HomeMy WebLinkAbout0208 GREAT MARSH ROAD - Health 208 Great Marsh.,Roa8
Ceriter.ville
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UPC 12543
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i ■mow 06 201�6 17:33 Jim The Inspector Man 5085349919 page 1
map Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments C?
208 Great Marsh Road r~�
Property Address �+
Howard Wright cr)
Owner Owners Name
information is
required for every Centerville MA 02632 11-3-16INQ
page. Cityrrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.Please see completeness checklist at the end of the form.
Irnpgoutf forms When A. General Informationfilling out f ����11111rrtrlrry��
on the computer, �p� q�
use only the tab \`���� �,SH OFF i���
key to move your 1• Inspector: �'cq
cursor-do not •• '�G-
James D.Sears ~ �: JAMES
use the return _ - •m c
f I Name of O SEARS= c
key. Na =v
Ca ewide Enterprises, LLC _ _ _ _ * _ __'C _
Company Name '.it '•.,R F O
153 Commercial Street NtgpV—
Company Address fl, 11 II
L. Mashpee MA 02649
Cityrrown State Zip Code
508-477-88 77 S 1623
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. 1 am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 16.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further.Evaluation by the Local Approving Authority
11-3-16
�Sp-,Icre 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 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.
l5ins.doc rev 6/16 Title 5 Official Inspection Form:Subsurface Sewage D"sposal System-Page 1 of 17
�ofri �S
Nov 06 2016 17:33 Jim The Anspector Man 5085349919 page 2 -
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owners Name
information is Centerville MA 02632 11-3-16
required for every
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E I always complete all of Section D
A) System Passes:
® 1 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 system is a 1000 Gal. Tank D Box and two trenche's.
13) 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 cir 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):
-151ns.doc-rev.6/is Me 6 Official Inspection Form:Subsurface Sewage Disposal system-Page 2 of 17
Nov 06 2016 1733 Jim The Inspector Man 5085349919 page 3
Commonwealth of Massachusetts
I kvi
Title 5, Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
208 Great Marsh Road `
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
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
16.303(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.doc•rev.6r16 Tale 5 official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
I
Nov 06 2016 17:33 Jim The Inspector Man 5085349919 page 4
Commonwealth of Massachusetts
MQ Title 5 Official Inspection Form
-- o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments --
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is Centerville MA 02632 11-3-16
required for every
page. Cityrrown State Zip Code Date df 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
❑ 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 tc an overloaded
or clogged SAS or cesspool
El ® Liquid depth in is less than 6" below invert or available volume is less
than 1/z day flow E/, `111 vG
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Suhsurace Sewage Disposal System•Page 4 of 17
Nov 06 2016 17:33 Jim The Inspector Man 5085349919 page 5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
- Subsurface Sewage Disposal System Form-.Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
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.
15ins.doc- ev.6116 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 5 of 17
Nov 06 2016 17:34 Jim The Inspector Man 5085349919 page 6
Commonwealth of Massachusetts
Title 5 Official Inspection Form -
- ' e Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information Is required for every Centerville MA 02632 11-3-16
page. Cityrrown 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 tvvd 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, locate.d,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) 1310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):
440
15ins.doc•-ev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page a of 17
Nov 06 2016 17:34 Jim The Inspector Man 5085349919 page 7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments— -- -
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-1.6
page. CIty(Town State Zip Code Date of Inspection
D. System Information
Description:
The system is a 1000 Gal. Tank D Box and two trenches.
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
Seasonaluse? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 2014-78,000Gais
g ( y g (gp �) 2015-80,000Gal's
Detail:
Sump pump? ❑ Yes ® No
- Last date of occupancy: NA
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:
15ins.doc.rev.6/16 Tille 5 Official'nspedion Form:Subsurfece Sewage Disposal Syelem•Pega 7 of 17
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Nov 06 2016 1735 Jim The Inspector Man 5085349919 page 8
i
Commonwealth of Massachusetts
Title '5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
.page, CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancyluse: Date
Other(describe below):
General Information
Pumping Records:
Source of information: NA
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):
tsins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page B or a
Nov 06 2016 17:35 Jim The Inspector Man 5085349919 page 9
C Commonwealth of Massachusetts
Title 5 Official - Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments_._.
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
page. ChylTown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of,all components, date installed (if known) and source of information:
Tank NA I D Box and Leaching 2004 permit # 2004 -654.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
4011
Depth below grade: 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.):
Pipeing is 4" PVC SCH 40.
