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Home My WebLink About0054 GREAT MARSH ROAD - Health 54 GREAT MARSH ROAD, CENTERVILL A= 210 122 meace UPC 12534 No.2�LOR HASTINGS.MN -7�� Commonwealth of Massachusetts /�,/.. a=1 Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _�;!✓ 54 Great Marsh Rd : 't J' Property Address `Y Daniel Murphy Owner Owner's Name � information is required for every Centerville V MA 02632 10-7-16' ' page. City/Town State Zip Code Date of Insp�ction rY Inspection results must be submitted on this form. Inspection forms may not be altered in aiq way. Please see completeness checklist at the end of the form. A. General Information 001 Y— 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 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 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 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluati n by the Local Approving Authority 10-7-16 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. ****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. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 1 4oIld �S i , Commonwealth of Massachusetts Title 5 Official Inspection Form �. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments /aF p•,�!✓ 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centerville MA 02632 10-7-16 page. CitylTown 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: System is in good working order with no sign of failure. 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. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts a=1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centyerville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced' ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts f� Title 5 Official Inspection Form : I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments p_s!� 54 Great Marsh Rd -t J3 Property Address Daniel Murphy Owner Owner's Name information is Cent erville MA 02632 10-7-16 required for every y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: 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 1/2 day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts fz Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy erville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts lal Title 5 Official Inspection Form I.t Subsurface Sewage Disposal System Form Not for Voluntary Assessments p_ 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centyerville MA 02632 10-7-16 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: ® ❑ 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(5)] 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form a� f ,4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy eryille MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? - ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 2016 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: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts I;1 Title 5 Official Inspection Form III Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s¢!» 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centyerville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) , Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--pumped 3yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts J: Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , ✓ 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is Cent eryille MA 02632 10-7-16 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 42" feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 36"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 4 i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;�!✓ 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy erville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 611 Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts fy Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy eryille MA 02632 10-7-16 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.