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HomeMy WebLinkAbout0110 LAKEVIEW AVENUE - Health 11.6 LAKEVIEW AVE,\. , CENTERVILLI A; 214 043T00 a � i F,�arnstable r Town of Barnstable A�AmerieaCity ." Regulatory 9&v ces Department ' 1 POW Health Division 039 10� 20U7 200 Main Street, Hyannis MA 02601 Thomas F.Geiler,Director Office: 508-862-4644 Thomas A..McKean,CHO FAX: 508-790-6304 02/27/09 Bradford Bond, Trustee n t.J 110 Lakeview Drive Centerville, MA 02632 FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 110 Lakeview Drive was last inspected on 9/15/1998,by Joseph Macomber, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR,15.00) due to the following: "System was in hydraulic failure" The deadline for repair has past. We, The Department of the Board of Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore,you are ordered to repair or replace the septic system within 60 days from the _ date you receive this.notification. You may request a hearing before the Board of Health;a written petition requesting a hearing on the matter; within seven(7) days after the day this order was received.- Failure taxepair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Crocker, Sharon From: Crocker, Sharon Sent: Monday, March 09, 2009 3:07 PM To: Parvin, Lindsay; Malkus, Karen Subject: FW: 110 Lakeview Drive, Centerville - Error on Failed Inspection Report was from Macomber(deceased) . I faxed report to Robert Paolini who used to work for him (now works for Capewide)and he'll see if he can shed any light on it. I'll leave the original report with you, Lindsay. Thanks. -----Original Message----- From: Crocker,Sharon Sent: Monday, March 09, 2009 2:13 PM To: Paryin, Lindsay; Malkus, Karen Subject: 110 Lakeview Drive,Centerville-Error on Failed Mrs. Bond, owner, called and said her septic has not failed. She received a notice for a failed system. I checked the file and apparently the septic inspector put the wrong address on the report. The report dtd 9/15/98 says: 110 Lakeview Ave and has the owner as: the Estate of John B. Whitman. The Bond's have owned their house every since it was built. There is another Lakeview in Centerville. It is Lakeview Dr. However, there is no# 110. I'll see if I can figure out which property the inspection report applies to. 1 o�t'�Tati Town of Barnstable Regulatory Services BAMSTABLE, * Thomas F. Geiler,Director MASS.9. ��� Public Health Division 'OrFn �A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Bradford&Helen Bond, Trustees Date: March 1, 2005 P.O. Box 526 Centerville,Ma. 02632 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. The septic system owned by you located at 110 Lakeview Avenue, Centerville, was inspected on, 9/15/98 by Joseph Macomber, a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: System was in hydraulic failure. Our records show that the system has been in a failed state for more than two years. You are ordered to-hire a,professional engineer or registered sanitarian to prepare a plan of:proposed replacement septic system component(s): This plan is to be submitted to the Town of Barnstable-Public Health Division Office (Regulatory Services, 200 Main Street,Hyannis),within (90) days receipt of this letter. The plan will bring'the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title V. You are a lso o rdered t o u pgrade o r r eplace t he s eptic s ystem w ithin s ix months (180) days o f y our -receipt of this letter. Any person aggrieved by any order issued by the local approval authority may appeal to any c ourt o f competent jurisdiction as provided for by the laws of the Commonwealth. You have the option of requesting an adjudicatory hearing pursuant to 310 CMR 15.422 Failure to comply with this order will automatically result in a public hearing scheduled before the Board of Health. PER ORDER OF T BOARD OF HEALTH Thomas A.McKean,R.S., C.H.O. Agent of the Board of Health CC: Board of Health J:\forml.doc DATE: . 9/.15/98. PR0.PE DRESS: T10 Lakeview Ave ' to 3V,a*g01 h Centerville,Mass. ����T/ — '� r * HcAIZHDFY4 V C� 1' l W 4 02632 J 1 On the above date, I Inspected the septic system at the above address. This system conslsts of the following: 1 . 1 -metal: tank. ' 2 . 1 -leachiing trenck. Based bn my insc�actlon, I certify the following conditions: 3 . This is not a title five septic syst6m!'