HomeMy WebLinkAbout0062 GREAT MARSH ROAD - Health E62Great Marsh Road, Centerville
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UPC 12534
No.2 OR '`�s►co
NA8TIN0!MN
Town loo of Barnstable P#
gyp,' Department of Regulatory Services
,�LK Public Health Division Date
a639 �� 200 Main Street,H annis MA 02601
lED t,A1tt a
Date Scheduled Time Fee Pd.
Soil Sur ability Assessment for Sewa a Disposal
Performed By: Witnessed By: S
LOCATION& GENERAL INFORMATION
Location Address (0-L &,-tor (Y)141" Owner's Name 571 u,p_. OA JY
Ce A�f t^V 1 `+Ci Address i2-Cl4-T- Min f-S
Assessor's Map/Parcel: Z l O l l Z l Engineer's Name
NEW CONSTRUCTIO
N 11 REPAIR Telephone# 2-74 7 3 q-1
Land Use Slopes(%) `�DIO Surface Stones u
Distances from: Open Water Body N` ft Possible Wet Area '`'to ft Drinking Water Well NI 19 ft
Drainage Way N ft Property Line i(I ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
Uri ve
Y=AA 11, 5 I
G G &krm
N
ca
fiP^l m
w -
r"l G.r sL N is
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kn cry
Parent material(geologic) , GCIG-t `k _ t Depth to Bedrock }1001
Depth to Groundwater. Standing Water in Hole:_ N I Weeping from Pit Fnoe
Estimated Seasonal High Groundwater
DETERARNATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: __-___ In, Depth to soil mottles:
'Depth to weeping from side of obs.hole: in, Groundwater Adjustment fit.
Index Well# Reading Date: Index Well level Adj,factor— Adj,Groundwater Level
PERCOLATION TEST bate . Thne.._
Observation
Hole# e � Time at 9" ,
Depth of Perc JItJ O�Ly S lS Time at 6"
Start Pre-soak Time @ Time(91141)
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) I
Original: Public Health Division• Observation Hole Data To Be Completed on Back----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conseirvation Division at least one(1)week prior to beginning. Uv
Q:\SEPTICIPERCFORM.DOC
l J
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture *, Sdil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
onsistency.%oravel)
0-�� F 1�
Ls 1 L) 3/1
1
C, S -`L
s- C2 C sand 10
C3 C scld 10 '16- 11,1
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsisten %Gravel)
a
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Grav
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsistencv.
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No '!� Yes,
100 year flood bounds No t� Yes Within y boundary
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? 25
If not,what is the depth of naturally occumng pervious material? ,..
Certification
I certify that on 0'i (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 trai ing,eexpertise and experience described in 310 CMR 15.017. l'
Signature Date $ 11
r
Q:WEPT10PERCFORM.DOC
/ tJ�
No. ` Fee J
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliLation for BispoBal 6pstem ConstCULtion permit
Application for a Permit to Construct( ) Repair(JrUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or I,ok No. (o fee,,- M.&IJ Owner's Name,Address,and Tel.No.
C e�-3ve^;O lY %3G d/—
Assessor's Map/Parcel AI
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�a�s\o t� i�i.rc,v9+J ..�NC spg-ClGr7"7/S'Yj dC Pc'✓$ �()� s t° f/C
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building rrsldrr+i-i& J No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) yyp gpd Design flow provided ySS' gpd
Plan Date ,q-2 - !`! Number of sheets Revision Date
Title
Size of Septic Tank /!CW Type of S.A.S. 3 5-00 Gt G 110-1 L h C10"A0/}
Description of Soil
Nature of Repairs orAlterations(Answer when applicable) X-A/s f-G f f c, /C 00 c Cr _&.4)d
S00 �►�I It9 N e�nr.✓�.,�pf-S l Ali 14 H i e L is ns a ��- T�lra.,�,v vev ✓d/r--✓
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 Boa Health.
S' d 4,C Date
Application Approved by Date 61`(10I/S
Application Disapproved Date
for the following reasons
Permit No. Date Issued
' 15 5/ - /(� Fee
71 r r7T� CJ�
i No. D
THE COMMONWEAL�TFIF MASSACHUSETTS Entered inooinputer:
Yes
PUBLIC HEALTH DIVISION OWN OF BARNSTABLE, MASSACHUSETTS
01pplication for bisposal 6pstem Construction,Permit
o
Application for a Permit to Construct( ) Repair`( Upgrade( )^Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.G G e w- Mu/S Owner's Name,Address,and Tel.No.
