HomeMy WebLinkAbout0139 EMERSON WAY - Health 139 EMERSON WAY, CENTERVILLE
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����I ,J® 2J�RECYC4cD�o2m
UPC 12534
No. 21 3LOFi
HASTINGS. HN
No. 1:9 ^� '� Fee [/ O
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '
PUBLIC HEALTH DIVISION - TOWN OF RARNSTABLE, MASSACHUSETTS Yes
ftpYitatiou for Disposal 6pstrm constouttion j3erMit
Application for a Permit to Construct( Repair( ) Upgrade()o Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 13Q UJOVI e Wr. Owner's Name„Address and Tel No.
At,A a T1 S LrSXM 0&0Q 0 jSid(
Assessor's Map/Parcel 8 9 1 v;k. 139 omea5et.1 LuM cevrtswq(LLB
Installer�'p Name,Address,and Tel.No.�D2,�-qTt—22� Designer's Name,Address,and Tel.No. 502 sa73 -'D Y1'�
e 4vewlw cP €S c.c.s, .QC_ EK)Gd t�-�NJC_X
153 C "4.&&P6Z9 I H W �:W*aG144M
Type of Building:
Dwelling No.of Bedrooms Lot Size 10, 150 sq.$. Garbage Grinder( )
Other Type of Building RESlfpQ�('(TWL_.. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided 5 a gpd
Plan Date I s 10 A61;L Number of sheets I Revision Date
Title 139 W,4'1 CE?�.)�(wC
Size of Septic Tank 1 500 &4L. Type of S.A.S. ;Ld fCr,
Description of Soil rtu
Nature of Repairs or Alterations(Answer when applicable) No&) JS0Q
�FmA92 1)04 "W 24 k 3& plc 'B kDOIF€USC!" I A, PU U>
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 Healt
igne Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. c' '' Date Issued
No. r901491 —" J Fee 0 /
THE'COMMONWEALTH�OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN'OT_F_� .,ARNSTABLE, MASSACHUSETTS Yes
t - 2ppl tation for Disposal 6pstrm �ori�t!'U'ttl > b errnit'"
Application for a Permit to Construct( ..j:.:.Re ar U ade Abandon [:]Complete System Individual Components
s p� ( ) pg (X ( ) ❑ p Y ❑ p
Location Address or Lot No. 13CI G'w4a"KWf C'caIJT. Owgerr''s 4 e,Addre�ss and Tel.No..
A RR U OGrONOW5<1
Assessor's Map/Parcel 189 1 O?• 139 e%4"SO J U Vk%1 "l,�'e�'�y 14,u4a
Installer' Name,Address,and Tel.No.50%-��7-�{�'� Designer's Name,Address,and Tel.No. SOS-a73 -0 S1
G41PGw1ps �cA s�s� �G � .t kX_-*I 0C
155 C u c&Xd 14(_ 5r M&tfpti>c N W r W*aeVA-aj
Type of Building:
Dwelling No.of Bedrooms Lot Size 101 1570 sq.ft. Garbage Grinder( )
Other Type of Building RZl bQ M A-r No.of Persons Showers( ) Cafeteria( )
Other Fixtures k
Design Flow(min.required) 330 gpd Design flow provided ," 5 5,off+. gpd
Plan Date 1 "1 D AO I X Number of sheets Revision Date
Title ►39 E(44aat* J Wr44 Ca OLQC
Size of Septic Tank ( S 00 &4L. Type of S.A.S. vk0 f`t k.-W Cwr-i4.
Description of Soil S(5LC PILAQ #k 6Z _r0 CAMWs"e, (P .3;t
`. Nature of Repairs or Alterations(Answer when applicable) (SUC7 -S E0'CtC,. 1)lam. 't Q
f�I�C� E�4u.OB.� 'tom.
