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HomeMy WebLinkAbout0040 JOAN ROAD - Health 40 JOAN RD. ,CENTERVILLE r_A-,=22$ 076 -:- UPC 12534 No. 2� 153LOR HASTIMGS. UN p No. 2 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes 'OPUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYication for Miopozal bpztem Construction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) '/Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel 5cel rr _ nII J/.., /vr, e7l� Installer's Name,Address,and Tel.No. /(� Designer's Name,Address and Tel.No. s6r*Gl*11�v C14)Xs/1- '3Q29 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(✓-7 Other Type of Building 1j G"l11LL No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �l� gallons per day. Calculated daily flow 3 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank l ©D Type of S.A.S. Description of Soil <fjQlt�4�� 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 b this Bo d of ealth. Signed = Date Application Approved by Date �— Application Disapproved for the following reasons Permit No. Date Issued --------- —_J TOWN OF BARNSTABLE LOCATION AID JQ4`I A01 SEWAGE VILLAGE dl ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY L Ii LEACHING FACILITY: (type)1-»A11_64-1 4A (size) NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: 0/7l©© COMPLIANCE DATE: 1 0'0 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 wetla;ids exist within.300 feet of leaching facility) 9 Feet Furnished by i let I i l' 7n^/l Q� 1 No. `"�v Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes 'tJ`B'LIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ZIppYication for Migaar 6p.5tem Construction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) M Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel eo le f/,/Ae Frz,_o4 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. le `/ _ Vf Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(ZI�7 Other Type of Building kef G'd1CL No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow j® gallons. Plan Date Number of sheets Revision Date Title / Size of Septic Tank Type of S.A.S. Description of Soil 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 by this Board of Health. Signed Date Application Approved by Date I-7-7-atrD Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- r, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site ewage Disposal System Constructed( )Repaired(t_�Upgraded( ) Abandoned( )by O/ Ad&Ilytl �lS at 6ID ,,724?W r6-1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Zfw 'Z dated Y—-7 "74" Installer r Designer The issuance of this permit s all not be construed as a guarantee that the syst�. will function as desined.f / o Date Inspector /Y ✓: r `l �9 '`fvf�� - '� '� ' V --------------------------------------- No-?� — ?/4/ '2- U cI271 Fee —+v e THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwtopogal *p5tem Construction Permit Permission is hereby granted to Construct( ) epair Upgrade( )Abandon( ) System located at 14D J04/1 �a 2KY!/i./% and as described in the above Application for Disposal System pp p y Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction mus be yompleted within three years of the date of this&WHt. Dater Approved by �iZt�/ 1/6/99 Y,,OTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) �/ 0o__ L Ak,1-rL7, -'/-� �� 'hereby certify that the application for disposal works construction permit signed by me dated `f! /00 concerning the property located at �!0 fa,' /"Oe �', /��lE' meets all of the following criteria: V/ The failed system is connected to a residential dwelling only. There are