C y Sow f- 6
Assessor's Map/Parcel /
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�v.�S1c s arc N%�vc �pF3-41CO-7!5_`7 or re Or s ,P f i c
Type of Building:
Dwelling No.of Bedrooms Lot Size y2 g sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons A-/ Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gA10 gpd Design flow provided y!E5 gpd
Plan Date 2 J aJ Number of sheets Revision Date
Title /
Size of Septic Tank /fUC) Type of S.A.S. 3 SUD
Description of Soil }
Nature of Repairs or Alterations(Answer when applicable) T�s jG/�c► //< oO 4o-� f-r n�h ?J nx C��(>
3 C kA GM b 1°/S j y 1' o y S to n,Q c�t���i►�>...i.� b.✓ ka/.,.✓
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 Boar Health.
d Date
Application Approved by Date
k
Application Disapproved Date
for the following reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( )
Abandoned( )by c,7 A 1 2 i b_-j .-.) -17 ry C
at 2 G✓Yo; /1/Ti��Li /?i���✓>'C✓v�/�< has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated (��t/Zois
Installer J ,��✓� ,5 A 1 ., :�[ ,v e Designer ne-,-r.4-5 IC) P 5;,-tgi fC
#bedrooms y Approved design flow 111q gpd
The issuance of this permit shal of b construed as a guarantee that the system wil' func' n as si ne .
Date Inspector
----------------- ��Z-------------------------------------------------------------------------------------�/- ------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS
Misposal *pstem -Construction Permit
Permission is hereby granted to Construct( ) Repair(v) Up/grade( ) Abandon( )
System located at �j 2 G r�G /�(y S dl ��/ r,✓ l✓v ���
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
E � III
Provided:Const ction must be completed within three years of the date of this permit.
Date�� ZO/� Approved by
locoed a� �� �� �%� ��� ��
� N��e GEC /� 1����-u-�- a�C a �'�`
a� `fie �� w`e �prwG�-�� �� ,� /��g,
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T®wn of Barnstable
' pFtH@ r�
Regulatory 5ervicO
} Richard V. Scali, Interim Director
anaNsrneLE,
,ASS. a Public Health Division
Thomas McKean, Director
200 Main Street,Hyannis,MA 92601
!
Offi e: 508-862-4644 Fax:! 508-790-6304
Installer & Dpsi er Certification Form
Da Sewage Permit#f ��`�f-�8�- Assessor's Map\'arce1Z1 b �2'l
C_k5',n9"e Z �:
Designer: 6 oc\,. Installer:
'AdLess: 1Z W..< Gam,s:� t �ZcA Address: f c-4�e lta�. 4 �`
On l� '���.alav�v� (V�_L was issued a permit to install a
(date) (installer)
sep'is system at based on a design drawn`by
(address) o
d'1
dated
(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. Strip out (if required) was inspected and. the soils
were found satisfactory.
1 certify that the septic systern, 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 systein) but in accordance with State & Local Regulations. Plan revision or
certified as-built by desi:gper to follow. Strip out (if required) was inspected and the soils
were found satisfactory,
I certify that the system referenced above was constructed I'lanee with the term s of
the 11A approval letters (if applicable.).
.. :� / of� • !Y `��
ller's Signature)
(9esi�€r's Signature) (Affix-Designer's Stamp Here)
.P ASE TURN TO BARNSTABLE PUBLIC HEALTH DM. SION. CE:LaT.1FICATE
'O C0fY1PLIANCE L NOT BE ISSUED Ui�ITiL BOTH THIS FORI'4!1 AND AS-
B. �T CARD ARE RECEIVED BY THE B.AR1�dSTABLE PUBLIC HEALTH DIVISION.
T YOU.
Q:13eptic0esigner Certification Form Rev 8-14-13.doc
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z_elT G-3 TOWN OF BARNSTABLE 1
LOCATION/eA4 '64re4T /ys"1 - SEWAGE #
VILLAGE C Bar//�i^�1/ � ASSESSOR'S MAP&LOT j 0
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY �A. 2e2 e e
LEACHING FACILITY: (type)f rI —/ X6� C ��►1�2(size) MA&I
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 7 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( any wetlands exist
within 300 feet y sleachin VaXfi! n Feet
Furnished b /
�1A $x,i
. `
i
5
t
TOWN OF BARNSTABLE
LOCATION SEWAGE# 901 ,--
VILLAGE ASSESSOR'S MAP&PARCE - k—
INSTALLER'S NAME&PHONE NO."'�2 ,J cS k 136e9v.9>� n+C
SEPTIC TANK CAPACITY I S 0 C.
LEACHING FACILITY:(type) �C�1Csfh�St� size) la.,�3X 33.5XZ.
NO.OF BEDROOMS
OWNER &,��17
PERMIT DATE: -I I -I S COMPLIANCE DATE:-7
Separation Distance Between the: iJ�Ne C. F PP�C
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��DV,3 ,y 1 `O c A)
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-30.S
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ova• _
DATE: - 9/18797_.
