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HomeMy WebLinkAbout0048 LARCH LANE - Health 48 Larch Lane Centerville yli -489—006— 013 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important:When filling out forms A. General Information � on the computer, Lo use only the tab 1. Inspector: key to move your cursor-do not John Webby ®d u c) use the return Name of Inspector key. Belac Shores LLC. � Company Name 199 RT. 28 Company Address West Harwich MA 02671 City/Town State Zip Code 508-432-1313 S12987 Telephone Number License Number B. Certification F I certify that I have personally inspected the sewage disposal system at this address and th�t:t�e information reported below is true, accurate and complete as of the time of the inspe ion. Tfis inspection was performed based on my training and experience in the proper function and mai enanc€W on site sewage disposal systems. I am a DEP approved system inspector pursuant to ction li5 40 of Title 5(310 CMR 15.000).The system: N3co 5 +.; ;- ® Passes ❑ Conditionally Passes ❑ Fair iZT ❑ Needs Further Evaluation by the Local Approving Authority 12/19/07 ;Inor's Signature Date ystem inspector s submit a copy of this inspection report to the Approving Authority(Board alth or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.12107 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system compone s as described in the"Conditional Pass"section need to be replaced or repaired. The syste upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, , ND) in the ❑ fo he following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 y rs of or the septic tank(whether metal or not) is structurally unsound, exhibits substantia in ration or exfiitration or tank failure is imminent. System will pass inspection if the existin ank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass in ection if it structurally sound, not leaking and if a Certificate of Compliance indicating that tank is less t n 20 years old is available. ND Explain: ❑ /nspection sewage backup or break out or high static water level in the distribution box due structed pipe(s)or due to a broken, settled r uneven distribution box. System will if(with approval of Board of Health): pipe(s)are replaced ❑ obstruction is removed t5insp•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 '. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping mo than 4 times a year du to broken or obstructed pipe(s). The system will pass inspection if(with proval of the Board Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by Board f Health: ❑ Conditions exist which require furth evaluation the Board of Health in order to determine if the system is failing to protect pub' health, safety r the environment. 1. System will pass unless B rd of Health dete Ines in accordance with 310 CMR 15.303(1)(b)that the system " not functioning in manner which will protect public health, safety and the environmen . ❑ Cesspool or privy s within 50 feet of a surface ter ❑ Cesspool or p y is within 50 feet of a bordering v etated wetland or a salt marsh 2. System will fai unless the Board of Health(and Publi Water Supplier,if any) determines that a system is functioning in a manner th protects the public health, safety and ironment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5insp•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distan **This system passes if the well wat\aalysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the premmonia nitrogen lid nitrate nitrogen is equal to or less than 5 ppm, provided that no otriteria are trigge d.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All S tems: You must indicate"Yes"or"No"to eac of the folio ing for all inspections: Yes No ❑ ❑ Backup of sewa into facility or syst component due to overloaded or clogged SAS o cesspool ❑ ❑ Discharge or onding of effluent to the rface of the ground or surface waters due to an ov rloaded or clogged SAS or esspool ❑ ❑ Static liqui level in the distribution box a ve outlet invert due to an overloaded or clogge SAS or cesspool ❑ ❑ Liquid d pth in cesspool is less than 6" below invert or available volume is less than '/ ay flow ❑ ❑ Requi ed pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. t5insp-12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 - c I '. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M '( Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ❑ Any portion of cesspool or privy is within a Zone 1 of a public well. ❑ ❑ Any portion of a esspool or privy is within 50 feet of a private water supply well. ❑ ❑ Any portion of a ce spool or privy is less th 100 feet but greater than 50 feet from a private wate upply well with no a eptable water quality analysis. [This system passes if th well water analy s,performed at a DEP certified laboratory,for fecal oliform bacteri indicates absent and the presence of ammonia nitrogen nd nitrate n' ogen is equal to or less than 5 ppm, provided that no other ailure c ' ria are triggered.A copy of the analysis and chain of custody m st be a ched to this form.] ❑ ❑ The system is a cesspools rvi a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑ The system fails. I have de mined that one or more of the above