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HomeMy WebLinkAbout0045 GREEN DUNES DRIVE - Health 45 GREEN DUNES DRIVE Centerville A = 246 - 210 SMEAD No.2.153LOR UPC 12W amaad.eom • Made in USA OCrQ4� OjF1 p►iFIESRiIgOYAMWWROGRAMAW - � �- a/0 c� Commonwealth of Massachusetts � - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 45 Green Dunes Drive,West Hyannis Port, MA Property Address Carol W Mackay Owner Owners Name information is Centervill)Nest Hyannis Port MA 02672 _- 1/7/2021 required for every page. Citylrown 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. Important:When filling out forms A. Inspector Information d s k cya on the computer, Reid C. Ellis use only the tab key to move your Name of Inspector cursor-do not Ellis Brothers Const. Co_ use the return Company Name key. 23 Enterprises Road, P. O. Box 59 , Company Address Yarmouth Port MA 02675 Cityrrown State Zip Code 508-362-6237 S12189 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and mai nance of on-site sewage disposal systems.After conducting this inspection I have determined that the ystem: 1. Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Insp ors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: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. t5insp.doc-rev.7/2612018 Title 5 Official Inspection Forth.Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: 1 have not fo 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: 2) System Conditionally Passes: ❑ One or more system components as d scribed in the"Conditional Pass"section need to be replaced or repaired.The system, upoi i completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not deterin iined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years Id*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or 641tration or tank failure is imminent. System will pass inspection if the existing tank is replaced w h a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if t is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less ha 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5insp.doe•rev.7/W018 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface'Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operatioi ial. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break ou or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a roken, settled or uneven distribution box. System will pass inspection if(with approval of Board o Health): El 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 imes 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): 3) Further Evaluation is Required by the Boarc of Health: ❑ Conditions exist which require further evalL ation by the Board of Health in order to determine if the system is failing to protect public health safety or the environment. a. System will pass unless Board of He Ith determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7262018 Title 5 Midst Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 504e� urface water ❑ Cesspool or privy is within 50 feel of a bordering vegetated wetland or a salt marsh b. 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 tribu Ary to a surface water supply. ❑ The system has a septic tank and SA 3 and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAII and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SA 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 11 ailure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) 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 t5insp.doc•rev.M612018 Title 5 Offidal Inspection Famr.Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form ,- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No 11 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 day flow 10 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: V❑ 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 water supply 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 2000 gpd- 10,000 gpd. ❑ 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 correctAthe�fail re. /W 5) 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 CA. Yes No ❑ ❑ the system is within 401 feet of a surface drinking water supply ❑ ❑ the system is within 20 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located iq a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a ma T ed Zone II of a public water supply well t5insp.doc•rev.7/26l2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. City(rown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Were any of the system components pumped out in the previous two weeks? ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break out? l� ❑ Were all system components,fccluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t5insp.doe-rev.M2612018 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments k9t , 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): Number of bedrooms(actual): All DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of beddms): / . Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes �f N Does residence have a water treatment unit? El Yes 0 No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ❑ Yes VNo Seasonaluse? ❑ Yes �i Water meter readings, if available(last 2 years usage /('gpd)): Detail- Sump pump? ❑ Yes No Last date of occupancy: oat t5insp.doe•rev.7/262018 Tine 5 Official In spection Form:Subsurrace Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. CommerciaUlndustrial 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 syste ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: _ Source of information: ` Was system pumped as part of the inspection? _ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: �' � t5'msp.doc-rev.7262018 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West His Port MA 02672 1/7/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type o yytem: Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool i ❑ 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): A roximate age of all components, date in Approximate g p s, t stalled(if known)and source of information: ere sewage odors detected when arriving at the sl ❑ Yes 5. Building Sewer(locate on site plan): .. Depth below grade: feet' Material of constructiV40 El cast iron PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage, etc.): /, 1n/ I-Al fie-&?-,64 4, J t5insp.doe•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owners Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate-on site plan): Depth below grade: 4_,>L444-1 � Ga-l{d" 1_7 u P� C/ feet Material of construction: go/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: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Scum thickness a Distance from top of scum to top of outlet tee or baffle J Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Aly '�'_VL Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as re l d to outlet inyert, evidence of leakage,etc.): � S I'Alilay- z a t5insp.doc•rev.7/28/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): ILIA Depth below grade: feet Material of construction: ❑ concrete ❑ metal E I fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet to or baffle Distance from bottom of scum to bottom of o itlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, i ilet and outlet tee or baffle condition; structural integrity, liquid levels as related to outlet invert, evider ce of leakage,etc.): 8. Tight or Holding Tank(tank must be pump a time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑metal ❑i berglass ❑ polyethylene ❑other(explain): Dimensions: . Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/282018 Title 5 dal In spection Form Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 .1/7/2021 . required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date.of last pumping: Date Comments(condition of alarm and float swit hes, etc.): II Attach copy of current pumping contract(required). Is copy attached? El Yes ❑ No 9. Distribution Box(if present must be opened) (locate site plan): Depth of liquid level above outlet invert ' � / Comments(note if box is level and distribution to outlets equal, any evidence of lids carryover, any evidence of leakage into or out of box, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t� 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 - 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order ❑ Yes ❑ No" Alarms in working order. ❑ Yes ❑ No" Comments(note condition of pump chamber, coi idition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, sy tem is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number. ❑ leaching chambers number. ❑ leaching galleries number: ❑ leaching trenches number, length: leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 official Inspection Forth Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owners Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every y page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS)(cont.) Comments(note condition of soil, signs of hydraulic failure, level of pondding,damp soil,condition of ,�r C ✓�/:: tom`•.. //,'' . �S Ala", r 12. Cesspools (cesspool must be pum ed a t of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil,signs f hydraulic failure, level of ponding, condition of vegetation, etc.): i t5insp.doc•rev.7/MMI8 Title 5 Official hwction For.r.Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage _Disposal System Form Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property.Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port required for every Y MA 02672 1/712021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of+raulic failure, level of ponding, condition of vegetation, etc.): I t5insp.doc-rev.7/AW18 Tide 5 Offidal Inspection Fow Subsurface Sewage Disposal System-Page 15 of 18 N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 46 Green Dunes Drive, West Hyannis Port, MA Property Address - Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 b ilding. Check one of the boxes below: and-sketch in the area below ❑ drawing attached separately .l c Ali- 371 kkl tZA r � i t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centerviil-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 15. ;rCheck:Slope am [Surface water [Check cellar [/]Shallow wells Estimated depth to high ground water. feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: VO Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: �L�L✓ MLA ��'` You mu describe how you established the high ground.water elevation: zzl; FWo Axr, 419/ -50% moo, 7 Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5nsp.doc•rev.7/26@018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Green Dunes Drive, West Hyannis Port, MA Property Address Carol W Mackay Owner Owner's Name information is Centervill-West Hyannis Port MA 02672 1/7/2021 required for every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Compl to all applicable sections of this form inclusive of: Inspector Information: Complete all fields in this section. Q1 B. Certification: Signed 8r Dated and 1,2, 3, or 4 checked U C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6(Checklist)completed 2f D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7262018 Title 5 Official Inspection Farm Subswface Sewage Disposal System•Page 18 of 18 No. L 4) e r * Fee / �V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for -Misposal :Fppstrm Construttion 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components rcatio ess or Lot No. vik ' Owner's Name,Address,and Tel.No. ap/Parcel-41:$7 MA ak F'/12 2,d Installer's Name,Address,and Tel.No. j$ Designer's 1,Ve,Address,and Tel.No. :v5'— p fit?✓G 9 �Q Type of Building: Dwelling No.of Bedrooms T Lot Size 3'8• / sq.ft. Garbage Grinder,VV P Other Type of Building 1160.4 r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date �����' Number of sheets Revision Date 6 / Titled -e«'� Size of Septic Tank ��G3t/^' 4-type of S.A.S. Description of Soil C5 66?� - Nature of Repairs or Alterations(Answer when applicable) �- � ✓ 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 syst m in operation until a Certificate of Compliance has been issued by this Board of H gned Date Application Approved by Date f Q Application Disapproved by Date for the following reasons Permit No. t5tcv y �� Date Issued i fV THE COMMONWEALTH OF MASSACHUSETTSEntered i coihputer: Yes PUBLIC HEALTH 61'"SION - TOWN OF BARNSTABLE, MASSACHUSETTS ltlYitatlDn for h, is JDSA psfrm Construction Permit Application.for a Permit to Construct( ) Repair(,-)-Upgrade O Abandon( ) ❑Complete System ❑Individual Components iori Address or Lot No.o t -'' O;Nner's Name,Address,and Tel.No. Lj.1f r1 �1'Z_A1"Z7//N� �/l 1�i MA_ , es o ap/Parcel �s 14AP ��� F� 41 a�! L /��9 ,r_4 Q &, a Installer's Name,Address,and Tel.No. E Designer's I%Ve,Address and Tel.No.5✓0- ev ea T-,— `- 3a'y: G as; �e, i a v_ :50 .I 6.