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0292 GLENEAGLE DRIVE - Health
292 GLEN EAGLE DR, CENTERVILLE A= 192-148 i No. 42101/3 ®RA E) 'almdEqnsK ESSELTE 10% o o �o Z�7 D Y✓ No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for �Digpo$o.Y 6pztem Con$truction VCrm t Application for a Permit to Construct( ) Repair-V) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. u6i--a 3, lXn �trL�la.K Ce Assessor's Map/Parcel Installer's Name,Address,and Tel.No. n`�t) Designer's IyaFne,Address and Tel.No. �'f�n-�`� W o+rtL! 3.stC 7.(6) Z�-5313 t2"t.�ea c ras>er--i-A Type of Building: 6 jk Dwelling No.of Bedrooms ✓ Lot Size y�� -3 sq.ft. Garbage Grinder ( ) Other Type of Building 51 , � No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �3 3 gpd Design flow provided 3 gpd Plan Date L'2 I Zr-,e Number of sheets Z Revision Date Title 2 (4a., Size of Septic Tank .1 000 Type of S.A.S. Description of Soil a C 69D 33 '-14S e` Nature of Repairs or Alterations(Answer when applicable) 4Ej2t ) V V, e.S jwl' b 1 (,j P-c ol Date last inspected: ?j Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by 40 � Date 7- 3 - ZO O "j Application Disapproved by: Date for the following reasons Permit No. 7-00F ':;?-( Date Issued IL- —————————————— �^+- .��, ��. ` y,. ^.. :..-.• :..`ry`^�... :w _ "_�.y..•:-ru.:s-+`.w-=—�'-- -`-,,,..w,o,...-.,xx� fir _ r- ....',. �_ _ ��� .. ;, � _ . ..... No. � _ 4 Fee t (J(J THE CCOMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for �igpogal *pgtem Construction permit Application for a Permit to Construct( ) Repair`() Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components (_Q 7t, i� Location Address or Lot No.Z C1 L �� yr t �2 Owner's Name,Address,and Tel.No. a1r0 1.vfi (1 3, ' lX l�i 2 c C�lr n_r1I(.e Assessor's Map/Parcel I . tX 1 Installer's Name,-Address,and Tel.No. ��s �� 7r� Designer's Name,Address and Tel.No. 67 i -�` W QiL(k1 3JK ta3. '"°I..y-7-5'3 IJ 12. t,Jc.; L( ; c✓us>��y���i�1 - ,. ', L U Z. Type of Building: Dwelling No.of Bedrooms �/ Lot Size (4 O c4 sq.ft. Garbage Grinder ( ) Other Type of Building 50�� t^1a�n- -A No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -3 3 Q gpd Design flow provided gpd Plan Date Z-1�2_c;" Number of sheets '�. Revision Date � Title k e,40,1-0- ' w Size of Septic Tank 1((O v� EK,S.�� Type of S.A.S. (2) 1A`26 756,=,cA(, Description of Soil ee C_ rC4 L-`(S � c Nature of Repairs or Alterations(Answer when applicable) t $ t��L, ��'1/� ( v-1rt is S A;,� b" Date,last inspected: '7y00 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date '7- Application Approved by / Date 7- Z - Zo U ,5 v Application Disapproved by: Date for the following reasons Permit No. Date Issued p O — ————————————— ———————— — ——.. T-———————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERT�i Y,that the On-siteSewage Disposal System Constructed (y ) Repaired ( ) Upgraded ( ) Abandoned( )by L4 at 2 Ptn e-VAI'-, �/, t 1 has een constructed in ccordance / with the provisions of Title 5 and the for Disposal System Construction Permit No. (�!/ '" dated Installer C&,9,Lx a%" bo%k� of 1 1- ", Designer ►Aj©$-1.:>_ ,,B, �iYy #bedrooms Approved design flow �f D L! gpd The issuance of this permit shallmt b6 construed asa guarantee that the system billaction as designed. Date / Inspector , �/1 /I//1 .� No. Z O O O— 2 17 Fee /O d THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Digogal *pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair (I(J) Upgrade ( . ) Abandon ( ) System located at *Z9-L f,V►�V� Ul,(�,.t= C IV l( ! and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this p it. Date 7 Approved by ,A� � l 07;"18/2008 07:37 5084775313 ENGINEERMG. WORKS PAGE 01 Town of Barnstable Reg datory Services l i Thomks F.Geiltw,Diirector M Pabli.c Health DivAsion ThOml�McI�ea n,Dii°ester 200 Main street,Hyvanh4'MA:02601 Office: 508-862-4644 Fax: 508-790-6304 Lastaller&Deigngr Cerfification Form Date. 7 1 l y`o Sewsge Permit# $ 01?-7 Assessor's MapW arcel �I L 4 S lea r` Mc :�►-tom: Desiper: FnZ l v,.�Y%c, V k"4" `►f- n-[ 1lustalleli• s . n Addresr; 2 In? c s s '�l� Addres>!4t 6,0 ,c `Y C 3 2.r�`{`t l lx on •7'3 - ZoO� �' + c --t ,+ was issued a permit to install a (date) (installer) septic system at �I? vt;cas,��,Ir c based on a design drawn by � (ads) sates . (designer) I certify that the septic, system ref=mced above waS installed substantially according to the design, which miry include T wor approved channges such as lateral relocation of the distribution box and/or septic tank I certify that the septic system i+eferenced above:wins installed with major changes (i.e. greater than 10' lateral elocatio>t of'the SAS or atyy wcrtical relocation of any component of the septic system)but in accordance with Slater&Local Regulations. Plan revision or certified as-built'by designer to totlow. "OF MqS� ,. - ! PETER T. -1 McENTE.E 's S1 CIVIL �s8/ONA� a� (Designer's Signature) (Affix Designer's Stamp Here) i'LEAs� � TO. DARNS_TA�L ' PT11i C IJMX;1 DM UM, "BlEMC z� Of — -- 'r�� __ t'QMPLIANCE.-BILL NOT '.0 ISSAMD UNTIL VM TH „'FORM CARD-A$� DIVED B�'T gARNS1 OJE nMLIC BJALTH D:[ St .N. THANK YOU, Q:HeWdAeoc/Dwiper CerMcatbm l~aM 3.26-t7440C 1e� TOWN OF BARNSTABLE LOCATION �l0 n ecS Lk SEWAGE# off 027 7 VILLAGE Oe rde f Ui k Vt ASSESSOR'S MAP&PARCEL 19 2 I C/b INSTALLER'S NAME&PHONE NO. �7n y It Ze <(0 a r SEPTIC TANK CAPACITY 4 w 0 10 LEACHING FACILITY:(type) O Sop LC (+Zy (size) 13 =a x d3 NO.OF BEDROOMS 3 OWNER C.C. L t` 2 PERMIT DATE: "1 Zoo COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility LI 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). 