no commercial or business �es associated with the dwelling. The it i so s classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the r p proposed septic system There is no increase in flow and/or change in use proposed There are no variances requested or needed. VThe bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor od when applicable] If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) ____, B) G.W. Elevation —LIC+the MAX.High G.W. Adjustment.3.6= c DIFFERENCE BETWEEN A and B 36 , 7 SIGNED : DATE: ` ©� [Sketch proposed plan of system on back]. q:health folder:cent i 140 l I i B Qe1 r oit TOWN OF BARNSTABLE LOCATION 1-le 7 V ral SEWAGE # VILLAGE /,-'eyl ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. + '� t`Jze loe) SEPTIC TANK CAPACITY i 00 & LEACHING FACILITY: (type)-;;L/ IA-i (U (size) Id,A 3,o',c.;2 NO. OF BEDROOMS BUILDER OR OWNER S Y 47/q' PERMITDATE: �7/01 COMPLIANCE DATE: 10 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �t 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 Feet within 300 feet of leaching facility) et Furnished by Anr �qa 33' To 02-06-2000 10:07PM FROM JOE MARTINS TO 7906304 P.02 , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS , DEPARTMENT OF EN =NMMAL PRO'trF MON ' I ONE WINTER STREET,BOSTON%A 02108 (617)2924M TRUDY CO)M AROEO PAUL CMUCCI DAVED Gevemor SVBStJRFAtE SEWAGE t»SPOSAI.SYST011(11SPEGTt01Q FOsilll PART A CaffnW.AT10N Prwaty AAdress: T0�/leq; �/!�/V%yG Nwne of Owner s m �o AW 4 FOA Fib �-, a o0o Addross of owner: � D to of Insp�rctlar: C'pq �✓� Name elk"Oemr:IP+.e.oMian ✓o i°i� M• M 9�r�Vs I.w•DEP syaes,n is Secdon 15.3A0 of Title 5 010 cm 1S.Ow co tap- 11 lfiW. C Gi{ ,rkdIft l: �► ����s �d ot►��6o Tats�Aorra'Slr �tic � r® �- � f STAT18�fT I certify$+dt f!loin personally inspected the sawege disposal system at this address and that the Information reported below is true,aaowrate and complete as of tM time of inspection. The inspection was parformod based on my training and experience in tiro proper f%mlion and maintenance of on-site sewage disposal systems. The system: Passes _ Conddlonally Posses PoubM luation fay the Local Approving Authority �rWe�eIe:The System inspectorof this inspection report to the Approving Authority 411oar4 of llealtl►or OEP)wWn WAY 130)days of completing.tide InSosction. N the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner `shall twit the report to the appropriate regional office of the Oepo ri . af•m*or1n%wUd Protection. The original shoulidie eentteVo system owner.and copies eent to•dw buyer.if applicable,and the approving sudwrity. . NOM AND COMMENTS 1 /c'lA.► ��/e Povpr -�v cPsspaa l .-�p�/Qc�� �y / A SP47cly r OAS., revised 9/2/98 Per Iofit PrintedOn Rttyekd Paper 02-08-2000 10:08PM FROM JOE MARTINS TO 7906304 P.03 $011WRFACE SEWAGE DISPOSAL SYSTM M SP0EC rM FOW PAUT A CdiTNWAVIOM toor6rarsd) Properly AOdraaa: owner: 40 Jon Rd.,CeatcrviUc Os"O.F.btlp COM smah F*MWY s 2000 NIZP'6t:711i)?a:GtiliGAARY: Cheek C, Of D: A. MU111100180: I hbva not found any information which indwotet that any of the Wwe coneltions described in 310 CMR 16.303 andst. Any fairrra criteria not evaluated are Indicated below. ` /'m&vim g - e. SY8T�1`.ComiT10NALLY PASSi;4: One or more system components as described in the'Conditions!Pass"section need to be reptaeW or repaired. The system,upon cornpletion of the replacement or repair,as approved by the Board of Health,win S. Indicate yes,no,or not determined(Y,N,or NO). Describe basis of determine ail instances. If'not determined',explain why n9L The septic tank is metal,Mess the owner or operator ovidad the system