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0036 ENSIGN ROAD - Health
36 ENSIGN ROAD, CENTERVILLE Al- 147 052. rlr�7�4W� �.0.ECYCCEO�, , UPC 12543 N4 �„ �� HASTINGS,MN i CO`1N10'\«'EALTH OF MASSACHt'SETTS EXECUTIVE OFFICE OF F?�vuONME\TAL AFFAIRS DEPARTMENT OF E��'IRONNIEITAL PROTEC 41,N% I. 1 i2 ONE u•1NTER STREET. BOSTON. NIA 02106 bl?•.S_•S:QG �� ' ��� ��-•� � �q ��%�� Div? 05i" 31— J 0 ` TRL-Dl`�C0%2 'WIL.LIAM F.WELD '. : _�• �FoIR�� •j99 �cT-; Gavc-nc- �/� ✓Sr `Sj- ` DAVID I ARGEO PALL CELLI'CCI �S7 rZl 1 Lt.Govc-,nor* SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM '�C�amrrissior_. PART A ' - CERTIFICATION Property Address; 31 qw'!S y r e t1t�Q, Address of Owner: V. f_%,N_P_ r Date of Inspection:,_:3 i / different) Name of Inspector. eT V i' h ED am a DEP �•ail roed system inspector pursuant to Section 15.340 of Title S (310 CMR 15.000) Company Name:_ifo vr71-r'C !C'_n `'i"CQ M P" 1P i^ 4""_/ Mailing Address: -Pe-) /;oA Y3719" • JyftSf•_O2LZ Telephone Number: r 57C zol _� CERTIFICATION STATEMENT I cent, that I have pe•sonally rnspec:ed the sewage d!srpsal s*stern a; this address and that the information reported be oN is true. accurate and complete a: o`the time of ,nspe:.p-.. The rnspec=;cn was pe�crmed baste on my training and experience in the proper fu C,c and maintenance o;on-sae sewage d,sposa: systems. The rvsten:: Pastes _ Conc,t,onaii% Passes Neec_ Funhe• Eva!uat-o^ E%. the Locai Approving Authorim _ F Inspector's Signature. Date: T;,e Sv!-.e^ Ins _o• sha" submit a cope of this inspecion reper, to the Aporoving Authont\ within th,m 130, da}s of Completing this inspe;,on. It the system Is a share: _cvstem p• ha' a design flc� o: 10,000 gx or greater, the ,nspec;cr and the system cwner shall submit the repo^ tc the appropnate restenal pa r.- ce of the De;a:-ment c:Env,renmenta' Frote ,or.. The erig-nal should b? se^t to the system, owne- and copes s-n: to the bu%,er, if applicable. and the apzroving authorin INSPECTION SUMMARY: Check A, E, C, or D AI SYSTEM PASSES: 1 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure c.,teria not evaluated are indicate^ below. . C0MMENT5: BI SYSTEM CONDITIONALLY PASSES: One or more system components as described in the 'Conditional Pass' section need to be replaced or repaired. The systern, upor- completion of the replacernent 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. _ The septic tank is metal, unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance lanachedt indicating that the tank was installed within twenty (20) years prior to the date of the inspection: or the septic tank, whether Gr,ncit metal, is cracked, structurally unsound, shows substantial infiltration or exfiltrat,on, or Lank failure is imminent. The'systern will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health, ' x SUBSURFACE SEINAGE DISPOSAL SYSTEM INSPECTION FORM r PART A CERTIFICATION (continued) Property Addcass: Owner: Date of Inspection: ej SYSTE..m CONDITIONALLY PASSES tcontsn.,�,d _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed Seµ'a _ Sewa l or due to'a broken. settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Healthi. Describe observations: _ _ broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to brokers or obstructed pipets).:The system will pass tnsoect;on if twith approval of the Board of Health): broken pipets; are replaced obstrualor. rs removed CJ FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH: iumhe•evaluation by the Board of Health in order to determine if the system is failing to protec th Conditions exist which requiree public health. safety and the environment. - t) SYSTEM WILL PA55 UNLESS BOARD OF HE4LTH DEfERMINE5 THAT THE SYSTE.IA 15 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or pr'%N Is within 50 fee: of a surface water 1 . s i hln 50 feet of a bordering vegetated wetland or a salt marsh. nc rl\1 1_ N t _ C__spoo• o� P • ND-PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT 2) SYSTEM WILL FAIL 11►�LESS THE BOARD OF HEll7H U THE SYSTEM 15 FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HE,kLTH AND SAFciY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system (S S'j and the SAS is within 100 feat to a surface water supply Gr tributary to a surface water supoly. _ The system has a septic tank and soil absorption system and the SAS is within a Zane 1 of a public water sup s'y well.. we!l. _ The system has a septic tank and soil absorption system and the SAS is within 50.feet of a private water supply _ The system has a septic tank and soil absorption system and the SAS is less char. 100 fee: but 50 fee! or more from a private water supply well, uniess a well water analysis for coliform bacteria and volatile organic compounds indicates thm the well is free from pollution from that facility and the prewnce of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not vaiid). 3) _ OTHER (revised 04!25/iti Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: DI SYSTEM FAILS: You must indicate either "Yes" or "No' as to each of the following: I have determined that the system violates one or more of the following failure criteria a< defined in 310 CMR 15.303 The oasis 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 Backup of sewage into facility or system component due to an 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 houid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspoo Lieuid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day floe. Reouired pumping more than 4 times in the last year NOT due to clogged or obstrucea pipes . Number of times pumped _. Anv portion of the Soa Aosorption System, cesspool or priv,)• is below the high groundwater eieyation. Arn por:on of a cesspool or privy is within. 100 feet of a surface water supply or tributar to a surface water supple Any porion of a cesspoo' or pri%)- is w ithir a Zone I of a public well. Am pc•ao-• of a cesspool or pries is within 50 feet of a private water supply well Anv por,,or. of a cesspool or pri%-�• is less than 100 feet but greater than 50 fee: from a private water supply well with no acceotable .ate, quality analysis. If the well has been analyzed to be acceptable. arach cop,, of well water analysis for coliiorm bacteria volatile organic compounds, ammonia nitrogen and nitrate nitrogen. r E) LARGE SYSTEM FAILS: You must indicate ei:her "Yes' or "No" as to each of the following. The iohow:rg criteria app;,, to large systems in addition to the criteria above: The system serves a facilim with a design flow of 10,000 gpd or greater (Large System; and the system is a significant threat to public hea!th and safety and the environment because one or more of the following conditions exist. 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 3.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 y SUESURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Addr*ss: Owner: Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal ater have not been introduced into the system recent]% flow races during that period. large volumes of w or as part of this inspection. As butt- plans have been omamed and examined. Note if they are not available with N,A. The fac:lm or 6%e►ling %.as inspected for signs o-sewage back-up. The sstem does not receive non-sanitary or industrial waste flow. The site vas inspected for signs of breakout. All svmerr. componenr, excluding the Soil .Aosorpuon System, have been located on the site. r The septic tank rranhoie� Mere uncovered. opened. and the interior of the septic tank was inspected for condition of baffies or tees. matena`, o`construction, dimensions, deptn of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption Svstem on the site has been determined based on The iacdw, oMne• ,ano occupants. t:dirteren: from owners were provided with information on the proper maintenance of Sub-Suriace Disposal Svstem. Existing information. Ex Plan at B.O.H. Determined in the field !tf an% of the failure criteria related to Part C is at issue, approximation of distance is unaccex.abie (15.302.3):b1 (r.vlsad 0{/25/5') Fag. 