t3 t o D t bus m_c 11`1 Ar P 4 k�U-3 e_k_ )r-4aA4
Date last inspected:
Ik 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 Healt
i n:<� Signe Date
Application Approved by Date
i
Application Disapproved by Date
'i for the following reasons
• r� q t �J
Permit No. �G/ '' �� I Date Issued /
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certifirate of Compriante
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded O0
Abandoned( )by (UPF-Le_)Q€
at 13<f &_WQC6,pQ ( key d eL)r]P V j"F_ has been constructed in accordance I
with the provisions of Title 5 and the for Disposal System Construction Permit No,./a4/q dated h -)-
Installer dA0&-W1DE &-y7&cA(.K6 ' t, Ct Designer S<` E7N&(Q(5C_ AJGV 1=
#bedrooms .3 Approved desi flow 35 l a gpd
The issuanc this .e it shall not be construed as a guarantee that the system wi
Date O Inspector
- ------- - - -------- ------------------------------------------ ---------------------------- -------------------------------
No. v`�O Fee _
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction permit
Permission is hereby granted to Construct( ) r ,ld4.�J
Repair( ) Upgrade(JC) Abandon
�t ( )
System located at i 3q t� M eV_Cc>Q C Qt M�1�1C�1.—
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:Constructio/must be ompleted within three years of the date of th s permit.
Date ( �� !�"` Approle b
Town of Barnstable
r Regulatory Services
Thomas F. Geiler, Director
BARNS'rABLE,MA38. Public Health Division
><b�a
ao„oc�►� Thomas McKean,Director
200 Main Street, Hyannis;MA 02601
Office: 508-862-4644 Fax: 508.790-6304
Date: ('246"1 Z Sewage Permit# a0( Assessor's Map/Parcel 169 10Z
Installer & Designer Certification Form
Designer: 5L` Er�gtoeecidl� ?�7G Installer: Qt2ewide C-ylferecl'Se.S LLB
Address: 2.F,,5 y Ccmbyvv W4%!k / Address: t�p
0
on i 1 1 °'� Ch i�, ��2 Q� {� was issued a permit to install a
(date) (installer)
septic system at i 3 9 Em4cs e.n way r based on a design drawn by
(address)
�C: Cri�irteeri�c� ; �+nG, dated aw ary 'o, 2-017—
(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. Stripout (if required) was inspected and the soils
were found satisfactory.
v _ 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. Stripout (if req nspected and the soils
were found satisfactory. 4 of Lik
JOHN
CHUWL;-SI:L
JR )
taller's Signat ) No ViL !
Ayz � I
eesigner's Signatur (Affix esi er s mp Here)
LEASES IRET1URN O BARNSTA13LE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE iBARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU,
I'•.nlli,;d Iii+Ua�dcaigua'vuililiculimi lunn.du� '
TOWN OF BARNSTABLE
... LOCATION �v�n e„r�cay� way SEWAGE G 't
'`.PILLAGE Cen+t rV i lie ASSESSOR'S MAP&PARCEL /
INSTALLER'S NAME&PHONE NO. Gapewide, rnfev^prises L.L��
SEPTIC TANK CAPACITY l! ®Q C,A L SoSC 4 Z Z �S8 Z Z
cad
LEACHING FACILITY: (type) A RC :36 N-dA (size)
NO.OF BEDROOMS _3
OWNER Ada y l E SuSc n L• Q5V JJa.JJ 'C i
PERMIT DATE: i 1'a COMPLIANCE DATE: / 027 /"
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility we FAr-cuo'efecFeet
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 y ooeld -C`- Ek�f�►$�.� LC-(_
r
q � = 33.5
A-3-lay a_3-3�♦
A- = 31 8-4 31:
�,ttE
Town of Barnstable P# 3 J�
Department of Regulatory Services
Public Health Division Date ,
NAM
�Fu.19. 200 Main Street,Hyannis MA 02661
Date Scheduled / Time�_ Fee Pd. V
(
Soil Suitability Assessment for Sew e Disposal
Performed By: i C,O,C Pim co w ,is Z 1 GS(,,
a Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address Owners Name
/
i 3q Ern�Sor► w-aY ' Q�9� a�d•�►c�wsrt�
t.e&v+,/L Address .Sllyt,L
Assessor's Map/Parcel: l O C'/ / Engineer's Name �6G� SC ajio ceo nj
NEW CONSTRUCTION / REPAIR ✓ Telephone# �� 'j _50.8-273�6 377
Land Use SC031eJo nJ i� &,eAJ1,,) Slopes(9b) 6- 1 Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property lane 7/0 ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
See- at Pia
Parent material(geologic) D�kuxk b Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Nee
Estimated Seasonal High Groundwater 7 12 40"( 515
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: Vt c eGE &Sc.r va ha n
Depth Observed standing in obs.hole: 7 12fo In. Depth to soli mottles: In.