PROPERTY ADDRESS: 62 Great Marsh Road
Center•ville.Mass .
02632
On the above date, I Inspected the "ptic system at the •above address.
This system consists of the following:
1 . 1 -6 ' x8 ' block cesspool .
2 . *1 -6 'x6' block cesspool .
Based on my_Intkc-a&ction,_I_ certify the following_ condltlons.:.. ___ -
1 -This is not a title five septic_- system.
2 . This is a sewage system.•
3 . The sewage system is in proper working
order at the present time.
4 . Pumped main cesspool as required.
5 . Overflow cesspool has 8" of wastewater.
• SIGNATURE:
Name : J . P . Macomber Jr•,
Company -J . P_Macomber &- Son- 'Inc •
Address :_
Centerville Aass__02,632
Phone :-- , 508
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRAN
• f
JOSERH P. MACOMBER. & SON, INC. ¢'
Tanks-Cesspools-Lasthflelds
Pump+d & Inst.alltd
Town Sewer Connections
P.O. Box 66' Centerville, MA 02632.0066
7 7 3-3 3 35 7 7 5-6d 12
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER R STREET. BOSTON, MA 02108 617.292•5500
WILLIA.\1 F WELD TRL D1 C(
Go�cmor Sc'r'
ARGEO PALL CELLUCCI D.A\ID B STR
Li Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Corr.rnissi
PART A
CERTIFICATION
Property Address: 62 Great Marsh Road CentervillAddress of Owner:
Date of Inspection: 9/17/9 7 (If different)
Name of Inspector: Joseph P. Macomber *Jr .
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: Joseph P. Macomber _&_ Son,_ Tnc .
Mailing Address: =OX bb 1 Centerville . Ma . 02632-0066
Telephone Number:
CERTIFICATION STATEMENT
I cenify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurai
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function ano
maintenance of on-site se age disposal systems. The system:
�P:asses
Conditionally Passes
r.l—ic F„nhor Fvah,aunn Rv the I nral Annrovine Authoriry �^-7
Inspector's Signatureal'lsubmoit
The System Inspecto a.copy of this inspection report to the Approving Au(horiry within thirty (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 submi
the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system own
and copies sent to the buyer, if applicable, and the approving authority.
INSPECTION SUMMARY: Check A, B, C, or D:
A) SYSTEM PASSES:
2s ave not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR )5 30'
Any failure criteria not evaluated are indicated below.
COMMENTS:
B) SYSTEM CONDITIONALLY PASSES:
4/4, One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system. up(
completion of the replacement or repair, as approved by the Board of Health, will pass.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not
4 ip t e_The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
a' Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection. c
the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tan
failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic Link
as approved by the Board of Health.
(revised 04/25/97) Page 1 of 10
DEP on the World Wide Web: hrtpW*ww.magnet.State ma us/dep
Printed on RecycJed Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 62 Great Marsh Road Centerville,Mass .
Owner: W.G.Kerr
Date of Inspection:9/17/97
B) SYSTEM CONDITIONALLY PASSES (continued)
4,1&&-- Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health). Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
A,0 The system required pumping more than four 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
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 the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
426 Cesspool or privy is within 50 feet of a surface water
!G 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 APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that
the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. Method used to determine distance (approximation not valid).
3) OTHER
C r— Aeee'�'l 46L'-g' 4V
(revised 04/25/97) Page 2 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 62. Great Marsh Road Centerville Mass_ _
Owner: W,G. Kerr
Date of Inspection:9/1 6/9 7
D) SYSTEM FAILS:
You must indicate ei;•.er "Yes" or "No" as to each of the following:
k,�D I have determined that the system violates one or more of the following failure criteria as defined in 310 CN1R 15.303. The bans
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Yes No
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
__4)d4/6_ 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.
Required pumping more than 4 times in the last Year NOT due to clogged or obstructed pipe(s).
Number of times pumped 45P tris)4 M "C-744 0
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
Q LARGE SYSTEM FAILS:
You must indicate either "Yes" or "No" as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
Yes No
10 the system is within 400 feet of a surface drinking water supply
A-49 the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area • IWPA) or a mapped Zone II of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 04/25/97) Page 3 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 62 Great Marsh Road Centerville Ma
Owner: W.G. Kerr
Date of Inspection: 9/1 6/97
Check if the following have been done: You must indicate either "Yes'. or "No" as to each of the following:
Yes N
Pumping information was provided by the owner, occupant, or Board of Health.
None of the system components have been pumped for at least two weeks and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or
as part of this inspection.
14 As built plans have been obtained and examined. Note if they are not available with N/A.
41/ _ The facility or dwelling was inspected for signs of sewage back-up.