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C j� SYSTEM INFORMATION Propert%fdriress- Owner: , t` I` j Date of Ihspelion: r FLOW CONDITIONS RESIDENTIAL: Design floe o.d. bedroom for S. .S Number of bedrooms Number o'current restdents-� Garbage g•: der (yes or no,:,K' Laundry co.—ected to system (yes or no! Seasonal use Ives or no!: j Water meter readings. if a%-gable (last two i2, year usage tgpd): �'—N.toa `i Sump Pump (yes or no r Lw.: da;e o-occupant-, 13 Cfh� COMMERC;,kL'INDL'STRI`AL• Type of establishment Design fio%% ga!ions/da% Grease trap present Ives or no_ Indus;ria! %%aste Holding Tani; presen; %es or no_ ':on-sancta-, Naste d,scnargec to the T!;ie 5 sys;em. Ives or no_ eater meter readings. if a.ailabie OTHER: .Descrtbe Last sate of occuoanc. GENERAL INFORMATION PUMPING RECORDS and source of infor a; dr. - ��sin Dl ,'� System pumped as par, of inspeCion: tees or no If yes, volume pumped eallons Reason for pumping TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Prn)• Shared system (yes or no) (if yes, attach previous inspection records, if any) 1/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: �i J Sewage odors detecfed when arriving at the site. (yes or no)4SIb (rw»ed Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION; FOR.tit PART C SYSTEM INFORMATION (continued) Propert} Mdress: . Y�14/ Owner: Date of Inspbction:-A f BUILDING SEWER: (Locate on site plan) Depth below grade._ P Material of construction. _cast iron _40 PVC _other (explain', Distance from private water supply well or suction Ii Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site pla Depth beloN grade S-2 material of construction, concre:e _me-.a _Fioergla5s _Polyethylene _othenexpla,n If tank is me:al, I:s: age _ I: age confirmec o% Ce-t:fica:e of Compuance _(tesNo Dimensions Sludge depth Etl Distance from top o: s:udee to bo:;o-n o' ou:ie: tee o• ba�e t Scum thickness �r Distance from top os scum to top o' outle: tee or.bake _ Distance from bottom o'scur^ to bo-on of outie: tee e• bar-e _. How dimensions were determined �4,(14,k'NA ". -9 C) Comments trecommendation for pumping. rond,tion o,. iniet an ' outlet tees or baffles. depth of liquid level to relation to outlet invert, stru ural integr ,, evidence of leakage, e:c i J tJ j GREASE TRAP: (locate on site plan; Depth below grade: 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: 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.; rep eed 04!25:9-, Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR-M PART C (� SYSTEM INFORMATION (continued) Propertm Address:` L�' 1j 0%ner: H (- Date of Inspection: TIGHT OR HOLDING TANK: -Tank must be pumped prior to. or at time, of inspect)oni (locate on site plan, Depth below grade. Material of construction. _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Capacir\ gallons Design floe gahons-da, Alarm level A;arm in \%orking order Yes. _ No Date of previous pumping Comments (condition of inlet tee. condition o7 a!a,rr: and float switches. etc.( D15TRIBUTION BOX: (locate on site pa- Dniti o; hcuid le%e' aoove oune: ime- Comments (note ^ leve! and distributio . q e ua' . dence f solids n•o. e�ode\ce I ka a to or out of boa, etc.) r" PUMP CHAMBER: ff) (locate on site plan. Pumps in working order: (Yes or No' Alarms in working order (Yes or No Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Pag• 9 01 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORki PART C SYSTEM INFORMATION (continued) Property Adrfr-ss: Owner:t Date of Ins p coon: III f Cr SOIL ABSORPTION SYSTEM (SAS):_ (locate on srte.plan, if possible, exca.ation not required, but may be approximated by non-intrusive methods, If not determined to be present, explain. Type: leaching pits. number. X� leaching chambers, num leaching galleries, number. leaching trenches. number,(ength: leaching fields, number, d.