failure criteria exist as described i 3 0 CMR 15.303, therefore the system fails. The system owner should co act t Board of Health to determine what will be necessary to correct th failure. E) Large Systems: To be considered a la a system th system must serve a facility with a design flow of 10,000 gpd to 15,000 g . For large systems, you must indicate ither"yes"or"no"to ach of the following, in addition to the questions in Section D. Yes No ❑ ❑ the syst is within 400 feet of a surface inking water supply ❑ ❑ the s stem is within 200 feet of a tributary to surface drinking water supply ❑ ❑ th system is located in a nitrogen sensitive area (Interim Wellhead Protection ea—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp•12f07 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t5irsp•1207 Title 5 Official Inspection Fomr.Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): 69,000(2005) 40,000(2004 Sump pump? ❑ Yes ® No Last date of occupancy: currentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15. 3): Gallons per day(gpd) Basis of design flow(seats/persons/sq. . etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Titl 5 syste ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): t5irsp•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed(if known)and source of information: 21 years Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s••`'r Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: 30' feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) 1000 gal concrete tank in good working conditions, all components secured and working properly. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 8'-3"x5'-5"x5'-7" Sludge depth: lot Distance from top of sludge to bottom of outlet tee or baffle 3.6" 211 Scum thickness Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? measured t5insp•1207 Title 5 Official Inspection Fonn:Subwrfaos Sewage Disposal System•Page 9 of 15 '. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At this time no pumping is required. All inlet and outlet tees are allowing all liquids to flow properly. Grease Trap(locate on site plan Depth below grade: feet Material of construction: El concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee b e Distance from bottom of scum to bottom of o tlet tee r baffle Date of last pumping: Date Comments(on pumping recommendatio s, inlet and outl t tee or baffle condition, structural integrity, liquid levels as related to outlet invert, idence of leakage etc.): Tight or Holding Tank(tank mu t be pumped at time of inspecti )(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): t5insp•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip C e Date of Inspection D. System Information (co ) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: ate Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ® No Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert Liquid level is even with outlet invert. Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): No carry over, liquid is level, as is d-box. Pump Chamber(locate on site p n): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5insp•12/07 Title 5 'al Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner owner's Name information is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: 6 ft pit located and cover removed to check pit, no liquids seen, some staining on walls at 2 'from bottom, everything is in good working order.. Note"*bushes and small trees growing above pit that should be removed so roots do not grow into pit Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): As stated: small trees and bushes should be removed and no evidence of any ponding or hydraulic failure. t5insp•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 '. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property Address 48 Larch Lane Owner owner's Name information is Centerville MA 02632 12/19/07 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools(cesspool must a pumped as part of inspection) (locat on site plan): Number and configuration Depth—top of liquid to inlet inve Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydra c failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Gordon Turner Property address 48 Larch Lane Owner Owner's Name infomtation is required for every Centerville MA 02632 12/19/07 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Sketch Of Sewage Disposal System:Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. LOT 1_3 17,f -1-4r�uS� j} �\ b LEACH1lt36_ t cal, c°Deb CO tQ�Jk :e o PIT t5'msp•1207 ram 5 Ofliaal kispeWW Form:SubeW16e8 Sewage Disposal system.Page 14 or 15 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M Gordon Turner Property Address 48 Larch Lane Owner Owner's Name information is Centerville MA 02632 12/19/07 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 3/10/86 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: Checked with records on file and checked with USGS ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: Checked with current USGS on the internet as of 12/19/07 for high ground water elevations as per local well site. You must describe how you established the high ground water elevation: Current Potential Water Level Rise for index well for Nov. 2007 is(4)which would give a elevation of 19.7 and the bottom of leaching pit is at elevation (24).After reviewing bottom of pit(which has no water)and review of all documents, system is currently in great working condition and not in any water table. I t5insp•12107 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 SUBJECT TO A* :'. '' .