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HomeMy WebLinkAbout0150 FOX HILL ROAD - Health 150 Fox Hill Road Centerville 189 053 i � �ryrir��y �pECYC(Fp� gM/,m, `(fp No 53LOR �O,�.CONSJ HASTINGS,MN 0 4 Commonwealth of Massachusetts 199-067 Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' s 150 Fox Hill Rd. Property Address Kelly ' "! Owner informa4ion Owners Name is ,/ required for every Centerville MA 02632 9/18119 page. cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. A. Inspector Information 5/4& Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Cityyrrown State Zip Code 508.272.6433 13010 Telephone Number License Number B. certification I certify that I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true,accurate and complete as of the tame of my inspection;and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system. 1. 0 Passes 2. ❑ Conditionally Passes 3. ® Needs Further Evaluation by the local Approving Authority 4. ® Fails a4*]Nr-- 9/18/19 InspectoesSighature Date I The system inspector shall submit a copy of this inspection report to the Approving Authority(Board + of Health or DEP)within 30 days of completing this inspection_ If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. I Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address hove the system will perform in the future under the same or different conditions of use. t�rrsp doc-r®v.7r16/20r8 rae 5 DftO Form:stbwfaoe wposd •paw t at 9a i I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property address er Kelly Infform oaffnation 6s owners Nme required for every Centerville NIA 02632 9/18119 Paw- City/town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary:Complete 1,2, 3,or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CNIR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: A new system was installed in 2004 and the old was left in place.At the time of inspection the flow was to the old. It was video inspected and the effluent level at the pat appeared to be within a couple inches of the invert.The new system was dry but staining in the piping suggests that flow does go to it when the old system backs up 2) 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 Hoard of Health,will pass. Check the box for`yes","no"or"not determined"(Y, N,ND)for the following statements. if"not determined,"please explain. The septic tank is metal and over 20 years old$or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): twwdac-rev.7&M M8 TMB 5 00i kaPecdw Fam:SWmaface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly information isi Ownees Name nform required for every Centerville MA 02632 9118/19 page. CWTown State Zip Code Date of Bnspecton C. Inspection Summary (cunt.) 2) System Conditionally Passes(coat.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumpstalarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is,removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) Further Evaluation is Required by the Board of Heap: ❑ 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1Hb)that the system is not functioning in a manner which will protect public health, safety and the environment: 1 iSnsp.doc•rev_706=8 Title 5 Mid kmpedmn Fam:St6arface Sewae rear Steen.Pege 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Full Rd. Property Tress Kelly infbrMation is W Owner's Name orm required ibr every Centerville MA 02632 9/18119 page. Cwrown state Zip Code ®ate of Irtspection C. Inspection Summary (cunt.) ❑ 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 b. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well_ ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. der: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: I Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool tskwdmm-ter.7asme Tire 5 0fficad Mtspectimn Fwm:Subsaraoe Sewage Disposal System^Page 4 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 150 Fox Hill Rd_ Property Address iKelly owner owner's Name infortnattan is required for every Centerville NIA 02632 9/18119 page- citylrawn State Zia Code ®ate of Inspection C. Inspection Summary (cunt.) 4) System Failure Criteria Applicable to All Systems:(cant) Yes No ® ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® liquid depth in cesspool is less than 6"below invert or available volume is less than Y day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation. ® ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. ['his system passes if the well water analysis,performed at a®EP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ® ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either`yes"or*no'to each of the following,in addition to the questions in Section C.4. 