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HomeMy WebLinkAbout0292 FULLER ROAD - Health T292 Fuller .Road - Centerville_. .,P,IIEW _ J4TscycCFpco 112F(ILG pUPC 12543 = y� No. 3LOR Hasr�raos,mN No.A-7-Y THE COMMONWEALTH OF MASSACHUSETTS FEE e rya BOARD OF HEALTH 01,GM OF\� Jl/11� F� APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - Complete System [:]Individual Components 11 Luce onc" Owner's Name Or-a rh I --3 1 I Map/Parcel# Address Lot# Tcicpho, r L-L Installers Name / Designers Name Ir Address Address Telephone# Telephone# Type of Building: Lot Size3Q 43 Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons 11,12 Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) !a3 gpd Calculated design flow >3 3 gpd Design flow provided 5 gpd Plan: Date �� 3 Cl� Number of sheets Revision Date Title (Lro: ,Le ��d o k v Description J Soil(s) sc d- Soil Evaluator Form No. Name of Soil Evaluator« d-_ uE Date f Evaluation (o-l?�cR i{- DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and fu er agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. or Signed4 to d FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 1 No:-� THE COMMONWEALTH OF MASSACHUSETTS F FEE :_ `/ b BOARD\ O.F HEATH APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - Complete System ❑Individual Components L occator Owner's Name u II—Map/Parcel# Address ? ell 29 3/n Lot tr hon OL 01 �_j rA.L l i_Q_Q L iC I i Installer's Name �� Designer's Name Address Address v Telephone# Telephone# Type of Building: -" Lot Size3O, 439 Sq.feet I Dwelling No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.,of persons Showers (. ), Cafeteria ( ) Other fixtures Design Flow(min. required).- - gpd - Calculated design flow 3,3 ZDgpd Design flow provided3SSgpd Plan: Date Number of sheets �_ Revision Date Title SLNL 4 Description o Soil(s) O" S.Lc i,� lam' -�� sz. d �� lao"'1U!�" 1 14=, d-- Soil Evaluator Form No. Name of Soil Evaluator' r?c1 taA u-c, Date f Evaluation 10-k om-fill- P-3LJ�o DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fu er agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Si red IDate g �l[Iiti�►'>Ers 7 .. 2—3-- 9�" 4. FORM t - APPLICATION'FOR DSCP DEP APPROVED FORM 5/96 Noy O ' � THE COMMONWEALTH OF MASSACHUSETTS FEE I!7p BOARD OF HEALTH CERTIFICATE OF COMPLIANCE ` 3 i t Description of Work: ❑ Individual Component(s) ❑Complete System KoOt'he undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. f—7 dated "Z-3,9 Approved Design Flow (gpd) r Installer Designer: Inspector Q Date ' �; 7- <� � The issuance of this certificate shall not be construed as a guarant4Ahat the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 k THE COMMONWEALTH OF MASSACHUSETTS No. l-� FEE J O U r BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT 4 Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) at�individual sewage disposal system at as described in the application for Disposal System Construction Permit No. / S -7 °-) dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health. 14 FORM 2 - DSCP DEP APPROVED FORM 5%96 t f I\ f FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON ' TOWN OF BARNSTABLE LOCATION O� ��2ZZ.C�dL� � SEWAGE # 71?' Y VILLAGE ASSESSOR'S MAP & LOT , On3 INSTALLER'S NAME&PHONE NO. C> �o G T%•+ SEPTIC TANK CAPACITY / 5 ®® LEACHING FACILITY: (type) �=.�_ (size) NO.OF BEDROOMS BUILDER OR OWNER •= C�t;r.p.,.�Q rem PERMI TDATE: —U COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 I Dt.ti�f 37 3 q, © � , � `l 1.� 43 a TOWN OF BARNSTABLE LOCAT10N elk. SEWAGE # 'VILLAGE 440e7, ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. °l7rc./O�o 77.7 SEPTIC TANK CAPACITY / y act LEACHING FACILITY: (type) (size) 13 X 2 _ OF BEDROOMS ;.."BUILDER OR OWNER q r n ::PERMTT DATE: 1 COMPLIANCE DATE: ,:;Separation Distance Between the: .-Maximum Adjusted Groundwater Table and 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 :E ge of Wetland and Leaching Facility(If any wetlands exist :within 300 feet of leaching facility) Feet `.'::Furnished by 13- y �l-W i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS,: DEPARTMENT OF'ENVIRONMENTAL PROTECTION MAP PARCEL • ® ® ®�j LOT TITLE 5 �4�3 OFFICIAL INSPECTION.'FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL`SYSTEM FORM PART A CERTIFICATION >>/1AP . Property Address. 911-;) 1-�6jP txee LOT Q' `... A� • '` Lam. Owner's Name: Owner's Address: Date of Inspection: CJ Z Name of Inspector: (pleaseprint). b Y4 g Intel RECEIVE® Company Name. u AdY3 Mailing Address: •O 1770 V JUN 3.. 