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0110 HERRING RUN DRIVE - Health
110 Herring Run Drive 146 1■■■ ■■■■■■■■ ■■■■�■■�■��■■■■■■■■■■����■■■■�■■■ �1■■ ■ ■■■■■ ■■■■■■■��■■■■�■■■■�■■■e■ �■■�■�■ME■ 1■■■■E■■■M ■N■E■M■■S 1■■■■M■■■E■■■■■■■■■■■■■■�■■�■■��■■■� �■■�■■■■■� i■■■■■■■■■■■■■ ■■■ 1■■■■M■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■�■�■�■■�® 1■■■■■E■■■■■■■■■■■■mA1:m■■■m■■■o■moo■ M■■E■■■■■■ 1��■■■ ■■■■■■■■�■■■�■■■�■�■■■■■■■■■■■��■■SOONER ■■■ ■■■■ ■■■■■■■■■■■■■■■■■■■��■■■■■■■■■■■■■■■■ 11■■■■EM■M��■■■■■■��■■■■■■■�■■■■■■■■■■�■■■■■■■■■ ■i■■■■N■■■■■ ■■■■■■■■■■■�■■■■■■■■■�■■■ ■�■■■■�■ i TOWN OF BARNSTABLE 1 '? � .LOCATION A6 /i�C //pit S SEWAGE#. VILLAGE J ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 0,b-VOAd rPW(� S y&a,r\ SEPTIC TANK CAPACITY V5 O® o n y LEACHING FACILITY:(type) 4 <<6 (size) NO.OF BEDROOMS 3 OWNER //ekt J2oI,�-FS PERMIT DATE: -?- COMPLIANCE DATE:1 J d I/I 1 Separation Distance Between the: pef C -/-a "3`r f1 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /_ G 4—" 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) 100# Feet FURNISHED BY E j { 1--r 4 4-0 w No. f/ i� Fee l V v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Bisposal *pstpm ConstCUttiott permit Application for a Permit to Construct( ) Repair( ) Upgrade(Z Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.Il a I--le f r,',yam /Z,. Owner's Name,Address,and Tel.No.lqrle,�7 e �6�Pf C 'e/)t rl )o I/CW 9 oO 2 c Assessor's Map/Parcel 1 ,..0 l,�, J a -71 e— glelre_!ry Install is Name,Address,and Tel No. W��,c o�,D S�<-✓ Designer's Name,Address,and Tel.No. 095_h!�,r�jc e /Ao_ �-•�ct. /7 02- 6 Type of Building: Dwelling No.of Bedrooms Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3e7© gpd Design flow provided S6 t/ gpd Plan Date `$' �� Number of sheets 2 Revision Date Title Size of Septic Tank 00o Type of S.A.S. ����� '^y C�Am h-�S 6 C! 2D Description of Soil Nattur��pa s or Alterations(Answer when applicable) ,s��NJ ,�,`S,f-r,` j t,.,'f s"C"el b a%- t0 /j C_ �oCC I"h �l'a�f` D � ��. iS`�-�t� �n �/� a S �✓e/'/ a.5 � �C� Geo�e 1, Grab-crS in. �41e Date last inspected: "'Po✓ Z Ole Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code d not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea Signed Date s— Application Approved by 1/— IV Date 3 j Ij f 7 LApplication Disapproved by Date the following reasons Permit No. oZC� Date Issued =_-__---------------- -- - - -- r z. No. �/ v �Ll� s�` �.+.. Fee Vv THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS I Application for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(/Abandon( ) ❑Complete System ❑Individual Components i' i Location Address or Lot No.///J A1e/r;^� /Zn 0A Owner's Name,Address,and Tel.No.19/-/t°h e �6/�e/t Assessor's Map/Parcel � (9 Q_�1(d, S c, -,,7 e q/W,e-s'S Installer's Name,Address,and Tel.No.D;'A&A o..0 sty Designer's Name,Address,and Tel.No. rh�,:4 e-el,t~5 w / V5 /9 02-aC € Gy Type of Building: Dwelling No.of Bedrooms 12 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3,70 gpd Design flow provided .3 57 `l gpd Plan Date `$_ 7 Number of sheets Revision Date Title Size of Septic Tank l p00 Pe of S.A.S. Description of Soil - Natureof gepairs or Alterations(Answer when applicable) '/��GL/ (�,`�-/^/ [.. (+j,.�t ba t 0 n e / L e ca l t,•'r�, C [�74k e,4�► b— 15 i t,_ _'d�fv.i Date last inspected: /mod✓ 2 4l Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea Signed '� Date Application Approved by Date 3 /h Application Disapproved by Date j for the following reasons Permit No. P Date Issued 7a --------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by �j I., C,r► O j e�-c! at f 1 �// r�L n /�<'� has been constructed in accordance with the provisiojns of Title 5 and the for Disposal Sysstem Co struction Permit No..201-4`06b dated 3-1 9- 1 Installer C), io L• o h a SE'J�.C/ a rC UCGc 1 besigner L14 i I A e./! c� #bedrooms Approved design dw 3 3 gpd The issuance of this ermi shall not be cco�strued as a guarantee that the system ill fiinstii6n� de i'ed. Date // Inspector y � No. a G Fee [ `' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit ' Permission is hereby granted to Construct( ) UC.,�pRepair(n)// Upgrade(� Abandon( ) System located at�219 .