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 ftap dw•rev.7(ZSWS Tde 5 ofscar tragecbon Forth:Subsurface Sewage Daposd Systain-Page 5 of IS Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments kw 150 Fox Bill Rd. Property Address Kelly owner Owner's Name infomation is required for every Centerville MA 02632 9/18/19 page- Cityfrawn State Zip Code ®ate of onspection C. Inspection Summary (cunt.) If you have answered'yes'to any question in Section C.5 the system is considered a significant threat,or answered"yes'to any question in Section C.4 above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section C.4 shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department_ 6. You must indicate"yes"or"no"for each of the following for all inspection. Yes No ® ❑ Pumping information was provided by the owner,occupant,or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ VWre as built plans of the system obtained and examined?(if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? 1 ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions,depth of liquid,depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: I ® ❑ Existing information. For example,a plan at the Board of Health. ® ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CNIR 15.302(5)] f 1 I l5snp tYOC•n v.�1 118 r&-5 Of5Od kMPed M Fans S6rfaoe i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Mill Rd. Property Address owner Kelly information is Owner's Plante required for every Centerville MA 02632 9/18119 page- C4frawn State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Dumber of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CHAR 15.203(for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 1 Does residence have a garbage gander? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes,discharges to: Is laundry on a separate sewage system?(include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date I t5inW.doc,tev.MOWS TWO 5 OftM kgmdm F-on St"dam Sewage Dqmd Sy!*=•P.W 7 or 18 I Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal Systems Form-Not for Voluntary Assessments 150 Fox Full Rd. Property Address Kelly Owner Owneds Name information is required for every Centerville MA 02632 9/18119 page- Cityyrrowm State Zip Code Date of Inspection D. System Information (cons.) 2. Cormserciallindustrial Flow Conditions: Type of Establishment Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes,discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings,if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Pumped 1.5yrs ago per owner Was system pumped as part of the inspection? ❑ Yes 0 No If yes,volume pumped: gallons Flow was quantity pumped determined? i Reason for pumping: I � tswip.doc-rev.706=8 Tie 5 MOM traper3ion Fam:SLft rfaoe Sawaw Disposm S -Page a of 9a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Fonn-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly Owner Owners Name infotrrtation's required for every Centerville MA 02632 9/18119 page. cityrrown State Zip Code ®ate of inspection D. System Information (coot.) 4. Type of System: ® Septic tank,distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes,attach previous inspection records,if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components,date installed(if known)and source of information: New system 2004 utilizes the original septic tank, no records of the original system date of install Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24" feet Material of construction: cast iron ❑40 PVC ❑other(explain): ' Distance from private water supply well or suction line: >10°feet I Comments(on condition of joints,venting,evidence of leakage,etc.): ISasp.doc•mv.712SMS rage 5 nai i knpecPcn Fam:Swiaraa;sewage o4asat spsi®n-page got ie Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly Owner Owner's Name information is required for every Centerville MA 02632 9/18119 page. Cityrrown state Zip Code ®ate of Inspection D. System Information (coat.) 6. Septic Tank(locate on site plan): Depth below grade: 18"feet Material of construction: ®concrete ❑metal ❑fiberglass ❑polyethylene ❑other(explain) H-10 tank appears to be structurally sound, inlet cover raised If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000g Sludge depth: 10" Distance from top of sludge to bottom of outlet tee or baffle >12" Scum thickness trace Distance from top of scum to top of outlet tee or baffle >Z. '�yn Distance from bottom of scum to bottom of outlet tee or baffle LL 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.): Pumping suggested every 3yrs to prolong the life of the system ftapAoc•mv.7 AW18 rde 5 Ovicw kmpechon Fam:&"wkoe Seaage Dq=W Spstem-Page 90 or 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage®ssposa6 System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly Owner Owner's Nam inforrnation s required for every Centerville MA 02632 9/18119 page. City/Town State Zip Code Date of inspection D. System Information (coot.