Septic Tank(locate on site plan):
Depth below grade: 29"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. Precast H-10
Sludge depth:
4"
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Nov 06 2016 17:35 Jim The Inspector Man 5085349919 page 10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
— — - . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
' 208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
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 26
Scum thickness 2
Distance from top of scum to top of outlet tee or baffle
8n
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined? Asbuilt-Plan-Tape
Sludge Judge
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 at working level. Tank at 29" below grade w/inlet cover cement at grade, outlet cover at
19". In and outlet tee's. No sign of leakage or overloading.
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.doc•rev.6116 Title 5 Official Inspeciion Form:Subsurface Sewage Disposal System•Page 10 of 17
Nov 06 2016 .17:36 Jim The Inspector Man 5085349919 page 11
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments-
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is
required for every Centerville MA 02632 11-3=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
t5lns.tloo-rev.6l16 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 11 of 17
Nov 06 2016 17:36 Jim The Inspector Man 5085349919 page 12
Commonwealth of Massachusetts
_ Title 5 Official _-nspecti.on _Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owners Name
information is required for every Centerville MA 02632 11-3-16
page. Citylrown 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.):
D Box is 16"x16"-37" below grade w/cover at 22". Box is clean and solid w/two line's out. No sign of
- --- �—__ — - -- over loading-or solid carry over._.
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 appurtehances, 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:
15ins.doc• ey.6f16 Title 6 Official Inepeclion Form:Subsurface Sewage Disposal System•Page 12 of 17
Nov 06 ,2016 17:36 Jim The Inspector Man 5085349919 page 13
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;--- - —
208 Great Marsh Road
Property Address
Howard Wright
Owner Owners Name
information is required for every. Centerville MA 02632 11-3-16
page. CttyfTown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number.
❑ leaching galleries number:
® leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ inn ovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching is two trenche's. Trenche's are 361 x 4'W x 2'Deep.Ck D Box and camera out line's. No
sign of over loading or solid carry over.
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.doc-rev.6/16 71119 5 Offidel Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Nov 06 2016 17:37 Jim The Inspector Man 5085349919 page 14
Commonwealth of Massachusetts
Title 5 Official _Inspection Form
Subsuifa.ce Sewage Disposal System Form -Not for Voluntary Assessments
` 208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is Centerville MA 02632 11-3-16
.required for every
page. CitylTown 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.doc•rev.6116 Title 6 Official Inspection form:Subsurface Sewage Disposal System-Page 14 of 17
Nov 06, 2.016 17:37 Jim The Inspector Man 5085349919 page 15
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ---___- -- - —
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is required for every Centerville MA 02632 11-3-16
page. Cityrrown 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
Rip
S��a
4.
r �
3
t5ins.doc•rev.ruts Title 5 Official Inspedion form:Subsw face Sewage Disposal System-Page 15 of 17
Nov 06 2016 17:37 Jim The Inspector Man 5085349919 page 16
Commonwealth of Massachusetts
Title 5 Official Inspection Form
b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
w 208 Great Marsh Road
Property Address
Howard Wright
owner Owner's Name
information is required for every Centerville MA 02632 11-3=16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
__—____ —_______ ❑_Check cellar___
❑ Shallow wells NO
Estimated depth t high ground water: 11 +
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: 12-6-04
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:
T.H. on Design Plan 12-6-04 1 T+ no G.W.. Bottom of trench 6' below grade. Bottom of trench 5'
above T H Depth
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5lns.doc•rev.W16 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-page 16 of 17
Nov 06 ,2016 1.7:38 Jim The Inspector Man 5085349919 page 17
Commonwealth of Massachusetts
i Title 5 Official Inspection Form_
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
208 Great Marsh Road
Property Address
Howard Wright
Owner Owner's Name
information is Centerville MA 02632 11-3-16
required for every -