#C f/ /�(� h n !/6 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. f Provided:Construction must be completed within three years of the date of this permit.�� \ Date �j- 6` Approved by Town of Barnstable �F SHE Tp� zo Regulatory Services Richard V. Scali, Interim Director BARNSTABLE. MASS. �Q Public Health Division Qd ib39• ,��. ArFdv:a Thomas McKean, .Director 200 Yl.ain Street,1=lyannis,MA 02601. t)tfice, 508-862-4644 f 508-70-6364 installer & Desi_ener Certification Form Date; 2 jl'7 Sewage Permit# Zo)-7 —6 G6 assessor's MapTarce[ Z2q Designer: L=,� a rl�e bjo r G s I/I c: Installer: �+ �0 n o °' d 4•'' rlciclres.s: LZ C ,Qys s-f- field /ZrA, —__ Address:MA On, �.� 11 _ ��-as issued a permit to install a (date) (i.ristaller) septic system at )1 y �c�► 1 � _�� Cep-. _based on a design drawn by — (address) tt Pfr, T 1,"Ic.6�:n0ee e, _ dated _ 3 fig 1-7 (designers) l certify that the septic system referenced above was installed substantially according to mm 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 st ils were found.satisfactory. I: certify that.;_the septic system referenced: above was itistalled with major c[Zangc s �i e. greater than 10' lateral relocation of the SAS or any,vertical relocation of any component Of the septic s} ern) but.in accordance with State chi Local Regulations. Plan revrsio- or ecrtifie:d.as-built by des.i. lien to fol ow. Strip out (i.f required) was inspected and the.soils: were Found satisfactory. I certify that the system referenced above was constructed in corn l , E 'ith the terms of th.e [`,A appryal letters if applicable.) �MASSA VIE� C (`Installer's Signature) Signer's Signature) (Affix Designers t� PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION—CERTIFICATE OF CGIMPIaIANC:E `VILL NOT :BE .ISSUED UNTIL BOTH THIS FORM AND As,:- BUILT CARD ARE RECEIVED BY"i'H.E BA.R.NS'I'ABLE.PUBLIC HEALTH DIVISION.. THANK YOU. O Sermc'%Dcsi�nel Certification Form RCN,)-14, 13.doc I ME ��, Town of Barnstable Department of Regulatory Services PubliclHeal r�s th Division Date �'� 1� �A 0.19. �e 200 Main Street,Hyannis MA 02601 Tt rF0 MAt'' M t� Date Scheduled O� Time M Fee Pd. Soil Suitability Assessment for Sewage Disposal , Performed By: 1 4ct✓ ✓t-e-R SSA I1.5 yZ Witnessed By; )1/v /jyt n LOCATION & GENERAL INFORMATION Location Address 1 1 O 40-y'n Owner's Name t� n1 g,, d2 v+�t � A�i�✓t e Address ))© Assessor's Map/Parcel: 2,2y Ge rt efl�1�2 'Yvl(4 Q ZG3 Z �P Engineer's Name , ,ng vie4 n rns &J f S )h l NEW CONSTRRucTION REPAIR rA Telephone# ]—L�-74 L Land Use Slope (90) —Z Surface Stones N o'er Distances from: Open Water Body? � ft Poss'ble Wet Area ft Drinking Water Well ? c�ft Drainage Way / ft Propi rty Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locati ns of test holes&perc tests,locate wetlands fn proximity to holes) I -pn^-q_ Parent material(geologic) Depth to Bedrock. Depth to Groundwater. Standing Water in Hole: Ajdev Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR S�NAL HIGH WATER TABLE Method Used: neprh Obge7-!ea r...d n,,is obs.-tole: -_ -- ir,, Depth to soil n'tdstias; in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj,factor— Adj,10roundwater 1 evel PERCOLATION TEST bate Thne - Observation IP— I I l ; 9 Hole# i Time at 9" Depth of Perc I Time at 6" 1 `� v Start Pre-soak Time @ k 1 y _ Time(9"-6") End Pre-soak 1 � � z ! Rate Min./Inch. Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) 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:\SEPT[CU'ERCFORM.DOC DEEP.OBSERVATION HOL LOG Hole# A Depth from Soil Horizon Soil Texture oil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. an istenc Gravel) DEEP OBSERVATION HOLr LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) h- �'H-lam � •P�-c.Sw�.f' �� ��� i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA)- (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Grave DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil . Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi ten Flondlnsurance Rate Map:. Above 500 year flood boundary No— Yes V--1.1 Within 500 year boundary No Yes Within 100 year flood boundary No<.,— Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required tra' expertise and experience described in 310 CIv1R-15.017. Date Signature .I I I . Q:\ EPTlC\PERCFORM.DOC i Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town 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. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain rab Company Name 8 Johns path Company Address S Yarmouth Ma 02664 City/Town State Zip Code 508-364-9587 S103522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority _ 11/6/16 Inspector's Signature' Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or' has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has aseptic 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: Y N Yes o ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ® ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 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 198 Gpd 9 ( Y 9 (9P ))� Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form u Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: None provided 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Original system 1978 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5feet 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.): Septic Tank (locate on site plan): 1.5 Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1000 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: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. CitylTown 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 24 Scum thickness 311 Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle 1,1 Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No evidence of leakin ,Tees and or baffles in place at time of inspection Grease Trap (locate on site plan).- Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd M Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 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.): Tees are in place and levels are normal. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form 4 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert NA 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Based on Test hole data and elevations from 100 Herring run drive, From my observation. The bottom of the leach Pit at 110 Herring run is approximately 1ft above high ground water. This does not give the Oft seperation to high ground water and there for fails according to state and local guidelines. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is Centerville Ma 02632 11/5/16 required for every page. Cityrrown 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.): No ponding no break out 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-3113 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is Centerville Ma 02632 11/5/16 required for every page. City/Town State Zip Code Date of-Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10, feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Test hole data on plan from 100 Herring run dr shows Ground water at 6' Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 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 ,z t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form R o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ -Check cellar ❑ Shallow wells Estimated depth to high ground water: 10, feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑' Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Test