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ®metal ®fiberglass ❑polyethylene ®other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scam to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): � I 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade. Material of construction: ❑concrete ®metal ®fiberglass ®polyethylene ®other(explain): Dimensions: Capacity: gaffers Design Flow gallons per day tS�rrsp�c-rev.7r16rloreMe 5Ofadall I "i, Fa :Subsurface SewageDisposalStem-PageAtofla t Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address oWneP Kelly informaWn is 11s Na-e required for every Centerville MA 02632 9118/19 page. Cityrrmn State Zip Code Date of lnspecieon D. System Information (cont.) & Tight or Holding Tank(cost.) Alarm present ❑ Yes ❑ No Alarm level. Alarms in working order: ❑ Yes ❑ No Date of last pumping: ®ate Comments(condition of alarm and float switches,etc.): 1 *Attach copy of current pumping contract(required). Is copy attached? ® Yes El No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): The d-box to the old system was video inspected and it appears to be structurally sound,the new d- box was excavated, it is Z below grade,cover raised to IZ%with no adverse conditions I 1 i oisysM-Page 12ofea t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address owner Kelly information is Owner's Name required for every Centerville MA 02632 9/18119 page. City/Town State Zip Code Date of inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order ❑ Yes ❑ No* Alarms in working order ❑ Yes ❑ No* Comments(note condition of pump chamber,condition of pumps and appurtenances,etc_): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System(SAS)(locate on site plan,excavation not required): If SAS not located,explain why: Type: ® leaching pits number 1 ® leaching chambers number. 2 ❑ leaching galleries number_ ❑ leaching trenches number,length: I ❑ leaching fields number,dimensions: f ❑ overflow cesspool number f ❑ innovativelalternaitive system Type/name of technology: i t .tbc•tee.7/�r1a18 lie Soffadkwpemon Fam:Stbmfaw Sewage Som•page f 3 om a It 1 t Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Bill Rd- Property Address Kelly Owner owner's Name information is required for every Centerville MA 02632 9/18/19 page. Citylrown state Zip Code ®ate of Inspection D. System Information (cont.) 11. soul Absorption System(SAS)(cont.) Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): The SAS of the old system was video inspected and it appears to be a leach pit,effluent level was gust below the invert, it presumeably failed in the past The new SAS is comprised of 2 500g leach chambers,the chambers were video inspected and are dry at this time 12. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool II Materials of construction � Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): tsbwaoc•mv.Mm me TWe 5 Offidal kqvW=Form Stkariace Sewage Dual Systp-en•Pace 14 or 18 Commonwealth of Massachusetts Title 5 Official Inspection Forte Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly Owner Owrnees Name infomrtation is required for every Centerville MA 02632 9/18/19 page. C4rrown State Zap Code Date of Insp2cfion D. System Information (cont.) 13. 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.): I i 4 4 I tsk% dot•mv.72sma We 5 dftiaA Wspecim Form:Subsafaoe Sewage sVsftn•Page 15 ag 98 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Fora,-Not for Voluntary Assessments 150 Fox Hill Rd. F�operty Addness owner Kelly infom►ation is Owners Name required for every Centerville MA 02632 9/18119 page. Citylrown State Zip code ®ate of Inspection D. System Information (cont.) 14. Sketch of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.Check one of the boxes below ® hand-sketch in the area below ❑ drawing attached separately Q.. a. o -L G � r (SLL0 L� lSiisp dx•tev.7P1TI1018 Tde-5 Ofi k {-fim form:Subsafare Sewage Disposal System-Page 96or18 i Commonwealth of Massachusetts Title 5 Official Inspection Form WN Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address owner Kelly infartnation is owners Name required for every Centerville MA 02632 9/18119 per• Cityfrown State Zip Code ®ate of 6nspedon D. System Information (cont.) 15_ Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >12' Let Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked,date of design plan reviewed: 2004 NCW 144" ®ate ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with load Board of Health-explain: 4'seperation per 2004 compliance ® Checked with load excavators,installers-(attach documentation) ® Accessed USGS database-explain: TOPO mapping You must describe how you established the high ground water elevation: See above i R Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5hV-doc a mv.7f26W8 rde 5 offica kgmcdm Fam:sftWrraoe seww mwosd SrAem-Page 17 of 18 r l� Commonwealth of Massachusetts Title 5 official Inspection Form 19 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Fox Hill Rd. Property Address Kelly owner owner's Name information is required for every Centerville MA 02632 9/16/19 page. City/Town State Mp