1 feet FURNISHED BY 6A P&Wt CG � ( �Cl�✓��2� LLC, S a - 131 c,3 �-q, "r � 2 41.0 Cy a y, s 3 g. �, cs" 1I,� :<:..:.......:...:...:.........:;;:.;.:::8..:.:..:.:. .....:: .::... iL .: 1 ::::.::::::,............. Depth from Soil Horizon Soil Texture $oil Color Soil Other .. Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistenrya° 1 e S L tO y d-3/3 4-�--13� ........................... ::._:.::.; . . ::::::::: �'I�l�i>H:C?:���.:I,t�:�:.;::.;:::.:::.>:.::::::.:.:.H.ofc.:#..�::..:::::.:::.::::.:::::::.::.:::::;:..�:::.::.:: Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface m. USDA Munsell Mottling (' ) (USDA) (Munsell) g (Structure,Stones,Boulderes. -- } Consistcricy." Gravel) Q - 1 (,P — 3 3/3 I3 --Sz CZ :.:.........................q.................... .......................:........:: .U. ;> .::.:;;;:<::>..:.k .+n. >;:> ..e.......:..:.........:.:::..:.:::::::.:...................... ..................... Depth from Soii Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % ION D:.:<:.`>;::r ; :> 'oil Texture«:;: Soil Color Depth from Soil Horizon S Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. %Gravell Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within MO year boundary No/4-1 Yes Within 100 year Flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Y-e S If not,what is the depth of naturally occurring pervious material? Certification I certify that on Ck" (date)I have passed the soil evaluator examination approved by the. Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature _ � Date � ��lo Town of Barnstable P# Department of Regulatory Services opt►,e,l Public Health Division Date 200 Main Street,Hyannis MA 02601 l/ BAtwsTeeif.e, MA88.039. Aifo i,��► Date Scheduled (V Ing Time�_ Fee Pd. � Soil Suitability Assessment for Sewage Dispnosal Q , Performed By: I �C �� � a Witnessed By: \✓6 t�A ` ar-r"' CJ�( I�� .:::...r.....,.,,:.i,,.......:r................. ....:....i.:r.. i!��i.,:::!:::,:,::.r.:.::i:v:•,::::u'i::.:::::•r::::::��:l:i:illiii!!!'.:i ..........:...v............,...,,,,............L..L......,....i!,..,,........:.....r.:.:n,.._,,.r.il.:.....:...,,.:..,..,...,...::... ,. ! ...I I:a:::,_•..,�:..:... !L...!.:.I,.. :::.:...u,::n::..,..!u......,..r. :,.....a......u.: n5u,;.�.,l,rr.!.::....r-�;,.:..:i....r .: ., .:.. .r..... .. ....,. _... .. ..,!. Nil ..... ... ....r. ,.,,,,lur.�....,.i,L:::,.,.6.u.I,.....r.�.,,.u:r..I:,I�n:..:...:.......:..:...:.:...........r.r..�....'T...._.,._...,,.......,,,....,..r..r.�,,:....r„r.. Location Address �(�� �,e- V v )G06 Owner's Name ��l� 1�5 024,3 2 Address `Lq Assessor's Map/Parcel: ��Z t�� Engineer's Name 6"feAI" NEW CONSTRUCTION REPAIR Telephone# 50J_ l(1Z `J02g Land Use 145 Slopes(%) �J� Surface Stones �-- Distances from: Open Water Body�ft Possible Wet Area 1�U ft Drinking Water Well 1 ft Drainage Way 2J"L) ft Property Line 4 " ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) C o �J 2 s J fl Parent material(geologic) (J C`^`� ���N � Depth to Bedrock 3 p Depth to Groundwater: Standing Water in Hole: �/ Weeping from Pit Face Estimated Seasonal High Groundwater 7 i-3 t ..... ...... ...... Tor: ,.,.:.. n.;.,,::......:.:,ri...,n.,::.....:... ..,,......::....,..,...:.;�i,.l.L e:r.,..r,.........:u: .n....u...:.,.,.........:.,...i:,..!:,;....:I:!:uII:�.I:.I::L:1::.::....:..:. u..,:-r!r,_,,..;,.4•:..:I..I..,.,,.•I..L,..a!:l:'v....:.:._:;.:.v ..:_.r.v....r.......,.n..::v:::� :..-.: Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ ....:.r..:r.....,.0........:....r......n. ..... r....,r..i.,r........r........:,_....,..:r.r........,...r.r. ........r........._ ....!.........................:.:... ,. .r..rrr..........,......:. ,. . .:.. i!,.::::..:r.:. ,.....L......r,.:....i...:.LI.r..l.,,...:...r........,:. I.. :! .,.n.....,.,!......:... ... ... ..:... .......a ..:. .. . ...,...... .. a,r.•:,. ;:. !'lia !,, :!r!:.��:'!`"'�' ... .u_,,.....,..I.:.,..!.:,......... ..............:.:...........:..::.:... .. .... u. ,...,r ..........:!... T :$ L,, 11tt 'm!I:r:::;!.:....,....,..,. a ..i. r........ .I..... .: :...r.:.., !...rr.... I i.:..,_.., 1.1i...........:.. ....i. ,...4v..._....:..:.:.::�!a:.:I:.1::!,!�.....-.....:....,..�:...:....._:.........:.._!.._..................._....................::..:.......,:r...:,...:.. �:.:.I ..rrl.rir,�.:::::..::,'nr.wn.r.:,wrw,,..ii.!.i iLuu r,r:::::::l::,r'irrr.:r,:,;...,,,,ul,i,.r::::::,�r:::,:::.,,_::,::,,::r,:......::..:...r..r...`t.....:.._...... :!...�,..,�...r,.....r.r....:..:..._.. r,...:...:�.. ... .:...,,:..,,..r:,. Observation Hole# Q Time at 9" L(8J Depth of Perc ` (0 Q Time at 6" Start Pre-soak Time Q l Q 23 Time(9"-6") � �,r 2y �l lcr1� End Pre-soak Rate Min./Inch �Z _ Site Suitability Assessment: Site Passed. Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back ,— 1 Q:HEALTH/WP/PERCFORM Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Asses7nents ^M 292 Glen Eagle Drive 0 Vq Property Address Ellen Childs Owner Owner's Name ' information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town Y '� State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC Company Name ran P.O.Box 763 Company Address Centerville Ma. 02632 return City/Town State Zip Code (508)428-4028 S 14454 Telephone Number License Number B. Certification 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 1411 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 i4 Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails r- y ❑ Needs Further Evaluation by the Local Approving Authority �- 4/14/2008 I pector's Signature Date s ; : J The system inspector shall submit a copy of this inspection report to the Approving uthority (Board of Health or.DEP)within 30 days of completing this inspection. If the system is a sh red 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. ****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. 