DRIVE USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUA [, ip 60.10 \6) WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' CLASS I SOILS P# 12733 58.20 9 77 \ = �- \ /58.15 BETWEEN UNITS \ 12" ELEV. ELEV. \ �} i or, 4 58.5' 0r, 58.5' \ OAK t�/ I LOT 43 c �, �y 15,741 Sq. Ft. x'57.81 \ 7.95 12" P \ 59.89 58. {LS LS \ OAK = r o / MA \ rTT� 1 o° / Q APPROVED DATE BOARD OF HEALTH 10YR 2/1 10YR 2/1$» $„ j� 0 TITLE ITE PLAN B B 21- 5 S LS LS \ _r \ OF �57.60 �2d �� f ��j _5 6 / �O 10YR 5/4 10YR 5/4 \ �' j 39" 5.25' 39" 5.25' \ �57.41 �� 131 ELIJAH CHILDS LANE s,O �\ 58.1/,'' G CENTERVILLE C C \`7.10 9 58 PREPARED FOR 7 PERC Z �� 27' R=25 r- ' BORTOLOTTI CONSTRUCTION/ 5�6.68 LITTLE MCS MCS --x-§-6, 1 49' i ® 37_ "'56.79 OCTOBER 26, 2009 REV 11/3/09 (MOVE SAS) 1OYR 6/6 1OYR 6/6 �Q N OF off 508-362-4541 DANIELA9cy�s DANIEL � � fax 508-362-9880 0 A. �, I downcape.com o JALA `° JALA CIVIL 52 `A 1 Noo.0960„ down cope engineering, inc. 120 48.5 120 48.5 ° ��, �aF civil engineers Scale: 1"= 20' L)Rv�t° /QI7d SurVeO/"S NO GROUNDWATER ENCOUNTERED t I'S /off -� e y 939 Main Street ( Rte 6A) 0 10Mm- 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 09-236 09-236.DWG (SBO) I