anode Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information:Complete all fields in this section. ® B. Certification: Signed&Dated and 1,2, 3,or 4 checked ® C. Inspection Summary: 1,2, 3,or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ® D. System Information: For 6:TightlHolding Tank—pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included (5insp.doc•rev.71dS12018 Tdo 5 WOW k spechm Form:Slbaaraw Sew Disposal Sy$Wn•Page 18 of 18 G/— No. ` / -; Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Migonl *p5tem Cori.5truction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) El Complete System LTIndividual Components Location Address or Lot No. ° Owner's Name,Address and Tel. Asses '`Map/P 1 Installer's Name,Address,and Tel.No. `d Designer's Name,Address and Tel.No. led .1 h111`10111wle_4 -7 36 el-a$py Type of Building: Dwelling No.of Bedrooms 3 Lot Size�sq.ft. Garbage Grinder( D Other Type of Building ,� ,�/IGP No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date 5_ Number of sheets Revision Date _ Title 9eUWe.. / ae fD LC is Size of Septic Tank e o ifr&J`%l9 Type of S.A.S. 2— Description of Soil, 2- 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 Certifi- cate of Compliance has been issued b is, of ealth. Sign Date / Application Approved by Date -7 a Application Disapproved for the following reasons Permit No. _ Qw-4 — 3 3 I Date Issued No. *0 ' Fee Q . THE COMMONWEALTH OF MASSACHUSETTS"' Entered in computer: "�~ Yes f PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01 ZippYication for ;Digpo!5a[ *potem Construction Permit Application for a Permit to Construct( )Repair( V)Upgrade( )Abandon( ) O Complete System 21 dividual Components Location Address or Lot No. i r Owner's Name,Address and Tel.No. Assessor's Map/Parcel F/a'r�,�' y- 0 3 Cee era Ille Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. nor7L,?) Type of Building: Dwelling No.of Bedrooms 3 '1.ot,Size /.y119� sq.ft. Garbage Grinder(�/0 Other Type of Building_ ,c/ll No fPeersons Showers( ) Cafeteria( Other Fixtures �? 33D ®y Design Flow gallons per day. Calculated daily flow gallons. Plan Date 13//J V Number of sheets / Revision Date Title 5rr'"4-.a Size of Septic Tank 4> Type of S.A.S. Z 'S 4�< Description of Soil Nature of Repairs or Alterations(Answer when applicable) f 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 Certifi- cate of Compliance has gbeen issued by this and"of Health. / E, Si ne�� Date / 7 Application Approved by Date dy Application Disapproved for the following reasons 9 Permit No. &oo " 3 3 ► Date Issued G' ---------------- `— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTI , that the On-site Sew gc Disposal System Constructed( )Repaired( /fUpgraded( ) Abandoned( )by /:' CJ /�� has been constricted in-accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 oo It-M dated 7I.2 k)y Installer Designer i / The issuance of this permit shall not be construed as a guarantee that the system wiliffti1nction as d i ne . Date / 0�� Inspector ,��)A4 A t —— ———. —— — - ————— — r——— ————— No. 100 �— — / �-05�3 -Fee a� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLE, MASSACHUSETTS 30izpozal *pztem Con!6truction Permit Permission is hereby granted to Construct( �epair( )Up ade( )AbandonSystem located at /.5-0 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons�ttrruc 'on ust be completed within three years of the da of this p !Date: /�/0 Y Approved by /TOWN OF BARNSTABLE LOCATION SEWAGE VILLAGE lV 74vi//e ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Doo /;, LEACHING FACILITY: (type) 00 Cf,L C4oj i-j L.21 .(size) 12 r'Aar'X O" NO.OF BEDROOMS BUILDER OR WNER PERMTTDATE: y 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 Feld- Tick �is'o ��- ,� ,3�, 3G Ya' , (oy� 0 566 �y' y i j /TOWN OF BARNSTABLE LOCATION -)V �� �`'�I SEWAGE � VILLAGE ASSESSOR'S MAP & LOT ®""d j INSTALLER'S NAME&PHONE NO, SEPTIC TANK CAPACITY Dmo LEACHING FACILITY: (type) 00 C L 11ag lCeJ j2) .(size) NO.OF BEDROOMS BUILDER OR WNER k1ll PERMTTDATE: Y COMPLIANCE DATE: Separation Distance Between the: Feet j Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility exist ' Private Water Supply Well and Leaching Facility (If any wells �� Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist O Feet within 300 feet of leaching facility) / Furnished by Zf-,eO r,,4 3� Ys` 566 Town of Barnstable Regulatory Services Thomas F.Geiler,Director sXRr"r MIM NAM ,e Public Health Division EDP Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Designer: QkVID D. (f©UGH IWOWK Installer: I Address: ( P436(.L^ C[19Cl C Address: i'l,rP�s I 5.wDwle-H, MA 02,563 ,�i On71� a4�0-IKI' was issued a permit to install a dat ) (installer) septic system at 150 T-01< Hill IZog4 based on a design drawn by (address) V l D CQ6QJ A WV I.