Depth to weeping from side of obs.hole: in, Groundwater Adjustment B.
Index Well# Reading Date: -Index-Well level ., AdjAhttor -,off..KdJ.GroundwaterrLevel
PERCOLATION TEST bate f-6-12, Time io A tt
Observation �
Hole# Time at 4" A�1
Depth of Perc Time at 6" 3
/V/ Ail
r
Start Pre-soak Time® 'lime(V-619) J M S
End Pre-soak
Rate Min./Inch C 2
Site Suitability Assessment: Site Passed Y 5 Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back--------_
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:1,SEPTICIPERCFORM.DOC
DEEP-OBSERVATION HOLE LOG Hole# 1 _
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
i tent2y.%Graven
LY 45 .16"r 311
j0r3Z �3 L5 jof516
^G S 2.5Y71- t. 5 l5� gfov��
DEEP OBSERVATION HOLE LOG Hole# Z
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsisten %Grave
a"y FJ/
107 3z -
32-�2(� C- 11'G S . �G
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistencv.%Gravell
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories;Boulders.
Consistency.
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No.2, 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 pervious material?
Certification
I certify that on /2"11�9 (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 experi described in 310 CMR 15.017.
Signature - Date
Q:\SEFn0PERCFORM.DOC
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Grad
DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector
ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119
TeaTicket,Ma. .
(508)564-6813
TRUDY COXE
Secretary
ARGEO PAUL CELLUCCI DAVID B.STRUHS
Governor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
- PART A
CERTIFICATION
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Name of Owner JONNY MESHULAM
Address of Owner: SAME
-
Date of Inspection: 10/6/99 rp 1 r
Name of Inspector:(Please Print)JOHN GRACI �'cQQgl, 999
1 am a DEP approved system inspector pursuant to Secdon 15.340 of Tide 5(310 CMR 15.000)
Company Name: n/a
Mailing Address: n/a
Telephone Number: n/a e 9
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 inspection.The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems.The system:
X Passes The inpection is based on criteria defined in Title V
Conditionally Passes code 310 CMR 15.303.My findings are of how the system is
Needs Furtheiubmit
ation By the Local Approving Authority performing at the time of the inspection.My inspection does
Fails not Imply any warranty or guarantee of the longgevity of the
septic system and any of its components useful life.
Inspector's Signature: Date:1018/99
The System Inspector shall a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING SYSTEM EVERY ONE TWO YEARS TO PROLONG THE SYSTEM'S
USEFULL LIFE.
revised 9/2/98 Page 1 of 11
t
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
INSPECTION SUMMARY: Check A, B, C, or D
A. SYSTEM PASSES:
_ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated.
are indicated below.
COMMENTS:
System passes Title V inspection
B. SYSTEM CONDITIONALLY PASSES:
WA 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.
Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not.
nLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or
the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank
failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as
approved by the Board of Health.
nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
_ broken pipe(s)are replaced
_ obstruction is removed
_ distribution box is levelled or replaced
Wa The system required pumping more than four 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
revised 9/2/98 Page 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:1016/99
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the distribution box above out invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped n&.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure.
E. LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and
safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2198 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
Check if the following have been done:You must indicate either"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 None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles
or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption
System on the site has been determined based on:
X Existing information,For example,Plan at B4O,H,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
[1 5.302(3)(b)j
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
SubSurface Disposal Systems.
revised 9/2/98 Page 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 46
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped n[a.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure.
E. LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and
safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X 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)
The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2198 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:10/6199
Check if the following have been done:You must indicate either"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 None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles
or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption
System on the site has been determined based on:
X Existing information,For example,Plan at B4O,H,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
11 5.302(3)(b)j
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
Subsurface Disposal Systems.
rrwis.r•rl rl/7/�fi ... .- . .