page. Cityrrown 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
I
t5ins.doc•rev,6116 Title 5 Official Inspection Form:Subsurface Semage Disposal Systen Page 17 of 17
TOWN OF BARNSTABLE
BOARD OF HEALTH
2 l ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
Date 7 ! Time: In Out
Owner Tenant �J A-LaJAddress � �" Address 9-o
Compliance Remarks or
Regulation# Yes NO Recommendations
2. Kitchen Facilities
3. Bathroom Facilities In 0
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities
7. Lighting and Electrical Facilities
8. Ventilation
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use
12. Exits
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
17. Temporary Housing
18. Driveway Width
19. Number of Tenants Observed d+`� 1
PART II c�(9V Ey
37. Placarding of Condemned Dwelling; 01
Removal of Occupants; Demolition
Number of Bedrooms Number of Vehicles Allowed (max)
Number of Persons Allowed (max)
Person(s) Interviewed Inspector
If Public Building such as Store or Hotel/Motel specify here z
COMPLETE THIS SECTION OP;,)ELIVERY
SENDER: COMPLETE.-THIS SECTION
■ Complete items 1,2,and 3.Also complete A. Sign tu
item 4 if Restricted Delivery is desired. ' " w; ❑Agent
■ Print your name and address on the reverse X a- ❑Addressee
so that we Can return the Card to you. g, R eived by;(Printed Name) ,0 Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery ad6ress different from iterii-* El Yes
1. Article Addressed to: n
If YES,enter elivery addre belo ❑ No
-- -. - N
` I
Howard Wright
52 New:York Avenue NW#1
Washington, DC 20001 3. Service Type
'r � ❑Certified Mail ❑Express Mail
❑Registered ❑Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
1 4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service/abed �7�0 6 0810 0000 ,3524 5 3 6 2 � }
PS Form 3811,February 2004 Domestic Return Receipt to25s5-o2-M-154o
I'
I UNITED STATES POSTAL SERVICE First-Class Mail
I Postage&Fees Paid
USPS
Permit No.G-10
I � I
I
• Sender: Please print your name, address, and ZIP+4 in this box •
I I
a Town of Barnstable
Health Division
200 Main Street i
Hyannis, MA 02601
II
I � I
I I
I j F jj ttjj j tt j.j ff ii !j '�^ I
I'.1eI1111111111111111.11'fill ifJ llill�lli}l i i1 I111I fill i l l��rf �f ,
Certified Mail#7006 0810 0000 3524 5362
oFTM�t � Town of Barnstable
Regulatory Services
* E ARNSTA13M
MASS. $ Thomas F. Geiler, Director
Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis; MA 02601
Office: 508-862-4644 Fax: 508-790-6304
March 12, 2012
Howard Wright
52 New York Avenue NW 41 OQ-
Washington, DC 20001
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II —MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION,
THE STATE ENVIRONMENTAL CODE, TITLE 5.
The property owned by you located at 208 Great Marsh Road Centerville, MA was
inspected by Timothy O'Connell, R.S., Health Inspector for the Town
Of Barnstable. This inspection was conducted on the basis of a rental registration.
The following violations of the State Sanitary Code were observed:
105 CMR 410.450—Means of Egress. Observed a room being used as a bedroom
within basement of home without proper second means of egress as required by 780
CMR 3603.10.4.1 of the Mass State Building Code.
105 CMR 410.482: Smoke detectors: It was observed that there was not a functioning
smoke detector within home. Also no Carbon monoxide Bete tors prese .
You are directed to correct the violations listed above within twen -four (24) hours
of your receipt of this notice by ceasing and desisting the use of said room within the
basement as a bedroom and removing mattresses; by installing smoke detectors
and carbon monoxide in accordance with Massachusetts Fire Codes.
You may request a hearing before the Board of Health if written petition requesting same
is received within ten (10) days after the date the order is served. Non-compliance will
result in a fine of$100.00 per violation. Each day's failure to comply with an order shall
constitute a separate violation.
R Q,F THE BOARD OF HEALTH
�7fho . Mc/Kean, R.ector of Public Health
Town of Barnstable
I
QAOrder letters\Housing violations\Rental ordinance\208 great marsh j
Town of Barnstable
Regulatory Services
7 HARN3TABI.E,
Thomas F. Geiler, Director
*
�f;��A Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
March 12, 2012
Attn: COMM Fire
Health Inspector Timothy B. O'Connell, R.S., conducted a rental inspection in
accordance with Chapter 170 of the Town of Barnstable Code. In accordance with the
State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify the
Fire Department if there is a smoke detector violation, or possible smoke detector
violation.
The following property had possible smoke detector(and\or CO detector) violation(s):
208 Great Marsh Road Centerville, Assessors Map-parcel: (210-086):
No working smoke detectors or CO Detectors within home.