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) 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 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. 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 292 Glen Eagle Dr.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code. Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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. 3. Other: i D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: 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 ❑ ® 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 Y2 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. 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ E. Any portion of a cesspool or privy is within a Zone 1 of a public 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. [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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. 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. 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection C. Checklist 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? ® ❑ 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: ❑ M Existing information. For example, a plan at the Board of Health. El ® 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(5)] 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2006:57,000 g ( y g (gpd) 2007:64,000 Sump pump? ❑ Yes ® No Last date of occupancy: 4/14/2008 Date Commercial/Industrial 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 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): 292 Glen Eagle Dr.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: J.P.Macomber Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: . gallons How was quantity pumped determined? Reason for pumping: 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 Leaching Pit installed 1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 12"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 20'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: 14"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) , ij i1 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No ------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000 2" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness 1 7" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Measured 292 Glen Eagle Dr.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments <c 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pup septic tank every 2 years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears to be structurally sound. 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 scum 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.): 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): 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'wM 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No 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.): Box is level.Distribution is not equal.Flow is going to the new leaching pit.Old pit is not getting flow.No evidence of solids carryover.No evidence of leakage into or out od box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 292 Glen Eagle Drive M Property Address p Y Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2-1000g1. ❑ 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.): Sandy dry soil.New leachinpit water to invert was 10" at time of inspection.Old leaching pit was empty. 292 Glen Eagle Dr.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 292 Glen Eagle Drive M Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): 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.): 292 Glen Eagle Dr.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size ® Zoom Out �z In J� 1flfl MJJ {� y v K r r— �3 4 r 1 �J �'--------- y r h f ' 4F d 3 r mj y�t�a hSxr �i a ' 1 7` *+ e Lts d :. 1 x aV x, I I I a0 Feet A.Set Scale 1" = 20 1 I Aerial Photos (`nnurinhf 9Wr-') 07 Tnum of Q.—tahlo AAA All rinhf.rocenn http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=192148&map... 4/14/2008 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 292 Glen Eagle Drive Property Address Ellen Childs Owner Owner's Name information is required for Centerville Ma. 02632 4/14/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of LP 40' feet 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: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: As-Built Card ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 plate#2 annual ranges of groundwater elevations. 212 Glen Eagle Dr.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 'THE la Town of Barnstable of y, Regulatory Services •ARNSI'ABLF, ; Thomas F. Geiler,Director 1639.ArED��p Public Health.Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-8624644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this s Division does not warranty the functionality of the septic system in the future not does this Division agree with any technical observation s and interpretations contained within this report. In addition,by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. 