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Home My WebLink About0052 KENNESAW AVENUE - Health L ESAW AVE.,CENTERVILLE 020 1, J p (} 1�w,. No. F VV .X ee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Zigpogal *pgtem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) El Complete System Xdividual Components Location Address or Lot No.&7;L '�/r/L '�� L�' Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Ao*" _ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3y® gallons per day. Calculated daily flow 3�0 gallons. Plan Date �g �—'— Q Number of sheets > Revision Date Title Size of Septic Tank Type of S.A.S. 3 X re� 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 b this Board of Health. Signed Date Application Approved by Date -�s—� 1 Application Disapproved for the following gasons Permit No. 947V — Date Issued 5 k � No. O O .:` a . '.' Fee THE COMMONWEALTH OP MASSACHUSETTS Entered in computer: - Yes PUBLIC HEALTH. DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS application-for Ziq' ozaf &potem Congtrurtion Permit Application for a Permit to Construct ° ~pp ( . )Repair( .)Upgrade( )Abandon( ) Complete System�C�Individual Components Location Address or Lot No. 0, Owner's Name,Address and Tel.No. Assessor's Map/Parcel .2019 C�� S",�•1'Lt�jtyvy�l,sl(d� «��-. 0 �0 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ,r 77 s' 0.7 J� 7 E >> Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other j Type of Building_ -*4?40 r. No.of Persons Showers( ) Cafeteria( ) Other Fixtfres Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets > Revision Date Title Size of Septic Tank -x��'�`i /'o®o Type of S.A.S. / 3 50r.7 3" -Y d.2 Description of Soil -,ry - o c iyrisltt��t.r y/o 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 Board of Health. Signed Date Application Approved by I,.,;t. 2- Date s" Application Disapproved for the following iee,7asons Permit No. 9(709 7- Date Issued (o - --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Complianre THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired�K)UpgradedAbandoned( )by �"- I;t? ./'�`�404' r' at �� a- /'�Cti+�+'�'syJ'.4�' ,�6i� C E'ir.�. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 70 0C/— ! dated (9 Installer oe JrAe%Aid�'+60,00e� Designer .�4�P'�ac7 • /+�"?/eo�'', R::pl The issuance of this permit shall not be construed as a guarantee that the system/will function as designed. Date f l�S f D 1 Inspector �� No. a� bb� �O� _ — ———————— ------Feed /00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE MASSACHUSETTS Zioagar *pgtem Conztruction Permit Permission is hereby granted to Construct( )Repair( Upgrade( )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: 5— O Approved by TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE C �`' ASSESSOR'S MAP&PARCEL—" INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO. OF BEDROOMS 3 OWNER PERMIT DATE: _4 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 bn 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 C.Axv i oer AZ W,e THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA 3z- 4,1 11 sit, V ;c- � e d X '., e. 4i` ,; Ji� 4XI to 0 2 q¢ { T [� t I } �e 1 F i I i E � { T � �� ' ? y e �t�y _ of Town of Barnstable P# ljg-5� troo Departiment of Regulatory Services 44 10 : LUMST"LM : Public Health Division Date �O � i639 �� 200 Main Street,Hyannis MA 02601 prFD MXt� Date Scheduled r7 � ��"Tlme Fee Pd. Soil Suitability Assessment for Sewa a Disposal Performed By: �I I jV t"� Witnessed By: I OCATION& GE RAL INFORMATJQ0N Al , Location Address �/V& �q y� Owner's NameaSq/f� r///JJJ ��W IV Address vvv i I Assessor's Map/Parcel: fh- (J�/ V Engineer's Name D4V f� 97AS0/V NEW CONSTRUCTION REPAIR Telephone# Land Use T1 l Slopes(�Yo) �� S a Surface Stones KI __ Distances from: Open Water Body ft Possible Wet Area_—ft Drinking Water Well ✓ ft Drainage Way / ft Property Line : ( O ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) LAO I [ I 1 Parent material(geologic) ® � CP�T Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater e DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: __ __in. Depth to soil mottles: in. Depth to weeping from side of obs.hole, in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level�— Adj,thetor— Adj.Clrouttdwater Level , PERCOLATION TEST bate�..w e, Time Observation Hole# Time at 9" �7, N Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate MinJlnch 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:\SEPTIMERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole#—[ Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% ravel -(o Go ' $Nil DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con istency,%Grave DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. - Consistency, 1 Flood Insurance Rate Map: Above 500 year flood boundary No_ Y Within 500 year boundary No Yes Within 100 year flood