� A . Type of Building: y DwellingNo.of Bedrooms ? 3! 3 8� � ,�, Lot Size t sq.ft. Garbage Grinder,(vo Other Type of Building 1_ Q ``+ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Lj`1jr�l� gpd Design flow provided 4ellip" lf? gpd Plan Date Number of sheets Revision Date (D Al Title -1 Size of'Septic Tank L j /s7.,a' ype of S.A.S. Description of Soil 5 Nature of Repairs or Alterations(Answer when applicable) �- - �/✓ j2 t Date last inspected: r \ f 4 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 syst m'in operation until a Certificate of Compliance has been issued by-this Board of H a geed Date Application Approved by Date Application Disapproved by Date for the following reasons L� { p U • Date-Issued , /a ---- -- "- ----- ---- ------ ------- ------ -------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS °y; ,BARNSTABLE,MASSACHUSETTS 1. Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired O, Upgraded( ) !y Abandoned( )byfns 3 y at �I Q.P r� PVV(( .okl4le_ has been constructed in accordance with the prov ' ns of Title 5 and the for Disposal System Construction Permit NoC-O/Z/- ac 0 q dated Installer ��'!! � `� Designerty' L� #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. 1 Date c pq 1.2d '/ Inspector �� ---------------------J------/------------------------------------------------------------------------------------------------------------ No. �Lr - < Fee / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS � 5 M.isposal :�Ppsteta Construction permit Permission is hereby granted to Construct( ) '. Repair( Upgra e( ). Abandon( ) System located at 4/5 ��� G �w�°✓ /21 /6l� j�, r 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. Provided:Construction ust be om leted within three years of the date of this(\perm}t. Date IU �d / / Approved by Town of Barnstable Regulatory Services t Richard V. Scali,Ifterim Director Public Health Division 039. ' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: �� Sewage Permit# �10 I L4 Assessor's Map\Parcel Designer: Sr.��ar�h2 Cs Installer: fz 111S (30'0 Odors Co"h5�4 Address: ��0�7�J Address: a 3 S17t prYS t /Ld On ( Q— It( EU-.0i I''j�a r. Co�sT_- was issued a permit to install a (date) (installer) septic system at qS kuiia based on a design drawn by (address) / Sa�Q � xG,✓t- dated _ ���y�sr4( � (designer) v 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. 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. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) / �okA OF hlq`� ty�tiZN OF�j S TERENCE �� TERENC` (Installer' to o� h�� a ° M. T'` 0. 979 f �O/STEREO (Designer's igna e) (Affix Desl x's StaIere) S�H/TAR%PN �yiv'>v'vL PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. 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:\Septic\Designer Certification Form Rev 8-14-13.doc Print Page 3/20/14 9:26 AM Town Tax (Residential) $ Fiscal Year 2014 TAX RATES HERE J,421.25 99003.34 • Sales History- Map/Block/Lot: 246/210/- Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: MACKAY,EDWARD E &CAROL W;.8/4/1983 C92947 $47000 • Photos 246/210/- Use Code: 1010 r n • Sketches- Map/Block/Lot: 246/210/- Use Code: 1010 act/ PT0 30 ` $' 6AF laiv d Nl�v F, f'.4v K.�'1 Fd 20 3. � + cktd— f 44 ONI 24 I 7 � As Built Cards:Click card#to view: Card #1 I • Constructions Details - Map/Block/Lot: 246/210/- Use Code: 1010 Building Details Land http://town.barnstabie.ma.us/Assessing/print14.asp?ap=0&searchparceI=246210 Page 2 of 4 Prins Page /20%i4 9:26 AM Town Tax (Residential) $ ) Ve-ai- A-6-`=1'_TAX kA:LF 1✓ �,421.25 9,003 s34 * Sales History - Map/Block/Lot: 246/210/ m Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: MACKAY, EDWARD E &CAROL,W 8/4/1983 C92947 $47000 * Photos 246/210/0 Use Code: 1010 Y4� id Fv 1 T a Sketches m Map/Block/Lot: 246/210/o Use Code: .1010 IN E7E� AS Built Cards°click card#to vie\v: Card ;Y 1 1 Constructions Details e Map/Block/Lot: 246 / 210/ - Use Code: 1010 Building Details Land t- r„p itown.barnsrabie.ma.us/Assessinglprin:i4.asp?ap=0&searchparce;=2462i0 Pace 2 of 4 i TOWN OF BARNSTABLE WCATION SEWAGE# 301 -1 VILLAGE C,,I�y7,-'-,4 ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. 