^nensions overflow cesspool, number Alternative s\•stem Name of Tecnnoiog% Comments rnAe c ndrti ,� of�oi', s: r.s of .draulic failure, level of p nd;ng. c nditi n f v etation, etc.' C CESSPOOLS: (locate on site plar. Number and confrgura:-on Depth-top of liquid to inlet inver, Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of constructior Indication of groundv`ate- inflow (cesspool must De pumpeC as par, of rn5pection) 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.) (revised 04/25/97) Page a of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORA PART C SYSTEM INFORMATION (continued Proper,,Address:-3, 6 Owner: M V-j Date of Impeion: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 63- y� i page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propert%El Acl l,ev-Owner: 1v(P Date of ection: . Depth to Groundwater' IFeet Please indicate all the methods used to determine High Groundwater Elevation: Obtained irom Design Plans on record 1( Observation of Site (Abutting property. observation hole. basement sump etc.) Determine it from local conditions CnecK %%tth loco! Board o• nea!tr Chec:. FE.NAA ntam Check pumping records Check loca! e*ca�ato•s irs:alle•s L-se -AGE Da.�-.. Describe in %ou, oN%- %,.orcs ro•.. %o- es:ao!!Shec the `-iig`i GroundAater Elevation. (Must be completed lz.vv.d .�:L'9 Page 10 of 10 TOWN F'BAMSTABLE LOCATION N, SEWAGE # VII.LAGE �-• ASSESSOR'S MAP &LOT 1 Z INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 C� LEACHING FACILITY: (type) 1 (size) _146 C� NO.OF BEDROOMS BUILDER OR OWNER PEMaffbATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility I 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 ��.tl A22 vtl Q i WY 1 No...�4 ?. Fps....... ................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF F-I/fE/,ALT1 K- ........OF............ • 0 `�"-. <-9 l 1 ... . ........ .. ApplirFation for, Disposal Works Tnntrnrtion rantit Application is hereby made for a Permit to Construct (K) or Repair ( ) an Individual Sewage Disposal System at• _Pt__ .............L_J(2_.-T........... =3-•---6-/'a/. ..1_. . -......, . ...........--------- - •- Location dre or Lot No. Owner - ress ••-•----------------------. .��. �s......--_...PA.I--5-- -��� .......................... f��.:.. ......... ---- Installer Address d Type of Building . Size Lot-___--Z v_OO_Y"Sq. feet U Dwelling—No. of Bedrooms..... ....c���xpansion Attic ( ) GarQe Grinder (?4 Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ----•••••=--••-•......-••---•... . W Design Flow.................. .r.............._gallons per person per day. Total daily flow................3.5...L!...........gallons. WSeptic Tank—Liquid capacityj�O.Qallons Length................ Width---------------- Diameter________-_______ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---_---_--------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( , ) � Percolation Test Results Performed by.................. Date............. Test Pit No. __..minutes per inch Depth of Test Pit------t.�. Depth to ground water------ A fs, Test Pit No. 2..7J&4*c._minutes per inch Depth of Test Pit____________________ Depth to ground water....... ............. x ...I..........................................................._._..._.__..__.._Y -------Ic----..--------•------ ODescription of Soil...............................V � o AA-5` O ..........t•-------•- �v •-••--••-•••-••---••-•------•••••-••-••-••••---....-•---•-•-•• ----•-•--•••--- . ........................................................ -------------------------------------------------------------------------------------------------------•-------------•--------------------------------------•------••----------•--•-•-••--------------•- 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 AITLi: 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 healt / Signed................-- - ..... 