2002 4 00� Telephone Number: G08,'77/ • .9 Lq TOWN OF BARNSTABLE HEALTH DEPT. CERTIFICATION STATEMENT- I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(MO CMR 15.000). The system: Passes Conditionally Passes Needs.Further Evaluation by the Local Approving Authority. Fai Inspector's Signature: Date: ��- The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is.a shared system or has.a design flow of 10,000 gpd or greater,the inspector and the system.owner shall submit the report to the appropriate regional office of the. DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and.under the conditions of use at that time. This inspection does not address how the system will.perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I s Page 2'of l 1 OFFICIAL INSPECTION FORM—. NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A W' CERTIFICATION (continued) .130FY ......—Prditf'I'y Address: Date of Inspe tion: ��®� - a .. Inspection Sumnnary: Check A,B,C,D or E/ALWAYS complete all of Section D A.Iytem Passes: 1 have t found any information which indicates that any of the failure criteria described in 310 CMR 15:303 or- 310 CMI R 15.304 exist.Any failure criteria not evaluated are indicated below. -Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the 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. ND explain: Observation of sewage backup or break out or high"static water level in the distribution box due to broken or obstructed..pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 IPage3 of 1'l OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARY-ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION(continued). Property Address: , deadaj Owner: Date of Inspe ion: j C. Further Evaluation is Required by the Board of Health: Conditions.exist which require.further evaluation.by the Board of Health in.order to determine if the system is failing to protect public health, safety or the environment.. 1. System will pass.unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety.and the.environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will.fail.unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a.manner that protects the public health,safety and environment:. _ The system has a septic tank and soil absorption system.(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I 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 I00.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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A,copy of the analysis must be attached to this form: 3. Other: 3 Paae 4 of I 1 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:LN - Owner , Date of Insp tion: 2 Cod_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes Np _ V Backup of sewage irito.facility or system component due to overloaded or clogged SA5br cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or / clogged SAS or cesspool Static, liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped 1! 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. _ � Anyportion of a cesspool or privy is within a Zone l of a public well. kUj Any portion of a cesspool or privy is within 50 feet of a private water supply we11. '/ Any portion of a cesspool or privy is less than 100 feet but,greater than'50 feet from a private water . supply well.with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic.compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen.is equal to.or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one.or.more of the above failure criteria exist as described in 310 CMR 1.5.303,therefore the system fails. The system owner should contact the Board'of Health to determine what will be necessary to;correct the failure. E. Large Systems: To be considered a large'system the system must serve a facility with a'design flow of 10,000 gpd to 15,000 gpd• 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) yes no _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15`.