* 4 . This- system installed- in 1951 with a metal tank. The tank is -rotted badly and is completely full . with scum and solids . Very little water is present. 5 . The system is in failure and must be upgaded to the new title ' five .-septic system. ( 95 Code ) SIGNATURE: G%'( Name : J . P :MJr...omber Ji ' . ---- - ,----- ------- Company:J• P_ — Macogber & Son- 'Inc ; • ' , Address:— Centerville . Masi_02b32 ' ,• Phone:---S08LZ7 .�338------- - 1 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY • (J�IOSEPH P. MACOM'BER & SON, INC. Tsnks4st4pools-Leachffields . Pumpfd & Installed Town Sewer Connoctlons P.O. Box 66' Centerville, MA 02632.0066 77.5-333.8 775-6412 ' 1 ` D 1' COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 r WILLIAM F.WELD TRUDY Cowl Govemor Sccrctar ARGEO PAUL CELLUCCI DAVID B.STRUK Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissionc PART A CERTIFICATION Executor Property Address:110 Lakeview Ave Centerville Address of Owner:Edward Kneale Date of Inspection: 9/1 5/98 Mass. (If different) 617 Main Street Name of Inspector: 10c;e h p Macomber Jr. t-! ville,Mass . I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 C�Ii�TS.000)02655 Company Name: J.P.Macomber & Son Inc. Mailing Address: RQx 66 C:Pnt-Prvi 1 1 ar M,acc —09632 Telephone Number: r,n—77 5_Z 3 Z 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: _ Passes _ Conditionally Passes Zeeds Further Evaluation By the Local Approving Authority Fails c Inspector's Signature: r Date: ��✓ The System InspectoA�allsubmit 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: AI 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: 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 ye , no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. Cg The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate 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 ex-filtration, 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. (revised 04/25/97) Pay 1 of 10 DEP on the World Wide Web: http:/Iwww.magnet.state.ma.us/dep Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 1 0 Lakeview Ave Centerville,Mass. Owner: Estate Of John .13. Whitman Date of Inspection: 9/1 5/89 e) SYSTEM CONDITIONALLY PASSES (continued) A,I*y, 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, senled 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 NO The system required pumping more than four limes 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: rVD Conditions exist which require funher evaluation by the Board of Health In order to determine if the system is failing to protect the public health, safety and the environment. t) 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: Vo Cesspool or privy is within 50 feet of a surface water ,up Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 1) 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: A� The system has a septic tank and soil absorption system (SQ 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 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 eqwl to or less than 5 ppm. Method used to determine distance ��(approximation not valid). J) OTHER 7 �lP�l��C y',¢�� Ly/�1 aD Xv�r /V✓� ram' r4T>✓� ?&go 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropenyAddress: 110 Lakeview Ave Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection:9/1 5/9 8 D) SYSTEM FAILS: You must indicate ei;�.er 'Yes' or 'No" as to each of the following: 1 have determined that the system violates one o morard o(Health should of the betcontacted to determine lure criteria as defined in 310 will be 15.303. ec0�to basis for this determination is identified below. T the failure. Yes . No cku of sewa a int acility or s stem om onent 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. ,V�_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. _,V,4A)� Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. m in more t 4 times in the last year NOT due to clogged or obstructed pipets). Required pu P g 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 SO feel 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: 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 ,(JNo the system is within 400 feet of a surface drinking water supply _ Ld 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) rehquiremen s o p14 CMP 5.00ua ds6.00. Please(consult thet local regionlalYoffice f oflthe Departmentt forh feu rtherrin oartmation.t nt program (r•vl••d 04/35/17) ➢•q• ] o! 