boundary No Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious inatepal exist in all areas observed throughout the area proposed for the soil absorption system) ems If not,what is the depth of na urally occurring pervious material? - Certification I certify that on 9 (date)I have passed the soil evaluator examination approved by the Department of Environ enta Protection and that the above analysis was performed by me consistent with . the required training,exp rtise and ek eri nce described in 310 CMR 15.017. Signatu_T:�7j re Date t€� 114 � Q:1SEPTIC�PERCFORM.DOC r�- S LTROY WILLIAMS �� SEPTIC INSPECTIONS J Certified by MA Department of Environmental Protection T0W" 'A"STAILr �< (5D8) 385-13QQ r�C HEALTH DE?T 19 Hummel Drive South Dennis, MA 9 COMMONWEALTH.OF MASSACHUS - EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON, MA 02108 617.292.5500 y. WILLIAM F.WELD TRUDY COxE Govemor Secretary ARGEO PAUL CELLUCCI DAVIp B.STRUHS Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioncr PART A CERTIFICATION Property Address: 5,2 Address of Owner: —Date of Inspection: 8 425— �9� (If different) S �' L 4-1,cr Name of Inspector: Troy Williams �6 ' Suzy P t c 3 I am a DEP approved tern inspector pursuant to Section 1S.340 of Title S (310 CMR 1S.000) Company Name: Troy .Will iams Septic Inspections 5.2 Mailing Address: _19 HUmmp1 OriVp , South 2p11ni $ MA 02660 Telephone Number: ( s Cc r. +'w✓: I(c /(/10. --�-.5 0 8T3 8 5-13D 0 CERTIFICATION STATEMENT 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 inspection: The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ,Passes _ Conditionally Passes _ Needs Further Evaluation By the local Approving Authority Fails ' • Inspector's Signature: �/1�.+�,r Q.� Date: 8 /;Z /S 8�y The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design now of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, 8, C, or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: /Y 49 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. Indicate yes,no, or not determined(Y,N,or ND). Describe basis of determination in all instances. If'not determined',explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector wiih a copy of a Certifi�e of Compliance(attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. - (r:vi..d 04/71/11) ., ►.a. 1 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 52 Kennesaw Avenue,Centerville, MA Property Address: James P. Luther Owner: August 25, 1998 Date of Inspection: BI SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coli(orm 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. Method used to determine distance (approximation not valid). 3) OTHER SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 52 Kennesaw Avenue,Centerville,MA Owner: James P. Luther Date of Inspection: August 25, 1998 DI SYSTEM FAILS: 111/- You must indicate ei;,.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 112 day flow. 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: /v You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system_ shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 52 Kennesaw Avenue,Centerville, MA Property Address: James P. Luther Owner: August 25, 1998 Date of Inspection: 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, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or / as part of this 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 back-up. ✓/. _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have 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 size and location of the Soil Absorption System on the site has been determined based on: The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of / Sub-Surface Disposal System. V _ Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.301(3)(b)) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 52 Kennesaw Avenue, Centerville,MA Property Address: James P.Luther Owner: August 25, 1998 Date of Inspection: RESIDENTIAL: FLOW CONDITIONS Design flow: 5U 3 g.P.d./bedroom for S.A.S. Number of bedrooms:. 3 Number of current residents: 4 Garbage grinder(yes or no): -/u Laundry connected to system (yes or no):Y13 S Seasonal use (yes or no): NO Water meter readings, if available (last two (1)year usage (gpd): 9 7 - 7 7�600 y G -3 Sump Pump (yes or no): /o Last date of occupancy:-61--i'---N; < d. COMMERCIAUINDUSTRIAL: A/ Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or.no) Non-sanitary waste discharged to the Title S system: (yes or no)— Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Goy l /101-.t 0 4-4h-a-✓ System pumped as part of inspection. (yes or no),,6(p If yes, volume pumped: _gallons Reason for pumping: TYPE 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) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) NO SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Properly Address: 52 Kennesaw Avenue,Centerville,MA Owner: James P.Luther Date of Inspection: August 25, 1998 BUILDING SEWER: k///9 (Locate on site plan) Depth below grade: Material of construction: _cast iron _ 40 PVC _other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:, (locate on site plan) Depth below grade:__�_�r � Material of construction: _concrete _metal _Fiberglass _Polyethylene --Other(explain) If tank is metal, list age _ Is age confirmed,by Certificate of Compliance _(Yes/No) Dimensions: s 'X '7 Sludge depth: 3 '� T Distance from top of sludge to bottom of outlet tee or baffle:_ �r Scum thickness: " Distance from top of scum to top of outlet tee or baffle: C rr Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: f�✓b�, . Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) CoH�. c c� ,, t t.✓ J // ✓C ct ✓ r H R t .L c it h V� f C /vh us c/l ?U 1n S ✓Y Arm C v �C ✓� t�r9 I� ✓ P y ! c�✓ GREASE TRAP:-[14 (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Scum thickness: Distance from`top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Kennesaw Avenue,Centerville,MA Owner: James P.Luther Date of Inspection: August 25, 1998 TIGHT OR HOLDING TANK:A/ (Tank must be pumped prior to, or 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: gallonstday Alarm level: Alarm in working order Yes; No Date of previous pumping: _ Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:, (locate on site plan) Depth of liquid level above outlet invert: L t Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box, etc.) c— A PUMP CHAMBER:_N (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Kennesaw Avenue, Centerville,MA Owner: James P.Luther Date of Inspection: August 25, 1998 / SOIL ABSORPTION SYSTEM (SAS): V (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number. e leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, si ns of hydraulic failure, level of ponding, condition of vegetation, etc.) L� t�a s)— ..,I t✓ . '{Jn c.� �p r S G..�.t- q�- -f'j.�,t v f i c. s a t.. CESSPOOLS: (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials of construction: Depth of solids: Dimensions: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Kennesaw Avenue,Centerville,MA Owner: James P.Luther Date of Inspection: August 25, 1998 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 3(AL�• I nor a.G' S3 a y �- w � 2 'Siah.� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Kennesaw Avenue, Centerville,MA Owner: James P.Luther Date of Inspection: August 25, 1998 Depth to Groundwater _ Feet adjusted high groundwatcr lcvcl Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers / Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) 'I �c i � �., I� S� o .✓c� k o W a.�w �'ou.., ,!� G- ( C, 1 s TROY WILLIAMS RECEIV'rD SEPTIC INSPECTIONS MAY 7 1996 Certified by MA Department of Environmental Protection LaLOFMRNSTABLE (508) 760-1 19 40 Old Bass River Road South Dennis,MA 02660 commonwealth of Massachusetts O Executive Office of Environmental Affairs Department of Environmental Protection WHllam F.Weld Trudy Cox* Go..mor .SscMary Argeo Paul Ceiluccl David B.Struhs U.Gommor Comninioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: Sa t4u e- "�f c✓�• 'Address of Owner. ,4h ti (9 J&� G S 0 e_y Date of Inspeotion: 51&A(. (If different) 1�7 Name of Inapecto�o Company Name,Address bnd Telephone Number. r CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: asses Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature� ' j j� Date: /76 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A B, C,or D: A] SYSTEM PASSES: V 1 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CUR 15.303. Any failure criteria not evaluated are indicated below. B]" SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate ves, no, or not determined (Y, N,or ND). Describe basis of determination in all instances. if"not determined-. explain why not) The septic tank is metal, cracked, structurally unsound. shows substantial infiltration or exfiltretion, or tank failure is inurunent The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (oontinued) Property Address: to q-sa.'j Owner. y Date of Inspection: �`� c-S - B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Al�9 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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 leas than 5 ppm. 3) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Addreax Owner. Date of Inspection: OTC� )^e y �gd D) SYSTEM FAILS: Y/a3 I� /Al//j I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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 1/2 day flow. — Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped — Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. — Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a aignificant threat to public health and safety and the environment because one or more of the following conditions exist: — 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address Sot JC�HkL 5 0.J Owner. pu Date of Inspection: Check if the following have been done: ,Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this 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 back-up. The system does not receive non-sanitary or industrial waste flow _ZThe site was inspected for signs of breakout. ZAll system components, excluding the Soil Absorption System, have been located on the site. ZThe 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 size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. V The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C C SYSTEM INFORMATION Property Address: J o2 Kz."