21 t�•l� / Date Application Approved BY <��' � j�l�G/---------- Date Application Disapproved for the following reasons---------------••-------•------------•-------------••------------------------------------------------------•---- ----•-•-----•---••-•----•-•....-----•-----•-•••••--•--••••••..............•----••--------•••- Date PermitNo......................................................... Issued-....................................................... Date _ • No......................... .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . 1.16 .........0F............ ....7. ......... ... ....... Appliration for Uh4pogal Workg Towitrurtion Vamit Application is hereby-made for a Permit to Construct (y ) 4or Repair an Individual Sewage Disposal System at: vv ............. 11............. ........................................ ... ............ Location, dress 11> -7 or Lot No. ..................... y.......5 .................................................. . ............ ......... ....................................................... Owner Address . ..............i......................... .................................................................................................. �f installer Address Type of Building Size Lot... A feet U 1 Dwelling—No. of Bedrooms___., C644"t-F pansion Attic Garbage Grinder ................_X Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtures -..---......--_gallons ---- ---.--- ... ------------*.........Design Flow. ................gallons per person per day. Total daily flow............... ...........gallons. Ix Septic Tank—Liquid ppacity(10.0(dallons 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. f t. Z Other Distribution box Dosing tank 0 � 1�....................—:. Date..........._-4 Percolation Test Results Performed by.................. 'r Test Pit No. ...minutes per inch Depth of Test Pit......p2....... Depth to ground water.....I Test Pit No. 2..7A_4t-._minutes per inch Depth of Test Pit..................... Depth to ground water.......C-,�-4a 4,A ...................................---------------------- .......I. . ..... ........................ ....... ...................... ..... ...................................... 0 Description of Soil................. 6_ 0 71:��0 7 t -f ...............................•............... �4 1 -1 A-L� fi .............................. ---------------------------------------------------e...=�/1............................................................... ........................................................ ....................................................................................................................................................................................................... U Nature 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'TTLE 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 healt Signed.................. ..... .............. ✓.................... Application Approved By...................................................... .......................... ........z� - t.......... -5 504 ate Application Disapproved for the following reasons:................................................................................................................ .........................................................................................................I............................................................................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / ............... ''........OF............ Tntifiratr of Tompliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed .( ) or Repaired b .J. 4 g4? -13... ............. y----------------------- ................. ...........Install F;i-v X.....*------------------------------------ at ----------- ...........4.................. ..................... has been installed in accordance with the provisions of T1Tk fhF State Sanitary Code as described in the application for Disposal Works Construction Permit No..............................7.......... dated_...