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HomeMy WebLinkAbout0039 HORNBEAM LANE - Health � I Hornbeam Lane Centerville F/R A = 206 070 p t Ovirford, NO. 1521/3 ORA �;., 10% TOWN OF BARNSTABLE LOCATION SEWAGE # OD " VILLAGE Ced��'�dill , ASSESSO't'S MAP & LOT 206 070 INSTALLER'S NAME&PHONE NO., SEPTIC TANK CAPACITY ®d "' ®®e2' vley LEACHING FACILITY: (type) 07'Sao (size) Z fX A� NO. OF BEDROOMS .3 / BUILDER OR OWNER OOG //f PERMITDATE: '2-a'U 2, 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 F shed by o a TOWN OF BARNSTABLE � LOCATION II Z i SEWAGE # OD — it VILLAGE 2`� ASSESSOR'S MAP & LOT 206 071 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY DD 4OD G LEACHING FACILITY: (type) NO. OF BEDROOMS .3 BUILDER OR OWNER . L 114RT 1U04G✓�-�iJri PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) •.. Feet Furnished by J O 1 a � + �6,19 No. ��'� ( ! Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIPPYication for 33i9pool Opftem Con,truction Permit Application for a Permit to Construct( )Repair(y, Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Loca on Address or Lot No. '=j9 {2 g c in/� Owner's Name,Address and Tel. V_ Vl7 G Assessor'sMap/Parcel 'QQ� -TO(. � Q r,b 5ULL\v� t:--IliG tV EC-2\4 C. tV-7C Installer's Name,Address,and Tel.No. Desog�ner's Name Address and Tel.No. 5'$� 3 � •f'C�2�u���vi4►.a PE OsrE2�� c tr �'L/� 626�5 Type of Building: L"tt,sp tizY A K• �'-o`�-� G,� 'fib Fb C le C.0A fl Dwelling No.of Bedrooms 00 Lot Size sq.ft. Garbage Grinder okj Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 31y0 gallons per day. Calculated daily flow 3 33 gallons. Plan Date J 0 tv E ZZ 2CQ 1 Number of sheets R vision Date 14 o�3 C Title i T�1�t,�tvU ?Q_0qC-iFZ �aEPTILL�C� E'ie 39 hX 1j6A van t.A,_FyC Size of Septic Tank Type of S.A.S. Description of Soil ® `3 �� - 1 L .. 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 system in operation until a Certifi- cate of Compliance has been issued s Board ealth. Q Al 7, Signed �^r' Date Application Approved y Date Application Disapproved for the following reasons Permit No. oa l l rLe Date Issued l �. h" v► ti ' a€ , i No..� 1/Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS .- ZippYication for Migpogaf 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair(K)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 39 HU{2 N C3AJv� Owner's Name,Address and Tel.No. 6-r vkc27 `�uooVY2%rub Assessor's Map/P4cel '2..C>( -TO `c/D 5 U L C.\ AunOV G iV�G L..J+-��lV F—C--2 "7 1?P1CCFUZ `LNO &TM7e_v1 C.C.L Installer's Name,Address,and Tel.No._. DeVner's Name Address and Tel.No. `5t*-x 47- - 3?! l4� "" OSrEZV� �.LL tM/� 026'SS Type of Building: ��o�u�rz.Y K�2tt�,./1 �o��J c 1„ It> �E le.t=..}�b�/E Dwelling No.of Bedrooms 0N�- Lot Size Z ` ` sq.ft. Garbage Grinder(y i Other Type of'Btiilding No.of Persons Showers(, ) Cafeteria( ) Other Fixtures !`t / � GDesign Flow 33� gallons per day..Calculated daily flow 3�3 gallons. ;,���Plan Date �U�C Z8 2.bC� 1 Number of'sheets �.,. ,RQvision Date 1�l or.� �. ' Title � i�€.i��wy �2G�C�� w�`E' 'tc_l�P��.��. 3J T4�e►..k�E�,van L,�tv�, sSize of Septic Tank r�f� � Type of S.A.S. Description of Soil; U "3 v/1. Nature of Repairs or Alterations(Answer when applicable) ' Date last inspected: Agreement: F 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 Certifl- Cate of Compliance has been issued is Board o ealth. 