(n a f o.w Owner. O>c,�,�-SH� Date of InspeotIon: u/a�/ 9 _ / 6 RESIDENTIALFLOW CONDITIONS Design 1low:_,jjL_gallons Number of bedrooms: Number of current residents: Garbage grinder(yes or no):,,&LO Laundry connected to system(yes or no):— E 5 Seasonal use(yes or no):_ZVD Water meter readings, if available: Last date of occupancy: dL�c�`p,e COMMERCIAL/INDUSTRIAL• Type of establishment: Design flow:_ganons/day Grease tr8P Present: (yes or no)_ 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: OTHER (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS.and source of information: Sy=em Pumped as part of inspection: (yes or no)l`l If yes,volume pumped: gallons Reason for pumping. TYPE 9F 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) Other(explain) APPR 3UMATE AGE of all components, date installed (if known) and source of information: i 74L//c Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C f/ SYSTEM INFORMATION (continued) Property Address; '5a Owner. U C-�4S Date of Inspeotion: SEPTIC TANK: (locate on site plan) Depth below Ile Material of construction: 1/concrete_metal_FRP—other(explain) ` Dimensions:_ S 41 O o y 5�./ o I S Sludge depth; n? / Distance from top of sludge to bottom of outlet tee or baffle:_02 //,a Scum thicknem:—bOn/r Distance from top of scum to top of outlet tee or baffle:/✓b Distance from bottom of scum to bottom of outlet tee or baffle:Ny Comments: (recommendation for pump'ing, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) _ in w mar c t /r c..s �y / �� '� i 4- LC i.Ju S P? cAa J i N A S ✓Ll Q_ GREASE TRAP: /J (locate on site plan) Depth below grade: Material of construction: _concrete_metal_FRP_other(ezplain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or bane: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 11/o3/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM INFORMATION(continued) Property Address: 5-,�2 Ksz(n his�i-� Owner. Date of Inspection: TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: Material of constriction:_concrete_metal_FRP—other(explain) Dimensions: Capacity: gallons Design flow:_ gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: e.)v� Comments: n (note if level and distribution is equal, evidence of solids over, evidence of lea kage into or out of box, etc.) ✓ cK LJ CA- S PUMP CHAMBER.— HAMBER / 111/9 (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) . Property Address: J o2 KLL+ y�G S w Owner. Date of Inspection: OJ LL 6,5 L-At y SOIL ABSORPTION SYSTEM (SA9):_L/"� (bcate on site plan, if possible;excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: leaching pits, number: O %x_ I Xis / G 4 �- "l /"i w 'l~ r'Y0066'''-e- leaching chambers, number:_ leaching galleries, number- leaching trenches, number,length: leaching fields, number,dimensions: overflow cesspool, number: Comments: (note co dition of soil, signs of hydraulic failure, level of ponding, condition of vegeta 'on,etc.) o; r v✓� a CESSPOOLS: AIM' (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 constriction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:�/w (locate on site plan) Materials of constriction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 11/03/95) g f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (oontlnue(l) Property Address: 6a. . Owner. olu c, .e- ti�y Date of Inspection: �j/a 3 /7- - _ - - - SKETCH OF SEWAGE DISPOSAL SYSTEM—Include ties to at east two permanent references landmarks or benchmarks locate all wells within 100' a6 � 6� oZo o r a i Nr yX6 ��, �,�- DEPTH TO GROUNDWATER `.depth to groundwater. —' feet adjusted high groundwater level method of determination or approximation: r..� cx,> .c.i cif .�o✓ o f- I 9 TOWN OF BARNSTABLE LUCATION T -2 )/Gh�ff s rig -J SEWAGE # VILLAGE Ce-cl ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. S S c. SEPTIC TANK CAPACITY i h D V LEACHING FACILITY: (type) � (size) NO.OF BEDROOMS o BUILDER OR OWNER PERMITDATE: 2 Z 7 Z COMPLIANCE DATE: 17 /S Y Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 leachin facility) Feet Furnished by �� 3 �b oil b Qc 4 e '0Z t TOWN OF BARNSTABLE G .LOCATION jj� C (�ja e w SEWAGE # VILLAGE C��ry`�`�®. ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE NO.SwAV-�U U— -7 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) (,06aL m ' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER LLeonc.,'c) 'De us DATE PERMIT ISSUED: DATE , COMPLIANCE ISSUED: . VARIANCE GRANTED: Yes No c C- r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ter#ifirtt#e of Tantpliaure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ✓) ��p ir.�I at ................. ..--�!�..�'..-C r eI',- -..----- ---------------- ---..-------------------------------------------------------------------- ------ the application for Disposal Works Construction Permit No. ---_.c-/-..��_....__.-_.. dated ----------.._--.--.-..-__.---.-._...I-- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as descrf e in THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... f...e7 .` ....-. ../`. Inspector -- J'--.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... � FEE „ �i ern tt1 World Tonii#rurtion Permit _ Permission is hereby granted------("CAS 5.--C ---- - --------- �......... to Construct^( ) or Repair ( k4 an Individual Se%i" ge Disposal System atNo.------... F—L\,,:v P.. .f�, -?.......A f----•---•--•-:---------- - --------------------------------------------------------- -----------•---•-----•-- Street p1 as shown on the application for Disposal Works Construction Permit No./--�_-��------ Dated-...%�,.-.7::...7.5............... ---•-------------- ....................................................... Board of Health DATE.............------------�.......---.......................................... FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS a�_AC - 0 C) No.. !..r FRS. .0...� AP GVED COnaMefWh0 tent THE COMMONWEALTH OF MASSACHUSETTS 51�/BOARD OF HEALTH .. OWN OF BARNSTABLE Appliratinn for Mij-pinittl Mnrkii Tnnitrnr#inn thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( 0 an Individual Sewage Disposal System at: .. _2e......................... ............................................................. ........................... o(caati i--t\dod ss 'S.C. Lot No.��J....._..Y_V_�..!�1.. �...... -•----------------- •----•-----••---- 'S.C. Q... ... .......... �- Owne Address Installer Ad ,ss UType of Building 1 Size Lot............................Sq. feet �-� Dwelling—No. of Bedrooms-__ ._(___________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity_I .,_NN,..gallons Length--------------- Width---------------- Diameter_------------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length-.-------_.......... Total leaching area....................sq. ft. 3 Seepage Pit No--------__-..-.-.-- Diameter.. ,._ . Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ 4, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 --'----•---------------------------•----•------------•---------•----------------•-------•-•---------......................................................... ODescription of Soil........................................................................................................................................................................ x U ----------•---•---•-----•-•-----------------------------------------------••-•------......------'--------------------------------------------- ......................................................... w x .............................................................. .................................................. --------- --------- --------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable.___.... L�S2.. ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The unde ned further agrees not to place the system in operation until a Certificate of Compliance has been issu he board of health. Signed ...... ........ - ............................................. ... . .......................:... Date Application Approved By ................. J' Yl... °�- 7..�......�/ ............................. .............. / ' Dare Application Disapproved for the following reasons: ................... .............. ......... . ............... ........................ ............................................................................................................... .... .............. ........ .. ...................................................... ....................... Date Permit No. Q -C-- -/, Issued Dare ,»' •�r� �•• � � ... t� \1� - 0 � C� No...!`..!---- Y. Fss. �.��.... f THE COMMONWEALTH OF MASSACHUSETTS /j ,,) -,7 _�/BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uinpuuttl Wurk,i Tunutrttr#inn rantit Application is hereby made for a Permit to Corist uct ( it oyl'Zepair an Individual Sewage Disposal System at: -) ... Locat t -:\ddrss L.. or Lot No. -�... ' ---- 1 1 MP_ .................•-•----......... owne Address � Installer Ad Tess U Type of Building ry Size Lot............................Sq. feet Dwelling— No. of Bedrooms___jr -----------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-.