-_.__.._............._.._....__.._._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. e� DATE........................................../:7..t.60L Inspector ............................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .7 ........ ...........OF.............. No............. ........... FEE........................ Disposal Workii Tomitrudion,ramit Permission is hereby granted- ..............I P-4............. ....... .............................. to Construct?(X ot Repair* an Individual Sewage Disposal System at'No ................. -----------------7-��- .............. .................................................................................. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... .% ........................................ . �............................................... 1113/fV oard of Health DATE................................................................ ............ FORN( 1255 H0813S & WARREN, INC.. PUBLISHERS J LOCATION �J SEWAGE PERMIT NO. srl VILLAGE a INSTAIIE 'S AME i A NESS . GUILDER OR OWNER gl� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED _ Y 8� r T L: '7rT S s= i 00 Q� om' 4, t lel-IWOOL h �a t vac d°' 4a t 1 t I l 43. S.F Fka14T 5. 6. 30 S a Q. 15.00o S. F I 0� Fr �G771 LOT LF—,,Fa F J s�TOE"�K-� F Qow 5. B, sad s,(3 LEGEND �t�OF EXISTING SPOT ELEVATION Ox0 CERTIFIED PLOT PLAN EXISTING CONTOUR --- 0 -- ao� JON tiN FINISHED SPOT ELEVATION R ERT a LaT — J516�J 2QD FINISHED CONTOUR 0----- s AP-5Tl0#,15 MILL APPROVED, BOARD OF HEALT No suR��'y� IN f�A 2�-.IsTA 13L� DATE AGENT SCALE , I � Coo DATES 9.25•71 WE-LDRED.6f ENGINEERING G1Q /NC. CLIENT 1 Qk+ RE CIVIL RE EGLANJR I CERTIFY THAT THE PROPOSED J09 NO. z'olL3 BUILDING SHOWN ON THIS PLAN ENGINEERS SURVEY DR,Illy,_,_,�Q CONFORMS TO THE ZONING LAWS OF aA!R45iA8L;\ MA". 712 MAIN ST. CH-By, � HYANNIS,MASS. SHEET.:L_. OF DATE 0. LAND . SURVEYOR 20 FT. M//►i NOTLC /F E/TNER THE SEPTIC TANfC OR,,, �.EffCH//VG P/T ARE MORE THAN I2•�SEL0 e-V Ia MIN r/RAOE, fa 24'O/AMETER Co/yCR�ET.� CO!/ER SNA44 eE BROUGHT TO 6RA0E /✓,EXTRA CONCRETE P/Pl' 0YE.4VY CA S.T IRO/Y COVER SHALL BE USED �L= 1 Ot.o M/N. P/TCN /P /N OR/VEy1/A Y e.. COYE/_�S -+�B'PFip FT. 2% M/N. CO/VCRFTE �., s a: _ _ GhAOE CO►�E'R CLEAN SA v o / BACKFI L L '- ' - L/QV/D LEYEL •- ' ' 2 4`. LAYER 4"CAST� - - - _ . • o e QF !� _ IRON P/PE c CA4 o •a o: 1 • • • • • • • • p o M/N.P/TG/1 D/ST 4 ryA5HF0 57?�NE IrT. SEPTIC TA/V/C • s • • • • • • •4 • + 1 BMX p • 1 B • • • • � • 0 • 314 ::� Chi 1C�NA:-) '� • a • • •�E N�✓e • • �o y 1V.43HED/STONE 0 1 1 • • • a • • ' p o a� e • • . • • • • • • v P PRECAST SEEPAGE - I�g.S x a • • • • . • • • a • P/T OR EQU/V, I 1AIVWRT L`LEVATIONS 2.5-_ 4� I GP© „ a • 78.5 x l.p = � GPP � � �L= 91.c5 INVERT AT QU/LD/NG `R.O FT. 6 D/AM. INLET .SEPTIC r..4,vK 9g•� F T DiT as ` -( �4-g 6m PD I O FT. O/AM' C CAE T�ULATION�'�, OUTLET SEPTIC TANK 92.C• FT, INLET D/STR/B!/T/ON BOX 918A fr. GROVNo 044TER.TADLE OtITLETD/STR/BonON BOIL 9,3 -FT SECT/ON 4F' ly /N4E7-LFACHI.VG Ia17- 93,n Fr. SEJ�VAGE /.SOASA t SYSTEM TAB�ULATIG/V LEACHING P/T 3 FT. -SCALE DESIMV CRI7'ER/A O/•yE/vs/oN 8 FT. ' NUJ►lQER OF BEDROOMS � _ D/MENS/CN C�_FT. 'r Cv4R45AGEOISPOSAL UNIT O SOIL LOG SD/L TEST TOTAL EST/^lATED FLOK/ 350 6AL.1DAV SO/L TEST SOIL TE'S•TOR /VUMBER OF 4.-ACN/Nl. /ojTS i f^ELEY. 1�i.n® ELFY, OATE OP- SOIL TEST 5/OE.4&ACH/NG PER Pl7 (BS 510. FT. , cortf RESULTS h//TNESSED 8Y J K l Gtf--�` �• �'` 6OTTO/N LE�9CN/IVG PER P/T $Q, o p-2 T L=-m PERCOLAT/O)V RATE#/ L� M/IV•I/NCN TOTAL LEACHING AREA 2!� SQ. FT, _ urLEE� PENCOLAT/ON RATE j*2 �� M/N�INCf/ �?ESERVELEACNlN6 ARE./► rL�Co SQ. FT. 2'-{2` MED �ZN o f Mqs /3�h��N OF l F. _ Sr1�D lrST 3 — Et lSIC�aJ IZoAC MA2srcx4S M(LLS,eA2N_!-�SLf o JOHN �•,, ft�C �, BERT '., MORSE Ln p No.10951,o Q - EL DREDGE ENG//VEER/IVG CO,/NC 4�'G�s�EPc�c .7/2 -4A//V S7- O/STEM pQ` C NAA .tip NDG/tOLND YYATER ENCOCJNTLrREO HY.�tNN/3, MAss. 4NG SU GROUND wATER AT /V0 IpQ,3 SHEET'- OF 'L JOB