9Q © Z , SignedV �' Date Application Approved y / Date l Application Disapproved for the following reasons L Permit No. zoal--,6 l _0 Date Issued ---------------------------=*'�--------- — THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned at 7—�' i�UK N�'i E��ti ►ill: C G:t,A has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Perrg dc' � � dated 7- 1 Install Designer Th issuance of thi permit s not be construed as a guarantee that the sys will nction as d`e7gned. D to l o D Inspector ail. A i f ------------------------------------ No. Fee-6z- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogar �bpgtem Congtructton ermit M- Permission is hereby granteA t�z o Construct( )Repair( )Upgrade�+ )Abandon( ) System located at 39 TYkA K-D C.. and as described in the above Application for Disposal"System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru on must be completed within three years of the date of this Dermit., _ Date: b Approved by .......... DATE:_ 12/11 /00__ PROPERTY ADDRESS: 39 Hornbeam Lane_______ --�SaLex-vA.U..e.,Mass------- — 412632•----------------- On the above data, I Inspected the septlo system at the above address. This system conslsts of the following; 1 . 1 -1 -1000 gallon septic tank. . 2. 1 -Distribution box. 3 . 3-Flow Diffussors. eased on my Inspectlon, 1 certify the following conditions: 4 . This is a title five septic system. ( 78 Code 5 . The flow diffussors are dry at this time. They are also 6 ' below grade. 6 . The main house and cottage go into the septic tank. 7 . See page # 10A SIGNATURE: —.�C:Jcif! . Name :_,Ca. ksssmktr-­,�______ Company;�ca�,ph_P ;, Nacomb�r_b Son , Inc . Address ;_ Box_66__ Centerville Ha__02632-0066 THIS CERTIFICATION ODES NOT CONSTITUTE A CIVARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC- Tanks-Coll pools•Lotchfliids Pumped L Instsll#d Town Sower Connootlons P.O. Box 6775.3338 s.oryll1 A 02632-0066 RECEIVED D E C Z 12000 TOWN ALTH DEPT.BLE -\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION r TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:39 Hornbeam Lane Centerville,Mass. 02632 Owner's Name: John Conathan Owner's Address: Same as above Date of Inspection: 1 1 00 Name of Inspector: (please print) Joseph P.Macomber Jr. Company Name: J.P.Macomber & Son Inc. Mailing Address: Box 66 Centervillp,magg 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that 1 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 Needs Further Evaluation by the Local Approving Authority Fai Inspector's Signature?mit Date: l�ll`� The system inspector shallopy 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. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page 1 1, Pace , of I I OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 39 Horbeam Lane Centerville,Mass. 02632 Owner: John Conathan Date of Inspection: 1 2/1 1 /00 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: A,1 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: A)D 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. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined" please explain. _Lj_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 ai ur f I e 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. ND explain: AL D 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 obstruction is removed distribution box is leveled or replaced ND explain: - 410 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 obstruction is removed ND explain: 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (coffdrswd) P,.ryAdra1s39 Hornbeam Lane Centerville,Mass. Owner: John Conathan oa- of I"'°"t : 1 2/1 1 /0 0 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: AM Conc tion3 exist which require further evaluation by the Board of Health In order to dotsrmino If the system Is taAing to protect the public health, safety and the environment. 