-------------------------- 5liowers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------------- ------ -----------------------------------------------------------•- w Design Flow............................................gallons per. person Per da • Total daily flow - gallons. WSeptic Tank—Liquid capacity _gallons Length_______________ ` l Diameter_: -.---------------- Depth.. I x Disposal Trench—No. .................... Width--.--______-_-. Total Length-------------------- Total leaching area....................sq. ft. 3 Seepage Pit No--------._-.._._.__ Diameter.. .._�O. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by........................ ................................................. Date........................................ Test Pit No. I________________minutes per inch Depth of Test Pit_................. Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------------------------------------------------------------•-----------•--_........................................................--.-. 0 Description of Soil........................................................................................................................................................................ x U ----------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable---------Q,P_ �r.-�Q-_,___ S--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersign d further agrees not to place the system in operation until a Certificate of Compliance has been lissue�ythe board of health. Signed ....; J. ,..... ...... Dace Application Approved BY - -- _?..t_.�._ � _ -- t. j...................................... . J Dare Application Disapproved for the following rea.ronr: ........................ . .. ...... .......... ........... ............. ...................... .. ...................... ...... ............................................................................ . -- ...........-. --------------------------------------- Permit No. ------.�-.�/..----- Issued ------------ Date ASSESSORS MAP : TEST HOLE LOGS PARCEL # NOTES: PfC-� SOIL EVALUATOR FLOOD ZONE: G✓Q� �9 T, �G �i`f P Ca GJi _ ........... .. WITNESS: l t� ° ' X REFERENCE: 1) The installation shall comply with Title V and Town of Barnstable Board of r" �1 ems" ,L TJ2A .. O DATE: PERCOLATION RATE: ,G_ 1 , 1 Health Regulations. T _.dux? l - _ 2) The installer shall verify the location of utilities; sewer inverts and septic )v "A 2 components prior to installation and setting base elevations. p p g TH- 1 TH-2 3) All gravity septic piping to be 4 inch`Sch 40 PVC at 1/8"per foot. The first W _ two feet out of the d-box to the leaching shall be level. to 3 J �, lb t� 1 4) This plan is not to be utilized for property line determination nor any other � purpose other than the proposed system installation. oo'6D 5) All septic components must meet Title V specifications. 32 6) Parking shall not be constructed over H10 septic components. LOCATION MAP 7) The property is bounded by prop erty'comers and property lines. f7 ' f 8) The property owner shall review design considerations to approve of total L design flow and number of bedrooms to be considered for design. Receipt -7 1 l � of payment for the plan and installation based on the plan shall be deemed approval of the design flow b the owner. ( 9 9) The existing leaching or cesspools shall be pumped and filled with material -JA_ �� _ �� per Title V abandonment procedures. Those within the proposed SAS shall } p gyp----- be removed along with contaminated soil and replaced with clean sand per -. _ .., ..._ _ Title V specs. 2 10 System components to be 10 feet.from water line. Sewer lines crossing the . ._. ) Y P g water line shall be sleeved with 6 inch SCH 40 PVC 20' on center with ends x� ' z SEPT I C SYSTEM DES I G N grouted if applicable. The proposed SAS is being installed below the water '_�✓' I service line. The line is to be sleeved as aforementioned and maintained in FLOW 'ESTIMATE place. --- ' 11) If a garbage grinder exists it is to be removed and is the responsibility of the BEDROOMS AT I�n GAL/DAY/BEDROOM ' GAL/DAY owner to ensure such. 12)The installer is to take caution in excavation around the as line. r T S e _ ____ __._._ - - 13 The installer shall verify the location, it° EPT I TANK ) fy quantity and elevation of the sewer lines exiting the dwelling prior to the installation. x GAL . GAL/DAY 2 DAYS USE GALLON SEPTIC TANK S I L,ABSORPTI ON SYSTEM r SIDE AREA: 7e V BOTTOM AREA: z ?S 16 ` �c 0 t ? � tN PTIC SYSTEM SECTION ` U lt +a4v*pmwmroxmw+n_wn.. . oa- 1 zi IZ 9<,j e AL SEPTIC TANK sr ter f ° � L �o �. SITE AND SEWAGE PLAN LOCATION : I VV%i:- Vim.^'' t••r�� fr}( PREPARED FOR : L- o -.w SCALE: =' Z <12 11-5_ - DAV I D B . MASON R,' DATE: DBC ENVIRONMENTAL DESIGNS z YI EAST SANDWICH . MA W DATE HEALTH AGENT SOH) H33- Z 177 Z