Timothy B. O'Connell, R.S., -Health Inspector
QAOrder letters\Housing violations\Rental ordinance\\Fire Violations\F)RE TEMPLATE.doc
a Y
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, M'ASSACHUSETTS
01pplication for 30igpool bpgtem Congtructton Permit
Application for a Permit to Construct( . )Repair()<)Upgrade( )Abandon( ) O Complete System dividual Components
Location Address or Lot No. i�Gf Sh Owner's NAddress and Tel.No.
e.*l $t�tl
Assessor's Map/Parcel1 +�o �M E
Installer's Name Address,and Tel.No. Designer's Name,Address and Tel No.
C- S,)CS. 64A°e en- ) -
toL4g-53 53g - 399a
Type of Building:
Dwelling No.of Bedrooms Lot Size l i 1S00 sq.ft. Garbage Griner(,c
Other Type of Building No. of Persons 4 Showers( ) Cafeteria( ✓j
Other Fixtures
Design Flow �-e1U gallons per day. Calculated daily flow O gallons.
Plan Date�1 a1 231 0 A Number of sheets � Revision Date
Title
Size of Septic Tank - 14 Emp 0 Q 1r, Type of S.A.S. a 'T' C�*Q S
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 2<;U -(
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 E. ' al Code and not to place the system in operation until a Certifi-
cate of Compliance has bee e y d Healt
Signe a Date
u
Application Approved by Date
Application Disapproved for the following rea l
Permit No. Date Issued
No. n Fee
i ' Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS P Yes
----PUBLIC_HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
` `~ �p Yttatiott for -Migoal bp.5tem-.�on5tructiou Permit
Application for a Permit to Construct( )Repair(�()Upgrade( )Abandon( ) �Complete System A idividual Components
Location Address or Lot No.
aOf3 Owner's Name,Address and Tel.No.
c'F0.� MGfS1�
- Assessor's Map/ParcelCen A+p ry t ` Sw e Scst�
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C
5 �►C �CS. �j+4A`t' �r�.)tCattiM10.� JS.
-GL46-53 \a Sag 1390
Type of Building:
Dwelling No.of Bedrooms Lot Size ►S Qd sq.ft. Garbage Grinder(4A- l
Other TI pe of Building 6l-4— No.of Persons 4 Showers( Cafeteria( ✓)
Other Fixtures -`.C3c7C_ .� 6,C), S�r,k , r,_ J
Design.Flow Qt-40 gallons per day. Calculated daily flow a 4 gallons.
Plan Date 1 o4, Number of sheets Revision Date
Title
Size of Septic Tank I SA-. 1,CQ G Ce Type of S.A.S. c;2 -VW0C 1 Q S
Description of Soil s _1:) c.0
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
s 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 Envix®nmental Code and not to place the system in operation until a Certifi-
cate of Compliance has bee 4ssTed-by this_Board.. 1 Healt
Signeed ' F /7 Date `0
Application Approved by d Date �.
Application Disapproved for the following reas_ot�s
I V \
Permit No. Date Issued
M THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(certificate of (Compliance
THIS IS TO CERTIFY, t iit the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded
Abandoned( )by 'Cd 6e,-4S Sit r-.,
at �. !�S� �_ r &c -\— ig CST. has been constructed in accordance
with the rovisions off 5 and the for Disposal System Construction Permit No. dated
Installer Designer
The issuance of this pdrmit shall not be construed as a guarantee that the system w1111 fu' tion as Aligned.
Date �/ 3 Inspector
— -- — ' ----------------------------
No.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
;DigPooar *pgtem construction permit
Permission is hereby granted Cgn�truct( )Repair( -Upgrade( )Abandon( )
System located at l "L'/d wYS ,f?t is C__ _ n
C-
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construction iLst be completed within three years of the date of this pe i'.
J
Date:_ / / /`"1 Approved by
r
Town of Barnstable
tHE i
Regulatory Services
Thomas F. Geiler, Director
+ BARNSTABLE, +
MASS.
i639. Public Health Division
�0
'ED1'p�p Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: � �-
Designer: , SOC—S Installer:
Address! conAddress: S�7
� 'r-� " A )±�� A�' VMA
On lw c was issued a permit to install a
(date)' (installer)
septic system $ G� ('t sed on a design drawn by
(address)
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.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
�HOf MAS'
Installers Si nature o? CARMEN
8H" cn
No. 1181
Designer'sSignature) 0 (Affix De ��. . ' "ere)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVIS N. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:Health/Septic/Designer Certification Form
TOWN OF BARNSTABLE
LOCATION f SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT �D
INSTALLER'S NAME&PHONE NO. _
SEPTIC TANK CAPACITY .45—X-d5 `�'1��0 CJ S
1 LEACHING FACILITY: (typer_rsc s (size) �� Wte Xt V
.,NO.OF BEDROOMS
BUILDER OR OWNER 9(AJ&9,8 D?�
PERMTTDATE: 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
� cQ r
I
, o .