hole data on plan from 100 Herring run dr shows Ground water at 6' Before filing this Inspection Report, please see Report Completeness Checklist on ne xt ext page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Herring run rd Property Address Arlene Roberts Owner Owner's Name information is required for every Centerville Ma 02632 11/5/16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 .J CAT ION R SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS �®z R U I L D E R OR OWNER �. DATE PERMIT ISSUED , DAT E COMPLIANCE ISSUED ry r `- f cv -� A `, O No............ ......... �� Fims.... g.�............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... .....................I........OF..........................---..._.....---.._.............------................._..--.--.. ApplirFation for Di-nVas al Works Tow3unrtiort thrutit 1 Application is hereby made for a Permit to Construct (✓�or Repair ( ) an Individual Sewage Disposal System at: .. —� Location Address or Lot No. .<_.d ..............� - �........... ... ---------------.- ..---------- ------------------------•--•-•...•••...._.... W �_ _... /FF Ow ... ..............Address ---7=`�`-lam^ ...................................................... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms....�<....................... .. .....Expansion Attic (/-14 Garbage Grinder (No U '4 Other—Type of Building No. of persons............................ Showers — Cafeteria Other fixtures ................. WDesign Flow.--,. o............................gallons per person per day. Total daily flow....... .........:................gallons. WSeptic Tank—Liquid'capacity,/O(P..gallons Length.....-...... Width....'f/........ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area---� .....sq. ft. Seepage Pit No......... Diameter.AffF./.. °. Depth below inlet......V.._....... Total leaching area...13426....sq. ft. Z Other Distribution box ( Dosing to ( 1��` Percolation Test Results Performed by..... (.... y.kt.l., 'E.,�.._.__�................"..", Date..f a.............-7.....:.....__. Test Pit No. 1. :_Q......mmutes per inch Depth of Test Pit__ .............. Depth to ground water_____ _______________ 44 Test Pit No. 2_9...:.().....minutes per inch Depth of Test Pit...ZO.......... Depth to ground water...,C P4 --------•------------------------ ......................................................... O Description of Soil �� ..................a.`---k-----.... ------------ �.1' j: �/y d ��� xr �., UW ---------------------------------------------------------------------------------------------------•--------------------------------------------------------------------------------------------------. Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------•-------------------......_----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Si ed . _... Date Application Approved By .__ ..... Date Application Disapproved for the following reasons---------------------------------------------------------------•-•-------------......-------------------•••----•- --...-•-•--•--•-----•--•-•-•--•...............•------------...-------------••-------•----------------•--.-------------:....--------------------------------------------------------------------....-•--- Date PermitNo......................................................... Issued•....... Date No..---.......: . .:. Fss.... ............:.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF......................................................... Appliration for Bispos al Works Tonaratr#iun rruti# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ' f ._....... . .. Location-Address or Lot No. ................. .........._.......................... ............................. r ,. ..0., _. .... W Address IInstaller Add -•--•-••----•------•--•----...-•----•- ..............................