8;l iiS &&f4 3 C cS-Q- Wd-GO? SEPTIC TANK CAPACITY , So 0 LEACHING FACILITY:(type) Pane 10 Pf p,V- (size) 62 0 X 3 0 k (o�riar" NO.OF BEDROOMS OWNER I=01 (qI C PERMIT DATE: (to( 14 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 i E y� ' I I o G I e 1 ; Town of Barnstable P# V aTME Department of Regulatory Services Public Health Division Date 16lig,��� 00 Main Street,Hyannis MA 02601 �p MFt Date Scheduled Time Fee Pd. Soil Suitability Assessment for ewhiye Dis osal Q Performed By: Robin W. Wilcox Witnessed By. LOCATION 8� GENERAL INFORMATION Location Address 45 Green Dunes Drive Owner sxame Edward Mackay Vez iQDnrf P.O. BOX 506 --- (Centerville) Address W. Hyport 02672 Assessor'sMap/Parcel: 246/210 Engineer's Name SWeetser Engineers g NEW CONSTRUCTION REPAIR XX Telephone# 5 0 8—3 8 5-6 9 0 0 Land Use �L`�W IV-f)4 Slopes(%) �6a Surface Stones Distances from: Open Water Body_ t�e ft Possible Wet Area ft Drinking Water Well ft —y� Drainage Way / /y� ft Property Line ft Other ft SKETCH:(Street n e; nsiooldt;'<e�fact loca'ons of test holes&perc tests,locate wetlands in proximity to holes) � t J§ U Parent material(geologic) ff Depth t edrock Z� Depth to Groundwater: Standing Water in Hole: ND Weep' g from Pit Face 20 �' Estimated Seasonal High Groundwater ' t rN�i4TI4PORASONHGTWATERh'�AB�E Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole- in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ 1 €'. ✓{ � i.aN u s ay sus a� :. `DER iLAT+I$°� TTESjT ''s nate .me Observation � � Hole# _Time at 9'- Depth of Perc _V — Time at 6" ` Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/1) 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 Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC t DEEP OBSER�AT °'I�1 AOLELOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel G� '�-�- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel �r 4 L 5 o s� / lie DEEP'ORS LO E'ItVATION°DOLE G Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) M P,�-d"lt�J ,iL#3 Y•v' v' 2$1� N h 1'-: � b 'Ez OL" 35 + lE L Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood,Insurance-Rate-Mao: Above 500 year flood boundary No— Yes Within.500 year boundary No Yes Within 100 year flood boundary No (/ Yes DOW of.iZaturaliv Occurrinta Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the are.A.proposed for the soil absorption system? Ifnot ,fiat is the depth of naturally occurring pervious material? Certification r I certify that on ` (date)I have passed the soil evaluator examination approved by the Department of Environmental tection and that the ov analysis was performed by me consistent with i 3 &required-train ,e �e�x erie_ e de ri in15.017. Signature Date / y � r 1 y✓ Q\SEPTIC)PERCFORM.DGC It � �S 17": 9�% LO CATION EWAGE PERMIT N0. - ILLAGE e i I N S T A LLER'S NAME i ADD-RES'S _ e UiLDER OR OWNER DATE PERMIT ISSUED r DATE COMPLIANCE ISSUED Woe 3 THE COMMONWEALTH OF MASSACHUSETTS �., BOARD OF HEALT ......DU/. ...................OF....S b A;ip iratinn for Mipviial Workri Tongtrnr#inn Verntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: v ............................. . ................................... Loc ti Address � Owner. Addr is a �- 4 /.._/Vf� e•s�C llel � ,.} ......-•--------------- ress U _iCa Type of Building Size Lot_.oJ�?1.Ill>f�.....Sq. feet ., Dwelling—No. of Bedrooms............................................Expansion A tic ( ) Garbage Grinder (/YO aOther—Type of Building ____________________________ No. of persons............. ShowersCafeteria ( ) Othejj� fixtures ..............................................•................ .... czl Design Flow...... f__ ____________________________gallons per person per day. Total daily flow.................. �t��..............gallons. WSeptic Tank—Liquid capacityIA•�.._gallons Length................ Width................ Diameter-----------_.... Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... iameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( � Dosin /to k ) Percolation Test Results Performed by...C .o...._ -.Jq 9F_50- ________............. Date... /... A_ ...... aTest Pit No. I.... .._._.