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Properly Address: 110 Lakeview Ave. Centerville,Mass . Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/98 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 _ 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,4alkluding 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. 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) (15.302(3)(b)) (revla.d 04/:5/77) a.y. 4 of 10 Rt L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1 1 O Lakeview Ave' Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/9 8 , FLOW CONDITIONS RESIDENTIAL: Design flow: g.p. Jbedroom for S.A.S. Number of bedrooms: Number of current residents: 6 Garbage grinder (yes or no): ,f l� Laundry connected to syst (yes or no):- Seasonal use (yes or no): Water meter readings, if available (last two (2) year usage (gpd): & Sump Pump (yes or no): 4)6 7-eC 41NV56 `r /2�5, i,V e- �.vyew/:� Last date of occupancy:u _ COMMERCIAUINDUSTRIAL• Type of establishment: Design flow: 11,41 gallons/day Grease trap present: (yes or no)" Industrial Waste Holding P Y Tank resent: (yes or no) Non-sanitary waste discharged to the Title 5 system: (yes or no)-&W Water meter readings, if available: AM Last date of occupancy::Z? OTHER: (Describe) �7 Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and sours;of igforrnation: tin 2— �4.r1,4) System pumped as pan of inspection: (yes or no)AZ If yes, volume pumped: allons Reason for pumping: TYPE Of SYSTEM Septic tanW�imibufien-�eec/soil absorption system _AA,�i Single cesspool 4_ 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 Aa/it APPROXIMATE AGE of all components, date installed (if known) and source of information: -!!v7 Sewage odors detected when arriving at the site: (yes or no) (rvvls*d 04/25/97) Y&y• 5 of 10 i D64+ BARNSTABLE COUNTY DEPARTMENT OF HEALTH & THE ENVIRONMENT of Bea P.O. BOX 427 h 'sa SUPERIOR COURT HOUSE BARNSTABLE, MASSACHUSETTS 02630 J `'ASS PHONE: 362-2511_ EXT. 337 SAMPLING INSTRUCTIONS FOR PRIVATE WELLS An improperly taken sample wastes your money and has neither scientific accuracy nor legal acceptance. I. Obtain sterile sampling bottle from the County Lab or Town Health Department. Bottles sterilized at home are not acceptable. 2. It is recommended to use a straight faucet, preferably NOT swingtype. 3. Turn on the cold water and let it run for five (5) minutes. 4. Fill the bottle leaving one inch airs ace. Do not fill bottle to the p top. Be careful not to touch the inside of the bottle or cap with the faucet, your hands, or anything else. 5. Fill out the reverse side of this form. The laboratory requires accurate and complete information. The person filling the bottle must sign the form 6. The charge for a routine well analysis (coliform bacteria, pH, conductivity, iron, nitrate, sodium and copper) is S25.00. Checks should be made payable to Barnstable County. Exact change is required if paying in cash. Additional tests require additional fees. Consult lab or a price list for exact information. 7. Samples are accepted Monday - Thursday from 8:00 AM to 4:00 PM and Friday 8:00 AM to 1:00 PM. They must be delivered to the lab within 6 hours of collection or 24 hours if refrigerated. 8. Completion of tests and results takes 7-10 business days. Results will be sent in the mail. 9. Special requests such as results in 2 -3 days and sample acceptance on Friday from 1:00 PM to 4:00 PM are available for an additional charge. Contact the laboratory for availability. NOTICE: WATER FROM THE SAME SOURCE CAN PRODUCE CONTRARY RESULTS IF TESTED AT DIFFERENT TIMES AND/OR DIFFERENT LOCATIONS THE COUNTY OF BARNSTABLE SHALL NOT BE LIABLE FOR DAMAGES RESULTING FROM THE RELIANCE ON RESULTS OF WATER TESTS ACCURATELY PERFORMED PLEASE COMPLETE REVERSE SIDE OF FORM PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT 362-2511 X 337 DRINKING WATER ANALYSIS LABORATORY SHEET Name Sampling Date: Time: Mailing Address: Sample location: (Street or Box) (Street) (Town or City) (State) (Zip) (Town) Telephone: Year House was Built: Bottle Identification Number: Well Depth Feet (Taken from Bottle) Reason for testing (Check one): ❑ suspect a problem ❑ required by DEQE ❑ for information only ❑ new well 0 real estate transaction' Z_other: _ Note': Some banks and mortgage companies may require additional testing which costs more and requires more water. Check with Lab before bringing in the sample. Distance of supply from possible contamination sources (check all that apply): -4- septic tank / cesspool _ feet ❑ farm feet ❑ salted highway feet ❑ buried fuel tank feet ❑ land fill - feet ❑ other feet Treatment used: ❑ none Cl water softener ❑ filter SIGNATURE OF SAMPLE COLLECTOR Cl Well Driller ❑ Owner ❑ Realtor ❑ Tenant ❑ Other ---------------------------------------------------------------------- - FOR LAB USE ONLY - i .