292 Glen Eagle Drive Centerville Rear Existing 1000 T 0 Existing box New 1000 pit Existing 1000 pit TOWN OF BARNS T ABLE LOCATION `+ CID 1;-1egA I e i�$r SEWAGE # f VILLAGE C eniWU a I ` ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. 1 v k0!jR4C.d Y ,�ie r <nin. Ty►C- SEPTIC TANK CAPACITY 100 LEACHING FACILITY: (type) 2- �`�'�S (size) 1,4 r NO.OF BEDROOMS BUILDER OR OWNERC p� r {� PERMTTDATE: � "" �y f`2/IMPLIANCE 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 Edge of Wetland and Leaching Facility(If any wetlands exist within 3.00 feet of leaching facility) Feet I, Furnished by 37 op QL� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AVp iratilan for Dhi-Vitiiul odd, Cnnnitrnrtinn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair fK ) an Individual Sewage Disposal System at: 292 .Glen Eag......................................................enterille -•... •-•-•----------------••---••-••••---•--•--•--••••----•-••-•-•-•-••--•-----•-•---------._......---- Location-Address or Lot No. .........A111.ed...Childs................................---------------- ..............................---•--------............------......----......_.........---...------ Owner Address a J.P.Macomber Jr. Installer Address d Type of Building Size Lot............................Sq. feet U DwellingX- No. of Bedrooms-------------3-..._._---_----..----.._...Expansion Attic ( ) Garbage Grinder 4 ) `4 Other—Type e of Building No. of persons ............... Showers LL YP g ---------------------------- P ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ - - W Design Flow.......... .............._---_-----.gallons per person per day. Total daily flow...._......33.0-------------------------gallons. WSeptic Tank--Liquid capa60_0 0 0 gallons Length..a_'fj"_._ Width4'.1..0.'.'... Diameter---------------- Depth_.5............ x Disposal Trench—No. __.................. Width..........--........ Total Length-------------------. Total leaching area....................sq. ft. Seepage Pit No__...2........... Diameter...-6.............. Depth below inlet.....b............ Total leaching area..................sq. ft. Z Other Distribution box ( 1 ) Dosing tank ( ) Percolation Test Results Performed by-----------------------••----•.....-------------•---..................... Date........................................ a ..� Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water..................... �14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 •--•----•......................................................................•----••-•••-•--------......................................................... 0 Description of Soil........................................................................................................................................................................ . x Sand & Gravel ---- U -------•--•- --------- • . . . •--••----•--••-----•---•---•--•---••--•----•------••-••--•------------------•-------•••-• ----------••-•---•---•------------•---•••-•-•.••-- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable---.Adding an additional 1000 gal on leach pit to an_ existing tank box pit. 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 Corn li ce has��b /nssuLab ' at of health. Signed . ;1[°�--- -------�----------------------- ---6-12...6/.9.5.. ---------- - Da`e Application.Approved By ......... ----------1�9----- ..- .40.1:.. Dace Application Disapproved for the following reasons- ------- --------------------------- ---------------------------------------------- ------------------------- ----- _.... .................. ..................... _....... ... --............_........... - - - ................. At Permit No. ............�..---- ---------------- ---------- Issued (9 -------- Dace w i NO..........._.... ....... ....3 0.0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dhaip 1 ml Workri Tontitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 292 Glen Eacdle Drive Centerville -••-•--•....--••.............•-•--•----•--..........--------•--------------------••••••........... -••••----•------------••---•-••-••------•-••-----•---•----•--•••-•--•••---•--•--••••---.........•. Location-Address or Lot No. ........A l x ed.- ��� `................................................... ------------------------------------.......-••---------....-••----•....---•-...-••-----------•-•-. ~ Owner Address W J.P.Macomber ,Jr, ---------------•-••----------••----.........------------------......---------------------------•-- --•-----------------------•-•-•••----.....-••--•••----------•--•----•------------•-•-•-•••....... Installer Address d Type of Building Size Lot............................Sq. feet Dwelling v No. of Bedrooms-------------3-----------------------------Expansion Attic ( ) Garbage Grinder Other—Type of Building ____________________________ No. of persons........... -_-___--.---.._ Showers ( ) — Cafeteria ( ) a' Other fixtures ________________ ______________ _ _ W Design Flow..........1_ti:`�..........................gallons per person per day. Total daily flow..--_______3 31......._................gallons. WSeptic Tank-1 Liquid capacityl_OOO..gallons Length__8_'6."__ Width4_'.1_01".._ Diameter_---..--_.__--- Depth__ .......... x Disposal Trench—No_ ____________________ Width.................... Total Length-------------------- Total leaching area....................sq. ft. 3 Seepage Pit No........ ...... Diameter.._ -------- Depth below inlet......6............ Total leaching.area..................sq. ft. Z Other Distribution box ( 1 ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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...............