••--••-----..... � ress Type of Building Size Lot............................Sq. feet 1•-r Dwelling—No. of, Bedrooms.... ..................................Expansion Attic (No Garbage Grinder (Nta aOther—Type of':Building ........................... No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures d --------------------------- ------------------ ------•----•---------•------•---- w Design Flow.... ZIP...........................gallons per person per day. ,Total daily flow.......] 0....•:...........•......gallons. WSeptic Tank—Liquid*caPacttY./ .. allons Length.....*....... Width----V........:Diameter................ Depth............... x Disposal Trench—No. .................... Width..................... Total Length..........._.. Total leaching area.._.:-.::.:_...._._sq. ft. Seepage Pit No � Diameter.-. Depth below inlet...... i...... Total leaching area.... 36...sq. ft. Z Other Distribution box Dosing tank,,,( /,Q. a Percolation Test Results Performe� by............ .t... .0�f S .._..._....._.. Date..J_Q__" .� _..��'�"• minutes per inch Depth of Test :Pit ..� Test Pit No. 1.._:. Q..... /fI Depth to ground water .. Lt. Test Pit No. 2.2r() _...minutes per inch Depth of Tese Pit...AR........... Depth to ground water. ,��..w ........ 1 9 --------------•..... . ---•---••-•-••......----•- ...•.... --........... -- Description of Soil C .w. �G G?. ----------------- -! tS�s!�!/, ,�l1� �! , w V Nature of Repairs or Alterations—Answer when applicable........:...................................................................................... -------------••--•-•--------•-•.......------------•----•---•-•-•••------•--•--•--••-------......•-••--------....•-•------------•-•-•---------•---•-----•------•-------•-----.........•-•..........••-•_. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TST`. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sied _..- ------•--•-----------------•--•-•--•-•-------••-•-.._..................._ Date . Application Approved BY•.•.~ -----• � ' ---- Date Application Disapproved for the following reasons:................... ti t..................... Date PermitNo.......................................................... Issued-.---------.......Date...................------•-•-- Date ? THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH ...J... ............OF...... ....................... r (9rdifirate of utpliFanrr THIS IS'TO ERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) ' ........ .......................... ------•---•--•.....-••-•-•••...................•- ..._. . of TIeenhas been installed in acc'ord nce with tpvi _LF.-, � of The State Sanitary Code s descr,ied in the application for Disposal Works Construction Permit No......................................... dated_.... -"'-- ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UED AS A GUARANTEE'THAT THE SYSTEM WILL. FUNCTION SATISFACTORY. ' t �. DATE.................3 �� ......----•............. Inspector........: a� THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ............ .. .............OF..- t................................................. v No..........v,:'::.......r' FEE..:.......:............. a Disposal k Zonstrudinn rrutit Permissions hereby granted...... -------------------------------------- to Construct r epai r i ual Sew ge Disposal ystem trees as shown on the application for Disposal Works Construction er No._ Dated....ZngP'-'7_t............. 6 Boar of-Health DATE........................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS •� - F' s./ rK. a } s". 4./ _ n/IK i+��a 5� z. �,Yl S} �" a• �\ � �j; W /�'' �4 d � �',"ix i �k1� /� ° �'* . 7t1 ; % � I �jUX .�'�.✓ ,1.� � r � .�, 1 ? c. � �7 y wl� lk'� " � .l 5'" _ + 2 3 J 2 0 '"� •• ' t ,� e � loI tr / T, r •�.# t �j - a F• 6 Z-./ I D 112 L E G E 14 IJ2 ' Yz H OFE,l �L CERTIFIED PLOT' `' PLAN EXISTING SPOT ELEVATION 0x0 vN�P EXIS`TIN:G CONTOUR - p - � Roe�ERT. \ � ,�, L, - (�:I C.