► R ak; dated IM a Y 1) (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. N� R r (Installer's Signature) W.9 ..;,gig o F � (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form TOWN OF BARNSTABLE LOCATION `� 950-;6 }.fit 14- ;?J-) SEWAGE # %'1-'JLX VILLAGE ASSESSOR'S MAP & LOT /oP-Y— 65"a INSTALLER'S NAME & PHONE NO. 519 Cu5�- S -SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) -7 /V_ 2* / NO. OF BEDROOMS PRIVATE WELL OR UB 1L C WATE BUILDER OR WNER� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes If L ' 37� 36, 1' 57 ys° S1� 4 No.............•-AIT OVED FxB... �............ 9arnmbleConservation DepartmeME COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Signed Date TOWN OF BARNSTABLE ApVtiration for Diiipontti Works Tonitrnrtton rantit Application is hereby made for a Permit to Construct ( ) or Repair OQe) an Individual Sewage Disposal System at: 1 " ............................................................ Gin-- q2 Location- 1 s or Lot No. ---.......... .�/........ ----•------------•...... .......-- '�'.-- ----------- Owner ddress Installer Address Type of Building Size Lot.............................Sq. feet Dwelling—No. of Bedrooms-------------13----------------- ----Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------------------_.......................................................................................................................... W Design Flow............... ................ per person per day. Total daily flow.............;� . .................gallons. WSeptic Tank—Liquid capa6ty_/4V*..gallons L7gth---------------- Width__-__.-_------- Diameter-----.---------- Depth---------------- x Disposal Trench—No. -----/.......... Width.......7-------- Total Length...��.--.... Total leaching area....................sq. ft. 3 Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.._-_-.-.---_-----_--._. (% Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ C4 ................... --------------•-----••----•----•-------•--------•-------------•••----•------------------._............................-----....---.----- 0 Description of Soil....................................................................................................................................................................... W U •--•--•......•••-••--•-•---------------•------•-•-----••--•------------------•----•-•••----•--••---•----•-•••---•--------------•--------••-•••-•---•-•--•--•-----------•------•--•••--------••-•-------. x -•••---•---------------------------••-•---------•-----------------------••-... ---------------------------------------------------------------------- --• U Nature of Repairs or Alterations—Answer when applicable.___I�_ -----ff-.......(_�St1_Q___ ............f�---g �P-t 5�-----� �.cx..... ......--�a�---------.......................................... --...'------ TZ..JE. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h Zee issued y th and of health. Signed .... ..... ..... C; --------- ..........-------- Application � C .._... ....... -� 15 Approved BY ...... . ..� �) ' .� - �7 �7 Application Disapproved for the following rearons- ---------------------------------------------- -------------------------------------------- - ------------ -------- -------- .. ................... . .................... ... -----------------.------.........---- ------------............................----------------------------------------------------- ----------------*....................... ..--..... ..... . Permit No. ...........� ._ �'�-.�-..-------- Issued / '°' �Da�e - -------- ---------- � -- , s- 6 f No................_....... Fps...- .................. THE COMMONWEALTH OF MASSACHUSETTS --=`-�1-�-�'�----' 1 .,.,-(M BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Uinpuual Wurkg Cnunitrnrtiun Itermit Application is hereby made for a Permit to Construct ( ) or Repair ()!) an Individual Sewage Disposal System at: ...... ----------- ---------•--------•---•--------------------------•-•---•••......•- --------------C.� N r -�V"r t l.:�.1.1 Location-:1dd s or Lot No.______'__ ......_. �-� C��•` ------------------ 5 --------------��C"T'---------- - '� ( l_----------- '�?• <' F (A' Owner -/�� ,�,.� Address 10 Installer Address UType of Building Size Lot___________________________Sq. feet Dwelling— No. of Bedrooms------------- ______________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ----------------------------------------------------------•••-------------•-•---------- ---...----._.._---------------------------------------------- w Design Flow................ ..............gallons per person per day. Total daily flow.............._:?-7U.................gallons. W Septic Tank—Liquid capacity.* _.gallons Length �gth________________ Width_-______—-_--_ Diameter................ Depth---------------- x Disposal Trench—No_ _____ __________ Width........____. ----- Total Length_-_ Total leaching area....................sq. ft. 3 Seepage Pit No________ ___________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0.4 Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-_-------------------- 44 Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water..