-........ �+ ......-----•----------------•----------------------------•-•----..........-----••------•----......----•-•-------•--•----•••-----•-...------------------------ 0 Description of Soil----------------------------------------------------------------------------------------------------------------------------------------------------------------------- x Sand & Gravel U •-----•------------------••------------------------------•-•---•--------------------•----._...•--...----•------------------------------------------•----•--------------------••------•----------....... W ------------------------------------------------------------------------------------------------------------------------------ -----------------------------------------------•----•---.............. UNature of Repairs or Alterations—Answer when applicable----Adding an additional____ _ _ 1000 gallon leach pit to an existing tank box pit, -----------------------------------------------------------•------------------------------------------------------------------------....._..----------------------...__...---•---------•••-••--••••----- 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 Complia ce has ben.issued by the boar• of health. - Signed ....... - --------- ----- ---- ----------------------------- -- /.��h.�.9`a....-.:...... Dare / Application.Approved BY .. - ........... ........ --- .,� _ �.. � -- .. . ... - - --- ---------......------------------ --------- _ ...l./_... -� � Dace Application Disapproved for the following reasons: ....._.................. ........................ ..........._.........._-......------------------------------- -- -- ....__. ... --------------- ---------------------- -----------------------.....----.............;.........................Permit No. `.. .......... Issued �_ e Dare THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH ' TOWN OF BARNSTABLE Certificate of (11ampliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired)(XX ) by J P Mascomber Jr. ----------------------..............------------------------------------------- -' ..... - ... - ...'--- ................_..------------------------------------------------------------------------- Pnscnllcr at .----292 Glen Eagle Drive Centerville ............- ----- --......---......._.... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...... dated .... ...-1 I � -"..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------- ._ .--"�-. ...... ----- -- --- --- -- Inspect -- ... -----------' 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S TOWN OF BARNSTABLE No. . mod' FEE........................ �i��n�tt1 nrk� �u��tr�trtuan �rrnttt Permission is hereby granted... Tsp.a!uarne k?Ar -7r-,--------------------------------------------------- .-_------•-•-•----------•---......---•--- to Construct ( ) or RepairY(XX) an Individual Sewage Disposal System at No.---29 G1Plnt.... aitxl p..nr _ych..C eF n±nx.vt1 1 ........................................................... Street f as shown on the application for Disposal Works Construction Permit No Dated____ _!.............................. ................. ---------------------------------------- r, Boat�cl.oMliH alth ---'�---- DATE----•-•-------------r- -------•----.....--•------------•------- FORM 36508 HOODS&WARREN.INC..PUBLISHERS Oak rn g � 0 3 / �•-� � - � - .4 1,.5�'�: -s. F., 'a . 4 0 bDo x r !rY LEpfT DIST w i-To MTES t.3ZS1 1 V• - � i-..Ys'�. l000 *A CERTIFIED 'PLOT PLAN L - Lr N TRUCTION ONLY t C' i�IT F�l� tJ� 0 • OUNOATION IS ._ — FEET IN 09VE LOW POINT OF ADJACENT 2,1 SCALE: u_40 ! DATE = 7�/3 77 .._ !� N 1�NEERIIdl3' CD.lldP cN/L_Di I CERTIFY THAT THE SAT CLIENT . SHOWN ON THIS FLAN IS LOCATED 1$'t'1�A9E�' REGISTERED J09 NO. 7704-S ON THE GROUND AS INDICATED AND LANO CONFOMS TO THE ZONING LAWNS ,E' , 1ER 1 SURVEYOR • DR.BY, —�` OF BARNST ®L ;, MASS. ' �,.. By ST 712, MAIN ST. . �� � > VW t I EIU K MASS, .. .H A IS A��: - - .;. , .• r,s �A�E RES. LAND 3URYEYiR• •i�f'4: '� LI; .4` Y,J'`0 >�. .. :wt'. .+.. • ��A .. 1. ., .. :l. rKlf.'�- � ..n ,,.. a.a ., � .. .aF'd CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, J.P.Macomber Jr. , hereby certify that the application for disposal works construction permit signed by me dated 6/2 6/9 5 , concerning the property located at 292 Glen Eagle Drive Centerville meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system i • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED : DATE: 6/2 6/9 5 LICENS SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. Fimic ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD Of L-JE!AT ------------0F,........ .. . .... . .... . ...... .................... Appliration for Uhiposal Workii Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: j, .1-4 7 ............ Location-Address 7 or Lot No. T........................ .......... Y U ........ ................... 4;�rn !........................................ ............................................Address...................................................... Installer Address Type of Building Size .........Sq. feet U Dwelling—No. of Bedrooms___......_a..............................Expansion Attic (yes-) Garbage Grinder Qvj) PL4 Other—Type of Building ............................ No. of.persons.........Y.�-------------- Showers Cafeteria (XO) <PL4Other fixtures ..................................................................................................................................................... Design Flow...................4T--------_-- gallons per person per day. Total daily flow..........1,10..:.................gallons. 