- - - - ---—
_ The system does not receive non-sanitary or industrial waste flow:`
The site was inspected for signs of breakout.
/ —
�/ All system components, &cluding the Soil Absorption System, have been located on the site.
�iD•V� 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.
—The size and location of the Soil Absorption System on the site has been determined based on:
The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of
Sub-Surface Disposal System.
Existing information. Ex. Plan at B.O.H.
Determined in the field (if any of the failure criteria related to Pan C is at issue, approximation of distance is
unacceptable) (15.302(3)(b))
(rwl��d 04/25/97) Pag• 4 of 10
r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 62 Great Marsh Road Centerville Mqa. _ ..
Owner: W.G. Kerr
Date of Inspection: 9/1 6/97
FLOW CONDITIONS '
RESIDENTIAL:
Design flow:�/)O p.d./bedroom for S.A.S.
Number of bedrooms:-1--
Number of current residents:
Garbage grinder (yes or no): _
Laundry connected to system(yes or no):/F-9
Seasonal use (yes or no):,flyl) r
water meter readings, if available (last two (2) year usage (gpd):
Sump Pump (yes or no):.12Q
Last date of occupancy:���
COMMERCIAUINDUSTRIAL•
Type of establishment:
Design flow: allons/day
Grease trap present: (yes or no)A
industrial Waste Holding Tank present: (yes or no).A&
Non sanitary waste discharged to the Title 5 system: (yes or no)/V*
Water meter readings, if available:A/A
A119
Last date of occupancy: A)fi
OTHER: (Describe) AIA
Last date of occupancy: NA
GENERAL INFORMATION
PUMPING ECORDS and source of information:
��ytae . Ynmx) oto-,, ok
System pumped as pan of inspection: (yes or no)_9
If yes, volume pumped:/� A�gal lorls
Reason for pumping: Q
TYPE OF SYSTEM
AM Septic tank/distribution boxJsoil absorption system
/ Single cesspool
7 Overflow cesspool
Privy
A) Shared system (yes or no) (if yes, anach previous inspection records, if any)
I/A Technology etc. Copy of up to date contract?
Other XA
APPROXIMATE AGE of all components, date installed (if known) and source of information: 'r`v °�l�f' �
Sewage odors detected when arriving at the site: (yes or no),Y
(r.vi..d 04/25/97) Paq. 5 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 62 Great marsh Road Ma
Owner:
_ r. _ -Centerville-_ _ ._ ....._._. _.. _..
W.G. Kerr
Date of Inspection: 9/1 6/9 7
BUILDING SEWER:
(Locate on site plan)
Depth below grade:
Material of construction- Zast iron _ 40 PVC _ other (explain)
yJy �' ,lli/1P -
Distance from i Private water upply well or suction line WA
Diameter '7lr
Comments: (condition of joints venting, evidence of leakage, etc.)
/
3 T
SEPTIC TANK:/1/041e-
(locate on site plan)
Depth below grade:.4!W
Material of constructiowAconcreteA/Ameta( 4iberglassoVAPolyethylene4'�9other(explain) - - - ----— - - --- - - - -
A41X
If tank is metal, list age Vlf Is age confirmed by Cenificate of Compliance AI.0 (Yes/No)
Dimensions: J¢
Sludge depth: AN
Distance from top of sludge to bonom of outlet tee or baffle:_ 0
Scum thickness: A14
Distance from top of scum to top of outlet tee or baffle:AL4
Distance from bonom of scum to bonom of outlet tee or bafle:A
How dimensions were determined: Ally
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to,outlet invert, structural
integrity, evidence of leakage, etc.)
GREASE TRAP:2&,(-1ft/e
(locate-on site plan)
Depth below grade: X,41
Material of construction-44 concret&OW metakVAFiberglass-VA Polyethylene,,) other(explain)
Dimensions:
Scum thickness: 1W
Distance from top of scum to top of outlet tee or baffle:d/�
Distance from bottom of scum to bonom of outlet tee or baffle:_,10
Date of last pumping: .f�/�
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
�.t�,sG �•B4O 1 S ,dd� L�iIJ I�'
(zeviaad 04/25/97) Page 6 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:. 62 Great Marsh Road Centerville Ma
Owner: W,G. Kerr
Date of Inspection: 9/1 6/9 7
TIGHT OR HOLDING TANK:AI &(Tank must be pumped prior to, or at time, of inspection)
(locate on site plan)
Depth below gradeW4
Material of construction W,4concretetiAmetal&QFiberglasAAPolyethylenW,64_other(explain)
AJ4
AJ4
Dimensions: GA
Capacity: 4ZQ gallons
Design flow: AJQ gallons/day
Alarm level: A)A Alarm in working ordeWq Yes42A No
Date of previous pumping:
Comments.