TOWN OF BARNSTABLE
LOCATION ®� `� ��� SEWAGE #
VII.LAGE ASSESSOR'S MAP & LOT 'D
INSTALLER'S NAME 8c PRO NE NO
SEPTIC TANK CAPACITY
LEACHING FACILd'I'Yy: (typef r
S (size) �� ,c t�t�-t `7�-�
NO.OF BEDROOMS
BUILDER OR OWNER
PERMrrDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
i 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 Feet
within 300 feet of leaching facility)
j Furnished by
�i A It IN-` `
7 i '
' ....>THE COMMONWEALTH OF MASS
�
BOARD OF H
TOWN OF
TA 0'
°"�1��^~~°~°°=v°° for ��h~����+"~u` Works "+"on.w urtio*»
� �Applicationhereby made for Permit to Construct ( ) or Repair ( ) an Individual Sewage Di 4sal
System at:
...... ____-__- . ..................................................
-
Location-Address or Lot mu
qer
ss
i.staller Address
Design Flow -8aDoouperper000perday Totalda�yflow.—..-----_'--_----'- .
04 Sept� Tuok--L�o�l' ---'gulomo Length................ Width................ Diameter................ Depth................
Disposal Trench--IVo..................... Width.................... Total Length.................... Total leaching area....................s4 ft.
Seepage Pit No.---_--_.. Diaozetec-_--.--.- Depth b6mw ��eL---------- Tota lo�6' area---.-----sq. ft.
�� Other D�t�bu6vobun ( ) Dosing tank ( )
~� Percolation Test Ileyolta Performed by.......................................................................... Date........................................
Test I'6 No. l—.-----'nzinuzueuyerincb I)oytb of Test Pit---------' Depth to ground water.--.—.---._-
44 Test Pb No. 3................minutes per inch Depth of Test Pit---................. Depth toground water--_----.—_..
0 ---_- '---__.—_.----_'__'_'---_____'____-_-----------.-'_'-_---
DeoccipxionufSoil-.----' -------'-----------_----------------------------.-----------'--
_-'--'_---'-----_-__---------___-__--___--''_-_-------_--_--_—_-''------_-----'-'-------'--
.---'-------_.---'-'----__'-'__'—.—.—
�._&--- _".._ .)..........................
(.I;o
-U Nutore m6 or A�ocat� �- Aoawer w6eo _-'_--___
—'--_—.---.___---'—_'-_'--------_____-------'—.-'--_'-_-'--__-.--.--.----__-_____
Agcccooeuc
The undersigned agrees to install the afore6escrib� ��v�o D� �u System in accordance withn�
� theprovisions nfIlTLB-5cf t6cSruceBuv�ouozro' Code--The undersigned further agrees not to place the
system in.operationuu6 u Certificate m[Complia has been issued by the board of health.
Signed6... _____ __________
~~
�P�bcuoou ���covcdBr __-------- �
Application Disapproved for the following reasons: ........................................................................................................................... _-
-----` ............................................ -____-----' ............
Qte
Permit No. lanzed �
| m=
No.,rn FEs..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEA
TOWN OF BARNSTABLE
Appliratinn for Disposal Works Tonsttnrtiun 0mit-r
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
............. ..••• --- ---
Locatwn-Address or Lot No.
....
. �._�, CeQt'a ..... -----------------------•--•_•••-- ---...-----------•----..._......---....._.......--
-•- -_...
Ow per
q� t�j A�id'dress �//�� Q
Installer Address
Ty(/of Building Size Lot............................Sq. feet
U a Dwelling—No. of Bedrooms._____3.................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures -----•--------•-••------------------•--•---•----------•••----••---••-••--------------•--•••••-••••-•••-------------•-••••-••--..:----•-•-•...._..----
W Design Flow............................................gallons per person per day. Total daily flow..............................._............gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---_............ Depth................
Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching"area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by........................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
w Test Pit No. 2................minutes per inch Depth of Test Pit---- Depth to ground water.........................
p♦ --------- t. _
ODescription of Soil-------------= -'--------------......------------•--...-----------------••-----•-• ------ -•-- --• -----•••-•-•--- ----._..........--
x
V ...................•-•-----------••--••••----••-••••••------•-----•-------••--••----•-••••---•--•------------••-••------------•-•--•••------•-•-•••••---------••-•-•••-•---....------•---•-•-------------
Nwjy _---••- - -- -------- --- - - - _ _ ---------------_..._....---------.•----------._.__.A— f_I �"'��
U Nature of Repairs or Alterations—Answer when applicable. --------------i - �"' ;
-----•-•--------------------•--------------•----------•-••---•----•-••••---•---------••----•-----•••-------------
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 Sof ig Codmpha ��s been issued by•the board of health.
�� -...(...--- � �-�.� -------.--- ---------- ---- ------------- ------ -_-------
`,! Dace
Application Approved By .......................................U..-----% - ---- ---...----..--.... ---------------
........................................
Dare
Application Disapproved for the following reasons- --------------------------- -- ---- - ---------------------------------------..........................................---------
---------- --------- ----------
Permit No. ".-... .��J---- --------------------- Issued ..--....--..-�d.----� J-
Dace
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Cer#tfiratr of Graptianre
THIS IS , CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by......................... 4. ..........
I tall c
at ..................F ,f--....-�,A` E4 �9�I. ...--.... - --
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 ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED.AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. .. C
/ 1a DATE.................................. O Inspector ................................ . 1 ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
q�� TOWN OF BARNSTABLEQ
No............ ........... FEE..........:............
Disposal Works %Talnstrudion Prrutit
Permission is hereby granted..........
�1- ____r/._�°.:zvyl_ ............................. ..............................................
to Construct ( or Repair ( n I dividual Sewage Dispos �Syst
at No........
Street ,p y
as shown on the application for Disposal Works Construction PPe``rVi No._�� f_ Dated..___I ............................
.........Sag........ ............... _
Board of Heal/
DATEv .....................................
FORM 36508 HOBBS&WARREN,INC.,PUBLISHERS
TOWN OF BARNSTABLE
LOCATION �I�j'/ �LG �SEWAGE # /°-
VILLAGE. ASSESSOR'S MAP & LOT, 0 b
INSTALLER'S NAME & PHONE NO. '
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size) 4 -a�a_
NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER•
BUILDER OR OWNER Lley� del
.DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes d No
o � .�
� N
��I 5�
TOWN OF BARNSTABLE
LOCATION !^ SEWAGE #
VILLAGE ASSESSOR'S MAP LOT d 4
INSTALLER'S NAME PHONE NO. '
SEPTIC TANK CAPACITY C3
LEACHING FACILITYAtype) ' (sue) 4 JzzL-
NO. OF BEDROOMS PRIVATE WELL.O PUBLIC WATER
BUI�.DER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes i([y0 J
d
T , z
ALL OUTLET PIPES FROM THE t f ;. `; " y�E;- ;,rasa-
;• DISTRIBUTION BOX SHALL BE aAh p 1 .,•a.F "- r
SET LEVEL FOR AT LEAST 2 FT- t2 CONCRETE COVER
a �,� ',�r:, .
y er '
VENT PIPE ® Least 24 Inches tall ,.. .• t,,: r {a s
NOTE. ALL PIPES ARE TO BE 4 SCHEDULE 40 P.V.C. _ _ 3 - 5 OUTLET * "- 2 s
(( PVC w o coat Odor Ft e +r Schedule 4b C C
10 min. from S
NEW Foundation house to septic tank ` i ' {` KNOCKOUTS _ opt f4t
?' Septic tank covers must be 15.5• a' 12^' INLET "`
TOF ELEV _ 100.00 (Assumed).. within 6 in. of. finished grade -' - OUTLET .. t_
_ - Grade over Septic Tank - 98.50 Grade over D-Box 98.50
FlNsh GrvM. Ow 9e-50 4 \ /
�� / .� 8. 8 at&6enshRd O' b��
4 j y
/e +� •
15.5' 4"//N
SCH. 40 Te
S = 0.02 3 HOLE H-10 } Top Of system. ELEV. w.w 1.75•
DIST. BOX 3 w. lv aw
e o 14' EXIST. 5-0.10 Or Greater s- 0.010" per foot s-.0o5 _1/9-1J2 Washed Stan. PLAN SECTfON CRASS-SECTION,. NEW PIPE t\ 1000 GAL. OR GREATER 4• PerfaratsdP.V.C.