�!C.n. A�1%'A'aT,i .�y�-. ......'- ..s.,pi ....... ' a. "• •/'I L,/<%�/N (a` { � o -F1'f.,',,llcu '`�f v I ELCVA-I IUN �,QI �o q P z� / < / T :anF ISHED CONTOUR— 0 - 3 13U P s fitlEST_Ny�9 ✓ /s.__PD T 4 { IN No 22162 0 / IN o, o APPROVED BOAR,b: OF HEALTH �Fss/ANAL� g=l r`�!n A 1 .hl�/ 1} j W • {'' •.OA'TE AGENT SCALE / I/=¢0 DATE40G' S< LDREDGE ENGINEERING C0 INC? 4 - CLIENT 3& R0L2T-S' I CERTIFY THAT THE PROPOSED EGISTERE . LEISTERED JOB N0. 79�k03 BUILDING SHOWN:, ON . THIS PL-AN CIVIL LAND CONFORMS TO THE ,ZONING LAWS DR. BY ! A-_A -All NGLNE'ER VEYOR OF BARNSTA LE , MAS +" W3 NC MAIN STD 712 MAI ST CH. BY: n � 24, 40 ti> SO. YARMOUTH, MASSit-,: HYANNIS,,�MASS. y� SHEET OF Zs DATE RWEGLAN-D SURVEYOR G t -rA N07 -A/e!5-=PP77d' R Z-Z7ACH11Va P'/r ARE MORE 77H A.,V 12 OEL 0 JV Ali, T� COVER cF0NcJ1R4ffr4e tiEAV y CA s r /,i:po Iv. c o(/.--)R, SH.4 L L C3E USED MIN. 017-Cq ORI V-=JVA Y' co MEMS Y8 PzR FT. COA:Ce4&-7- 2 CC)Kl=- ,49? CLEAN 44i!FAN SANG . ...... eACAE)=14e .we. "LAYER .............. 4"CAST JCA IROA, M I IV.R1 7'CX riALL.. WA 5,Y,=D, SMNi-- 0 0 led p 60Y SEPTIC DIST TANK BOX P V�01 P,4 i"EC-A 5 7 SEEPAGE aa 4 a 0 0 0 0 P C',ip 0 0 0 old a 0 P17 OR wz//v. 2- -4N.<. 3 3 r 1,VYZR7' AT BUILDING Z11-A 7. .4 Fr 5 EE OV 71-e 7-SEPTIC 7A)V K 3 3.2- F7' "D,157 1/77401V BOX -3 41'-';r GROUND WA7E,'C 7,4BLE R/,S SECT/ON/O/v OF BOX 3 F7.- INLET SEJoVA04E AO1,Sa4%SA J- SYSTEMEACHIW ?�-Pj7-, -Fr 7A� -ATION AV4C�' EA CHI #1=1/7' A FT. TEM 1A 11 = /�-40 %TCArj-4ff X4 IYZIMMER O.F RMWO OAf 5, GA teAGED/SPOSAL UNIT 50/Z- Z-OC7 S011- 7-e5r 32, 0 - TOTAL -=-4rr1o%1A7-,FD FLOW G-41-1,0A Y .-SO/4 71657 Al SO/4 7-=57**2 NU148EA- 0,= LEACHING j4a/7`-,3L 30, -A--J-/.3 4-� Z>A Ojal 5 0/' TEST 0 Ar L 5/40E 44EACHIAICI JCPEAt.40/7* o-'r f — t/All/C I 0- 2- 0 -2- ' GO RESULTS J4V1rA?Z5S,-D AW 4!POr'rOM 4C74CHIAIC- SO. AT.r Jk,* 5co,15.50 /L- A'A7-0,*l -2-0 M.'",11MCH A 13 Sol L CHIIVrr AREA 7'OrA4 LeA 3 3 0 sp FT 211-41 D RRXFfflVELeAC'N1)FYC7 AREA 3-3 77 2-- TO 5 a:-�O-rs LOT ROSM e7 /V/,S P. A,-7 C-17-- o BYNIKIS OLD P4A&,A-N&JFA("A1NG No.2216,2 40. "0 41 33 -VO.MA 0 7/2 oar C3_ TIONA A reR 4mv 40CIA17"AMICIMP, .,WA 7149F;oe�,-Ar 4641=5 P UA10 Jos nip, K /Y07E. /F•,E/ TNeR, TsNE SEPTIC TANi�C'„OR M/N. ZZ14Cs,�/n/G ,P/7- ARE" /�'I,.ORE T!iA/V Ili 'SELD/N '. y M/N• .` • GRADE, A 24'O/AM¢TE�'. CO/1/CRET� �O!/ER _ SJ,rALL 9E BROUGHT T0,6�AOE.�AN EXTRA s CONCRETE g PI/C P/PE - hrE.4VY CAST //E'O/Y G:_O(/�R Sh�i4LL QE USE17 EL. 3 ,� CODERS M/OFipTFT /F/N DR/VE A y; a / /e„ i 2 Jo M,N. CONc R1TE A o• _ G7�ADE CU VE.4 CLEAN .SANG �.'' • � BACxF/LL DQU/D LEVEL - f z 4..C.45T a "LAYER it f c:i IRON P/PE Q'71Z� t D o� • • • i i • • • 1 ' p 04 Q� N. P/TCN GAL. D/ST, WASHED ST1�NE "%4 PER /T SEPTIC TANK o w - 1 • • . . . • • • • • u i BOX p • 1 B ♦ • • � • 1 .05 °" I P o D •� � :, � ' c•:'I ' a c � • •EFFECT/VE 1 ' . v 3 4 - � �2., '•': _ o ° • • DEP7;14 • • • ' ° �o 0 WASHED STONE 1 • • . e • • • • • d �np PRECAST SEEPAGE ?� /N(�,e 'T EL TION REt1AS - Q ♦ oat 1 • • • • • • • • ' e °o PIT OR EQU/✓. f EL: ZFfS /NYERT AT QU/L MlC, -3 3 9 FT. SS_:TASLLATI�N /NL-ET-KEPT/C TANK 33.4. FT, i_ —�'_ FT. 0/AM. -� C.-C O✓TLET S,EPT/C TANK 33.z' FT. /�1/LET D/STh?/6UT/ON BOX 'z 9 FT. SECT/ON OF OROvNO WAITER TABLE 0141TLETD/5TRID&MION BOX 3 Z • FT INLET LEAC/•//NG PI 7- 3-Z, FT. SEN/AGE O/SPOSA L SYSTEM 7i40414LATIDN LEACHING A/T Q/MENS-10N A 3 FT. j DESCGN CR/TER/R 01,M.-E.,Y5%ON $ f,T. NUMBER OA BEDT0OMS. 3 GAR45A AGE O/SPO.5AL. UNIT SD/Z- LOCG TOTAL EST/MU4TED FLOH/ 3 3 G GAL.�DAY SOIL TEST A/ SOIL TEST 4*2 SD/L 'TEST ' /4/UMBER-.OF LAA,GNlNC: PITS EL�Y 3 a,¢ . ELEY 3¢' PATE OF SOIL' :' S/OE LEA H/NG PER P/T �r Sv�s O/ L d'o' Ste' 40 A - PtRCOLAT/ON /��SSED BY� y Al//< I S' 4 O_Z .Lo p _y. Lo/► "'� RESULTS h//TN 60TTOM.:LEACN/NG PER P/T �' T - 3TE At I Z ,� M` /N�I NCN TOTAL-LEACHING AREA 3 3 OSQ. FT. ¢�. . J AE`ItcoLAT/ON R.7"F�2 'Z- MIN. /NCH. RESERVELEACMISEA 3 M AREA 3 D SQ. FT. ` /,v`c aN b . 