inspector with s copy of s CerdPiaaee of r. Compliamce tattealmd)indicating that the tarNk was ad wiftn twenty(20)veers prior to the dW of the booset)on:or whether the septic tank, or not metal.is cracked eturaly unsound,shows substantial(rrtltration or extltntlom,of tstdc failure Is imminent. The system will pass I #flto existing septic tank is replaced with a compllrktg septk tank as approved by the board of Health. Sewage backup or bra or tmigh static water level observed in the distribution box is Are to brokers or obstructed pipets)) or due to s bro ken. ad or uneven distribution box. The system will pass inspection if(with epprova!of the Board of Health). broken pipets)are repiaoed obstruction is removed diisviWAon box is leveled or re0seed . system-required punph mars ihnn iourtimas.s lroardua to broken or obstrootetE piPa(s1 Tltasystam a kmpscton if Iwith approve!of the Board of Health): ' broken pipes)are replaced obstruction is removed revised 9/2/98 PW10(11 02-08-2000 10:08PM FROM JOE MARTINS TO 7906304 P.04 SUBSURFACE SEWAGE WPOSAL SYSTEM NUPWTM OD" PART A CufiRCATM lawn rued) pwporty Aadra a: 40 Jaeo<t M Centerville Owner syrola Daw of wo Avim February 5,2000, C. .q 9/aLUATIWrI N D By THE BOARD OF MEALYK CendM M ar W which taqukb furthrer evduatien by the Board of Health in order to determine if the system is ���� public health.eatery end ire Mvlronment. 1) sy8T9iA VOL PASS tNO,ESs OF o N a00 WIT"310 tMdt is-weNilti4:;MnT THE S�� S Nor affleyoWIG N a f.W rita,Cr TW PUg=tF ALWAND SAFETY AXQ-7W ii aeoppam _ Cesspool or pdW is Votw 60 foul of surface water Cesspool or p►lvy is within 50 feet of a bordering ve9etated w and of a sah ma►st+. 21 Sysum WILL FAIL tM MS iM BOARD OF HMTH UW0 PUBLIC WATER U PPLOL IF AIM DES.TW1t TW STOM W gSiCT101rOiG N A MAC THAT pROIEC>lS ><H6 Pt 8m wALM AND SAFE-ty AnD THE or4mOIA= The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a aurfaoe water suPW OF tributary to a surface water supply a septic tw*and sal sbsorpoon system and the SAS is witWn s Zone I of a public water supply . The system has The system hu a septic tank and soil absorpti n s system tem and the SAS s toss ntt�60 fast feet Pd t fadt or M10ta itch a Tits system has a IV We tank and Soon wst*tho ys prlvaN water supply welt,unless a weN water anelysls for coNform bacteria and volade or�nic cOrrtpOtNrds Md<oatse that the from that faalky and the presence of smmorda nitrogen and nitrsta nhroger►is nod to or hoe weN is free from ponution than 5 per+• Mothad used to determine distance (spomdmatim ttOt sa6d1; 3) OT1494 S S/` f 40% %- 5 Arm-6E t X 2, X X 3. �ti pWytv,r/CQrlC ��'' p0e/ feWal neve,' P a/ rivos t- life all bb h PAOo, P mom- a ei-I oo/ k,r revised 9/2/98 pap3ofll 02-08-2000 10:08PM FROM JOE MARTINS TO 7906304 P.05 SUBSURFACE SEWA"DWWAL SYSTW wSPECTION FORM PART A CERTVWAYM(condrusO 40 doald K CentavUle Owner ]Wiary 5,2000 Date.o4 Mbpeeftu D. sYB :I?Aas: You must hokete either"Yes'or'No' to each of the following: I have determined that one or more of the following fadtae conditions exist as described in 310 CMR 15.303. The basis far Vds determination Is Idendfled below. The Board of Health should be contacted to determine what will be necessary to correct the faduro. Yes No Backup of•sewegs htlo faQiMtr^o►+7ata*ootrtponerrt dasass er evetteaded vr'�gAadSASexasspoal. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or dogged SAS or I cesspool. Static 64rrid level In the distribution box above outlet invert due to an overloaded or dogged SAS or Cesspool. Liquid depth In cesspool is lass than 6"below invert or available volume is less Om 112 day flow. Required pumping more then 4 times in the last year NOT due to Clogged or obstructed pipe(ai. Number of limas pumped—. Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. fr Any pardon of a cesspool or privy is within 100 feet of a Surface water supply or Notary to a sUrfaee water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 60 feet of a private water supply wed. Any potion of a cesspool or privy is less-than 100 feet but greater than 60 feet from a private water supply well with no acceptable water qw ty analysis. If the wed has been analyzed to be acceptable,attach copy of well water enalyels for *cWarm,bacteria,volatile organioeompounds,ammonia nitrogen-and nitrate nitrogen. - IL IAR66'SYSTEfdR FAILS- You must k0aite either'Yes` or"No" to end+of the following: The followktg criteria soy to large systems in addition to the criteds above: The system serves a fee ty with a design low of 10,000 gpd (Low System)end the syetam is a significant throat to puffic health and safety and the environment because one or of the following conditions exist: Yes No _ the system Is wi8ttn 4 t of a surfew t1drdring water supply _ the system 200 too ofbuterl►toa -sapPly• . is located In s nitrogen sensitive arse(Interim Wdthead Protection Area=1WPA)or a mapped Zone II of a public atlr supply wael Tits owner or operator of any tludt syatain shad upgrade the system in accordance with 310 CMR 18.304(2). Please consult the local review ofliss of thr oopartment for hrAlter intordna6on. revised 9/2/98 Pop.&Ofit 02-08-2000 10:09PM FROM JOE MARTINS TO 7906304 P.06 SACS SEWAGE OTSPOSAL:SYSTVA M$PECTION FOAIN PAWS CHECKLIST PMttifeflY Add►e 40 Jam Rd,Centerville oil: $YjB� Fe*uary S,2000 Check if the following have been done:You must indicate tither"Yes'or`No"as to esch of the following: Yes,- No _ Pumping informaton was provided by the owner.oacupaM,or Board of HeaM. . _� . _.: •.Nara Of MaaYatemean�a�antsl�aaabaan Pon�sQ+�l/sast�ro•�reaka��mhes�aa�weeltdp�llgMlbw rates du►ing that period. Large volumes of water"ve not boon introduced into the system recently or as pert of this inspection. /o7#4hi/N41 14sE Do/y As built okra have been obtained and examined. Note if they are not available With NIA. The facility or dwelling was impacted for signs of sewage backup. _ The system does not receive non-sanitary or industrial waste flow. w The site was inspected for signs of breakout. i✓� _ AN system components,excluding the Soil Absorption System,he"been located on the site. The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. The si2a and location of the Sal Absorption System orrthe site has been determined based on: Existing information. for example,Plan at B.O.H. v Determined in the field(if any of the failure criteria related to Part C is at issue.approximation of distance is unacceptable) (I 6,30213M) The 1=111ty owner(and.—apamu.if different froaLawnerLwara.proAded.withio1mandoo.on pow mdat"ameof Subsurface Disposal Systems. revised 9/2/98 Papesor11 02-0872000 10:09PM FROM JOE MARTINS TO 7906304 P.07 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART C 40 J=Rd,Centerville SYSTEM INFORMATION Property Address: Syrgala Owns: Feb[twy S,2000 Dote of hrspeadonk FLOW CONDITIONS REstDF78i1A1• Design ftow::j&_g.p.d.1bedr9om. Z Number of bodroome idesign): Number of bedrooms(actual):_ Total DESIGN Sow 2 2 O Number of current residents:r0 arbsps or G lyes no):NO Laundry(separate system). as or no):J✓�; if yes,separate inspection required Laundry system lnaptfeteWailbble or no) �1 Seasonal use(yes or no) :/�Q� G,RD T Water meter readings,if (last twp year's usage fgpd): .000 avAkj., Sump Pump(yet or nol:_!d Last dsw of oecepaney:�g�ipr� If►gf'j/Ate / CO USTIM: Type of sttslift6vane Design flow: aDd 1 Based on 15.2031 Basis of design flow Grease trap present:tyes or no)_ h+dustdol Waste Molding Tank present:(yes or no) Norr &,Vtwy west@ discharged to the Title am:(yes or no)_ Water motor readings.if available_ Lost date of occupancy: OTH19R,( a) Last date of occupancy: GINMAL INFORMATION i PUMPNO RECORDS and Source of information: sole!p��ee/ �DuAi val //'6"87 System pumped as part of inspection:(yea or no) ` If yes.volume pumped: o gallons ybj)}G Reason for pumping: .PE,--w!�� f k /�SD0AV-A - r tJS�®a/ Ad�^,B TYPE OF SYSI ��" oj�L hodr f' SOPtio twWdistribution baideoil absorption system ss / Singe cesspool—6Z Oversaw casspool Privy Shared system(yes or no) Of yes,attach previous inspection records,if any) UA Technology etc.Attach copy of up to data operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXNATEAGEofallcowdNionts,date igotaNe44111 known)-and source of infatme6on: (lLV QuJ/r --iflo e— 4 Sswrsge odors detected when arriving at the site:(yes or no).&Q revised 9/2/98 Page 6ccIt 02-08-2000 10:10PM FROM JOE MARTINS TO 7906304 P.08 SUM MACE SEWAGE DWOSAL Sy9M§WWTpM FORM PART C SYSTM XFORMAT)ON(ooeSWOM naps4ly,Ati�ss: t>wdw.. 40 Joan Rd,CeNeville OeiDr'11 Smak Fekuuy►S,2000 Itoogtra+altstt�nf ( Depth below grade:�`� vats"of OergtnDtaon: bon_40 PVC^other teen) SQwe testL S Distance hatt.Pt 1 water Yi Wy wed or suction fine Write,vend",evidence of Ina SEPTIC TANK:_ (beano on:dte pleW Depth below tlrede:_ Matet(sl of canst ation:l cont rate metal_-Abargtess _polyethylene_other(explalrn) tf tgnk is r4W,fiat age_ !s_GGe4on&m"&y Cerdfi: of CcffVNunce IX } WttnerOians: Sludge,depth: Ckur ee ftm top'of sludge to bottom of m oet tee mor S.ewn.tiiielaneas: � Distett0�t'brti top of scum to top of outlet baffle: Distance tlom-bottom of scum to butt outlet toe or baffle: NOW oMs were diferntined: Cointttenm: (►econtrrnerndedon for plug.Conditlon of inlet end outlet tees of baffles,depth of liquid navel in retatiort to outlet invert,atwcturaHtntegrky, evidence of 4 ate.t QWAK7RW-_ tfo m OA s1ld.ptan) Oeplh boloiNr;sTaft _ Metom of eonstluetlon:_concrete_t*W_Rberst"s __Polyethylene_oth ) moons• Sgao pnleltrNgs:�,,_ Distet".froth cep of gown to top of outlet to or bef8a: Mum VMM:bs�Cliom of scwtt to bottottt of outlet tee or cow oflas-off4ing: Comments: ( iWpet for punpdng,cottdtlon at end outlet tees or bsfAea.depth of Squid level M relat3on to codet imrstt.struetoral ', evidence of leafage.oft.) CP revised 9/2/98 Ptge7of11 02-08-2000 10:10PM FROM JOE MARTINS TO 7906304 P.09 SUBSURFACE SEWAGE DISPOSAL SYSTEM WPECTWK..POW PARt.Ci , SYSTM 1NFORMAU N kerrBnroQ Ptibyeett!AaArees: :. 40 Joan PA,CentuNiUe (fir- gnu FATuary 5,2000 Twff OR 1mOLom rANK;. (tank must be pumped prior to,or at lima of,Mspecdon) (kmete on site plant De06 below grode:_ Mate"4f tonabve*M:—oenaete M"_fiberglass Po1 exdain) Ca�eity: ga0ons Dodo flow:._..__oaeoneldey Alsarn.prsssat Alann.6W:,,_Alann.in wodit :.Yes^ No_ Oste vi•p wAwis pumpiny: Contmeras: (eondMm of Wet tee, of dorm and float switches,etc.) 10�i3OX: (kcsere on site phi") Depth of ligM levil above outlet invert: Corrnnerns: (note4f level and distribution is eW of solids carryover,evidence of leakage into or out of box,oft.) - PtlMP C (locite'en eltd pNn) Pwltl*in waihq order:(Yap or No)_ Alice:in elthg order iYea or No) OortY"Mne: (none oondidon of pump chwnber,oOtdiGar of pumps and purtenanoes,etc.) revised 9/2/98sorti 02-08-2000 10:10PM FROM JOE MARTINS TO 