FROM FOUNDATIDN OI
� SEPTIC TANK `� 20 ;;4- Invert Elev.-94.07
14� H-10 �j O 2 3/4-i$' washed$tone B Bottom of leach Facility Elev.- 92,50 t
Qioso , 3 HOLE H-10 DISTRIBUTION BOX ,
�o�. rriff+ea
CONCRETE FULL FOUNDATIO II II rn 36 NOT TO SCALE
Note, All leach lines to be cappedat ends w/p cops.
VC s. 5' PROVIDED �, Y
P ®i1^L4 Rarsl meet€Ye'r a eu,yr Ei 2id;4 uAbTEa � ....: •-�;-a-
CD 'e -
SYSTEM PROFILE s in,ot 3/a"-t 1/2' > s Bottom of Test`Hae I Elev.-87.50
compacted stone LEACH TRENCHES -
Not to Scale (2 TOTAL) LEACH TRENCHES CROSS-SECTION (2 TOTAL) GENERAL NOTES
_ 1. Contractor is responsible for Digsafe notification
and protection of all underground utilities and pipes.
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6 BELOW GRADE 4'-0• wide 2, The septic tank and distribution box 'shall be set
level on 6 of 3/4"-1 1/2" stone.
2•of 1y8•-1y2• 3. Backfill should be clean sand or gravel with no
Washed Stone stones over 3". in size.
4. This system is subject to inspection during installation
by Carmen E. Shay Environmental Services, Inc.
5. The contractor shall install this system in accordance
�3/4•-1 washed St- with Title V of the Massachusetts state code, the approved plan
P E R C 0 LAT I O N TEST compacted-torte
4•perforated P.V.C.pipe and Local Regulations.
NOT TO SCALE 6. If, during installation the contractor encounters any
Date of Percolation Test: DEC. 6, 2004 �I soil conditions or site conditions that are different
Test Performed By: CARMEN E. SHAY, R.S., C.S.E. from those shown on the soil log or in our design
Results Witnessed By: WAIVER (per BARNSTABLE B.O.H.) �j T installation must halt & immediate notification be
EXCAVATOR: Shay Environmental Services, Inc. made to Carmen E. Shay Environmental Services, Inc.
Percolation Rate: Less Than 2 MPI ® 42" i
I 7. No vehicle or.heavy machinery shall drive over the I
septic system unless noted as H-20 septic components.
l
8. install Tuf-rite gas baffles or equals on oil outlet tee ends. j
[?� 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
- O
Test Hole 10. All solid piping,. tees & fittings shall be 4" diameter
No. 1 N \I Schedule 40 NSF PVC pipes with water tight joints.
---- -
DEPTH SOILS ELEV:I i 1 1. Municipal Water is Connected to ALL OF The Residence and Abutting
0 ' 98.50 I \ 100.84 102 Properties Within 150 Feet.
Qi �� ----------------------------- ----
Loomy THE PROPERTY LINES ARE APPROXIMATE AND
Sand COMPILED FROM THE SURVEY PLAN GENERATED BY
10 YR 3/2 O
0"-4" A 97.83 �i r_-_-__�29.5' BRADFORD ENGINEERING, HAVERHILL, MA ENTITLED
I-- 1 t CERTIFIED PLOT PLAN OF # 208 GREAT MARSH ROAD, CENTERVILLE, MA
\
Loamy �.7I i FAILED_ i __- 100 DATED.DATED AUGUST 7, 1991
-Sand I \� ------------- 1- ---- AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
10 1R 5/8 CL
-SA� 1
4"-4z" B" 95.oD 1 - 4' - I IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
p I I THE SEPTIC SYSTEM INSTALLATION.
Medium Q - ----------- L
1
Sand
z.s v e/s CD1 i h 3' EXISTING SAS TO BE PUMPED OUT AND FILLED IN PLACE OR
42"-132" C, 87.50 11 SHED i b REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
b 1 Mt I �
I :•
,� •, �, NOTE: ANY STRIPPED .OUT SOIL CONTAINING LEACHATE
�
ASPHALT FROM THE EXISTING SAS TO BE DISPOSED
1000 GALLON �
_. AT
i OF AS PER BOARD OF HEALTH SPECIFICATIONS.