-Total 41iform / 100 ml PH Conductivity (micromhos / cm) Iron (ppm) Nitrate- Nitrogen (ppm) Sodium (ppm) Copper (ppm) � 1 SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 0 Lakeview Ave Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/9 8 BUDDING SEWER: (Locate on site plan) Depth below grader Material of construction• /cast iron _40 PVC _other (explain) �IJ Distance from private water supply well or suction line 14'7" Diameter i_�_ Comments: (condition of joints, venting, evidence of leakage, etc.) Join The system is VPnt-PH f-hrniicl;h+—hQ 1;nuse Dent SEPTIC TANK: 1&r7qLk -AAA (locate on site plan) Depth below grade:, Material of construction: _concrete metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age MIs age confirmed by Certificate of Compliance (Yes/No) XGLar Dimensions:-6 C! Sludge depth:_7(�" f� Distance from top�f$J�ge to bonom of outlet tee or baHle: Scum thickness: �1J� Distance from top of scum to top of outlet tee or baffle: 0rVJ' 4f-p— Distance from bonom of scum to bonoln of outlet tee pr baffler_ How dimensions were determined: ,0 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.) Tank should be Damned and rP=1 ar•'zd with a 1509 gallon tank When the system is tlpgrarled Tees arm r�aeted•Tan +-np hag many 7rotted holes ;The tank is net strttrt-nral 1j;, _cound. Must sae omitted and rPnlar-PH GREASE TRAP: 2WQ- (locate-on site plan) Depth below grader Material of construction, concreteVdmetal4!&iberglass J//APolyethyleneAgother(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:-Ay- 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.) Grease trap is not present. tr•visod 04/35/97) ?.go 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:11 O Lakeview Ave Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/98 TIGHT OR HOLDING TANK:f?bd(Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade:N14 Material of consuvaion:�concreteN metal/1If�FiberglassA,4PolyethyleneA4other(explain) AM AM Dimensions: AA Capacity: gallons Design flo�E gallons/day Alarm level: Alarm inn working otderAVA Yes4A No Date of previous pumping: Alh Comments: (condition of inlet tee, condition of alarm and float switches, etc.) Tight or holding tanks are not present. DISTRIBUTION BOX:AbW (locate on site plan) Depth or liquid level above outlet inven:� Comments: (note if level and distribution is equal, evidence of solids carryove(, evidence of leakage into or,out of box, etc.) Distribution box is not nrpsent _ PUMP CHAMBER:_V6-V'- (locate on site plan) Pumps in working order: (Yes or No) 11 Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) Pump chamber is not present. (z•vi••C 0//71/f7) ?.go 7 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 110 Lakeview Ave Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/98 SOIL ABSORPTION SYSTEM (SAS): (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: leaching chambers, number:' leaching galleries, number: leaching trenches, number,length: _ leaching fields, number, dim sions: overflow cesspool, number: Alternative system: Name of Technology: 1 Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Loamy sand to medium sand System Jr- J R hy, _ t_• , CESSPOOLS: A)",U12 (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 pan of inspection) Cesspools are not p spnt Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Cesspools are not prespnt _ PRIVY: �pN� (locate on site plan) Materials of constr i n: ALA Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privy is not =rPGant, treviaod 04/25/37) Yay• 8 of 10 gob L V SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION jconlinvtd) PropcnY Address: 11 9 Lakeview Ave . Centerville,Mass. Owner: Estate Of John B. WhitmaN 041e ol.lntpcclion: SKEICN Of SEWAGE DISPOSAL SYSTEM: inclvdc tics to It least two permanent references landmarks or benchmarks - - --- pP-Y_ Iot�Ti 171 wb11s wiiFin T150 (Locatewheie ublic water su_ l - --- T "IN C^ i r.. r lr...s,.a os/�s/ttl i.y. a of so f SUBSURFACE SEWAGE DISPG:--*-L SYSTEM INSPECTION FORM P..r.l' C SYSTEM INFOR'.', .PION (continued) Property Address: 11 O Lakeview Ave Centerville,Mass. Owner: Estate Of John B. Whitman Date of Inspection: 9/1 5/9 8 7 Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record —4Enervation of Site (/� uning propeDobservation hole, basemcN'sump etc.) _j,f-1D'etermine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records heck local excavators, installers Use USGS Data Describe in your own words how you established the High Grounck�/,rcrElevation. Must be completed) Used Gahrety & Miller Model 12/16/94 a.y,. 7.00r 10 I - .rt 1 it T..-.t l.•.t•:•„t-.,,rTmr•P,.....-n+,,.+T.,:.,.t.,P'.T...T.T...,.Yf..,..tT.7..,..-.l.,a,t.,. .T,.-fT,r-,.—,-:,..,.,-...` �T TOWN OF Barnstable BOARD OF HEALTH SUIISURFACR SFWACE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION `^ �•••T!•1�T•'.".:t—T./t7.^.TlT11t7•.f1'II.'T1ri TIT/CT7R�RiT.T.S'IT'1tRTtifIRICrT�f/T1lAf/R1�f11♦Rf1Tr7 ..� .tT.111RyTT1}rTn-rgT.TR.•.T I`tl�'T'�1t�. . .-TYPE OR PRINT CLEARLY PROPERTY INSPECTED + STREET ADDRESS 110 Lakeview Ave Centerville,Mass . ' ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Estate Of John B. Whitman PART D - CERTIFICATION r NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber. & Sor!<•tnc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Torn or City State LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT R I certify that I have personally inspected the sewage disposaj system at this address and that the information reported is true , accurate , and complete 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 «hick I have conducted has not found any information which indicates that the system fails to adequately protect public health or t)le environment as defined in 310 CMR 15 . 303 , Any failure riteria not evaluated are as stated in the FAILURE CRITERIA section of his form . System FAILED* The inspection wllicll I have con tcted 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 . "r Inspector Signature Date l� One copy of this ce f i c a t i o n must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or"h 'Perator shall u he within one year of the date of the inspection, unless alloweddortrequiredaYatem otherwise as provided in 3.10 CMR 16 . 305 . partd .doc W Z7 v� b THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE S SYSTEM INSPECTOR as provided in 310 CNIR 15 .340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. lone X. 19v5 ncimp. Dircctc,r Of Uic I) i lull ut water !'ullutiun Cuniro, �E d n , DATE: . 9/15/98• PRO�PE � � , DRESS:_T10 Lakeview Ave n D10Fsosgml h.• Centerville,Mass. STD - ' 02632 ,� z aa:j.� � ..lct�i4* .'sa"" z,r'),. +'S r ;•.'i" si, s On the above date, I Inspected the "ptic sy r k ,� aF� This system consists of the following: " p � ,' , . . g: �4t 1 . 1 -metal' tank. M�4Z0� y w , "ay=e•, µ -`A 2 . ' 1 -leaching trenck. Oh Based bn my Insc�a {'ctlon, I certify the followW- {�''�` �°�y u e�r-� ° .. �' s, �L'� 3 . This is not a title five septic systbm,-- 4 . This- system installed- in 1951 with a metal g The tank is -rotted badly and is completely � ' with scum and solids . Very little water isbzt �_g 5 • The system is in "failure and must be title ' P Y'fivese tic system. 95 Code (: ) � 4.'Fx � r -eg • SIGNATUR"'• Name J P Macomber Jr. Company:_J•P_Macomber & Son 'Inc • , Address:_ _66______�___�-- __Cente�rvilLeLMas��._Q2b32 ' f. THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P, MACOMBER & SON, INC. Tanks-C*upools-Laachflelds Pump*d 1, Instilled Town Sewer Connections P.O. Box 66' Centerville, MA 02632.0066 77.5-3338 776-6412 I AsBuilt Page 1 of 1 C) ��'� �� TOWN OF BA'RNSTABLE LOCATION Ila lafi y,mew Atre. SEWAGE # r VILLAGE �thft�-'tr;/�� ASSESSOR'S MAP & LOTi�/Y�'{ )/� INSTALLER'S NAME & PHONE NO. 0 d SEPTIC TANK CAPACITY l e 4r/. LEACHING FACILITY:(cype) �/flw (size)Ia r)e NO. OF BEDROOMS PRIVATE WE L OR PUBLIC WATER AVP 11 r -BUILDER OR OWNE /,'ll.4nl B�!✓I DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: i VARIANCE GRANTED: Yes No i 1 I �36 � ' �► http://issgl2/intranet/propdata/prebuilt.aspx?mappar=214045T00&seq=1 2/27/2009 0 ( b0gj-- TOWN OF BARNSTABLE LOCATION �/� �.