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 46
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
FLOW CONDITIONS
RESIDENTIAL:
Design flow:-M g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual):$
Total DESIGN flow: =
Number of current residents:l
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): NO If yes,separate inspection required
Laundry system inspected(yes or no):JM
Seasonal use(yes or no):JM
Water meter readings,if available(last two year's usage(gpd): n/a
Sump Pump(yes or no): NO
Last date of occupancy: Wa
COMMERCIAL/INDUSTRIAL
Type of establishment: n&
Design flow: n&gpd(Based on 15.203)
Basis of design flow: Wa
Grease trap present:(yes or no):DLO
Industrial Waste Holding Tank present:(yes or no): MQ
Non-sanitary waste discharged to the Title 5 system:(yes or no):No
Water meter readings.if available:n&
Last date of occupancy: n&
OTHER: (Describe)
nLa
Last date of occupancy: n(a
GENERAL INFORMATION
PUMPING RECORDS and source of information:
THE SYSTEM WAS PUMPED WEEKS AGO BY ROBINSON
System pumped as part of inspection:(yes or no):NQ
If yes,volume pumped nLa_ gallons
Reason for pumping: xi&
TYPE OF SYSTEM
XSeptic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no)(if yes.attach previous inspection records,if any)
I/A Technology etc.Attach copy of up to date operation and maintenance contract
Tight Tank Copy of DEP Approval
Other: Wa
APPROXIMATE AGE of all components,date installed(if known)and source of information:
1970 WITH A REAPAIR IN 1992
Sewage odors detected when arriving at the site:(yes or no): N12
revised 9/2/98 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 46
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
BUILDING SEWER:
(Locate on site plan)
Depth below grade: V
Material of construction:_ cast iron _40 PVC X other(explain)
Distance from private water supply well or suction line: TOWN
Diameter: nLa
Comments: (condition of joints,venting,evidence of leakage,etc.)
n1a
SEPTIC TANK: X
(locate on site plan)
Depth below grade: V
Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain)
Wa
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ
n[a
Dimensions: 6'X6'BLOCK CESSPOOL
Sludge depth: 11
Distance from top of sludge to bottom of outlet tee or baffle: .0
Scum thickness:-Q
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: 11
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
MAIN CESSPOOL AND ALL COMPONENT ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM EVERY ONE TO TWO YEARS
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain)
Wa
Dimensions: WA
Scum thickness: nla
Distance from top of scum to top of outlet tee or baffle:iVa
Distance from bottom of scum to bottom of outlet tee or baffle Wa
Date of last pumping: Wa
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
Wa
revised 9/2J98 Page 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 46
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nLa
Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain)
nLa
Dimensions: n&
Capacity: nLa gallons
Design flow: n& gallons/day
Alarm present: NO
Alarm level:j3ta- Alarm in working order:Yes—No—: NO
Date of previous pumping: n&
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
n/a
DISTRIBUTION BOX: _
(locate on site plan)
Depth of liquid level above outlet invert:nLa
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
nLa
PUMP CHAMBER: NO
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): NQ
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
n&
revised 9/2/98 Page 8 of 11
SUBSURFACE SEWAGE DISP
OSAL SYSTEM INSPECTION FORM '
PART C
SYSTEM INFORMATION(continued)
Property Address: 139 EMERSON WAY MAP 1
Owner: JONNY MESHULAM 89 PAR 102 L 46
Date of Inspection:10/6/99
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods
If not located,explain: )
n&
Type:
leaching pits,number: 1000 GA i n --•
leaching chambers,number: _VA
LE
leaching galleries,number: -a&
leaching trenches,number,length: n&
leaching fields,number,dimensions: n&
overflow cesspool,number:
Alternative system: n& 0WM=KMSSEQQL
Name of Technology: _n&
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
CESSPOOLS:
(locate on site plan)
Number and configuration: n&
Depth-top of liquid to inlet invert: n&
Depth of solids layer: n&
Depth of scum layer. n&
Dimensions of cesspool: n&
Materials of construction: n[a
Indication of groundwater: n[a inflow(cesspool must be pumped as part of inspection)n&
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
o/a
PRIVY:
(locate on site plan)
Materials of construction:n& Dimensions:n&
Depth of solids: n&
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n&
revised 9/2/98
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:10/6199
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
n/a
AA3a�
�R a�
revised 9/2198
Page 10 of 11
1$q - l®
ASSESSOR'S MAP NO. PARCEL Cj .r-lf�3
LQ CAT ION SEWAGE PERMIT NO.