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1.1 OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM P.ART B CHECKLIST Property Address: c�2 Owner: Date of Insp t►on: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Pumping.information-was provided by the owner,.occupant,or.Board of Health, Were.any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? _ Have large.volumes of water been.introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,excluding the SAS, located on site? i/ _ 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: Y"es� no V _ Existing information.For example,a plan.at the Board of Health.. Determined in the field(if any of the failure criteria related to Part C.is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of I I OFFICIAL-INSPECTION•FORM—NOT FOR VOLUNTARY°ASSESSMFNTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: ..7 „1 Owner:. C Date of Inspe tion: 22&9 -9a, FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): .3: Number of.bedrooms(actual): �J.. DESIGN flow based'-on 3 1 0 CMR 15.203 (for e)6mple: 110 gpd x#of bedrooms): 2326 -Number of current residents: Does residence have.a garbage grinder(yes or nol�(�- Is laundry on a separate sewage system (yes or not .jif yes separate inspection required] Laundry system inspected(yes or no)�� Seasonal use: (yes or no); ' Water meter'readings; if available(last 2 years usage(gpd)):(J/."qg,®Da Sump pump(yes or-no)---- �/ ® Last date of occupancy: _ &Palme A44Zaex6f COMMERCIAL/INDUSTRIAL\. Type of establishment: Design flow.(based on 310 CMR.15.203):. gpd Basis of design flow(seats/persons/sgft,ete.): : . . Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):-_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system.pumped as part'of the inspection{ye or n If yes,.volume.pumped:__gallons--How was quantity pumped determined? Reason'for.pumping: . TY."F 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) _Tight tank _Attach a copy:of the DEP.approval _Other:(describe): proximate age of all components,date installed(if known)and source of information: S — Were sewage odors detected when arriving at the site(yes or no 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: p�.� Date of Inspe tion: BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron 40 PVC_other(explain):- Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage"etc.): SEPTIC TANK:—L-Vocate on site plan) Depth below grade: -4� Material of construction: concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:- Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: /0,G )< �p Sludge depth: A,2 Distance from top of�ludge to bottom of outlet tee or baffle: 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' How were dimensions determined: cji ��,0 Ct�%?�Ji�. Comments(on pumping recommend ions, inlet and outlet tee or baffle condition, structural integrity, liquid levels s related took i'vert, evidence of leakage,etc.): ) -7Z X � GREASE TRAv40ocate c,n.-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(on pumping recommendations, inlet and outlet.tee or baffle condition, structural integrity,liquid levels as related to outlet invert, evidence of leakage;etc.): 7 Page 8 of 11 OFFICIALINSPECTION FORM`—NOT FOR VOLUNTARYASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C `SYSTEM INFORMATION(continued) Property Address - C;, Dew Owner:j Date of Insp tion:,_ � _ � (J� 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(expla►n): Dimensions: Capacity: gallons '.Design Flow: gallons/day Alarm present(yes or no): Alarm level: _ Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): 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.): �O-c(S fi PUMP CHAMBER- (locate onsite 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.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM—.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address Owner: �— Date of Ins pec ion: �i G!!/_ r. .7,c>)00 SOIL ABSORPTION SYSTEM (SAS): _ cate on site plan,excavation not required) If SAS not located explain why; Type beaching.pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool;number: innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil;condition of vegetation, etc.): CESSPOO S:11 (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet.invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): 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.): 9 Page 10 of 11 OFFICIAL INSPECTION,FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOS"AL SYSTEM INSPECTION FORM :PART C SYSTEM.INFORMATION(continued) Property Address: � G QkAA1&.'2P_0 d1 4 Owner: ,, /106&22 Date of Insp ction: '9'Wa SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. �9 10 f , Page 11 of I 1 OFFICIAL- INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ,7 Owner: ) Date of InspeMon: SITE EXAM. Slope Surface water Check cellar. Shallow.wells Estimated depth to ground water 40 feet Please indicate(check).all methods used to determine the high ground water elevation: Obtained from.system design plans on record-If checked,date of design.plan reviewed:_ Observed site(abutting property/observation hole within 150 feet of SAS) Checked-With local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database=explain: You must describe how you established the high ground water elevation: S, ]1 ` Permit Number: Date: Completed by:. -let HIGH GROUND-WATER LEVEL COMPUTATION Site Location: 7i7 7, j� !