�``P��Nt� ��� SEWAGE # eV VILLAGE 6 rnfiel-V"'11C ASSESSOR'S MAP & LOT 2fj1--0Y5 / d INSTALLER'S NAME & PHONE NO.- To Ito SEPTIC TANK CAPACITY LEACHING FACILITY:(type)�/�l�w ,�;�{yf O 'f (size) ja��Ilk / NO. OF BEDROOMS q PRIVATE WEL OR PUBLIC WATER BUILDER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: r' 2�--- VARIANCE GRANTED: Yes No" IN o< / t Xyl� �G �'rv✓ec4i fiv A � �r7► r NOP±! 4100jo zj� PA4,tA 010�f THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Appliration for Uiopooal Workii Tonstrnr#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ✓5an Individual Sewage Disposal System at: e�Ii 1.3e�e✓sT �....................................................... --Location-Address or Lot No. ... L/�! ....--- �. '.-/® rI.......... , MM�c� M--•-----• AEcPJ J.. ............................. ..... Owner Address W Installer Address Type Hof Building Size Lot.1 :7i4 S:!�Sgmh Dwelling—No. of Bedrooms... Attic-(—�) Garbage Grinder (No) Other—T e of Building ......^................ No. of persons -........_.___. Showers — — a Other—Type g p ---- � ( ) Cafeteria Other fixtures ----===-------------------------•--------------.-....------ W Design Flow_..__��_�r................................gallons per person per day. Total daily flow....�1��.�..._..._.........._.._......gallons. R� Septic Tank—Liquid'capacityd%?P..gallons Length.%td...... Width..y'.eo'�_- Diameter.__......... Depth S'*7`:._.. W x Disposal Trench—No.__57.rR-___ Width...%Z............. Total Length.....Y . Total leaching area.....6 7..--sq. ft. Seepage Pit No._-— Diameter...:777n........ Depth below inlet_._..-'.......... Total leaching area..................sq. ft. Z Other Distribution box (Z ) Dosing tank (—) Percolation Test Results Performed by_.��Z7 A�& LL........................... ... Date--f-Z2--�­/--------------------. a� Test Pit No. 1.....;?�........minutes per inch Depth of Test Pit.....`K`......... Depth to ground water_.__(4`•.6_.....__. L=, Test Pit No. 2............minutes per inch Depth of Test Pit.................... Depth to ground water_______-_.-_--_--------. a •---•-•-----•-------••---•------------------------••------------ ------•-••-••--........... Description of Soil..a.-. � 7?2eZ,6 l��-�o/� -•------------------ T� T 1� .Z� ................................ ---••---•-----------•.................. v ..............:.....•------•------3� � 1.N._F/�!?. :---!.�EY___SQ4Nd_.: fFl!u , _ _�a�. .---- . _-ls'._M �./ �r9 � .. or✓ /BAN®_w/xt�l�`: v / St_ 7z�!cll�S:............. UNature of Repairs or Alterations—Answer when applicable..X/_--P r47,-_C__.4�.:SSA ?4A .ke7-1-Z A................... ----------------------------•----------------------•-------•---•--•---------------...................... !................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL Mj 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the board of 1 lth. Signed--••--. ...._. L.: ............................ --------•-----------------•- Application Approved B ....... .. _ - � .A Date Application Disapproved for the following reasons-------------------------------------- -•---------------•---••----------------------.....----•---------------•------------------------•- -- ------u---•-•----•--- Permit No....... -------------- Issued_......//_'±�.� :. ---- A Date OL NoP THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... �6 �.-----....OF...... Appliration for Disposal Works Tontrudion thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( --fan Individual Sewage Disposal System at: Cv o7 v 4", ...-•--•----•--------•...........................................•--•..........._.------ .........•---..................................................................................... Location-Address 4,17 - a.._.... ::.........-••--•-•-............................................. W Owner Address Installer Address _ Q Type of Building Size Lot_.�_ . G £ : -� �-, Dwelling—No. of Bedrooms._... ..................................Expansion Attic (—) Garbage Grinder ( �) aOther—Type of Building -_-___................. No. of persons......___-__-_.............. Showers () — Cafeteria () Q Other fixtures .._77=: W Design Flow.....: 5..............................gallons per person per day. Total daily flow__--- /0 ..._..-.................gallons. WSeptic Tank—Liquid capacity/�Q�?