1 J SYSTEM WUl PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CUR 16.303(1 Kb)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WH1C4tWUI.PRQTECT THE PUBLIC 8EALTVLAND SAFETY A11D THE E)C%W6kMEWT Cesspool or privy Is within 60 feet of surface water -yJya Cesspool or privy Is within 60 lest of a bordering vegetated wetland or a sell marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPKIER,IF ANY)DETlElUADlES THAT THE SYSTEW IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFIET'Y AND THE EINWONMEWT: A5 The system has a septic tank and soil absorption system (SKIS) and the SAS Is within 100 foot of a surface water supply or tributary to a surface water supply. The system has a septic tank and toll absorption system and the SAS Is within a Zone I of a pubUc water supply weU. JcY Y Private water w Y weU. The system has a septic tank and soli absorption system end the SAS Is within 60 test of e p DW The system has a septic tank and soil absorption system and the SAS Is less then 100 feet but 60 feet�idmr«id1•c t om an�at tl�e private water supply well, unless a well water analysis for collform bacteria and volatile organic compour wall Is free horn pollutlon from that facility and the presence of smmonls nitrogen and must• Nvogen Is 9W&) to a less than 5 ppm. Method used to determine dlstsnce �� (approximation not v4d).• JI OTHER revised 9/2/98 Page 3ofII i Page 4 of I 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 39 Hornbeam Lane Centerville,Mass. 02632 Owner: John Conathan Date of Inspection: 1 2/1 1 /0 0 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No 2Backup 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 � w ,044air4.At C fry -7 g'dl s?aae, _ Liquid depth in cesspe, is less than 6"below invert or available volume is less than ''A day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped_Q. 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. y.portion of a cesspool or privy is within a Zone I of a public well. y 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma _i(YesfNo)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• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes now 1 the system is within 400 feet of a surface drinking water supply -,K 4e system is within 200 feet of a tributary to a surface drinking water supply _ _Zthe system is located in a nitrogen sensitive area(interim Wellhead Protection Area- IWPA)or a mapped Zone lI 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. 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ' CHECKLIST Prop,*MAddrass: 39 Hornbeam Lane Centerville,Mass. Ownw: John Conathan Deu of V4pection:12/11 /00 Check If the following have been done; You must indicate either'Yes' or 'No' as to each of the following; Yes No/ Pumping Information was provided by the owner, occupant, of Board of Health. None of the systamcompoaartts harsa:baart puss►p4d4opacJaut two•xv"ks&A44 ravyst4m haabwowcslaoq.1wor AC rates during that period. Large volumes of water have not been Introduced Into the system recently or as pan of wa Inspection. _ As built plans have been obtained and examined. Note If they are not available with N/A. _ The facility or dwelling was Inspected for signs of sewage backup, _ Y The system does not receive non sanitary or Industrial waste flow. _ The she was Inspected for signs of breakout. _ All system components,•i Iuding the Soil Absorption System, have been located on the Nte. _ The septic tank manholes were uncovered, opened, and the Interior of the septic tank was Inspected for condition of bam or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The site and location of the Soil Absorption System orrthe site has been determined based on:- _ Existing Information. For example, Plan at B.O.H. f _ Determined In the field(11 any of the failure criteria related to Part C Is at Issue, approximation of distance is unacceptaWr 116.102(31lb)l �. _ 'The facility ownu dlttaraot from.ownor).w wa p;a%1Idad.