VILLAGE '
INSTA LLE ? NAME i ADDRESS
BUILDER OR OWNE
i
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED 9-,2 -52-
_ .
r
l �
t
�� �
� �
a� z3 -
�g ��
`� � � — -�
�-
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 139 EMERSON WAY MAP 189 PAR 102 L 45
Owner: JONNY MESHULAM
Date of Inspection:10/6/99
NRCS Report name: n&
Soil Type: n&
Typical depth to groundwater: n&
USGS. Date website visited: n&
Observation Wells checked: No
Groundwater depth:Shallow _ Moderate _ Deep _
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
_ Shallow wells
Estimated Depth to Groundwater 12 Feet
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
_ Observed Site(Abutting property,observation hole,basement sump etc.)
_ Determined from local conditions
_ Checked with local Board of health
_ Checked FEMA Maps
Checked pumping records
_ Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS
revised 9/2198
Page 11 of 11
FINISH GRADE OVER D-BOX= 51 .0'± 4"SCHEDULE 40 PVC MIN. SLOPE 1
TOP OF FOUNDATION - 53.7 ± FINISHED GRADE OVER BIODIFFUSERS= 51 .3' - 51 .4' GENERAL NOTES
PROVIDE EXTENSION RISER SLOPE @ 2% MIN.
WITH COVER OVER INLET&
REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH
FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE 510,± 1- UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
OUTLET TO WITHIN 6"OF F.G. ACCESS BOX TO WITHIN 3"OF METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
.
-5" DIA. OUTLET(S) F.G. (ONE PER OUTER ROW) CODE AND ANY APPLICABLE LOCAL RULES.
FINISHED GRADE
@ FOUNDATION - 51 .2'± \� - I _-----
1 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
20"MIN.ACCESS
COVER(3 TYP.)-
YP.) 9"MIN. t 1 DESIGN ENGINEER.
36"MAX.
PROP. PVC
9"MIN. 9" MIN. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
SEWER PIPE PROP. PVC 36"MAX. 36" MAX. TOP OF SAS/B.O. = Q.8,4.3'
SEWER PIPE (48.20') SYSTEM UNLESS OTHERWISE NOTED.
2" DROP MIN. PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
MIN.SLOPE g 9� 6- 3�� 3" DROP MAX. 3- 9" @ L=Tt JOINTS (TYP.) ELEVATION =48.20 FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS A
MIN.SLOPE 1% � ' '
10" 4"PVC IN FROM 1.33' 1 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
(49.11 ) 14- 48.45' SEPTIC TANK 4" PVC OUT TO 0. 01 (TYP.) nIP) THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
*48.8'+ LEACHING FACILITYCLEAN SAND 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
(48.62 )
„ , 12 s" ' 147.87 )' 48.00' 47.10' laid flat 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
OUTLET TEE 48.27 MIN. 48.10 ;
48 ( ) (46.87') 2.875'(34.5"(TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
48.70'
(48.86 ) (47.77'� .o'
GAS BAFFLE l�� u7') 6"CRUSHED STONE (TYP.) 5'MIN. 11.5' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
OVER MECHANICALLY REQ'D NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
14.6'TO FND COMPACTED BASE 25 0' AND DESIGN ENGINEER.
5 OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON AN APPROXIMATE M.S.L. DATUM OF 52.00'
6" CRUSHED STONE OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV= < 40.90' BIODIFFUSERS (END VIEW) ESTABLISHED ON A NAIL SET IN A 12"HOLLY TREE AS SHOWN ON PLAN.
BASE. FIRST TWO FEET OF OUTLET
COMPACTED BASE BIODIFFUSERS PROFILE 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. (PROFILE) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
(Dimensions per Wiggin CROSS SECTION VIEW (BY ADVANCED DRAINAGE SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
LENGTH 10'-6" WIDTH 5'-8" DEPTH 5'-8" (D� j
Precast Corp., Pocasset,MA) ARC 36 H C (#36� 6 B D BIODIFFUSERS H-ZO l TO THE DESIGN ENGINEER.