1:4 Septic Tank 4Liquid capacity) gallons Length................ Width__............._ Diameter---------------- Depth.............._. Disposal Trench—No. .................... Width ....... Total Length.................... Total leaching area....................sq. f t. Seepage Pit No......../---------- Diameter,;�.. ........ Depth below iylet......... ......... Total leaching area..................sq. f t. Other Distribution box Dosing ;z 7 Percolation Test Results Yerformed by-!............... ................ Date__..7:�Z!. ......... Z QU Test Pit No. I... �i ........ -Ig per inch Depth of Test P i ................... Depth to ground water-------11;').. Test Pit No. 2................minutes per inch Depth of Test Pit___........._....... Depth to ground water._-_._......_......._... ...........;;- ..;d_ ,........ ---------------- ------------ L /.....�../........0 -------- 0 Description pff Soil...... . ..... . ......... ....... .................... U ....................... ................................................................................................................................. ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable._.............................................................................................. ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the dforedescribed Individual Sewage Disposal System in accordance with the provisions of TL Ili U 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 y the board of health. Signed. .. ..... ...........1 ..... .................. ............D..a..t................ e Application Approved By........ .. .. .... ....... . ... . ..... ... ........... ............Date Application Disapproved for the following reasons:................................................................................................................ .........................................................................................................I.............................................................................................. .f ;p,, Date .__ Permit No......................................................... Issued.. ...... .y............................... Date • / s No.......... 79� Fim$.......J...................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH ...........t� �---......OF......... .. ..(. !.�J..... `-- ----.......---.---•---------- Applira#ion for Disposal Works Tonstrurtion thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: N :A(,Ct �J? jai .... -- ............... ..•--•-----•---•-----------•-•-•............... -•-•--•-•-...--•---------....••-•------...---••-•-•••--•••-•---••-.._..-•-•--•-•._..............-- Lro,,c'ation-Address q or Lot No. ?�f" .C n �V C H�/.. ..�? ..............................................................✓ 1�/-1/�..5................... ___ .. 1,,..... ............. /Owner Address a /...`.. ! � C t;1117! I nsta ller Address Q Type of Building 13 Size .........Sq. feet Dwelling—No. of Bedrooms......... ...............................Expansion Attic (Y,15) Garbage Grinder (Na) P4 Other—Type of Building ............................ No. of persons........`f___-- ---------- Showers ( ) — Cafeteria (ea) al Other fixtur _-_ W Design Flow....................9............. _ "gallons per person per day. Total daily flow........ 3 ..................gallons. WSeptic Tank-l-Liquid capacityW ...gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.... -------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......../----------- Diameter/ot�!___--__ Depth below ' let.................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin ,tanc(/ )- C 7 aPercolation Test Results Performed by........I..... .I1.._ ... ................................. Date___.7....`................•............. a Test Pit No. I s per inch Depth of Test Pft.................... Depth to ground water......Yd............. �T4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ................. ....................................... s _. . _ _ C 1 Description o Soil --- � -- - -�=�. ............Z.; ....................... W --------•..............•------------------•-----------------......---------.......----.--------•-----.------------ ----...--------------------------------•-------------------.•-••-•-•-•--•-----..•... 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 TIT712 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 health. f ! � Signedi ------------------ ------ --------•-----•--• ------------...........-- / D to � ........ :'y• �7--.•-••••-•-- i 1 Application Approved By..... GL %-'__.. GU �L� Date Application Disapproved for the following reasons:................................................................................................................ --•--•...--------•••-......-•-•-••-••-----•---------•-••-•---•••••••••••------•..............•-•-•------•--•---••-•••-•-••••----•••-------••----•••....•-•--••--•-• ••-----•--•--•-•--•-•--......... Permit No..................... Issued................................ P ....-._-1_.....7-7ate...__. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ?F HEALT �14Z�............O F...... .............. ... .. ........................ (9rdif irat a of Toutphaanrle T IS IS TO C ,RTIFY, That the Individual Sewage Disposal System constructed (or Repaired ( ) bya... , ":.. ------------- ----- ---- - -.