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 /01111 Commonwealth of Massachusetts t; p Title 5 Official Inspection Form ;.I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy erville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and no sign of back-up from chambers. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspecton Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy eryille MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2-500's ❑ 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.): Leach chambers in good working order and empty at inspection with no visible stain lines. 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts �+ f Title 5 official Inspection Form + I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s¢!✓ 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy eryille MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts ail Title 5 Official Inspection Form ! Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centyerville MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i A ~ 03 lop /1'3 r r t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts al Title 5 Official Inspection Form i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centyerville MA 02632 10-7-16 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: 12 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: Checked with local excavators installers- attach documentation ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 •11 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Great Marsh Rd Property Address Daniel Murphy Owner Owner's Name information is required for every Centy eryille MA 02632 10-7-16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOW OF FBA RN T LE S`f �� SEWAGE # ViLGAvv7'G'�d �`"G�e ASSESSOR`S 7�}S TAi.I.ER'S�tAtvt£&3�€iQtdE Na SEP't'LC TANK CAmcrr.X LEAaENG FACT€ (sue) EtJIIQER QR OWi1ER PERK '£DATE :GO�CE DATE. Separsuon Distance Between�e I�faximuraAd�ustecl C attam of LeachmgFac�tzty Feet:: Pnvate V4►ater 3uppiy iNell and I.eaclung Facyltty (IF auy wits east an stta ar rntlein feet of feactnttg fatty) fit. EdgeoPletiatid and Z.eacltt►g£%aa'lity(If any wetlands exist � within 304 feet p teacfuag facilicj') � j �Fi�t``' Furnished by -- - i J ek r5- /3 ' 11� 3 J �r TO�1WN�O�F BAR/NSTABLE LOCATION CK. // rMQleSh 1Q� SEWAGE # t VILLAGE C a'�V ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ��®L b _,. � �� G� �' ��t �`` 3 �' o No. . N — Fee /00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppliCAtion for Mi$pogal *pgtem Con.5tructton Verna Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑ Complete System WTIndividual Components Location Address or Lot No.&4 c(w (� O ner's Name,Address-and Tel.No. Assessor's Map/Parcel _ ��, `fin ' Q� o af 1 I/L I°1.6a Insta Name Address,and Tel.No. n Des igCner's Name, QJ` ress and Tel.No. 20 ,k t�l a1�6S� l6w. 6v M4.�tQ1 ►1 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 0 gpd Design flow provided 19 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank tJ.,_M 10 0 o Type of S.A.S. Ej/��; Description of Soil Nature of Repairs or Alterations(Answer when applicable) o q I a S0,Q - Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H lth. / Signed tr J Date ( Q� Application Approved by f Date vZ (D Application Disapproved by: Date for the following reasons Permit No. pay (p y Date Issued /a 7 G C No._ — 6 / s=�^w�"s r � Fee '"^ uteri Entered in computer:T6iE COMMONW EALTH OF MASSACHUSETTS p PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYication for Di9;posSa11,*p!5tem Cottgtruction Permit Application for a Permit to Construct( ) Repair N, Upgrade( Abandon( ) ❑ Complete System ,Individual Components Location Address or Lot No. 5y fee} ( h c-A Owner's Name,Address,and Tel.No. cm+QXV i ,v�1,el, o-�I p 11 ff Assessor's Map/Parcel O _ es(� �cQ t� 1, Gq USE)gS 3331161 an (� ) 7 Installer's Name,Address,and Tel.No. Designer's Name,Address d Tel.No. w!Gon j C , =6 ��kmvl Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) D 3 gpd Design flow provided 3 gpd Plan Date Number of sheets Revision Date 1 Title Size of Septic Tank c�y.l-S�t_YIC I O o o Type of S.A.S. a - S 04D �c-►� W�� Description of Soil I Nature of Repairs or.Alterations(Answer when applicable) S ,0 o 1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He ]thy J Signed Date / Q Application Approved by I �S Date /.2 Application Disapproved by: Date for the following reasons Permit No. U(I S`' y Date Issued /o 7 6_S^ i i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliartce THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( IV) Upgraded ( ) Abandoned( )by , L.(l� 011 p OJIA at (y ( eI11 ( ) I Cn1n has been constructed /in accordance with the provisions of TTi l itle�.and the for Disposal System Construction Permit No. o?UU S - y'7 dated /� d 7/OS Installer RC1�'1 �( IA l Designer —a C _ ,� (h,k V&r('t �i #bedrooms _Z Approved design—flow esign flow ?, gpd The issuance of this permit shall not be construed as a guarantee that the system wall functio, d se i�ed. Date , Inspector No. t) oOS,6 `/ L� Fee l/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1=i�po5al 6p.Wm Construction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at �1 (-mac(�of +{�(� a� A R of 11� Vt � �(1 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: Co truction must be completed within three years of the date of�J this-P Init. Date �� Approved by 1 t�9,�. 7 DEC-21-2005 09 :56 AM JC'ENGINEEPING 508 273 0367 P. 02 9/1003 o Notice: This Fords Is To Be Used For the Repair Of Failed Septic Systems Only PERCO1L.ATION TEST AND SOIL EVALUATION EXEMPTION FORM I, JWP) t:. C#vtU TC hereby certify that the engineered plan signed by me dated ✓ 4JS-2 , 200.� ,concernmg the property located at 5`f 6s'eGk 14as�. R<l, Ce��1e.r�;t1� KA lueets all oftile following criteria: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. The applicant may use historical data to conclude this fact or may conduct doep test holes and percolation tests at the site without a Health :.agent present. • There is no increase in flow and/or change in use proposed. • There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table cuvation, (Adjust the groundwater table using the Frimptor method when applicable) Please complete the following: A) Top of Ground Surface Elevation fusing GyIS information) -50 }` B) G.W.Elevation 3 (f s +adjustment for high G.W... 3 t DIFFERABI *dBSIGNED DATE: �. Zoloor NOTICE Eased upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans, q,tualtA faider�perccxretp Town of uarnstawe °ptHE t° Regulatory Services Thomas F.Geiler,Director • ■ARNS'1'ABLE, 9 MASS. Public Health Division i63q. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Designer: TL �n�w�eeci�5 -Tv�c _.......__._ _ Installer.__ Address: 285Y C_cc,.berry IiV5�cua)� Address: F_. war6A.&m 0 2 r3 8 d �1 yik ' \- On n "Qr it®tk 1 was issued a permit to install a (date) (installer) septic system at 51 6srea� Norsti �00d based on a design drawn by (address) dated hoy5A 2, 2005 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation'of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or _ - -- _--.certi ie -as- uilt by designer to follow. -. OF JOHN L. Gm (Ins al er s Signature) CHURCHILL JR. CIVIL No 41807 �j esigner's Signatur (Affix si p re) P EASE RETURN ARNSTABLE PUBLIC HE H DIVISIO CERTIFICATE F COMPLIANCE 4YVILL NOT BE ISSUED UNTIL BOTH THM FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE / LOCATION S* ltZ e A 7 V A A5// EWAGE # D•�'C��'� L VILLAGE C f-IV Z'(''R V IZZ f ASSESSOR'S MAP & LOT 2 ZO �L `INSTALLER'S NAME&PHONE NO. J /p41 A C 0,41 YJ' C'/t'-+ $ O/✓ SEPTIC TANK CAPACITY 1006 Q Z1,7- LEACHING FACILITY: (type) UI-9LL-5 (size) NO.OF BEDROOMS 3 BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet;=, r 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 f El i I , 001 f, r BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address Prop �j � Q �� y�OQt Ci 101 V �a Date of Inspec} Ma arcel Owner 1, �'A9 �Zl D Z 2 ,q��ela. S r-k,�s PART A — CHECKLIST ,9 . CHECK IF THE FOLLOWING HAVE BEEN DONE: d7 PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. rut S —�LNONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM HAS B RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. (/AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A. !--THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. (/ ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. 1/THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK WAS INSPECTED FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE, DEPTH OF SCUM. (i THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY.NON-INTRUSIVE METHODS. rr `—THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION RESIDENTIAL FLOW CONDITIONS --No of Bedrooms ?L No of Current Residents /�/6 -__Garbage Grinder Laundry Connected to System D` Seasonal Use NON RESIDENTIAL: ---- Calculated flow WATER METER READINGS,IF AVAILABLE: — ----- - Pumping Records and Source of Information: GALLONS SYSTEM PUMPED AS PART OF INSPECTION?/ G IF YES,VOLUME PUMPED GALS Reason for Pumping: ------ -- ------------- ------------ TYPE OF SYSTEM: - ----- Septic tank/distribution box/soil absorption system ! Single Cesspool Overflow Cesspool Privy Shared system (if yes, attach previous inspectgn records, if any) Other(explain)- GC-jGc n,J< Qt-' rersl.Doo/ nx'sd Approximate age of all components. Date installed,if known. Source of information. SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? /yU SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SEPTIC TANK: Depth below grade: n /I Dimensions: ` Material of cons (�traction: oncrete Metal FRP Other} Sludge Depth V,v Distance from top of sl 3 ud a Vottom of outlet tee or baffle Scum Thickness Distance from Top of Scum to top of outlet tee or baffle 0/7te- a Distance from bottom of Scum to bottom of outlet tee or baffle Co ments: _ a- /lam w �aveb,�y ` a e� &&V Scce e DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: PUMP CHAMBER: AID Pumps in working order? Comments: SOIL ABSORPTION SYSTEM—(SAS): IF NOT PRESENT,EXPLAIN: TYPE: — 'Z F C7 C E- CJ Comjn ' ZiL enQ. �n CESSPOOLS: AIX Number and configuration Depth-top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimension of cesspool Materials of construction Indication of groundwater inflow(cesspool must be pumped) Comments: PRIVY: Materials of construction Dimensions Depth of solids Comments: r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' Ste" 1 L t 0 -4 DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: )t-'&P Ap? C(. bea a 1 ca -sf�rr� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C — FAILURE CRITERIA (Indicate Y-yes N-no ND-not determined.Describe basis of determination.If"not determined",explain why not.) Backup of Sewage into Facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the districution box above outlet invert? A/ Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? Al— Required pumping 4 times or more in the last year? Number of times pumped Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiftration? tank failure imminent? Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? Within 50 feet of a surface water? ( /V _.Within 100 feet of a surface water supply or tributary to a surface water supply? Within a Zone I of a public well? Within 50 feet of a private water supply well? --�-;� Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools &privies only, not the SAS)? 