CONTRACTOR TO VERIFY THIS ELEVATION SEPTIC TANK F'RO F I L DISTRIBUTION BOX DETAIL \ / 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
&REPORT TO ENGINEER IF DIFFERENT NOT TO SCALE NOT TO SCALE NOT TO SCALE
TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
/ ' • • ' ' U + PERC NO. 13523 APPROPRIATE AUTHORITY.
,! • bra + e • . ,r INSPECTOR: Donald Desmarais, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
00
+` • + + � � " EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE
••*.+ ► + ++ ,' • +" THEY SHALL WITHSTAND H-20 LOADING.
06 C.S.E. APPROVAL DATE: Oct. 1999
`++� � +' * + +`+ * • DATE: January 6, 2012
O 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
• • i +' • + '• TEST PIT#: 1 i 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
UP 801/1 • • + ` + • ` r MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
j� �� "• f ; • $Q ELEV TOP= 51.40' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY
/ L • ' + +•+••` E • ELEV WATER=
MAP 189 + <40.90' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
%/ '� • •• • •
p ,. +� . 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
+. • \` +.**, PERC RATE _ <2 min./inch
PARCEL 101 �� BM 6p SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
/ o � � ,/ *
w
/ \ tch
w O LOCUS ` • DEPTH OF PERC= 32"-50" 16. PROPOSED PROJECT IS LOCATED WITHIN:
r = y / d •• + + TEXTURAL CLASS: 1 ASSESSORS MAP 189 PARCEL 102
l l i /NE ' chwo
3 520". *\ f*• • - 4 -- OWNER OF RECORD: ADAM E. & SUSAN L. OGONOWSKI
'
/9' + # H • ; +,+ 0" ADDRESS: 139 EMERSON WAY
z / " ti / • n . i°• Fill 51.40 CENTERVILLE, MA 02632
a / �/ r , +� A 4" Loamy Sand 51.07'
v 3 /\ 51 x9 + •• + 10„ 10Yr 3/1 50.57' FEMA FLOOD ZONE C
an erry •
�. / 1k� • ` I B Loamy 10Yr 5/6 d 17. DEED ROEnFERENCEPAL.C.0#1592331 0005 C
IT f o ` \ 51 x8 w k k.,,,52x0 -�,, « £'f
J j 0 * 1 �' 32" 48.73' i 18. PLAN REFERENCE: L.C. PLAN 24614-E (SHEET 1)
Z' �� ! MAP 189 �52� /�2 i +' . ,• + • ' w • t► Perc
O to 2 \8 /� • * ` •�; p 50 47 23, 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
CO [u � `� � PARCEL 102 C s 6. h., • . C.
10,150 S.F. • • 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
t M. 51 4 (5 ��ti h + + •� .
FOP,SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
o / ~ / s O ` •�i C Med. to Coarse Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
cv / -T
/ * : • + 5-15% Gravel
µ,
\ ^ o /h`L HC-1 2 52x0 - - - - 2.5Y 6/6
1x4
o o p �70, AS-BUILT INSPECTION PORT
z �' LOCUS PLAN
�� 6) WITH ACCESS BOX TO GRADE
DECK TREE !3 (TYP OF 2)
STOOP SCALE: 1" = 1000' 126 40.90
3 t✓ #139 o No Mottling, Standing or Weeping Observed
r
Q b \\I✓ EXISTING
o / \��w DWELLING
2s.2. DESIGN DATA TEST PIIT2
TOF=53.7'± DATA LEGEND
AS-BUILT TOTAL 20 ARC 36 HC (�3616BD) PERC NO.