__.minutes per inch Depth of Test Pit_______ _______ Depth to ground water........................ Test Pit No. 2________________minutes per inch Depth of Test Pit....... .____. Depth to ground water........................ 04 ............- ODescription of Soil.........• ?_.................................................................................................................................................. x U -----------•---•-•-------•-.....---•--••--•---••--••••-•-•-•-••.._..-------•-•---------------------------------•--••---......-•••--•••-•---•-•...-----•-••---....._..-•-••--------•••---•-•---••---•---- w VNature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------- -.............. •........................... ---------------------------------------------- ••-------------------------- •------------ ... ....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beeil issued bYth oard f hea th. ed---- -_- --� ----••-_..... .--• • .......................... 121�v V 7_ �Ap Application Approved By.. C� _...._.. /_/ ..Da Application Disapproved for e f of wing reasons:............................................................--................................................ - ------------------------------------------•-------------. .................................................. Date PermitNo.......................................................- Issued-......................................................... Date i r Na.�fe 7.... Fm3.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HSALT t Uuin F....O 1. Appliration for Dhip sal VotkbCn� e• "tun" �erixti# Application is hereby rr for Fermlt to e�f.'uc�. ) `,�'r Repair ( ) an Individual SewageDisposal System at• ! / #.1/ 1!1V' L)Pi.�. �.aZ.. . ! p�;t��5 y `................................. �••-•----------------------•--••---........ Loc do Address �t ! Owner, w ------ ref+� h _� S �.Y.. . t ._Y..._y1._Address _1.. ........ staller d. �..» Address — —...... Q Type of Building Size Lot_. t jjlJll__-._Sq. feet Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( /\YO aOther—Type of Building ---------------------------- No. of persons...........4............. Showers (A) — Cafeteria ( ) dfixtures ------------------------------------•--------•-------.--•----------•-•-----•••------------....---•-•...-------------•--•---••--......•-••--......---- W Design Flow......l 0....... ....................gallons per person per day. Total daily flow............._._. 44 19 ........gallons. W Septic Tank—Liquid capacity>A_0..gallons Length................ Width................ Diameter................ .... epth....._.......... x 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 Result Performed by... "� -a`r. .1.1/ .!'L. !_ _____________________ Date...�. ��--� , ...... a Test Pit No. 1...�........minutes per inch Depth of Test Pit......�f ._..... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit........ ......... Depth to ground water........................ -----------•---•--------------•-------......-•-•--.....--•-----...............--•-•-........................................................ ODescription of Soil.............�--------------.......-----------.........---------...-----••--•••---------------- x U w VNature of Repairs or Alterations—Answer when applicable._.............................................................................................. -----------------------------------•----------------------...------•----------------......---.......----••-------------------•----•-•-------------•--------------•--------------••-........-•-•-••••---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,issued b theboardof health. Si", 01 ed.--- I-/ta �F . .r D l Application Approved By.......... -- �ekeA:............................................................ -•---� "�f��!-------- Date Application Disapproved for e f o owing reasons---------------------------------•-•------------------...----------------------...------......--...... - •------•--•-....---•-----•-•.............................................. -------•-------••-------------------......