(condition of inlet tee, condition of alarm_and_float switches,_etc.)_
DISTRIBUTION BOX&bt)e
(locate on site plan)
Depth of liquid level above outlet inven:��
Comments:
(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.)
PUMP CHAMBER:Atwe
(locate on site plan)
Pumps in working order: (Yes or Nolte
Alarms in working order (Yes or No) �
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
A
(revised 04/25/97) Page 7 of 10
-
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 62 Great Marsh Road .Centerville Ma
Owner: W.G. Kerr
Date of Inspection: 9/1 6/9 7
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:Q
leaching chambers, number:
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:-
Alternative system: &A
Name of Technology: L4
Comments:
(note conditio of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
CESSPOOLS:
(locate on site p n)
Number and r rati6n: -LIZ IK
Depth-top of liquid to [rile( invert: 4
Depth of solids layer: ��AIA2
Depth of sc{im layer:
Dimensions of cesspool: • �ao0 �X�
Materials of construction:
Indication of groundwater: D.f!'-
inflo (cessggppol must be pumped as pan of inspe ion)
L`�� V,4 S �•i i 1r 4
Comments:
(note cop4tion of soil, signs of h draulic failure, level of ponding, condition of vegetation, etc.)
PRIVYN�
(locate on site plan)
Materials of construction: Dimensions:
Depth of solids:_A)X
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
OF i
.(revised 04/25/97) ➢.g. 8 of 10
%u
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
P.ropertt Address: 62 Great- Marsh Road Centerville Ma
Owner: W.G. Kerr
Date of inspection: 9/1 6/97
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
, r i
44d.
(z.vi..d 01/15/97) Page 9 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:62- Great Marsh Road Centerville Ma - -
O� ner W.G. Kerr
Date of Inspection: 9/1 6/97
r
Depth to Groundwater/Lk Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observation of Sit (Abuning property, observa� tion _hole, basement sump etc.)
_✓Determine it from local conditions
heck with local Board of health
Check FEMA Maps
heck, local excavators. installers
Use vSCS Data
Descr,be in your o,,•^. words how you Pcrablished the High Groundwater Elevation. (Must be comol.ro.4-
J.P.Macomber & Son Inc. We have installed.septid_ systems
at 6 Great Mars4t-Rc Centerville. permit #sqs -5j2_ .
38 Great Marsh Road permit # 1,16--71
222 Great Marsh Road permit # 94-404
271 Great Marsh Road permit # 94-295
No water encountered at 12 '
(revised 04/25/97) Page 10 of 10
(- .+�r+-r r.—Tr'..+.r m r m rs-r•.-n.++.m.r•.r+•.wr:�^*r.n-.'rsr.v mr�rrs•nr. .rr....-v-n-s�rnT-.-r-,.-�- -. ._
TOWN OF Barnstable WARD OF HEALTH
SU.I1SU1?FACF, 9FHACE DISPOSAL SYSTEM IN811FCTION FORM - PART D CENTIFICATION
`- �...-._.T......-� •.- T.T.�'n:TTT.'LTA.TTn'�•.1^1n'RIRTTT�•T.IT4�lIIR�..�TC"� rm.n-...'r.-..r'r'r+-..,-�•-.r.... �._ _.
-TYPE OR PRINT CI.EAAL1•- _
PROPERTY INSPEC7'ED
STREET ADDRESS 62 Great Marsh Road Centerville,Mass .
ASSESSORS MAP , DLOCK AND PARCEL
OWNER ' s NAME W.G.KERR
PAR7' D - CERTIFICATION 1
NAME OF INSPECTOR Joseph P . Macomber Jr .
COMPANY NAME Joseph P. Macomber & •_Son , Inc .
- COMPANY- ADDRESS-Box _66 , _ - _Centerville , Ma . 02632-0066
Street Town or City St.t. (IP
COMPANY TELEPHONC (508 ) 775 -3338 FAX ( 508 ) 790 -1578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage dispos(3-1 system nt
this Address And that t)le information reported is true , accurate , and
complete as of the time of .inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintelinnce of on-
site sewage disposal systems ,
Check one :
{XXXXXXXXXXSyste6 PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or Life environment as defined in 310 CMR 15 , 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form .
System FAILED*
Thee inspection which I have con acted has found that the system fn ! ls to
Protect the public health and the environment in accordance with Title
5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form ,
.Inspector Signature Date9/18/97
Qne copy of this certification must be provided to the OWNER , the DUYER
( where applicable ) and the DOARD OF HEAL71ll .