_.gallons Length._ 6 ... Width--'Z_Z12.__ Diameter................ Depth.:5.'Z....... x Disposal Trench—No. ._��. D_.. Width..-1_-Z.`....... Total Length__...`1.-9.1....... Total leaching area___•_n_3_r....sq. ft. Seepage Pit No..................... Diameter................... Depth below inlet.._............. Total leaching area.... .........sq. ft. z Other Distribution box (Z) Dosing tank ( ) '-' Percolation Test Results Performed by_._;�?0 Mt! 9M..... r 0 ` / ..a . ..--•-----•--------•-•-•----_. Dat......................................... Test Pit No. 1___-- ....__.minutes per inch Depth of Test Pit...._-�........... Depth to ground water....f.l_✓_........ Lrr Test Pit No. 2....._.. ......minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------•••---.....--------•------ O Description of Soil---n >'_..... fit/ ------••-----....---•--..TEST..._�7 z7 x ._7' a ----•-----•---........................................ U --•---••-•••---•------------------ ..................... /e��IF_�.._�'f•,�}' 5.�1..i1...-...... s=/i►iE,S t�U��3GF5 W -•--------------------------------......................................../5 ' . ,P.. ...�.e..c✓�/_ ..I"re, �,rf�inL .r....... ..S�U +✓! '= ----------- UNature of Repairs or Alterations—Answer when applicable._/ Lo T/Al A _ ------•-•---------------•---------------•----------------------------------•----------•--------•---------TOTE E---'z---= 1'S.T• ............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI T TLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b iss ;db,,y the board of ealth. Signed-•--•• ••-•-- ` --Application Approved B - -------- -•---......-•--. ---• ---• ...................... Date Application Disapproved for the following reasons:------••-------------•---------•--------------------•----------------------------•---------••--•------....__.._ ----•---------•-----•---------•--•-•----•-------------------------------------------------------------------•-----...-----------••--------•-•------......------...---------------•-----••------••....--- Permit No..- 9 -" - Issued---•-- l • Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ !�G•/.'!J..........O F...T--/i�;2IVS,T�`}- L ............................... �rrtif irtttr of Tompliattrr THIS IS TO CERTIFY Th t e Individual Sewage Disposal System constructed ( ) or Repaired ( ✓�" by--------------------------------- == ':.... .. u -�_.._.....-----•................. ------•---••-•-.......---•--•---------•-•-•-•-•-•.....------•-•---............---•-----..._..._ Installer at.-----f/U..�_i Ilr U/!=G� t/F... •PR �rs5:Tr1Lii4: ---•--------•--------------- has been installed in accordance with the provisions of TIT / 5 of T to Sanitary Co y as es ib aid• the application for Disposal Works Construction Permit No.__.. 1_`� _ ........ dated___.. !_:"'_ -----------7......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTIONS ISFACTORY. DATE.....y74....�_!-.- "��'' � A-5 ......-•---•--. ---------------------•...---- Inspector- ._.-• ------ -------..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,.., TU'l�f/�✓.........OF...... J/C✓'11-$7,`? NO...................... FEE................... Dispas al Works T.Wnstration Urrmit Permission is hereby granted..................... A..........}3-------•_"----� ----------------------•------...----•-............•--.................•....... to Construct ( ) or Repair ( rj an Individual Sewage Disposal System at No../CR--GGU/ •(� itv TSfJ��Ls ------------•-- ...... — Street Q �Rt as shown on the application for Disposal Works Construction Permit ! _...... ed.. ...... ............................ Board of Health DATE............-�....'� ,( It FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i s�rcET 2 of 2 PLAN •_VIEW FL0W CHAMBER 8,o„ _ " � "fLOWOIffUSOR; `AMERATION CHAMBER OR EOUAL Nor ro SCALE I II I I it ji I i ��.�•• •� BREAKOUT FOR ADDI TONAL FLOW /F REQUIRED �*'/ • I T it —� -- --�- — A I = ==- =i r-= I-�"Ir= _ 21 INSPECtION COVER• DETAIL I— — — JL•� ——I— — — — I 410" __ A NOrE- I. 5000 PSI CONC ® 28 DAYS ILIL _ __ `-`�' 2. DESIGN LOADING 600 PSF AASNO H-20 L - - - - -- _ - 3. WEIGHT 2400 LBS. RE/NF. RIB 28 %q" SLOTS®24"% SEC rION A A SECTION 88 ;;-GAL L lFT/NG NOOKS MALE KEY v* FEMALE KEY MALE CONNECTION. ® ® KNOCKOUT FOR TRENCH FEMALE ® INSTALLATION CONNECTION KNOCKOUT FOR BED EARTH BAC(FIL L-2"4 rO4" INSTALLATION WASHED PEASTONE FREE 31" _ __._ OF IRONS, FINES AND 19"CLEAR 4'T DUST IN PLACE. 