4-- Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water I quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for col'rform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508)771-9399 CERTIFICATION STATEMENT I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY RECOMMENDATION REGARDING UPGRADE.MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE IN THE PROPER FUNCTION AND MAINTENANCE OF ON-SITE SEWAGE DISPOSAL SYSTEMS. CHECK ON i I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED AREAS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I HAVE DETERMINED THAT THE SYSTEM FAILS TO PR OTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. INSPECTOR'S SIGNATURE: DATE: f` ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY TOP OF FOUNDATION CONTRACTOR SHALL VERIFY SIZE AND FINISH GRADE OVER D-BOX= 100.7'± FINISH GRADE OVER CHAMBERS= 100.8' - 100.2' PVC VENT PIPE WITH CHARCOAL FILTER ELEV= 102.3± CONDITION OF EXISTING SEPTIC TANK REMOVABLE CONCRETE COVER SLOPE @ 2% MIN. OVER SYSTEM TOP OF BASEMENT FLOOR TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE GENERAL NOTES ELEV= 9$.9'± 5" DIA. OUTLET(S)FINISH GRADE OVER TANK EL.= 1 pp•1'± 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE @ FND. EL.= 100.5'± 20" MIN.ACCESS COVER PLACE RISERS ON ALL CHAMBERS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE (TYPICAL FOR 3) 36"MAX. 9"MIN. TOP OF SAS= 96.80 TO 6"OF FINISHED GRADE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. , 12"MIN. 95.80 36"MAX. BREAKOUT EL = 96.30' 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. I 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 6" 3" 3" 9" PROVIDE WATERTIGHT 7- 4BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. JOINTS (TYP.) 0 Doo O o0 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN EXISTING 4" 10" _ 4" PVC IN FROM CD ELEVATION =96.80' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. SEWER PIPE 14" 96,6'±* SEPTIC TANK 4"PVC OUT TO oSID• o 0 o UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACED AT LEAST FIVE FEET FROM S.A.S. - � LEACHING FACILITY oo 0 0 0 0 0 0 0 AND THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 0 CONTRACTOR SHALL 12" 2' o o0 0 o0 5. SLOPE ALL SOLID PIPE AT 1.0 % MINIMUM. 48" VERIFY CONDITION OF OUTLET TEE 96.10' IN. 95.93' o 0 CDC) 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. EXISTING TEES o 0 0 00 0 0 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO AND REPLACE AS 6"CRUSHED STONE o NECESSARY 22"ZABEL FILTER OVER MECHANICALLY 4.0' 4.0' BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR MODEL#A1801 HIP(GAS COMPACTED BASE 8.5' (TYP. OF 1) 4.0' 4 9' 4.0' INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING BAFFLE ON BOTTOM) 5 OUTLET DISTRIBUTION BOX 25.0' APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. (TYP') 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.00' OBTAINED FROM A - - - TO BE INSTALLED ON A LEVEL STABLE < ' BASE. FIRST TWO FEET OF OUTLET 93.80' GROUND WATER ELEV.= 88.77 12.9' NAIL IN UP 31 AS SHOWN ON PLAN. EXISTING 1000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION *CONTRACTOR SHALL VERIFY CROSS SECTION VIEW 2 - 500 GAL. CHAMBERS (H20) 5'MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE SEPTIC TANK PROFILE DISTRIBUTION BOX (H20) DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS CHAMBER END VIEW DISCRAT EPANCIES HEDESID ANY THENGINE CABLE AGENCIES. REPORT ANY DISCREPANCIES TO THE DESIGN ENGINEER. NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE WATERTIGHT. MAP 210 ( TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. ?�- � PARCEL 120 � INSPECTOR: Non-Witnessed it t 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS N/F SLATER #00 Hayes ij j o OTHERWISE NOTED ON PLAN. Y� SOIL EVALUATOR: Michael Pimentel, E.I.T. DATE: July 13,2005 •�: 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND ¢� Li00.9 TEST PIT#: 1 FINES. + fir rent ELEV TOP= 99.50' PROPOSED PVC VENT •, ELEV WATER= < 88.67' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND • •, Pt UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF •• . • PERC RATE_ <2 MIN/IN LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN w • COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN -� w • Q �v ' ••s : DEPTH OF PERC= 30"-48" ACCORDANCE WITH 310 CMR 15.255(3). •r �' o .