• If the inspection FAILED , the owner ors parator shall upgrade
pg ado the e yote �
.+ ir.liin one year of the dnte of the inspection ,
p ion , unless allowed or requiresut
otherwise as provided in 310 Ch1R 15 . 305 ,
partd . doc
<<
3L
w
cn z�
S
THE COMMONWEALTH OF MASSACHUSETTS
DEPARTMENT OF E ONNIENTAL PROTECTION
BE IT KNOWN THAT
Joseph P. Macomber, Jr.
Has -satisfied the Deparnnent's qualifications as required and is hereby
authorized to use the title
CERTIFIED TITLE 5 SYSTEM INSPECTOR
as provided in 310 CMR 115 .340 and Section 13 of Chapter 21A of the
P P
General Laws. Issued by P The Department of Environmental Protection.
iunc s, 1"5
Acting Dircctor of the on UC Wztcr Pollution Control
. 1
. t
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675
10/22/02
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch. 139, Sec.313
BARNSTABLE HEALTH DEPT.
BARNSTABLE TOWN HALL
367 MAIN STREET
HYANNIS MA 02601
Re: insured: jULIE ,i BADOT
Property Address: 62 GREAT MARSH RD, CENTERVILLE, MA 02632
Policy Number: 0672099
Type Loss: Mold
Date of Loss: 10/22/02
Claim Number: 194337
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, j
Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139,
Section 3 B is appropriate, please direct it to the attention of the writer and include a
reference to the captioned insured, location, policy number, date of loss and claim or file
number.
MPIUA Claims Division
CMA00021
TOP OP FOUNDATION 24"d,ameterconcrete covers CENTERVILLE,
EL-5o.2 rasedtow,thm6oted) MA
shgrade SYSTEM DESIGN CALCULATIONS
(or as noted)
Q-
5
lxistmg EL=48.4t FL=46.5(mar) EL=46.0 48.5+ 5EWAGE DE5/6N fZOW REQU/RED.•4 BEDROOM DWELLING Q /10 GPD/BEDROOM of e�e
440 GPD REQu1RED
5fWA6E DE51GN FLOW PROV1DE0: THREE(3)500 GALLON 15ACtf 0fAM25ERS WITH
4'OF5TONEALL AROUND
47.4t 455+ 46./t Vt =[(33.5 x /2.63) +203.5 f /2.63)x 21 x.74
=4552 GPD PROV/DED e~�
Gf07 XT/LF FABRIC
A.-47.3t' a _ TilL (IN PLACE OF//4°r/2'PEA5rONF) 455 GPD PROVIDED>440 GPD REQUIREDK,
46.25 `" 0 46.00 45.77 - : 45.60 45.40 3/4°- /-//2°STONE 'n LOCUS
N r (DOUBLE WA5HED) 5EPTIC TANK CAPAC/TY REQUIREP. 440 GPD X 200% =WO GPD REQUIRED N h Pq Q
Gas Baffle 43.40 5EPTIC TANK CAPAC17YPROVIDED. 1500 GALLON PROVDED(MIN/MUM ALLOWED)
N
Tf/REE(3)S1�OREYPRECAST 500 9_}
Lon est Run I e'-' A GARBAGE 0/5PO5AL/5 NOT PERMITTED W/Tf1 7H15 DESIGN FLOW n Route 28
#
40 I7 !2 GALLON LEACH CHAMOFR5 WITH 4' FL
DB-6 OF5TONEALL AROUND
/500 GALLON EL=37.6�Bottom of Test Ho%#I
"Plumbing at"B"to be (f!-20Rated) (END V/ INSPECTION NOTE: SITE
LOCUS
Raised and plumbed to
"A"-inside the buddm
SBPTIC TANK 0-DpX LEACH CHAMBf95
PRIOR TO FINAL INSPECTION BY THE ENGINEER,SYSTEM NOT TO SCALE
and the outlet capped. p NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS.
f LO p! I\0lF I LE 1 .) Assessor's Map 2 10 Parcel 12 1
V 33.5' V 2.) Deed Book 1 1400 Page 332
NOT TO SCALE
p
4' 8.5' 8.5' 8.5' 4' 3.) Plan Book 12! Page 125
CO N ST ICU CT I O N NOTES 4.) This property Is in a Town of Barnstable Resource
h'DPEL,rrer -Protection and Saltwater Estuary Protection Zone
1 _ (See Note#22) 5.) This property is not In a Zone 11 of a Public Water
1.)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE,TITLE 5 (3 10 CMR 1 5,000);STANDARD 1 ' Supply
REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, UPGRADE,AND EXPANSION OF ON-SITE SEWAGE G.) Flood Zone: C
7/ /
TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT AND DISPOSAL OF 5EPTAGE,AND THE LOCAL BOARD OF Q� x
HEALTH REGULATIONS. q a
2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS POTENTIAL FOR VEHICLES OR HEAVY r *.