-_._..._..__._:_..__.. P ----------------•-----•-•------•-----------•-------•------•--•--___-_--..................................................................................... D Description of Soil-------------------------------------------------'-----------'----------------. x w UNature of Repairs or Alterations—Answer when applicable__- __________(.CI00...-;..... ���t•• 1,4 N�- -'--••--- ..............j ........................................ -�.Ti � t Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha'/been issued y the-board of health. / / Signed .. fic -------------- 1�f---��/----- ... Application Approved By .!...... %� �': J 71 � ��1 J° . ' v -------S±r�/'v ............................--------- Dace Application Disapproved for the following reasons- ------------------------- - ..........----------------------------.......---------------.--------------- .... ...... .. . . . ...... . .... . . ...................................... ....... .... ........... .................. ..................¢..../---------------- Permit No. ..... .�o".... Issued ......... `"'.. ! `..... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�er#ifira e of C11IImialiance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ('-N< ) ULO tS-�J'SI by -' ... ------------------------------------------------------------------------------------- /57J (C) �S a�e . at ..... ....---------------------------------------- ............... ..... ---------- - ,:-------------......_---------------------------- has been installed in accordance with the provisions of TITLE , of The State Environmental Code as describedn the application for Disposal Works Construction Permit No. -- f��.. .. dated .. ^. air.. .. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED,�AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � � DATE ............. ............... ?".... __.. Inspector ------ /lf - ----- _._.... . .. ------------/-,-_--------------- --------------------- --------------------------�------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE L. iunuttl �urku Tunutrurtiun Permit Permission is hereby granted................... I to Construct ( ) or Repair an Individual Sewa_e Disposal System I '�`'� -j�--=.....--'�.... '-------`-. C- ------.. f�iLcJt L t E,-J at No.----••••••'•----'--•-------'_-•-- . _ Z Sir as shown on the application for Disposal Works Construction Permi;?l�"..�_fFa_VDated........f7 i -------------------------- Board of Health r DATE----- -�-�-✓____ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS L0 (:'ATION - SEWAGE PERMIT NO. VILLAGE ^.1 f� Gop INSTALL R'S NAME & ADDRESS 8UILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �.e. �.. L S ,s p�� a l No. 3 :.Y.... F>�s...... ................ THE COMMONWEALTH OF MASSACHUSETTS r BOARD 0§ HEALTH . Appliration for Dislimal Workg Tomitrnrtinn rantit Application is hereby made for a Permit to Construct ( ) or Repair ( " ) an Individual Sewage Disposal System at: .- ---.� ....�� .1,%.. .......��---------------•--.-••---... •-- •----••---........... ..• --------------------------------------.•. ✓ Location.Address / or Lot No. .. - l .t�1! !. ........................................................ 6Owner / Address a ' Q�L i✓�c,�,l r------------------------------------------------------ Installer Address Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms......... .__ .Expansion Attic ( ) Garbage Grinder ( ) �+ Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ................................. . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity---.........gallons Length---------------- Width.........--.---- Diameter--.............. Depth................ Disposal Trench—No. .................... Width....................Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.-----......---..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date---.................................... $--4 Test Pit No. 1----------------minutes per inch Depth of Test Pit.--.--.............. Depth to ground water.......--............--. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.--...----.............. -------------------------------------------------------- ------------------------------- •--•-----•-_--------------._... --------- -----------•--- O Description of Soil . .�. _ �L-...._.__ x --•--•----•-•--•--••--...-•--•--•-•••----•---••-••••--------•-----•-------•-••-••-----••-•---•............................... U ------------ •-------------------- .....------ .------------------ ._.......... -------------------------------------------------------- -------------------------....._...------•----------------- W ------------------------------------------------------------------------------------------------------------------------------------------------------- ----------- _ �} U Nature of Repairs or Alterations—Answer when applicable..--1 --4.