-.-..----------.-.--------------------- � - I taller /' � � at..........6'6r•- -` - G �� t .......................` ` --- ................. -rtabe -- - ----�--------•--•----•--•---•---------------- has been installed in accordance wttil the provisions of T�jF 5 of The Sanitary Code as described in the application for Disposal Works Construction Permit No.v .... _7_y 7..�y_�__�. -------------- dated--------- - - - - 7---------------• THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM JILL FUNCTU3N SATISFACTORY. A C / DATE...... .. .. ................7....................................... Inspector_..... --- THE COMMONWEALTH OF MASSACHUSETTS r ) BOARD H�i4LT���'�`,"-� J� r7 G2. ..........; ..... .OF.................................. ....••••- No......................... / Disposal Vorkv Oonu#rudion rrutit Permissions ereby granted..... ....___ � L _ to Con t ( ) r epaiar ( an Indii ul Se.'wa e Dispdsal'System U. y r r g i atNo.G !C:_- Y ..............I ` � f,?'�. .,1� } Gt�............................................ ............................. Street r� as shown on the application for Disposal Works Construction Permit N �....... Dated.........�.y...�..�...... DATE................................••-•-••-------•-...............-••-•---•-•-••... /` Board of Health / 1 FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS / / -L'O-,C A T ION S E W A G E PERMIT NO. -e f � �. � � cV� 77 37 !? VILLAGE Le, br L D Lb i v? INSTALLER'S NAME & ' ADDRESS 4 , 8 U O'L DE R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED I ,�_� ., i. .,_ I• �� n r'?: :F► a `���I: - ,' � � c � ! ! . r ' I�' ` 1 3 / { .4b , r t e � 9 • t� ` � r;.. '2 , ,. ' "$ ,tip u a -� 6 .s. ../OGC G/a-L" '� \_ • .. r �tACM P"7 D�sT tl H -1Nia. �pa� ajvr t V• R p T RC�. ,I,� � , ro�#,.. �s$t'' � r .n }` , :F \►Vr ::+ � r� ' 1 ,i _ _ t' . ' fir. /ODO_ 0 A )� z 4i t pvLo -Tt b CERTIFIED PLOT PLAN ' —/C / G /\��5/4.- 7- s [ N TRUCTtON ON LY — -- — NOATION iS I FEET IN f r4` voyi L0' P01 NT` OF ADJACENT SA JIB S TA B L ASS* lu: r r: SCALE. / =10 PATE 3 .77 N INEE'Rl/IfQ' CO.•IN N/L�; ' I `CERTIFY. THAT THE 1!�Olu/✓OAr/0a 4, CLIENT c- SHOWN.' ON THIS PLAN IS LOCATED RE®ISTERFQ v d0®.'IdO. 77 ¢5 ON THE .GROUND AS INDICATED AND LANO CONFOFWS TO , THE ZOMN4 LAMPS "r 1� SURVEYOR OR.B.Yl —� 144! OF BARNST ®4 ; MASSch By g s .,.L O F LAND ER t ,1 I, �'',... ,:;sf• .d..=+.. `� {a-�-�i 1._ 5;,i,�y .. 1. F"- � ,, 2ir?::a C. _.R... ;ssL�': u... s•i'.� r .a a . � ..,<., ;.._ '`� •=.f�=-.w `_ -. ' '�, ... .4'd LET. '/"N/Of. 1 5 Y. _ - _ . ...u'4 _. .':".:n. ..•.. ..— ....f;>. •, a... .'�r �.43 .1, rR:_: 'ry. y 71 .., --• x• Svc F►iPL'"_ '- CLE y _ r . _ `' N�i47"� M./�1[. PITCH: � - :3 ,� - _ COYERS _%a�� Ors e r GoNCFe►tT ,r' y woo »Ar MIDI P/76N* G14G. , _ I • • �• . .' e > o WASHED 5MNE Per t .�"iElrYlC TANX D./� o o�b �-a .-_ o .�_ •• •• a O :aPq $! , d _ '.i- a-e • e. . 3�4P. >' /T oo s a s o:9Q e 1 • • • • e e oD o .: �: .. - -: f ' • ° e e • ..•: a s . e e e •o - - �V - a o at�eJt �L� �T`®Ivs - p . r. _.. ;r /�1W&"..AT �I1lLrD/WCr. 9 7! O FT. $9UTL ET'S'E / 43LET ` - 9G lC TANK T - yNT pJ$T/�1f3d/T14Af �QX q F7r : SECT/ON OF' G/POUNo' N�1TER TA64�E „ O,t/TL�T�D/STRIBI�TION�►OXS fT -,. _ l:V4R75EER1400 b,T 9 w . - LEACHIM6, / SCALE :. F7" DES/cs CJri�T�FtlA D/LIENS/o N $ IVU/ BE/� Q/� EL7►ROS C.A*BW r4015,00 SAC L/NI/' M r TO?AL. ASS/ICED 7-4rY:Ot W 2 0 a. 641.14AV .,.. , -7 /88 .�OlL LOG SIDL AAMACN1N6 PL?/q P/T SYt hT• RESULTS N/ITNESS&D �Y �' P•f'7�Ifl/!c/s =, 1. BOTTO/W 464CNINO PVR;P/T 7&. �; �T TEST P/T / TEST P/T 2 RENC04AT/Oiv_ R%ATE AIJA/iNCN TOTAL ZEAC�NIMO AREA 26 sp FT ELEdi9T/ON _ RL? RI�EL64�',NlN6 ARSEA '�4f 6.SQ..J=.T. DATA'; G�/✓> 4 "L J Y �HOFM ArrF/S7-' i3�f. �R�- ass Q L v 7 3/ GL cA(4 iC E I>R 1 vC �o•�� ROBHRT. 4pyG C rtAGr L - t c.-rn' ,. 4B � sk�v b •, �F�24•A- _ Ida NW 23162 MA/N NYA /!l 33dt,I " 14�A - ti q Y , . : •'' .a.'.., x . 3 -H -_ u..' 1 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:95.00 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. (3) 5" DIA.OUTLETS SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. , INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL RISER & COVER OVER ONE CHAMBER AND 15.5" 16" �2" T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE SET TO 3' OF F.G.`ITO SERVE AS INSPECTION PORT F.G. EL.=99.9t F.G. EL.=99.8f F.G. EL: 99.4t F.G. EL: 99.6t VENT 12" L = gg' L = 23' 15.5" (TO TANK) (TO TIE-IN) L = 5' LAYER OF E8" TO 1E2" 6" @ S=1`u (MIN.) OUBLE WAS D STONE 4'SCH40 PVC 4"SCH40 PVC' APPROVED FILTER FABRIC) T ll I 10.. 1)2 14' B` M 3/4" TO 1-1/2" DOUBLE2„ ' WASHED STONE H- 10 LOADING EXISTING 48" LIQUID LEVEL INV.=95.27 INV.=95.10 4 5.2' 4' D_BOX GAS BAFFLE X PROPOSED D-BOX EFFECTIVE WIDTH = 13.2' EXISTING SEPTIC TANK W/INLET TEE INV.=95.00 N.T.S. 2-500 GALLON LEACHING CHAMBERS (SEE NOTE 14-SHEET 1) SURROUNDED OUNDED WITH STONE AS SHOWN INV.=97.74t TIE-IN TO EXISTING SEWER (EXISTING) AT, OR ABOVE, INV.=95.50 H-20 RATED TOP CONC. ELEV.=96.1_ BREAKOUT ELEV.=95.5 INV. ELEV.=95.00 MEMO NOTES: 1) D-BOX SHALL BE SET LEVEL AND TRUE TO 9999E ®®a®® GRADE ON A MECHANICALLY COMPACTED 51XEME3 37" INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=93.00 - w ® Eil Ea 310 CMR 15.221(2). 3' 2 X 8.5=17.0' 3' N Z 2) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 23.0' ®L; ®®® ® u Ea 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE T.P. EXCAVATION OR G.W. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. LEACHING SYSTEM SECTION 4) MAXIMUM COVER OVER SEPTIC TANK, D-BOX & S.A.S. NO GROUNDWATER, EL.