2.-�1' a L Ruff c. ROSERT �ti��, Gem 0IV I> /E( TL WO BUNIKIS A Na 22162,o Q � �-� y ELOf?EDGI�ENG/NCR/,VG 42 INC. 4 G1STc��\��c�c, `£.r ,r �~ "f t - n 7/2 J►lI!�/N ST.: 33.N0.M/1/N ST. SOMAfLEN ` ` NYANK/3 MA 4 Ot/TH M.4ss _ s ''O "NO GROUNP-WATCR erNZOU/VTfh'EO ss• sv:.YivRM , ` ,p A v _ " �'GM U/VO LV/;TE T•6 E J08 NO J.„ .. .. .. _ - ..4.. :`_ .. .. -- , -,,, .."; � ' +.._--Y .•-3 r. ...i.:.. . _1..>n a.. .., _ .n- e:1 axj 1s ... ,- .. 4: 3 +py .. Z. ? 30' /0343 �, '� 00 '( 10 R _ 4 A S 7� to '7a - 44 c� LEGEND _�_ �� \J" 0r CERTIFIED PLOT_ PLAN EXISTING SPOT ELEVATION 0.0 EXISTING }CONTOUR ��� ,. r c - - � _- �--.�"�v K06ERT ^:� �� �. _lo"r/i HCR2/.✓ly`fev� �/�/✓E t,. FINI3,HED, SPOT EL_EVATION (0._0� �, P. F I N I SHED `.CONTOUR - 0 ---- BUNIKIS > (BEST y�9 n/iliis p�jIZT_ F o p No.22162Q. %u I N r, APPROVED - BOARD OF --HEALTH Po F`G%ST TA ,—DATE..:, -- -------AGENT :SCALE : t DATEQc! I EL D RED GE ENG/NEER/N�(a, C0 /NG� CLIENT I CERTIFY THAT THE PROPOSED ` EGISTER.E REGISTERED ` JOB NO. 7kXO-3 BUILDING, SHOWN ON THIS' PLAN ' CIVIL LAND �/ CONFORMS TO THE ZONING LAWS " °ENGINEER _ SURVEYOR DR. BY : _._ ___�— OF BARNSTA LE ) M A S r£` 33 NC MAIN 'ST, . 712 MAIN ST. CH. BY >� 'SO `YARMOUTH MASS. HYANNIS MASS: ;y , 'a S T . F Z DATE :REG. LAND SURVEYOR a� rs - 56-- EXISTING CONTOUR N Long Pond x 100.98 EXISTING SPOT GRADE EXISTING SEPTIC TANK ® ---- TOP OF TANK=100.35 ENCHMARK EXISTING LEACH PIT -W EXISTING WATER SERVICE INV.(OUT)=99.00E sH� -- OVERHEAD WIRES o COR./BOTT. STEP TO BE PUMPED, FILLED WITH TEST PIT s EL.�102.12 SAND AND ABANDONED LOP 20973E \ BENCHMARK 5 C LOCUS Q105.29 104,84 X 106,41 - _ ° - LEGEND a ` ° Pine Street \ Q0-2- 101.76 N 05'14'40" E7 101.40 101,39 \ W 202.0 f 0' -0\ ° r 4 "-70 \ s 1(}2 .101.88 Y 98,16X X101,26 101.87-+ '�. ��Rv\ ` LOTS 15 & 18 r 101.17 I cal = 100,83 X 20,545 ts.F. LOCUS MAP I SHR. 101.51 l PARCEL ID: 229-046 NOT TO SCALE � I ' I DECK 102, \� �11u 103.40 GARAGE 1.80 / �� 98.481 VE r co EXISTING '� 58 3 101416 tia gpRON °icy HOUSE(#110) c� /f• ` °: + X 104.44 GENERAL NOTES: o 71 oFc� T.O.F.=103.02E /'= °:�/ 102.77 !7 X1__1 85 X TP-1 /. O/ \ 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 99,73 \ 101.8 �/ _ \ O M 10 ,44 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS p� \ TP-2 Q / N �j OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE (o \ 3¢' o / 10j 76 `)4 LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: 141 -310 CMR 15.405(1)(b): CONTENTS OF LOCAL UPGRADE APPROVAL / \ X E \ �y 1) A 3' variance to the 3' maximum cover requirement, for up to �p� 3 101.30 101,36 °. ': C ' \ <O 6' of max. cover. S.A.S. shall be H-20 and vented. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR \ �' : '';'':•I ;V1 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 101,42 L X 102.09 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING X 100,28 C7 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 97,33 4':: 99,01..= ^ •; . \ y e ENGINEER BEFORE CONSTRUCTION CONTINUES. 97,91•' ``:.' �9p� -t` 100.65 \ 5. ALL ELEVATIONS BASED ON AN ASSIGNED DATUM. , \GRAVEL -,.,...,;.. . OR/liE'�%gy: r e \ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF v w� :'•,;`,. s � THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 97.66\ "9897`.::.,.•,•.''. ( \ 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 98, 0 I 1 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 133.54' I t' AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE CB EAL S 05.1 4'4O" Wes- s3S--'\ CB EAL DIRECTED BY THE APPROVING AUTHORITIES. \ �� UP / y 98,4 3 X 100,97 �I 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 68, THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING - J �¢ CONSTRUCTION. 