IONS.
I DRIVEWAY 36
SEPTIC TANK s.
GARAGE O O r. NO WETLANDS ARE PRESENT WITHIN 200 OF THE PROPERTY
ASSESSORS MAP 210 PARCEL 086
,,---.� ------------- f� •, LOT. #>5 LEGEND
PROJECT BENCH MARK I "
Perc #1 TOP OF FOUNDATION t „ D-Box
Depth to Perc: 42" to 60" ELEV. = 100.00 (Assumed) i 704X7 DENOTES PROPOSED
Perc Rate= Less Than 2 MPI I SPOT GRADE
EXISTING
Groundwater Not Observed .
No Observed ESHwT 4 BEDROOM X 104.46 DENOTES EXISTING
ADJUSTED H2O Elev, None HOUSE TEST HOLE #1 SPOT GRADE
I
' ELEV = 98.50
I
#208 3s'.� PL 1 PROPERTY LINE
ellI i i; Jf
zo' 4" PVC PROPOSED CONTOUR
L .i VENT
LOT #16 r, - - - - - -97 EXISTING CONTOUR
rn
a :
11,500 Square Feet +/
�� 11 �� r 4r 1' DEEP TEST HOLE &
pL
2-18" DIAM. ACCESS MANHOLES \\ S (!p n� --- 90
PERCOLATION TEST LOCATION
-_---------- L=76.9 - -----� -6 FOOT STOCKADE FENCE
s. �s •-
,--
1
• 4 THE ACCESS COVERS FOR THE SEPTIC TANK, I
INLET / 1�-` DISTRIBUTION BOX AND LEACHING COMPONENT DU ET SET DEEPER THAN 6 INCHES BELOW FINISHED P O. IT
Pi�
_AN '
GRADE SHALL BE RAISED TO WITHIN e• OF
.( FINISHED GRADE. -
v •.
YINSTALL TUF-„TE GAS BAFFLES DR EQUALS E T s'rY ®-A OF PROPOSED SEPTIC SYSTEM UPGRADE
STEEL REINFORCED PRECAST CONCRETE PREPARED FOR
PLAN' VIEW (40 FOOT RIGHT OF WAY)
ROBERT SWANSON
3-24• REMOVABLE COVERS - AT
3�m;� ��anc: `. ..r; #208 GREAT MARSH ROAD
I. 3• lNLEf
INLET 8• minim. -12- min:.Inlet to outlet e'mx,.
-ua-eve OUTLET G ENTERUI LLE , MA
10•min. u•mn. : . •: I...
t
s r Eo r `• 4'-0• min. Design Calculations
a-O.M. Liquid depth ;. -\N OF REPAIRED BY:
Number of Bedrooms:4 Equivalent to 440 Gal./Day (330 Gal./Day Min. per Title V)
,t y.., Garbage Grinder: No o� M N yGs
CARH�'N 17 ,,.S. HA Y
77' ' ""' ''.'' r ,••`,f - Leaching Capacity Proposed: 440 Gal,/Day Minimum (Min. Per Title V)
8•_0• 4 -10
9 Septic Tank: 2 x 440 Gal./Day = 880 USE EXIST. 1000 GAL, Septic Tank. 0 20 40 50 " SH NVIRONMENTAL SERVICES, INC.
CROSS SECTION END-SECTION SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch
Proposed Leaching Trench Dimensions: 2 TRENCHES -4' Wide b 36' Lon b 2' Depth EACH. P.Q. BOX 627
p g y g y p EAST FALMOUTH, MA 02536
` USE EXISTING 1000 GALLON H- 10 SEPTIC TANK Bottom Area: 0.74 gal/sq. ft. X 288 sq. ft. = 213.12 gallons NITAR�P
Sidewall`Area: 0.74 gal./sq. ft. x 320 sq. ft. = 236.B gallons TEL/FAX 508-539-7966
NOT TO SCALE Providing: _ L gallons SCALE: 1 r =20�
Use: 2 TRENCHES 361 by 4'W x 2'D
q-IOEK SCALE: 1 '=20 DRAWN BY: CES DATE: NOV. 30, 2004
:! PROJECT#SD663 FILENAME: SD663PP.DWG SHEET 1 OF 1 ,
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