=88.0 = 102" SHALL BE 36". I SEPTIC SYSTEM PROFILE 1 N.T.S. 4" KNOCKOUT 20" DIA. COVER SOIL LOG 4" KNOCKOUT 4 KNOCKOUT 62" DESIGN CRITERIA DATE: JUNE 10, 2008 (REF#12,242) SOIL EVALUATOR: PETER McENTEE PE WITNESS: DONNA MIORANDI R.S. NUMBER OF BEDROOMS: 3 BEDROOMS r /�/ / * HEALTH AGENT I 1 f 4" KNOCKOUT SOIL TEXTURAL CLASS: CLASS I 0 I I %'.,/F J ' �' / i , ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH DESIGN PERCOLATION RATE: 5 MIN/IN I PROP. 1 �� GARAGE 0 9 0" // i 99:6 9.5 S.A.S. 1 6'• / { FI ILL DAILY FLOW: 330 G.P.U. cal I 98.0 A � FILL 19 90.2 A 16" DESIGN FLOW: 330 G.P.D. ,! f SANDY LOAM SANDY LOAM TOYR 3/3 10YR 4/2 500 GALLON CAPACITY, H-20 LOADING GARBAGE GRINDER: NO 1 97.6 24" 89.7 --11.8--� 30 CHAMBERS EXISTING SEPTIC TANK: 1000 GALLON CAPACITY L' B BSANDY LOAM SANDY LOAM LEACHING AREA REQUIRED: (330) = 445.9 S.F. iOYR 5/8 10YR 5/8 74 95.8 X'j 45" 95.2 36" N.T.S. C C USE 2-500 GALLON LEACHING CHAMBERS IN SERIES ! P8RC PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 60" MED. SAND 2g2 GLENEAGLE DRIVE, CENTERVILLE, MA SIDEWALL AREA: 2(13.2' + 23.0') X 2 = 144.8 S.F. MED. SAND 2.5Y 6/4 BOTTOM AREA: 13.2' x 23.0' = 303.6 S.F. 2.5Y 6/4 Prepared for: Donald Childs, 292 Gleneagle Drive, Centerville, MA 02632 TOTAL AREA:............. ..............._.........................448.4 S.F. 88.1 138" 8&0 132" Engineering by: SCALE DRAWN JOB. NO. S.A.S. LAYOUT PERC RATE <.2 MIN/IN. ("C" HORIZON) Engineering Works NTS P.T.M. 192-08 DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 1 (508) 477-5313 6/27/08 P.T.M. 2 Of 2 i LEGEND N ' , ..... -- gg .--. --- EXISTING CONTOUR AD LOCUS x 100,98 EXISTING SPOT GRADE s Penny By, 26 o p�PN ---{_99 }-- PROPOSED CONTOUR Moon � d Lri SEWER CONNECTION 99 PROPOSED SPOT GRADE a 0 TIE IN TO EXISTING SEWER AT, Y OR ABOVE, INV.EC.=95.50 W EXISTING WATER SERVICE ��� w : IF PIPE IS TOO LOW, TIE IN _r TO TANK INV. OUT =97.74 EXISTING SEPTIC TANK TEST PIT o 0 N (LOCATION TAKEN FROM RECORD BENCHMARK EXISTING LEACH PITS AS—BUILT PLANS) OP OF TANK, EL.=99,07t (LOCATION TAKEN FROM RECORD TOP h INV.(OUT)=97.74t � Woodvole Ln C In AS—BUILT PLANS) aeon TO BE PUMPED, FILLED W/ c a SAND &. ABANDONED D a N LOCUS MAP 458.17 Edge of '�a�r 100.45 .x NOT TO SCALE GENERAL NOTES: x 99.50 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL C ?— BOARD OF HEALTH AND THE DESIGN ENGINEER. 0 1_1 ;E —10U— 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS • ,•,Y„u,__,,,,-,_�,w-,•.,�.; � OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE o� CATIONS EXCEPT A� REQUESTED BELOW: \ x 8.45 _ . _ U1)�)GU LOCAL RULES AN UES L „_,+,,,,,�....._•.--- � 310 CMR 15 405( 1) A 1' variance to the 3' maximum cover requirement, for no greater 6, `/ ,. >N than 4 of cover. S.A.S. shall be vented and H-20 Rated. ..... .................... l H� _ , �,, I G / DECK N 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACK,FILLED PRIOR \ %L`' TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 100.15 x x 99.74 m DESIGN ENGINEER. FdoP °A \ / UJ / °`"� \ x 98. �0j " / / ,% /' I : 2 4. ANY' CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ,/ ,% fi /f U� W FROM THOSE SHOWN HEREON SHALL BE REPORTED TO .THE DESIGN �;, r SHRUBS/TREES t TP_ -- �`�, o ENGINEER BEFORE CONSTRUCTION CONTINUES. . ., 1 ! ,� 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 1. 1 //% // /��EXJSTING,// /� N Edge of Lown � ` �J �J � HOUSE 292 '� o. � 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF f T� 12 I /GARAGE,/ / / �# ) � CV THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 94.ti8 x � ' ` �'� N 2� ��/ /j = CONSTRUCTION. / / T.O.F. 100.- o: a0 HEALTH FOR PROPER INSPECTIONS DURING / / / / r% v: 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. In .�O I /` / , / /�f� r / �'' z 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. r /J / / °' SHRUBS/TREES /, rc�LlHOFMgs 962- \ I' 1100.01 x „„ �� {,�u: ,m ,` 1 .� sy 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS .� J OR AS OTHERWISE �'� AGREED UPON BY OWNER AND CONTRACTOR SHRUBS SHRUBS PETER T. DIRECTED BY THE APPROVING AUTHORITIES \ VENT . . . .. . .. . . . . o McEI'•T EE -+ '� x 99.47 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY , 99,6 x I CitriL �' THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING g.�"' / 97.35 x ,� E..I; „1:3s .:= _ f �, No.35109.E CONSTRUCTION. 96'18 x -' - — �98+ — — �� I— J — �'� P� �Q 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 96_ _ ti APN 192-148 c n STE N IN THE AREA BENEATH`AND FOR 5' ON ALL SIDES'OF THE S.A.S. AND .. REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). PAVED — � 4 —1,423t -- — Qv 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE -- DRIVEWAY 98- - - -- - — (p f Z7� INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ON LY AND �' — 13-1-9-7L — _ — —— — — — 4' ' - - — — IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. S 11`31'40" W 14. STRUCTURAL INTEGRITY OF EXISTING SEPTIC TANK SHALL BE EVALUATED --. AT TIME OF INSTALLATION. THERE SHALL BE NO STRUCTURAL SUPPORTS SIDEWALK FOR DECK PLACED OVER THE TANK. USE OF EXISTING TANK IS SUBJECT " + TO THE APPROVAL OF THE BOARD OF HEALTH, EDGE OF PAVEMENT ��� 96'� ys�s PROPOSED SEPTIC SYSTEM UPGRADE PLAN Benchmark Set LT. COR. OF LANDING DRIVE 292 GLEN GLENEAGLE EAGLE DRIVE, CENTERVILLE, MA EL.-100.31 (Assumed) Prepared for: Donald Childs, 292 Gleneogle Drive, Centerville, MA 02632 I Engineering by: SCALE DRAWN JOB. NO. 1,r=20' P.T.M. 192-08 Engineering Works 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 6/27/08 P.T.M. 1 of, 2