EQUIPMENT TO PASS-OVER IT SHALL BE DESIGNED TO WITHSTAND AN H-20-LOADING.. IF UNDER AN IMPERVIOUS. c>
SURFACE, SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. Y , c\i LEGEND
r- )/ r
s. r ' X"� p ' y"�`' Y y
3.)TO MINIMIZE UNEVEN SETTLING, SEPTIC TANK5 SHALL BE INSTALLED ON A STABLE MECHANICALLY-COMPACTED BASE v p o 1 z3 EXISTING SPOT GRADE
N p -
d
ON SIX INCHES OF CRUSHED STONE. o
p 6 �. QUO 1 24x5 PROPOSED SPOT GRADE
4.) COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE DISTRIBUTION BOX,AND THE SOIL \ Parcel 12 1 21. EXISTING CONTOUR
ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN G" OF FINAL GRADE. LEACHING FIELDS,TRENCHES,AND OTHER SOIL 5 1 o a ( e e# ) 24 PROPOSED CONTOUR
ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALL HAVE AT LEAST ONE(1) INSPECTION PORT CONSISTING OF �� �� q ¢ Area=8,925 S,F.± w WATER SERVICE LINE
PERFORATED 4"PVC PIPE PLACED VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A CAP,TIED , ° 4 9, O OVERHEAD UTILITY LINES
WITH MAGNETIC MARKING TAPE, ACCESSIBLE TO WITHIN 3"OF FINAL GRADE. 43 ``C���U U UNDERGROUND UTILITY LINES
5.) PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A MINIMUM CONTINUOUS PLAN VIEW \ w QJ ° .+ 5 stng 5ept-Component5; G GAS SERVICE LINE
GRADE OF NOT LESS THAN 2% FROM THE BUILDING TO THE SEPTIC TANK,AND NOT LESS THAN I%OTHERWISE. 4 . °. n to be Abandoned ^� EDGE OF CLEARING
� a ° a ¢ (Se Mote#2/)SCALE: I" = IO'
- FENCE
G.) DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4"DIAMETER SCHEDULE 40 PVC(OR 7P
EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHERWISE NOTED. LINES SHALL BE CAPPED AT END OR AS NOTED. agl>�9 ° Q ( J �� TEST HOLE LOCATION
w \ _
�. �� / cd^ .- 5T
4 SEPTIC TANK
7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2) FEET BEFORE PITCHING TO THE 501E Re%ategas/me ° a do DB DI5TRIBUTION BOX
ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO ASSURE EVEN DISTRIBUTION. (5ee No to 0 5)
SAS SOIL ABSORPTION SYSTEM
8.) GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES IN ORDER TO \ //
PROVIDE A WATERTIGHT SEAL. 6 /
do
9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE DISPOSAL FIELD DURING Existing Rhododendron O41
THE COURSE OF CONSTRUCTION OF THE SYSTEM. I NSTALLER TO VERI FY THE LOCATION OF ALL to be Reno✓ed �h I /
UNDERGROUND AND OVERHEAD- UTILITIES PRIOR
10.) IN ACCORDANCE WITH 3 10 CMR 15.22 1,ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING 3 T q st 1
TAPE. TO THE START OF ANY EXCAVATION ACTIVITIES ,,, ia� i. iohg, / o�o� o�g // l
AND RELOCATE AS NECESSARY, ESPECIALLY IN
,,. oA r s VARIANCES REQUESTED
1 1.)THERE ARE NO KNOWN WELLS WITHIN 100'OF THE PROPOSED SOIL ABSORPTION SYSTEM. AREA OF GAS LINE (SEE NOTE #15) FG ° l 024dt �g
12.) FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF THE CERTIFICATE OF O / ° ��,G Local Upgrade Approvals: 3 10 CMR 15,403
COMPLIANCE,THE PERIMETER SHALL BE STAKED AND FLAGGED TO PREVENT USE OF THE AREA THAT MAY CAUSE (Y Fc /
5 O" Variances: 3 10 CMR 1 5.2 1 I Minimum Setback
DAMAGE TO THE SYSTEM, A'
2�-
13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS CONSTRUCTED AS SHOWN ON
Basin � �� ���{�` /0 2 "Pine O� 1.)Soil Absorption System not 20'from Cellar Wall:
PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY THE DESIGNER. \\ y /O '01 .