96.48 edge of pavement 98.19 99.10 / I 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 96.36 99,84 J IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). '' 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE HERRING RUN DRIVE 100,39 INSPECTED IS DESIGN ENGINEER PRIOR TO BACKFI 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. N�l 9� f 100.68 o� PETER T. �G PROPOSED SEPTIC SYSTEM UPGRADE PLAN Mc 110 HERRING RUN DRIVE, CENTERVILLE, MA CIVIL CIVIL "' No. 35109 Prepared for: DiBuono Sewer & Drain, 8 John's Path, S. Yarmouth, MA 02664 op�FSfGISZE��G OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. I ROBERTS, ARLENE M Engineering Works, Inc. CENTERVILLE, MA 02632 2 West Crossfield Road, or 1"=20' P.T.M. 126-17 HERRING RUN DRIVE 1d, Festdale, MA 02644 DATE EN CHECKED. SHEET f 2' (508) 477-5313 3/8/17 c NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL: 98.5 ' FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. ' INSTALL RISERS & COVERS OVER INLET & INSTALL RISER AND COVER INSTALL RISER & COVER ;OVER ONE CHAMBER(MIN.) DECK �1 OUTLET AND SET TO 6' OF FINISH GRADE SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE T.O.F.=103.02t GRADE AS AN INSPECTION MANHOLE. • EXISTING F.G. EL.=101.2f F.G. EL.=102.0t F.G. EL.=101.4 to 103.1 CHARCOAL VENT EXISTING HOUSE(#110) T.O.F.=103.02.E L = 60, L = 16' / S=1% (MIN.) S=1% (MIN.) / 4"SCH40 PVC 4"SCH40 PVC „ 43 6' 2" LAYER OF 1/8 A / p� / o� io"I E3 TO 1/2 DOUBLE �'� / Q 14" WPROPOSED 12" WASHED STONE •�' EXISITNG 48" LIQUID INV.=99.Ot (OR APPROVED FILTER FABRIC) LEVEL INV.=98.23 4' 3' 4' 3 3/4'-1 1/2"GAS BAFFLE INV.=98.40 EFFECTIVE WIDTH = 11' DOUBLE WASHED INV.=98.00 STONE 44'8' EXISTING SEPTIC TANK USE 6 LC-6 LEACHING CHAMBERS IN SERIES WITH 4' OF DOUBLE WASHED STONE-ALL AROUND H-20 RATED NOTES: TOP CONC. ELEV.=98.83 —BREAKOUT S.A.S. LAYOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=98.00 E3 E3 E3 0 E3 E3 E3 ELEV.=98.5 INVERTS, PRIOR TO INSTALLATION. mr, E3 E3 E3 E3 E3 E3 E3 2) D—BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=97.00 GRADE ON A MECHANICALLY COMPACTED SIX 4' 6 x 6' = 36' 4' INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 44' r a• KNOCKOUT � 310 CMR 15.221(2). PERVIOUS MATERIAL zo° ow coves 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 4' (MIN.) ABOVE G.W. I 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL=90.4 — LEACHING SYSTEM SECTION I — I n AS MANUFACTURED BY TUF—TITE, ZABEL OR EQUAL. _ (NO GROUNDWATER) a° KNOCKOUT 4' KNOCKOUTI SEPTIC SYSTEM PROFILE I L____ __ a_KNOCK OUT N.T.S. f 72" PLAN VIEW DESIGN CRITERIA SOIL LOG DATE: MARCH 3, 2017 (REF#15,286) NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE((SE#1542) Ea E3 E30 E3 Ea Ea22' E3 ® SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R.S. HEALTH AGENT INVERT I E3 E3 E3 E3 E3 E3E3 I I I DESIGN PERCOLATION RATE: 6 MIN/IN ELEV. TP— 1 DEPTH ELEv. TP-2 DEPTH 12 DAILY FLOW: 330 GPD 101.9 A 0" 101.8 A 0" .� DESIGN FLOW: 330 GPD SANDY LOAM SANDY LOAM 72" r' 36" GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN 101.2 B 10YR 4/2 8" 101.1 B 10YR 4/2 8„ SIDE VIEW END VIEW SANDY LOAM SANDY LOAM WIGGIN LC-6, H-20 LOADING EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 10YR 5/6 PERC 98.8 10YR 5/6 LEACHING CHAMBER LEACHING AREA REQUIRED: (330 GPD) = 550.0 SF 30"/48" 1 0.60 GPD/SF 97.3 55" 97.3 54" N.T.S. C C USE 5 LC-6 LEACHING CHAMBERS IN SERIES WITH PROPOSED SEPTIC SYSTEM UPGRADE PLAN 4' OF DOUBLE WASHED STONE-ALL AROUND M-C SAND M-C SAND 110 HERRING RUN DRIVE, CENTERVILLE, MA 2.5Y 6/6 2.5Y 6/6 SIDEWALL AREA: (11.0' + 44.0') x 2 x 1' = 110.0 SF Prepared for: DiBuono Sewer & Drain, 8 Johns Path, S. Yarmouth, MA 02664 BOTTOM AREA: 11.0' x 44.0' = 484.0 SF Engineering by: SCALE DRAWN JOB. NO. 594.0 SF 90•4 138" 90.3 138" Engineering Works, Inc. N.T.S. P.T.M. 126-117/ TOTAL AREA:........................................................... PERC RATE 6 MIN/IN. B' HORIZON est DATE CHECKED SHEET 12 DESIGN FLOW PROVIDED: 0.60 GPD/SF(594.0 SF) = 356.4 GPD NO GROUNDWATER ENCOUNTERED (508) 477 r1d Road, Forestdale, MA 02644 5313 3/ / 2 8 17 P.T.M. 2 of 2