`L�i� f�`� i ��iGj}�/��/ _Lot N'o. Owner: �Q /1'� �G ��/J Address:. -q?/I/ Contractor:­ !J ` ®�5 Address: 1- 7—/ Notes:. STEP. 1 . Measure depth to water table tonearest.1./i6-ft........................................:.....;.;._..... Date e month/day/year STEP 2 Using.Water-Level.Range Zone and Index WeII.M:ap.locate site and determine: Z L O Appro.priate.index well................... :... �� ................. Water level range zone- ............. ........................... STEP :3:• Using monthly.repo.rt,:'"Current Water Resources Conditions" determine current depth to ®�f�z � water level for index well ........................... 91 month/year STEP. 4. Using,Table.o.f•WaterJeYel Adjustments for index well (STEP 2A),.•current depth to water level for index wel.l (STEP 3), and water-level zone (STEP 2I3) determine water level adjustment ................................ ...:..................................... ...:.........__..: �l�J ST.E:P:. 5 `stimate depth to:high water by subtracting the water level adjustment..(STEP 4) from measured.depth to water levelat site.(STEP 1) ............................................:........................................................ ........ Figure. I--Reprodueible eamPutution farm: ��, " �� ��� . � '�,t �S iv. \... `�� >� f E-? i t® E. . � �� t � � -. � . .� � � �_�. � � ,. ,� � . - �.3 � � . . . . ;. .:. _ :.. : � �� � � :� l � . � � . . � � � � � � � ,,. �,�. ; . :� . �� � i � �° `� j �l .. - kl � ��� e i a_(`� t� � �� � .� y 3 NOT '30'4 L E TOP FPVDIV. FINISH GRADE FINISH GPALE OVER EL . FINISH GRADE FINISH GRADE OVER OVER TRENCHES DIST. BOX •4 SEPTIC TANK A 2 MAX. 7/7/17 40 TOTAL LENGTH OF TRENCH OUTLET PIPE LEVEL A.,0.- 7 LID FOR 2 FT. MIN. L :0 Vv CA P END 9P EL I. OR PVC TEES 91 �7 b: Y. JI TON D.1500 GALLON 3SM T FL . EL . INS TALL ON LEVEL BASE "500 GALLON DRYWELLS " PPECAST CONCPETE 1;va H- 10 PEINFOPCED 0: SEP Tf C TA NK TRENCH SECTION INSTALL ON LEVEL BASE NO TE EXCA VA TE TO EL E V. V11-1 OR 74 L OWER TO REMOVE A L L IMPERVIOUS /77� A, HA 7r::_PIA L 3ENEA TH THE L EA CHING AREA 4 DIAH. 12 MIN. PE PL,A Cc-7" ZXCA VA TED HA TEPIA L MI TH 31' OF 1181V-11211 �.�.6" V�: CL EA N, C,_A Y FREE SA NO YA SHED PEA S TONE ROAD , — 7 ' 9 314 1-1/2 WASHED 7t5 CRUSHED STONE S '5 77 0 1 TRENCH WIDTH 1 A L L zEl E 1A T.4"ON.; SHO)IIN Ai;�E 5,4SED Obil ASSUMED NUMBII OF TRENCHES 1 r/ 2. ALL PIPES IN "H,,:- SYS7EM MUST BE CAST IRON NUMBER OF DR YWEL L S 2 OP SCj'-1E0U,'_E 447 ,PVC. - " a 'L- 0LR5E)c,';1A TION PIT 15OA ,� �IF T i; ,EA -i I NO 7lt'--1EL-1 rAPE ,'00 SURVEY P-3440 AIHEIV COtvS7RUC',7lON IS COAIPLEfE PRIOR L ' ' TO BA CKFIL L IN,, PERCOL A TION PA TE: .In 4. ANY CHANGES 1/1 THIS PLAN A/U,57T 07E APPROVED <2 MIN.11N. IF BOARD OF �Ll,'L:AL 77-/ AND :APE ISLANDS 3 Y T� WITNESSED 8 Y* SUF1Vf_--Y_rNG CO., INC. RON GIFFORD 00 00 5. MA TEP-i"A L S A NO INS TA L L A TION SHA L L BE IN i-goCORPL IANCE -H THE 5 TA TE SA NI TA R Y BA PNS- BPD. OF HEALTH DE571GN DA TA DA TE. JUNE 13, 1984 CODE - 7.17IL-4.' AND LOCAL APPLICABLE - — — — — — — L 19 PUL E S AND ,QC GZL A TIONS NUMBER OF BEDROOMS _3 6. NORTH APPOP 1,",' FPOR PECORO PLANS AND 7 770 NO IS NO T TO DE k'�5� FOR SOL A P PURPOSES GA RBA GE DISPOSAL 1-1 0/6 7. FL OOD HA ZA RD .11I ION-H X.,',-'A PD N2 TO;,/N W4 TER DAILY FLOW 330 GAL . 8. WATER SUPPL Y_ SEPTIC TANK PEG 'D. 1500 SAL . SEPTIC TANK PROVIDED 1500 GAL . LEACHING REQUIRED 330 GPD. / � I� fl ltitJs�o NdN. � W ,�"�m�"� i n`i ,cam ,�'f y v i a�­rl If-- V_ r. 1>r5'vn-- SIOEWA L L AREA S.F. 0. ��4GIS 112 GpD. L -152S. F. X F.LOT 3 I—lAlr w 30, 43-9 SF. 80 T TOM AREA = 32-9 S. F. i aeook war¢J y�o�p¢ �n, ;x, -LEGEND -32-9 S. F. X 0. 74 G/S. F. 243GPD 7�1 r (jk I ivel LEACHING PROVIDED = 355 GPD Pi-,OPOSED EL E VA TION a q' 51 � %'� EAIS TING CON TOUR bll� N SINGL E FA MIL Y RESIDENCE 06 SEP VA TION PI T DiSTRIBUTION BOX PROPOSED SENAGE DISPOSAL SYSTEM r_7 FOR - PREPARED F SEPTIC TANK CEN TPA L CONS TPUC TION CO . L 0 T 3 (HSE 2,92) FUL L ER ROAD RE'SEi4 VE AREA 102. 00 ' v BARNS TABLE MASS. N 64'21 '57'W CENTER PI r-!E INVERT EL E 1A TION DAVID CHAPt Es SA1,16vi DA TE: \�7A,' CAPE ISLANDS ENGINEERING PLOT PLAN SCALE AS NOTED - SUITE 2E 133 FA L MOU TH ROAD SCALE: 1 1(?.9 go- Ad P 1 qF-r, 6 Pci 1or fi,7 PLAN NO. MA SHPEE, MASS.