� \ • • ' TEXTURAL CLASS: 1 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN o, '4 ' PROPOSED DISTRIBUTION BOX(H20) ' • . : • • SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. • W o «' ••• �`� + 0" 99.50' 16. PROPOSED PROJECT IS LOCATED WITHIN: 4) i \ PROPOSED 2- 500 GALLON LEACHING • ' • •' +�+�• * • 8" Fill ASSESSORS MAP 210 PARCEL 122 98.83' �I x100.8 CHAMBERS(H20) • �• «••• •• + ♦ • • • OWNER OF RECORD: RICHARD A. &CATHERINE A. MURPHY CV ?S •s i . • • �,, .• B Loamy Sand o, A ♦ O `� �+ 10YR 5/8 ADDRESS: 54 GREAT MARSH ROAD o p __ EXISTING 1000 GALLON SEPTIC TANK TO BE • 5Q MAP 210 / �' O 90, UTILIZED AS PART OF THIS DESIGN �.•�,,. .r.p own ' + •Q• 30" 97.00' CENTERVILLE, MA 02632 xx PARCEL 121 / 3) _ _ EXISTING LEACHING PIT TO BE PUMPED �• • • ��* . " o• • , �1 Perc FEMA FLOOD ZONE C x100 100.E +'"� • r, AS SHOWN ON COMMUNITY PANEL# 250001 0005 C N/F BADOT 0 AND FILLED WITH CLEAN SAND 60 1 0% ► 16 48" 95.50' 100.0' 1) " 1 17. PLAN REFERENCE: + M-C Sand 1. BOOK 228, PAGE 29-F3(GREAT MARSH ROAD L.O.) MAP 210 • eech i c ► C 2.5Y 6/6 2. BOOK 122, PAGE 89 • (100o Gravel) �X/ - 'oo I (2 O PARCEL 119 • •+ • • �� 18. DEED REFERENCE: 100.2 N/F DIMATTA o + ` ,�� . • �� 1. BOOK 9775, PAGE 97 • ' + : �/ • • • • 1, 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. HC h 00.7 ^oo • � • • No Groundwater 20• PROPERTY LINE INFORMATION IS APPROXIMATE, ONLY. THIS PLAN IS TO BE USED ONLY or Mottling Observed FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY LP 130" 88.67' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. LOCUS PLAN MAP 210 21. VARIANCE FOR COVER OVER THE SYSTEM TO BE APPROVED BY THE BOARD OF HEALTH PC SCALE: 1 1000' OFFICE. NO BOARD OF HEALTH VARIANCE MEETING REQUIRED FOR THIS VARIANCE. "= PARCEL 118 #54 ENCLOSED / / N/F CHRISTOPHERS TEST PIT DATA / LEGEND G E N D EXISTING PORCH �- `- 3- BEDROOM \ x99.0 INSPECTOR: DWELLING \ DESIGN DATA Non-Witnessed X100.0 EXISTING SPOTGRADE TOF = 102.3'± / �\ SOIL EVALUATOR: Michael Pimentel, E.I.T. -100 - EXISTING CONTOURS / SLAB =98.9'± TP1 � DATE: July 13,2005 102 PROPOSED CONTOURS o �\ NUMBER OF BEDROOMS 3 TEST PIT#: 2 99x5 �\ / DESIGN FLOW 110 GAUDAY/BEDROOM ELEV TOP= 99.60' 102 PROPOSED SPOT GRADE � ol� DRIVE TOTAL DESIGN FLOW 330 GAUDAY ELEV WATER- < 88.77' EXISTING OVERHEAD UTILITIES ' DESIGN FLOW X 200 % = 660 GAL/DAY PERC RATE= <2 MIN/IN w EXISTING WATER LINE \\ S / USE EXISTING 1,000 GALLON SEPTIC TANK = x98.7 ` TP2 DEPTH OF PERC 28"- 46" � TEST PIT LOCATION TEXTURAL CLASS: 1 O O EXISTING 1000 GALLON SEPTIC TANK 9 UP31 / . / / MAP 210 - - \C� o INSTALL 2 500 GAL. CHAMBERS (H 20) 0" 99.60' -X-X-X-X-X-X- EXISTING FENCE B M PARCEL 123� Fill g" 98.93' Nail in UP#31 \ / / N/F LEVINE SIDEWALL CAPACITY PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE Elev. = 100.00 ,y g Loamy Sand (Assumed) 10YR 5/8 (LENGTH +WIDTH) (2)(2' HIGH) (0.74 GPD/S.F.) = GAUDAY 22" 97.77' ❑ PROPOSED DISTRIBUTION BOX(H20) 25.0' +12.9' 2' ( ) (2) ( ) (0.74 GPD/S.F.)= 112.2 GAUDAY 28" 97 27 ; 0 PROPOSED 500 GALLON LEACHING CHAMBER(H20) Perc =y: G _ BOTTOM CAPACITY 46" sra 95.77' WG MAP 210 ( LENGTH x WIDTH ) (.74 GPD/S.F.) = GAUDAY M-C Sand (25.0'x 12.9') (.74 GPD/S.F.) = 238.7 GAUDAY C 2.5Y 6/6 REV. DATE BY APP'D. DESCRIPTION PARCEL 122 V `x 10 ravel 8,712 S.F.± PROPOSED SEPTIC SYSTEM UPGRADE (0.2 AC±) TOTALS: PREPARED FOR: RICHARD MURPHY 98 i -` \ TOTAL NUMBER OF CHAMBERS: 2 No Groundwater 0 TO IS � \ / LOCATED AT /Q i TOTAL LEACHING AREA: 474.2 SQ.FT. 130" or Mottling Observed 88 77, 1 O FQ TOTAL LEACHING CAPACITY: 350.9 GALJDAY �F 96 54 GREAT MARSH ROAD % ON.0 CENTERVILLE, MA 02632 RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 10 FT. DATE: AUGUST 2,2005 0 5 10 20 40 FEET PREPARED BY: DESCRIPTION PC ' HC \ 1'± UFO,, cH�FiNNit_L'1(�; LEACHING CORNER(1) 20.8 34.8' JR. JC ENGINEERING, INC. CIVIL LEACHING CORNER(2) 13.1' 24.7 No07 2854 CRANBERRY HIGHWAY \ �\ LEACHING CORNER(3) 37.8' 18.2' EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 LEACHING CORNER(4) 41.1' 30.6' SCALE: 1"-10' Drawn By: MLP Designed By:MLP Checked By: JLC JOB No.880