2 I I5y2" JY4"TO I%2"WASHED CRUSHED o h61 _2„ p FLOWL/NE p a STONE FREE OF IRONS, 4,0„ F/PLACED OUST /N -i- TO BE INSTALLED ON STABLE BASE T/VE WIDTH .MIN "'/0•5�/9�r � EFFEC llL_6ROUNO WATER—`----L- rYPI CA L PROFILE CoN�,,s�,ff,G'01/,Eie`�oTMo,E� TH,a�! /2„ i 5y s-o•o 5.�t/FxcD� 4„pvG �s«f• • �.:� 'o HN4o FLOW 41�. '''• OWEL L/NG L/S 1 TEE t Li'�/ N p C C7 G A °t sro. PRECAST CONC. 5 r0 PRECA s r maFL ow c���fl' y3•S IV ys 5 :_.GAL. SEPTIC TAN TYPE OF INSTALLATION O ti 1f AAT� 8„ NO. UN/TS REG F� sEPric TANK rO BE INSTALLED ON De5v,� 5-rCA1-IE7•`D ON LEVEL, STABLE BASE • SOIL -AND PERC. DATA TEST PIT NO. .1 TEST PIT NO. 2 # . F78z7 �L.98.o 0 P E R C. RATE O .---�y Dr-MIN. /IN pr.)q 3, SU,(35o/t ySo Na TEST BY ; �Gc�T'� %✓/��s/ G , _ FINE MGM GRE y s • i tn/�F/Nd$ {C o8I3L�5 WITNESSED BY JJOrYN SANv,,✓/��NEs,��� o ' /y • �s Toms TEST PIT GR. EL. DATE: �9 / GENERA L S NOTES DES/GN DA A BEDROOMS y " NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. No.y� SEPTIC TANK. AND FLOW DISPOSAL CHAMBERS TO BE STANDARD PRECAST •, o GPD REINFORCED CONCRETE UNITS. :.• EST. TOTAL DAILY EFFL..`L�. ' -GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SEPTIC TANK ��O° GAL• TO REVISED TITLE' 5 OF THE STATE ENVIRONMENTAL CODE , SIDEWALL AREA�O' GAL•/SQ•FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BO TTOM AREA . GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY I , 1977. ANY CHANGES TO THIS PLAN MUST BE APPROVED. BY THE BOAR OF HEALTH. { ,.. , • • .�sAT COMPLETION OF CONSTRUCTION; PRIOR TO BACKFILLING, . HE 00rT 0.�5)�(!Y9.o�X(/3.0� `` I BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES , I/ ' / FT. UNLESS INDICATED OTHERWISE. '-_'c/777v��as..1.,,._ . . VAL 5EWA GE Dl SPOSA L SYS rEM , GF 6 yc FOR' D 77 R Zvi t//,�I.�J 3417 c ONAILL SCALE AS INDICATED DALE WM. M. WARWICK 8 ASSOC. , l NC. BOX 80/ 'NOM' FALMOUTH MASS. 02556 - (5og) 563 -2638 i ZONE: - " MAP: R 2I4 0,15 TOO - - FLOOD ZONE: Panel No. _ JOnO l n _) C a�—A yF �, l TL PLAN REFERENCE. �h. l ' R P 2. BENCHMARK: 1) ����� PON LAKE WE;LPi.I.E: SEP TIC O LOCUS MAP Scale: 1"=2000" PROPOSED (5) PRECAST FLOW DIFUSSORS H-ZC W/ 4' OF STONE AROUND. 80.00, 70.00' C.B. fn d 87.65' C.B. fnd C.B. fn d , 93. 17 _ C.B. fnd WA Y � C.B. fnd 107' !i FLAG C C.B. fnd n I n/ �-} L V V ' WEL L ,t 1 O ' W 10 C.B. fnd 70.00 1 o K`) o ._ 87.6 " £B fnd _ r — AREA RESER VE I \ I G FLAG 0\ . 100 EXP _ _ J \ I EXIS HOSE T g0P 25.�' F/ LAC I AbeEXISTING v \ / r, 70 BE \ \ - - H FLAG , - - REMOVEp Q WEQUA QUE T PARKING \ . . . � FLAG G ✓ENT C TA11K FLAG F 0 . � STAIRS" 24.0 �o C, 1 SEP r/C PROPOSED. \ `0_ O s 4 SEDI? � FLAGGED TOP OF \BANK STONES ,o U i \ n 1� DWEL / e . / // � LNG •\ \ \ FLAG E \ vo • % » STAIRS 1 �� LAKE `< 2 \ j 1 \ \ o .o / A a' o \ \ 1 — -- 100 \ \ \ 1 I \ \ ' � ST ONE RET. WALL 1 I \ \ ( \ \ FL GC � �\ � I I 8.0 2f.0' N •�' \ � \ � I \ \ 1 I I \ •• 1 � I I EX/STING 1 I I D1i'ELLING ?c J I I FL' E s 060,30' I � I< I ' 1 �. _ . \ \ I II � FLAG B b \ I v SEP 77C I o \ WELL I I 1 \ 1 I \ I PLAN NOTES &• CONDITIONS ` - 18.2' CIO EXISTING GARAGE TO BE REMOVED. DWELLING TO BE DEMOLISHED — — — — — — — — — — — — — — — — — — 1 i EXISTING 15 e. I I I / I o r� AND REPLACED WI 7H A (4) BEDROOM DWELLING AT SAME LOCATION " — — t — — — — - / WITH A SMALLER FOOTPRINT _ — — I DRIVE 1 I 7 ' I / 25Y v EXISTING CESSPOOLS TO BE PUMPED DRY, WASHED, AND FILLED — — — — — — — — — — -t- — -' — -- — — — — _ _ 11 / // 5 WITH CLEAN SAND. CESSPOOLS TO BE REPLACED WITH A TITLE V i / ( I SEPTIC SYSTEM THAT COMPLIES WITH BARNSTABLE BOARD OF � 7J.2.�� HEAL TH REGULA 77ONS GOVERNING SYSTEMS WITHIN 250 OF WETLANDS AND 14' TO GROUNDWATER. I h I I � WELL SITE & SEWER PLAN PLAN REVISIONS FOR PLAN G5L W/LI/Ally! BOND 1 8129191 WORKSHEET L 2 /l 8�9/ SI TE1SEVVcR PLAN DHM � , 110 LAKEVIEW AVE. 3417 •S M 11/li �r » �� .T I V►� .� �o •���- 6,r/• CEN TER V1LLE BAR T NS ABLE, MASS. NO. DATE DESCRIPTION BY - Scale: 1 "=20' Date: 8129191 Uf s i .... .. WI�,LIAIvS GRAPHIC SCALEWA w;� 1 Wm. M. Worwick & Assoc. Inc. DRAWN BY.• GSL DATE.• 8129191 20 0 �o za so so No. 19771 l "eoNO" z ; .. °j^ �F�� N�° 213 Old Main Road Box 801 ssr s1t DWG NAME. • CHECKED BY.• DRAWING NO.: , North Falmouth, Mass 02556 ( � � ) WELL • �i�Ci'�`''''� j DISC NO.: BOND i }lscn m zo ft. ,® 508 563 — 7777 ✓0B NO.: 1 SHEET OF I i