%vUh t^fnrp3,•fomon rh-lUn •r msip? -.;f SubSurface Disposal Systems, revised 9/2/98 hilt 5of11 i~ Page 6 of 1 I + 'S OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:39 Hornbeam Lane Centerville,Mass 02632 Owner: John Conathan Date of Inspection: 1 2/1 1 /00 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): p DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x# of bedrooms): 9�z/tv Number of current residents: Does residence have a garbage grinder(yes or no): $ Is laundry on a separate sewage system (yes o no : AI (if yes separate inspection required] Laundry system inspected(Yes or no): t Seasonal use: (yes or no): Water meter readings, if available(last 2 years usage(gpd)): /sr Q'� /��Uf`� �'7�� i aA� Sump pump(yes or no): Last date of occupancy: / -/-p' COMM ERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): 4W gpd Basis of design flow(seats/persons/sgft,etc Grease trap present(yes or no): ,IZq Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no):' Water meter readings, if available: Last date of occupancy/use: AM OTHER(describe): A,14 GENERAL INFORMATION Pumping Records �II Source of information: IL%�n�e r4Vrt/,L,q�j�° Was system pumped as part of the inspection(yes or no): d2 If yes, volume pumped: 0 gallons-- How was quantity pumped determined? Aing Reason for pumping: A14 TYPE OF SYSTEM _tAeptic 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) Tight tank A119 Attach a copy of the DEP approval ti'0 Other(describe): Approximate age of all components date in talled (if knQQ,wn)an source of informatio Were sewage odors detected when arriving at the site(yes or no):Ap 6 i SUBSURFACE SEWAGE DISPOSAL'SYSTEM wsps TION FORM .� PART C SYSTEJ64 INFORMAMN (condr%md) Propw-tyAddreas:39 Hornbeam Lane Centerville,Mass. pvrnw: John Conathan Deu of a"°"tl ! 2/1 1 /0 0 BUILDING SEINER: (locals on she plan) Depth below grade:_ � Material of construction: cant Iron ✓40 PVC, JAther(explain) I Distance homLlp,/ivete water supply well or suction line�_ Diameter� ^„ jomrnents: (condition of)olnu, vending, evidence of tv"s *,etc.) oints a ear tight. s S07M TANK: (locate on she plan) Depth below grade- Material of construction: oncrete, metalNCtFlbergla*sNd Polyethylene L\1oth9r(9xpl&ln) If tank Is fnetal, Ilst age Js.age.confVm9d by Certlflcate of Compliance (Yes/No) Dimensions: `� -6r,ln�ciG ��6'�1�1/VA ��7�`��' Sludge depth: -. Distance from top of �Iu�dpge to bottom of outlet tee orbeMr, Scum Wckness: Distance tram top of scum to top of outlet tee or baffle:zrwd'—�' Distance tram bottom of scum to bottom of outlet tee r b+Me: C1 Mow dimensions were determined: dr - Comments: (recommendation for pumping, condition of inlet and outlet tee$ or•baMes, depth of liquid level In relation to outlet invert, atructurer w+tegrity. evidence of leakage, etc.) C6ei �ispo out( out e n 6 e an no evidence of leakage. OREJ►SE TRAP: (iocsts on site plan) Depth below grade:, Material of constructlon:l! concreteVAmetaVi&lbergl+sa�✓�Polyethylene/J(Bother(explaln) Dimensions: ',;>1 Scum%Nckno&s: AIR Distance from top of scum to top of outlet tee or baMs:A) . Distance tram bottom of scum to bottom of outlet tee cr,baMe:All", Date of last pumping: Comments: epr", (recommendation for pumping, condition of Inlet and outlet tee* or baffles, depth of liquid level In relation to outlet Invert, *tnrcturd Int evidence of leakage, etc.) rease tran revised 9/2/98 Pegs 7ofIt i, —a SV93VRFACE SEWAOE DUPIOSAL SYSTEM WSPECTION FOFUA PART C .' SYSTOA WFORmAT10N (c«+tirxmod) Progw y Adata.a:3 9 Hornbeam Lane Centerville,Mass. Owrw: John Conathan Dieu of W%pocton` 1 2/1 1 /0 0 nOKT OR MOLDWO TANKjeJ2�R(Tsnk must be pumped prior to, or at time of, Inspection) (1"814 on alto plan) Oopth below gr►de: .V'4 Moleriu of consvucUon:a/+ concrete U�meta) berpl►sePdyethyi►ne,�¢othertezpl►In) Olmenslom: .UPI Cspeclry: .tlJ4' 94110ni si im Ilow g►Ilons/doy Al Alarm present AWm ItrN: Mum In working order:Yee Noa/J} Oats of prsviovs pvmpinp: A.V9_ Comments: tcondrdon of Wet tee, condition of slum end float switches, etc.) 