----�j.s�./........._�.1 '`-4 ems`.. / +/� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LITLE 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 b the boar Zof �lth. gned .....r_.. ........ �.. t n^ Date Application Approved By-....•-• ... ._ !. .- - -..7 r 7 Date Application Disapproved for the following reasons:......................................................... .......__..... .......................................--................................................................................................................................................---- --------- Date Permit No......................................................... Issued-- ._ �. --Date --------•-^•--••--••--- C7 ! ,No.......... Ficic................*...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... OF.......... ......­.......................................... ---------- Appfiratiou for Uispoiial Works Tomitrurtion ramit Application is hereby'made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............................. .................................................................................................. Locati..-Address ..J�or Lot No. .le .............. L!t A VA .........I............................................ ---- ---------6;--------------------------------neri Address �p 0,04. .......... ...................................................... ---------------------- Installer Address U Type of Building Size Lot............................Sq. feet Dwelling No. of Bedrooms..........3... .........................Exp4iisl6n Attic Garbage Grinder ( ) Other—Type of Building .................. No. of persons............................ Showers Cafeteria ( ) Other fixtures ........................- ------------------------------------7:............................ ...................................................... Design Flow...........................................gallons.',P& person per day.',Total daily flow_'-- ..................................gallons. 94 Septic Tan Li capacity............gallons� , Length................ Width---------------- Diameter__-______._..__. Depth________.______. Disposal Trench—No_ .................... Width______,:____________ Total Length..................... Total leaching area....................sq. f t. Seepage Pit No_____________________ Diameter--------------------- Depth below inlet___.________________ Total leaching area.................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by------------------------------------------------------------------------------- Date_.__________.__ ........... Test Pit No. I................minutesperinch: Depth of Test Pit.................... Depth to ground water------------ - Test Pit No. 2................minutes per inch'-;:Depth of Test Pit_.._._..____________ Depth to.ground water........................ ..................... ----------*------- --------------*-----------------------------­---------­-----*......."­---------------- 0 Description of Soil._._, /C..* 4...........................................I.................................... .................................................. U ............................................................................ ................................................................. ....................................................... ......................................................................... . -----------­------------------------------------------------------------ ........ U Nature of Repairs or Alterations—Answ 64 when applicable­--2-40­0---0­- -10,0Z........ .......­. ...................................................................... ..................................... ...................................... ......... ... .. .......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisionst of TIT T 1L 5 of the State Sanitary Code— The,,.iindersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued be-the boar Zofalth,s of a_ APPO- . .................. gned. ........... .......................................... ........................ Date Application Approved By...!t...... ................ -------- Date Application Disapproved for the following reasons____________________________________________________ --.._.-•-•---------•---------- ..._.___... ...................................................................................................................................................................................................... Date PermitNo........................................................... Issued...................................................... Date THE,COMMONWEALTH-OF MASSACHUSETTS BOARD HEALTH ....... .. ... ......OF............ ................................. rtifiratr of Tompliaurr TH14S -S TO PoERTIFY That the'Individual Sewage Disposal System-constructed or Repaired by... . ............... ........................................ --------------- ..... ................... os stal tal------- ........ ... . ....... ...... . . ........... has been installed in accor Ancel w- the provisions of TIT r"6 The tate Sanitary Code as described in the application for Disposal Works Construction Permit No.._- I,,e------- dated .2-!!­)P_-n-,�-------------- THE ISSUANCE OF THIS CERTIFICATE SHALV*&,'tE CONSTRUED A A GUARANTE "THAT THE SYSTEM, WILL. FUNCTION SATISFACTORY.-,7,�,'���"�i"��,,,.tl&,�,,,�-' .......................... ...... 6 2111�r;`,..�i`............DATEI- :nspedoi.... ti 71 7',-e'.- ­-------­-­---- U 4 -THE COMMONWEALTH OF MASSACHUSETTS 7o.q BOARD of HEALTH., ........ ........OF.......... p. . .............................................. N 411 FEE...... ......... 'low Permission is hereby granted...... Pff....... . ............... .............. .. ......................... .......... to C op R an Ind* H al S,y S A/ s onstruc" ,R Ivi..11 ,In'op . ... ... Alv-. ­­ ......../1 ­9.... .... 4'.. -� ........... ............................ i at.No..-.. �-W. Street as shown on the application fo isposal Works Construction Per i o-------- . ...... ated. .................................ca ....... ... ........ ................. Board of ealt DATE.......7.,.................. ................................177....... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS w , < �l PLAN REFERENCE CONTOURS LLW J< LAND CPURT PLAN 33466-C EXISTING - - - - - - - 50 Cy �z3 FOB ASSESSOR'S MAP: 189 MINIMAL GRADING PROPOSED JN O�w 'ao ' LOT: 53 J m oo N0 <w� HILL FoX aWWy ROAD R N 1 !ocus y � N F LLz o E LOCUS MAP ,0 58 NOT TO SCALE 00 \ r N V Ok N U j z 3 el <ATER g A� I %.r� O,AL � ` 57 <W w W GATE LEGEND Ln cC CC < J o 2 �Q6 a o W < w s? EXISTING J (.9 * \� 1000 GALLON o 0 LU o� SEPTIC TANK o-BOX o J Z w\ 3." W LL ,� �� \v Q\ ` TEST PIT O�J ig� x c _ bZ0 J�So��\�G L 0 T 18 UTILITY POLE $ ccw K� �]� \ �C Z J N N in s �� � �, AREA - 16296 sf +- W LL ~ o -y1,� \ by TREE w ��0� Q OQ . ��. \ N NGEE� RB:ERST7ER OE TER 1&P O LL Z lU ��� 1 O-OAK "-MAPLE P-ftE < .S p to W•sr- J <0 aim v,,, p 57 OF Q .>, EVSTMIG SAW) SAS N COUGK, G�;R +T� t j 24 ft x 12.5 ft x 2 ft NP LEACHING GALLERY 3 -0 W Y _� a w z Sao LL Q s� yLL Z -� f- N AN � a o om � � � �-O � SEWAGE DISPOSAL SYSTEM PLAN O o o cn U -T0 SERVE EXISTING DWELLING Z w O a Ell j 1 in O w N s FRANK AND DIANNE KELLY Q- + V 1e P 8 150 FOX HILL ROAD CENTERVILLE. MA o S9 59 -3000 ft ECO-TECH ENVIRONMENTAL, S L 43 TRIANGLE CIRCLE SANDWICH MA 0256 o BENCH MARK a R PLAN 508 364-0894 TOP OF FOUNDATION LLW ELEVATION - 58.80 ETE-1633 MAY 3 2004 I/2 USGS DATUM ASSUMED SCALE: 1 in a 20 f t THS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER ORIGINAL PLANS INTENDED FOR SUBMITTAL TO THE BOARD OF HEALTH WILL BE SIGNED IN BLUE AND STAMPED N RED. SOIL TEST LOG i DESIGN CALCULATIONS DATE bF TEST: MAY 2 2004 SOIL EVALUATOR: DAVID D. COUGHANOWR, RS DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD WITNESS REQUIREMENT WAIVED - NO VARIACES SOUGHT NO GROUNDWATER ENCOUNTERED SEPTIC TANK: 330 GPD X 2 DAYS - 660 GALLONS TEST PIT I PARENT MATERIAL: PROGLACIAL OVTWASH ELEVATION - 57.9 +- PERC AT 48 in : 2 MIN/INCH IN C SOILS USE EXISTING 1000 GALLON SEPTIC TANK IF IS SOUND STRUCTURAL CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DISTRIBUTION BOX: USE 3 OUTLET D-BOX. (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 0-7 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE Abot - { 24 x 12.5 ) - 300 sf 7-32 B LOAMY SAND 10 YR 4/4 NOW FRIABLE A s d w - ( 24 + 2 4 12.5 • 12,5 ) x 2 - 146 s f A t o t - 4 s f 32-144 C MSEAD-CCOARSE 10 YR 6/4 NONE LOOSE x 6 Vt 0.74 x 446 - 330.04 GPD USE A 24 ft x 12.5 ft x 2 ft GALLERY. Vt - 330.04 GPD > 330 GPD REOUIRED GROUNDWATER ADJUSTMENT EXISTING GROUNDWATER LEVEL LEACHING GALLERY BASED ON BARNSTABLE GIS DEPARTMENT RECORDS INDICATED GW: 23.0 CONSTRUCTION DETAIL INDEX WELL: SDW-252 ZONE: D DRYWELL UNIT STONE READING: MARCH 2O04 8'-e'x 4'-10-x r-9' LEVEL: 47.2 2 ft EFF. DEPTH ADJUSTMENT: 4.5 ft 24.0 ft lo ADJUSTED GW: 27.5 0 NOTES, � M � tn N 1) GA`RBAGE- GRINDER NOT ALLOWED WITH THIS DESIGN o 2) ALL-LINES-,TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 3.5' 8.5. 8.5' 3.5' OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES 24.0 ft NOT SCALE BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING SOIL ABSORPTION SYSTEM TO BE ABANDONED IN PLACE OR REMOVED. 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0' BEFORE PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK SEWAGE DISPOSAL SYSTEM PLAN 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT -TO SERVE EXISTING DWELLING PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. FRANK AND DIANNE KELLY 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL 150 FOX HILL ROAD CENTERVILLE. MA STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING (/�� 12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR .AND CHECKED ECV-TECH ENVIRONMENTAL FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-1633 MAY 3 2004 2/2