-•'" ......-••••-•--- Date PermitNo--------------------------------------------------------- Issued-...................................... ............. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF- HEALTH ..........................................OF...... ............. ............................ ..................................... 01rdif iratr of Tom pliattrr T IS�TO`CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by..........1 t' -•--••-• .................. .... ..•.....----------•••••....--------...---.._.......------.......--•••----................------ Installer at. --......---•---------------•-•--•--._......._ .................................. has been installed in accordance with the provisions of TAT F of The State Sanitary Coe a de cribed in the ob r application for Disposal Works Construction Permit N .__.��/....................... dated /.� _._� _...__........_........ THE ISSUANCE F THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE SYSTEM WI FU TION SATISFACTORY. DATE...... �.�...................................•-••---------------- Inspector.............. ......-•--••--••----•----------_................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH j ...........................................OF..................................................................................... No.� �..�........._ FEE. 1 ............... Bilyoll t rkii Tonotrudilatt rrutit Permission is h eyeby: grante --'r . ..........................•-----•-------•-------•----•--•-----------•-----........----......----.................... to Construct or pair ) an I 1 (dual Sewage Disposal System at No. .. . `�-.._..� Lit.�..- Street as shown on the application for�Disposal Works Construction Permit LST....__ .............. Dated.......................................... •----------------- ---- --------------•--•----•-------•-•-•••••----------•-...-------••--............_ h - _ Board of Health DATE...... o /" .............................................. � . FORM 1255 A. M. SULKIN, INC., BOSTON Ok fy « y ��OF Gt� f'tko , • s ` w t ��, '✓� - 1 � d•VR T '�' - ! f,'!'� ,! � r SAL/ . ZFV REGISTERED' CIVIL ENG - y A � WACTER.• Gtn ��P Ifq�y ' ` ; � .V o� G a P -1 WALTER . T if"'• i e` t OLDHAM `" o E Df No. 23207�Q SMITH, JR:�, , �.�t"05 .,�.. +W-r^`t • #15128 .-• _ GIST N - 1 �FSS�ONAL w ^VO4AA4 , _. i qb 5 q6•o N (.104�PVCO 15T•.BcK f /Yb t 5 9 7 3 w e oo GF'r• DIAM. q7. 05 �j�.7 0�o GO—Xjc• L.F-AcNfuc,, Pir 125O Cul. Cast,. A 4A Sep+tc. T4K << d o AdA 0 oA 3Fr AAA 1 q a A Aµla ed 54ory Bor. PST ELEv 99•S �`� UaQUr�C� ��� '71oF'Scrc,, fJ 61t4 A-T-A r LLAy c-etZCot..ATt �N t:ZAT�.: 3 M�nJ 11�1 C Duo P TEST PEP-f=oRMED ID-Cc -a o, r 983 9�0,5 34o" 4 BapRooms x. I lO GPD = 44.0 C PD LEACNING 1?�ECxD COARSC Mo G7APag6.e ° D.tSP05AL USE I260 COAL-SEPrICT"l SAra.C�� a CA\PAC IT ,oV ID E D : 6-jc-'A vc L 130TTb1,01 -/7(, z x .915 _ /03• Srj p D Si DES 7T/2- x225x 6 - 508 9 C PP T-OTALCAF'ACIT`) R OVJPEp G, % Z . 4-clVDAZ= r'r.,Fze. e�VE � oTE-- D tsPoSA� s`lSTE-ti4f D�stGTNED f /� �� QCGoRDANGE. W ) T+4 PROVISIONS CoMPAe-r • T'cTL._E �� o� T'�� l�(�SS • �tv 1Rot�1ti1E►�T�z 5orvtC Gl2ou u D U�are:r; ErJ u���, eo C��I ; II car. I~A F 4 TEST P►-��1 � ��-- SoiL S.T'RArA _-.�. 8lC _ SOIL TEST TOP OF FOUNDATION _ �_i 20 I'T_ MINIMUM FROM CELLAR OR CRAWL SPACE _ i DATE OF SOIL TEST APRIIr 17, 2014 P 14334 - 10 FT. MINIMUM FROM SLAB SOIL TEST DONE BY SW-jETSFR .SNg-CNI RING ELEV. = 100•0_ 10 FT. MINIMUM �- CLEAN SAND ! A I WITNESSED BY ------- (ASSUMED',(ASSUMED` CONCRETE � � � -INSPECTION PORT COVERS 4" SCHEDULE 40 PVC PIPE ! f--LOAM ANi, SEED OBSERVATION HOLE 1 ELEV.=--�a 4 MIN. PITCH 1/8" PER FT. `\1/8" 2" LAYER OF " 1/2" r PERCOLATION RATE __< MIN./INCH AT 40-- INCHES WASHE'D STONE �4. 4" CAST IRON PIPE 6 MAT r - AX X- 97.9g MAX, , �' OR FIL7R FABRIC ! VENTRE4U!RED 00EPTH !A RiZ LOAMY TUBE COLOR MOTT. OTHER _ E MY SAND 10YR4/1 NO (ROOTS R EQUAL) MINIMUM , , 40 FLOW 7�E t f -�_ ��� - I11-17 B LOAMY SAND 10YR8/6 i T a" �.,.-- - - P! CH 1 j. PER F`. i _--- � I1 _ _ 4-- LEVE-CERS ? '��..