'I'lizOlt OT holding tanks ara not prPcnnt DISTRISVTION SOX:, uocsit on slit planl Ospin of liQvid level above ovtltt Invert: A-b Commonts: (nae it loyal and dlstribvtlon Is tgvN, svfdsnoe of solids curyover, r-Adsnot of lsskoge Into or out of boa, etc.) a' c+-ri bj,t}Q;; hR"hac nncz l ai-oral �nTQQ=,4 c]Q sye 6f, gRj i6fj6 PUMP CMWBER:dlitw llocatt on site pion) Pvmps In working order:(Yes or No).&d Alarms In working order(Yes of Commtnu: (note con(gUon of pvmp chamber, condlUon of pvmpo and appurtenances, etc.) revised 9/2/98 n�ei°rl1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � PART C SYSTEM INFORMATION (con*%jed) P,opartyAddress: 39 Hornbeam Lane Centerville,Mass. Owner: John Conathan Dau of h,p.ction: 1 2/1 1 /0 0 Sou. ABSORPTION SYSTE1d(SAS);_/ (locate on •It/plan, If possible: excavation not required,location may be approximated by nonanvuslve methods) If not located, explain: Type: leaching pits, number: leaching chambers, number: leaching galleries, number:_a leaching trenches, number, length: leaching fields, number, dim en ons:_ overflow cesspool,number: Alternative system: /�✓��� Name of Technology: Comments: (note condition of loll, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) ry at time ot inspec ion Tegetatio is normal CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to Inlst Invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: Inflow (cesspool must be pumped as part of Inspection) SsS-z n n l c are n n__n},r-pgoselat Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of-vegetatlon, etc.) tlocste on site plan) Materials of construction: IlJJ9 DimenWons: /y" Depth of solld&:.j2 , Commenu: (note condition of loll, signs of hydraulic failure, level of ponding, condition of vegetation;etc.) Privy revised 9/2/98 Pset9ori) Page 10 of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:39 Horbeam Lane Centerville,Mass. 02632 Owner: John Conathan Date of Inspection: 12/11 /00 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. Ja v 10 ASSESSOR' S MAP NO. Z-0 6 PARCEL a? �/irl I �=v� LOCATIO/N/ SEWAGE PERMIT NO. 70 VILLAGE INSTA LLER'S NAME & ADDRESS J. CRAIG MEDEIRG.S -50"S'., HYANNIS, NIA 02601 Rt OWNER Z::,E-D� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Sy sfi�� 2-`1 i SUBSURFACE SEWAGE Dl3P93AL SYSTEM WSPECTION FORM PART C , SY3TEM WFORMAMN fcondnuedl I rogwyAcidto": 39 Hornbeam Lane Centerville,Mass. Ownw: John Conathan Deu of k+wctw: 1 2/1 1 /0 0 NRCS Report name Soil Type_ Typical depth to groundwater USOS Date webalte visited Obssrvstlon Wells checked Oroundweter depth: Shallow Moderate Deep _ SITE EXAM Slope Surface waist Check Cellar Shallow wells J Estimated Depth to Groundwater Feet /lease I dicste all the methods used to determine High Groundwater Elevation: 7'Zelned from Design Plans on record bserved $lte (Abutting property bservatlon hole, beaemeot sump etc,) V Determined from local condltlons Checked with local Board of health Chocked FEMA Maps —zCh ked pumping records Chocked local excavators, Installers Used USOS Data Describe how you established the High Groundwater Elevation. (Mva be completed) Used; Water contours Map. Gahrety & Millaer Model revised 9/2/98 neel) br►1 rr.�n•ra—•rr trnrlrn•nmrsr'nr.arrrrr.m:•.Tr+ermr:•rnrsrmn rsa�v+•ra•ef•.sr.p-+ TOWN OF Barnstable WARD OF IIEALTII + SOBSURFACF SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION I •.•r••••T••••.'.a �.11 ^.�T TT1.1•R.T►ITR.T.TRPRT.T\'.—m�' Wrn-77PR1��•7••T'PA.•Olf fA90TItfT�IR7 /tT II I•!'T'T• .�..A -TYPE OR PRINT CI.EARLY- PI?OPERTY INSPECTED STREET ADDRESS 39 Hornbeam Lane Centerville Mass. ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME John Conattan PART D - CERTIFICATION I NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & So Inc COMPANY ADDRESS Box 66 centerville,Mass. 02632 Street Town or City State LIP COMPANY TELEPHONE ( 508 ) 775_ 3338 FAX ( 508 ) 790 - 1578 ■T , CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate ) and omplete as of the time of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , ,Check, one : • System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or LhF environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have cony acted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . I Inspector Signature Date Ynecopy of this c t,ification must be provided to the OWNER, the BUYER re applicable ) and the BOARD OF HEALZ'iI. * If the inspection FAILED, the owner or"'operator shall u within one year of the date of the inspection , unless allowed dortrequiredm otherwise as provided in 310 CMR 15 . 305 . partd . doc 4 I/2'�Galy Pipe 24"0Opening Above For M.H. NOTES p Frame aCover. Float Support I. Water Supply For This Lot is Municipal Water 2.Location of Utilities Shown on This Plan Are Approx. >r At Least 72 Hours Prior to Any Excavation For This q. • 1 '' Project The Contractor Shall Make The Re wired ik Pump Power a Float Control To D-Box Notification to DIG SAFE-1-888"344-�233. 1' Cables Installed in Accordance - � - 3.The Contractor is Required to Secure Appropriate With.Local Bldg.8 Elec.Codes. ( Permits From Town Agencies For Construction Defined by This Plan. v z 4 Install Risers as Required to Within 12"of Finished 1 4'0 From.Septic precast Pump Grode. Tank.Sch.40 PVC • Chamber 6-0 5.All Structures Buried Four Feet(4)or More or d a Subject to Vehicular to be H-20 Loading. rel °„•;a, �.;:•;o° 6.Septic System to be Installed in Accordance With 310 CMR 15.00 Latest Revision And The Town of Barnstable Board of Health Regulations. PLAN 7 All Piping tobe Sch.40 PVC. 4..0 Sch.40 PVC Finished From Septic Tank Grade DESIGN DATA .�.�� re, '+'aisys w- Minimum Flow Design Ig 4�t ;;p oe ;+, No Garbage Grinder t,, D Daily Flow:330 gpd. Conduit Thru Chamber Golv. SepticTank330 gpdx200%=660gpd. For Power 81 Float BoxChainUse a 1500 Gollon Se Uc Tank. VoEol►g3 GulOQe ii Cables. �Cover LEACHING AREAAlarm 177 Sch.40 PVC 330 gpd/0.74 c 446.s.f.Required Puml.11.p on ll.27 Mercury Float odedPipe Sidewall'.2(121+25')2=148 s.f. Switchs-3Req'd Bottom Area, 12x 25'=300 s.f. 448 sf.Total Provided. PumpoftE1.10.27 k Valve LEACHING CHAMBER DESIGN Securo Pipeof Top 8Bottom of Chamber— All Pipes to be Schedule 40 PVC.Use 2 BottomE1.9.27 I Washed -500 Gollon Leaching Chambers in a tone Min. 12'x 25'Washed Stone Field as Shown. SECTION PUMP CHAMBER DETAIL 20.4 20.0 F.G.24.0. Not to Scale Top El.21.0 ---- �:`: Sot EL 18.0 F.G.16.0 20.2_ 0 Bottom Test Hole El.13.8 t:14:.0 No Ground Wate 1500 Gallon Pump 13.8 Septic Tank Chamber Bedding as Per Title 5 DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM Not to Scale �rina Oad - Fil OF�Ai Fa a•`ie omoawe nu ' PETER ge 9 t� w TO 1-5 01 1_ !'rc�' aaSg//J��,LL111AN s? Leaching • 6. N0.29 w� xi CAamOer �I mo: 3 E 13RN• CO ARgE SANG CIVIL , 10 Y R 5/3 I I yEL1S1-1 [3RtV COARSE SgNp A-^""'��^'`•` w/Coo CROSS SECTION OF CHAMBER „ a C3> ES I o Y R Silo MOT TO eeAL[ C J LT• YL'LISFI 13RN, GOAR51= 122 SAND 10 YR L/`f N O GROUND WATER 0-uw 2-I, 7-00% suLLl�/AN'ENGINCLRING 1tV C, SHEET 2 of 2 CONATHAN CENTERVILLE,MASS. SULLIVAN ENGINEERING INC. OSTERVILLE,MASS. JUNE 28,2001 s o � _y 3\1 C. S,• o - k . A Public Landin4� �i� M LOCUS PLAN Scale: I"= 30' 5 25 Map 206 Parcel 070 w x 14 pN�-�y��n'���0 EX , pGN P�pE g�E ISTOPTIC SYSTEI 1987 �b3o. Ey��SA;t�a���' Roots ° cc�sT. y <3co / o 0 tw 61_LI 1 N Cr / N STAL` X II ST. 1'4N A, '1SpQ LCgC,{ T \ K�P4MP �^4L. g� CH�MQER p�'I� 0 PETER L NOTE: Exist.Garbage Grinder to be , SULLIVAIl Removed. talo.2g733 CIVIL rsT���` ��`✓�9lSi(=DOE MOF- o QA nr • K SITE PLAN Proposed Septic System Upgrade O P P Y Pg EaG�� 39 Hornbeam Lane Centerville, Mass. A rs N For:John Conathan Scale:As Noted DATE:J U N E 28,2001 \\, Sullivan Engineering Inc. �F PLAN VIE W Osterville Mass. Scale: 1"= 30'