W Np O 10'Held I O'Variance Requested
14.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE BOARD OF HEALTH i CERTIFY THAT I AM CURRENTLY APPROVED BY THE 'u
AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL 5YSTEM WAS INSTALLED IN DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO �� k
ACCORDANCE WITH THE TERMS OF THE PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE IS a,.e
3 10 CMR 15.017 TO CONDUCT SOIL EVALUATIONS AND THAT
REQUESTED. etc 4G;.,
THE SOIL ANALYSIS HAS BEEN PERFORMED BY ME CONSISTENT �
15.) LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR DETERMINING THE WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE G,2DESCRIBED IN 3!0 CMR 15.017. I FURTHER CERTIFY THAT THE a� \ O
LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, RESULTS OF MY SOIL EVALUATION AS INDICATED THAT
THE --
BUT IS NOT LIMITED TO, REQUESTS TO DIGSAFE, ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. �' E� BENCHMARK
ATTACHED SOIL EVALUATION FORM, ARE ACCURATE AND IN �
ACCORDANCE WITH 3 10 CMR 15.100 THROUGH 15.107
107 G /2 5t/9 I\ n Top Corner Step
I G.) CONTRACTOR SHALL VERIFY THAT ALL WASTELINE5 ARE CONNECTED BY WATER TESTING WITHIN THE DWELLING \
O EL=50.00(Assumed Datum)
PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS.
17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY SEPTIC SYSTEM
COMPONENTS. Linda J. Pinto, Certified Soil Evaluator / sh
15.) INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL NOT BE USED FOR STAKING, OR O' " Prepared for:
ANY OTHER PURPOSES.
19.)THIS PLAN DOES NOT CERTIFY, GUARANTEE OR WARRANTY COMPLIANCE WITH DEED OR ZONING BYLAWS, TEST HOLE LOGS �J �C SITE PLAN Julle Badot
SPECIFICALLY, BUT NOT LIMITED TO, SIDELINE SETBACKS AND BUILDING HEIGHT RESTRICTIONS. OWNER 15 RESPONSIBLE G2 Great Marah Rd., Centerville, MA 02G32
FOR OBTAINING SUCH A DETERMINATION FROM THE APPROPRIATE AUTHORITY. Test Hole#I (EL=48.G+) SCALE:
1tAOF,y Proposed Sewage DISpoSa{ 5y5tem
20.)TEST HOLES COMPLETED PER STATE ENVIRONMENTAL CODE,TITLE 5. SOILS CAN BE VARIABLE AND TEST HOLE Depth Layer Sod Class Sod Color Comments �� gSs9 G2 Great Marsh Rd., Centerville, MA
DATA IS NO GUARANTEE OF SOIL CONDITIONS IN OTHER AREAS. IF SOILS DIFFER FROM THOSE SHOWN IN THE SOILS p C
LINDA J,
LOGS, DESIGN ENGINEER IS TO INSPECT THE SOILS PRIOR TO PROCEEDING WITH INSTALLATION OF ANY SEPTIC
0"-28" fill
o PINTO N
COMPONENTS. 28"-32" A Medium Loamy Sand I OYK 3/2 c� 1� Prepared by:
32"-49" B Fine-Medium Sandy Loam 1 OYR 4/G
2 1.) EXISTING SEPTIC COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN SAND AND ABANDONED IN 49"-G5" C I fine-Medium Sandy Loam I OYR 4/G p fl ��PLACE. AREA TO BE COMPACTED TO MINIMIZE SETTLING. Q.G5"-98" C2 Coarse Sand I OYR 5/G 30%Gravel O F O
22.) INSTALL A 40 and HDPE LINER FROM EL 4G.I TO EL 42.1 AS SHOWN ON PLAN (SEE PLAN VIEW). 98"-132" C3 Coarse Sand I 0YR.G/4 s�NALE�N�'\��
DATE OF TESTING: 07/29/14 P#14440
23.) SOIL REMOVAL: ALL TOPSOIL("A" LAYER)AND SUBSOIL("B" LAYER)SHALL BE REMOVED FOR A DISTANCE OF FIVE(5) SOIL EVALUATOR: LINDA J. PINTO, P.E., OCEANSIDE SEPTIC,INC. 7 1"(
FEET LATERALLY FROM THE SOIL ABSORPTION SYSTEM DOWN TO THE CLEAN SAND LAYER(EL=43.2±). AREA TO BE BOARD OF HEALTH AGENT: DON DESMARAIS, BARNSTABLE HEALTH DEPARTMENT
BACKPILLED WITH CLEAN SAND AND COMPACTED TO MINIMIZE SETTLING. PERCOLATION RATE: LESS THAN 5 MIN/INCH IN "C"LAYER PER 51EVE ANALYSIS O 20 40 GO
NO GROUNDWATER ENCOUNTERED „ ENCINEL IN DIVISION
SCALE 1 =20' P.O.Box201, Brewster,MA02631 Phone:(508)896-1513
CAOceanside\OS-Great Mar5h\05-Great Marsh-SDS Plan.dwq Date:05/25/14 1 Scale: As Shown I By: UP I Check:MLA Project No.0514059
-------- ------