`. S_ + i Ii`7`132 C MEDIUM SAND 2.5Y7/4 F�O'W'' LINE `j-! -l _=� � 0.005 5i � �� I � NO WATER ENCOUNTERED AT __132" ELEV. - _ 87.4 _ TELEV. - ____ �p i /y I� I _ MIN. 94.95 0_••j o o a o° o a o 0 0 ° ° ° ° o °_ G o ELEV. - 1a4..3.3 OBSERVATION HME G 98.4_ T ELEV. - o ° ° o ° o o c � ELEV✓.=__.___ lJ�- - --/ LE vEL / o a a ° ° o a ° o a° °a o oc,°o °f r ---- -- --- b JUMP L _ ! O ° ° ° o °° o ° ° o o p TOTHERi ELEV. _�'t,� ._" ADD GAS ELEV. = 94y8t1 J LEV = _. o o ° o° ° O ° ° o 0 o ° • of DE. TH 1i0RZ TE3(iURE 1COLOR ~ MOT". . # BAFFLE - I o°° o o o o ° ° o ° ° o ° 06 { 0-11" `AD LOAMY SAND T1CYR4/i NO ROOTS DISTRIBUTION _ _ i a a o ° a al _ _ - _ - .1 ! ELEV. - ! O O a o ° c' OO O O a 93.83 _.. - 1.�_�.._._. L G a p O O .. _.. .. .. .. .. _ LIQUID OUTLET B©�/ _���__-� -- 0- 00 a o a o a o °` o o ELEV. - _____ 11-? ," B LOAMY SAND 'CYR6/6 1. � a SEE /� - t17-132" C MEDIUM SAND 2.5Y7j4 4 FEET '4 INCHES I rExISY"� TO BE 'WATER TESTED 4'" SCHEDULE 40 PVC PIPE _ ELEV. _ _ 87.4 _ f 5 FEET 9 INCHES IF MORE THAN ONE OUTLET NO WATER ENCOUNTERED AT __132" 6 FEET 24 INCHES 1000 GALLON ! WITH STONE iN A } z WELL NA f 7 FEET 29 INCHES I (TO BE PLACED ON FIRM EASE) 8 FEET 34 INCHES SEPTIC TANK -, 20' X 30' X 6' FIELD FORMAT`ON I �. zraE _ --- 3/4" TO 1 1/2" CLEAN f- `-- I :r INDEX DESIGN CALCULATIONS SEWAGE DISPOSAL SYSTEM TEM PROFILE DRUB E WASHED AS ED&STONTE SOIL ABSORPTION ADJUST- NUMBER OF BEDROOMS WA NOT TO SCALE SYSTEM (SAS) Gr�RBiA E DISPOSAL UNIT WE 9 - - -- 7.3"" _ E 110 GAL/�t./uAY X �_ BR.) _.�_ GAL./DAY 1 7,f 7' USGS PROBABLE WATER TABI__ ELEV. = REQUIRED SEPTIC TANK CAPACITY GAL. i �` OBSERVED WATER TABLE ( / / ) EI EV. _ _ SOIL CLAACTUAL SS?F!ZE QAT;SEPTIC TANK (DQ5i1NG) -) GAL BOTTOM OF TEST HOLE ELEV. _ DESIGN PERCOLAi,ON RATE S � MIN./iN. I / 97.9 �97.4 EFFLUENT LOADING RATE ,Qs GAL./DAY/S.r'. 1 LEACHING AREA • SO. F T. 2OX30 f � � � 9� LEACHING CAPACITY (.AREA X RATE) 444.00 GAL.jDA�- , / P ' . 98�4 g 600.00 X 0.74 RESERVE' LEACHING CAPACIT`' - GAL-/DAY' t 98.2 °o. • 98 ti x 98- \ NOTES: (f1 ( 1, ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D-E.P. BOX �\,98-;-' 95.8 TITLE 5 AND THE TOWN'S RULES AND REGULATIONS FOR 96.3 THE SUBSURFACE DISPOSAL OF SEWAGE. E 2. ALL COVERS TO SANITARY UNITS SHALL BE BRt7!..'G�HT TO p SOIL SOIL Wi THIN 6" OF FINISHED GRADE. gyp" TEST 1 TEST 2 7.3 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE. OF 98.6 0 FT_ OF ING DRIVES3ORLOADING UNLESS PARKING AREAS.THEY ARE UNDER OR H-20 OAD4NG SHALL BE 1000 GALLON'm I ', {�( ] USED UNDER OR WITHIN 10 FT, OF DRIVES OR PARKING AREAS.. f QE 4 SEPTIC TANK , �;�;/ v T T€) BRING COVERS TO GRADE SHALL >�8.6 98.5 a ANY MASONAR , UNITS US£J 98.5 � `--._ �� 99.0 ` � fir'•'' BE MORTARED IN PLACE. 5 NO DETERMINAT ON HAS BEEN MADE A5 TO COMPLIANCE WITH DEEDED OR ZONING REGULAT:ONS, OWNER / APPLICANT I$ TO 98.7 / d 3i{ OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. $ ! 6. UTILITIES SHOWN ARE APPROXIMATE ONL? EXCAVATION CONTRACTOR ° r> IS TO CALL "DIG-SAFE" AT 1-688-344-7233 AT LEAST 72 HOURS 96.0 �, u PRIOR TO COMMENCING WORK ON SIT£. 0 Z 101.3 ( + ARi�*t� 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL .AS SITE CCND 710NS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION I ��Z f 94.8 I! / ' IS TO BE BROUGHT TO THE ATTENTION OF THE !DESIGN ENGINEER r IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE ___C c 1 j i 9. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL _! � _ - r I 67 Mai >` 10. r XIST PIT S TO BE PUMPED AND REMOVED ALONG WITH ANY POLLUTED �r9 t sqa SOILS ENCOUNTERED. \ 98 6 �J� ` 1 �}I<..1 '� 11. THE INSTALLER IS TO GIVE THE ENGINEER .A MINIMUM OF 48 HOURS '' x 97.1 J LLI (2 WORKING DAYS) NOTICE FOR THE FINAL INSPECTION (NUMBER BELOW). 3Y, J I N •� / 96.5 g�) APPROVED: BOARD OF HEALTH v / � 97.3 (98) - / / 96.8 96. DAB AGENT t ! PROPOSED SEPTIC DESIGN � r / 45 G97.7 REEN D� DRIVE LOT 39 CENTERVIIIE, MASS. j sW► � MvGLNzTRLw 203 SE`U^KIT RCA � ! a G ° we � 3- P. 9C�X ''3 } i... GEND: I 3a5--690 _ SD-!T ' _ r,w; , Q s. o-660 t / LX STING SPOT ELEVATION 00 0 1 u"' {f _ EX ;TING CONTOUR ----00---- E W,F " ?n 1 I I SCALE "� J / FIRat SPOT ELEVATION �_ Fir CON TOUR 0 / S -`ST LOCATION tsi �EV. i ,�09 N0. r Tc N WATER �l I J U N E , 2 4 1 7381-00 � C, BASIN 4 !r' 4 �� REv. �T 7 w- CL AN OUT 1 CE.. OO<_ C.P. i k i I -C%0( d!tjjL87-SAS! WG 'C 2014 SWEE I"SER ENGINEERING