�\ � (3 i BIODIFFUSERS IN A FIELD CONFIGURATION
IV /(
o � w
�4.g� 4 � INSPECTOR: Donald Desmarais, R.S. 50x0 EXISTING SPOT GRADE
�
o \ \ o C/O NUMBER OF BEDROOMS (DESIGN) 3 EVALUATOR: Michael Pimentel, E.I.T. - - - 50 - - - EXISTING CONTOUR
r C.S.E.APPROVAL DATE: Oct. 1999
PAVED DRIVEWAY P DESIGN FLOW 110 GAUDAY/BEDROOM 6, 2012 --1 � PROPOSED CONTOUR
January_--51 (1 - CP 51x4 DATE: n'
TOTAL DESIGN FLOW 330 GAUDAY TEST PIT#: 2 ❑/H/W - EXISTING OVERHEAD UTILITIES
DESIGN FLOW X 200 % = 660 GAUDAY(2 / ELEV TOP= 51.40, GAS - EXISTING GAS LINE
USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV WATER= <40.90'
` GA HC-2 \ _.6�/ / AS-BUILT DISTRIBUTION BOX PERC RATE -_ - W W EXISTING WATER LINE
/ S
EXIST. CESSPOOL TO BE DEPTH OF PERC= TEST PIT LOCATION
/ GAS PUMPED AND FILLED WITH INSTALL 20 - ARC36 HC (#3616BD) BIODIFFUSERS (H-20)
GAS CID CLEAN SAND (TYP OF 2) TEXTURAL CLASS: 1 O O O AS-BUILT 1,500 GALLON SEPTIC TANK
i GAS EXIST. ^ h -
o / SHED o o� SYSTEM CAPACITY AS-BUILT 4"SOLID SCHEDULE 40 PVC PIPE
y h (TOTAL L.F. OF BIOS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD 0" 51.40'
(100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING/DAY Fill AS-BUILT DISTRIBUTION BOX
A 4" Loamy Sand 51.07
ENCE�1 ykP k�k „ 10Yr 3/1 Q AS-BUILT ARC 36HC(#3616BD)BIODIFFUSER(H-20)
x_ MAP 189 TOTALS: 10 50.57
h
LP S TOTAL NUMBER OF BIODIFFUSERS: 20
1 j
PARCEL 99 TOTAL NUMBER OF COUPLINGS: 0 g Loamy Sand (96.87 ) ACTUAL ELEVATION "AS-BUILT"
MAP 189 `k\ 1 l TOTAL LEACHING AREA: 480.0 10Yr 5/6
PARCEL 127 TOTAL LEACHING CAPACITY: 355.2 32" 48.73'
REV. DATE BY APP'D. DESCRIPTION
Benchmark
Nail Set in 13"Oak � � "AS-BUILT" SEPTICSYSTEM
Elev. =52.00' N73- '30" NOTE: PREPARED FOR:
Approx. M.S.L 10000, W EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE �� �� CAPEWIDE ENTERPRISES
_ DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER Med. to Coarse Sand AS-BUILT
"MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO ADVANCED C 5-15% Gravel
AS-BUILT 1,500 GALLON SEPTIC TANK EXIST. LEACHING PIT TO AS-BUILT SWING-TIES DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003 (LAST MODIFIED PLAN
BE PUMPED AND FILLED JANUARY 11, 2011). TRANSMITTAL NUMBER=W000052. 2.5Y 6/6 LOCATED AT
WITH CLEAN SAND
DESCRIPTION Hc1 Hc2 139 EMERSON WAY
CLEAN-OUT(1) 26.0' 23.0' CENTERVILLE, MA 02632
SEPTIC COVER IN (2) 33.5' 24.5' 126" 40.90' SCALE: 1 INCH = 10 FT. DATE: JANUARY 28, 2012I
NOTES: 0 5 10 20 40 FEET
SEPTIC COVER OUT(3) 27.0' 31.0' No Mottling, Standing or Weeping Observed i
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC SYSTEM
w��H o ,aassgc PREPARED BY:
COMPONENT. DISTRIBUTION BOX(4) 31.0' 39.0 RESERVED FOR BOARD OF HEALTH USE o`' S`W
JOHN JC ENGINEERING, INC.
L. s
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED LEACHING INSPECTION PORT(5) 40.4' 72.5' CHURCHILLJR. u E 2854 CRANBERRY HIGHWAY
SYSTEM TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO CIVIL
INSPECTION PORT(6) 41.1' s8.5' � No. 807 EAST WAREHAM, MA 02538
ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. R
SITE PLAN . F 's�� __ -� 508. .273.0377
1 � -
3.) ENTIRE LOCUS PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. SCALE: 1"= 10' �/ ail Drawn By: DDS Designed By: MCP Checked By:JLC JOB No. 2128
L