7906304 P.10 SUBSURFACE SEWAGE VISPOM SYSTEM WSPE M FORM PAllT C SYSTEM MUORMATION(eoMtlrrted) 40 Joao Rd.,Centerville Daft of Urpse6on: S)rga)a February 5,2000 SO)L ABSORPTION SYSTEM{SAS)- Aocete on•skgplen,If possible;excavation not ragwed.location may be approximated by non-intrushve methods) if not located,explain: Type: les"q pits.number._ leeohing.chwnbars,mmber,L__ kachintg gegenies.numbar:� leedd m trenches,nwnber,length: kadft Gelds,number.dimennsions: ovwftw empool,numbw:— Alterna0ve systom: None of Technology- Comments: (note eondlftri of sox,digns of auhac failure,level of ponding.damp soN,condition of vegetation,etc.) ,0011 + OOLB: . lboste on,site plan) 11�� Number wW configuration: 40clC Dep*,4w:of Sgpid to inlet invert: C.T.: L2_ 'B+ 1?FtiV ItSNE.'4: G•Sl Depa of sows layer:Depth of a I " ' • r' '' �'' O of cesspool VIP :JIScwnbyor- --- '` ' ' 9? xS S'' GiA. 6 RAo 7a p lT bo IMa wwo of construction: badkasioa of groundwater: 2t1G.-- hAow, Must be pu npe s of inspecba 6��vg�sl�fv)a a I n Aid— lacy, • ' PoND/N6 .• 7' �fl of.soil,shine of taflum lavel o of,sondhion drregea .e J •N S O4" f f9 L rr �ht�6r �o� a^o�tbo� R•t�S • ST�-tN ��L a' �or►n pry l�e770 >Dorvo,n�6 at! PONY: ttoeaRa an else plan) Msted!lk of ooret wftn: t�rtneroionta Dept)t of SM6. Wit: (now 0.6 Af mt of sob,shins of AydrauUc failure,level of �cm-,dftd0nft -*f vegstesm.atc.) revised 9/2/98 Page 9of12 02-08-2000 10:11PM FROM JOE MARTINS TO 7906304 P.11 • Sl189URFACE SWAGE DISPOSAL SYS M RUMTiOIi FOWA PART C SYSTEM OIFORMATION(eat Prepiclp Ad�fs: Ownw: 40 ion Rd.,caft v N D>rle.tlE�a�ps>:6on: Sy>g k F4ruary S,2006 SKETCH OF.SSIMAOE DI SPOSAL SYSM,- ftWe droll 10 at least.two po mment reference landmarks or bw4hmarks MGM ee wells wlth1n.100'(locate whom public water supply Comes k to house) W rho ' • B.D � 31SE 104 revised 9/2/98 PW10o(tl I 02-08-2000 10:11PM FROM JOE MARTINS TO 7906304 P.12 � n • v SU6St1wACE SEWAGE DISPOSAL SYSTEM NSPWTOW FORM PART C SYSTEM NFORMATDDN Fred! A Wit!Adduees? Orn*: 40 j=Rd.,Ceuwville Detr aR MteAPon Syrgahl Fobrkssny 5,2000 HRCS. Report name Soil Type— Typkd dam to groundwater USGS fists webslts vWW Obsettidtiogi Web c"ked Grsnndweter depth: $Wow Moderate �P SITE EXAM Skrpe Surface water Check caw Shallow won$ * f Estimated Depth to Groundwater_Feet > l z•J Fie4► c*sspao 1 b �k Pease indim%all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed.9ils(Abu"property,observation hole.basemoot sump etc.) Deterniitad Worn local conditions Checked whh local Board of health Checked FEIM.Maps Cfrsdred:puM�pirtB records Chseked local excavators,installers�Used SG.US Daft � ��� WC4er(dA4-ke MAP Desedbe how you established the High Groundwater Elevation. M(.,_o be completed) /• Si� oS .$� � /4• S • L (• j D CAP��'�/G1 nl I3Sj Al 44AQ r f44X V4 vlajo" i v- a bore Alk' sQ� C 70 — 3 7 s revised 9/2/98 Pap 11ofit TOTAL P.12 - i- In - 92-L -0366 oFrti Town of Barnstable Department of Health, Safety, and Environmental Services BAILNSMLZ MUSS �,�� Public Health Division 367 Main Street, Hyannis MA 02601 FAX Date: Number of pages to folio( To: From: ��� 21910 0 Phone: !!,w Phone: 508-862-4644 Fax phone: (-1 �7 —�12.2 —�3S W Fax phone: 508-790-6304 CC: REMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please comment /_ 707 - QzZ — 0356 T' 02-08-2000 10:07PM FROM JOE MARTINS TO 7906304 P.01 S. ygwft,MAVaoW -rQ �4A jog Mefam -- pasm t� /iv C/ c oveti Rey co O t*vw t OW ReMsw O Pk� CenWM* O Pkw"RWV O Pk Retyts .cowmatow Pear- A/r7 ACAWh lot v/16�2� . /tit y q�fi� �s id'oy, 3A � a PP lI C � .�� lvr� ?�-pP Iis� h�� pio /ems arQ on pb ��+o� P «- � y Per- ao