°.. FARNSTrAiB1_E .- col%imatltssil0d'i SOI L LOG DATE= WITNESSED BY O �.. r -- .1, r , -✓� t gyt i i No W4109 7F/4k r :.. 0 :i 7--5 rt ED MANHOLES AND COVER TO BE BUILT WITHIN OF FINISHED GRADE . ---, .- MIN. 2 SLOPE FI �► ISHED 6RA0E .•... :.. 4" PVC SC . 40 ? IST ' = n; ? PITCH 1�q FT. 2LEVEL% t MIN. 2" LAYER ►0 :�..; " - 1/2"PEASTONE 8. 7,5 2 8.08+; cI p INVERT DIST- F- a. C7' I NVE RT' =0 •. ON ?8. ;7 BOX ©: 3f4"- 1 1/2 DI'A . TANK INVERT 2?. :.p -Ip V Vp^ WASHED STONE INVERT o`A,p w < 0!.; ALL AROUND . 2 v ---� I J4 ,q y J p p. SE �. --- a O; ELEV. BOTTOM 2 O' KA I N. -�►i`' -E- �3--- ;4 4 t E L E V. _ .�a�o ROFILE OF GROUND wA ER TABLE T. ) ISPoSAL - SYSTEM � �-��o = �� i�• `� o iT TO SCALE DESIGN DATA =� BEDROOMS . TAR Y DISPOSAL DESIGN FLOW GAL ./DAY ' ' M TO MASS . LEACH RATF 'G- Z KAItU /INIrW USCiS(.irround water for USA: Water Levels-- 1 sites Pagel of 2 Water National Water Information Data Category: Geographic Area: Resources System: Web Interface Ground Water United States ,..GO:.. News:Available Now in NWISWeb Ground-water levels for the Nation Search Results -- 1 sites found Search Criteria site no list= . 413525070291904 Minimum number of levels= 1 Save file of selected sites to local disk for future upload USGS 413525070291904 MA-MIW 29 MASHPEE, MA Available data for this ske Ground-water: Field measurements GO Barnstable County,Massachusetts Hydrologic Unit Code 01090002 Output formats Latitude 41035425",Longitude 70029'19"NAD27 Land-surface elevation 15.78 feet above sea level NGVD29 Table of data The depth of the well is 40.0 feet below land surface. Tab-separated data The depth of the hole is 449 feet below land surface. This well is completed in the Sand and gravel aquifers(glaciated Graph of data regions)(N100GLCIAL)national aquifer. Reselect period This well is completed in the STRATIFIED DEPOSITS, UNDIFFERENTIATED(I 12SRFD)local aquifer. http://nwis.waterdata.usgs.gov/usa/nwis/gwlevels/?site no=413525070291904 12/21/2007 USGS Ground water for USA: Water Levels-- 1 sites Page 2 of 2 USGS 413525878291904 MR—MIN 29 HRSHPEE, MR P4 5.0 .y V 18.0 voi 6.0 o 7.0 4- �4 —18.0 % : 9.0 16 6.8 V G7 7 1976 1979 1982 1985 1988 1991 1994 1997 2808 2003 2006 cc ---- Provisional Data Subject to Revision ---- Breaks in the plot represent a gap of at least one year between field measurements. Download a presentation-duality graph Questions about sites/data? Top Feedback on this web site Explanation of terms Ground water for USA: Water Levels : http://waterdata.usgs.gov/nwis/gwlevels? Retrieved on 2007-12-2108:16:40 EST Department of the Interior,U.S.Geological Survey Privacy Statement 11 Disclaimer 11 Accessibility 11 FOIA News Automated Retrievals 3.62 2.13 nadwwOl hq://nwis.water&ta.usgs.gov/usa/nwis/gwlevels/?site no=413525070291904 12/21/2007 1 Town of Barnstable Op tHE Tp� Regulatory Services BAMSTABLE ; Thomas F. Geiler, Director 9$� 1639. ��� Public Health ,Division TED MAy A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts,Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition,by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. Ft=-1 066 �1 ASSESSOR'S MAP-NO,— LO CAT IO'�, E ; SEWAGE PERMIT. NO. VILLAGE C e •e . \',� -e INST-A--.L-LE_ R'S- ADDRESS t \e- cx o S U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � � � � ga�2 SC\ No. Fas. THE�O/"l�D Of H COMM914WEALTH FAS A CHUSETTS HEALTH L.. WAY..-.OF.......;P yr %,� L. .......--- A Appliration for Dispo,ial Works T tTlitrurtivit 1rruti# Application is hereby made for a Permit to Construct ( PI"or Repair ( ) an Individual Sewage Disposal System at: Locatio i Address or Lot G................ ,� �� ��21 d-c 1:------ •• --.� '� ...... �1. . !?// W Owned Address.l ••• l ................................ .........•-••-•••••.....••-------•...-•••••......--•-••......------•-•-•-•.._.._.. .._........ ' Installer •- p� Address U Type of Building Size Lot_` .y. ..Sq. feet �.. Dwelling—No. of Bedroom - ------------•._._._.....................Expansion Attic� Garbage Grinders---)-- a Other—Type of Building No. ofpersons.......... ............. Showers — Cafeteria-(--) a' Other fixtures........... � - d :�--•---•--•------------•--•--------------•--------------------------------------------............. W Design Flow..........................%_5 .gallons per person per day. Total daily flow................ �� _. ._........;._.gallons. i W Septic Tank—Liquid capacity._-15��allons Length... Widt . Diameter..4-...._..... Depth.......... x Disposal Trench—No..................... Width.....__............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..._.._.._.�........ Diameter.......1.41 ....... Depth below inlet.... _ .. Total leaching area...3.2-7.sq. ft. Z Other Distribution box (VI Dosing taak-'(� Percolation Test Results Performed by.................. :. _....._........ 1-. _•••�• ? tt �' �-' 1�--�r `"'_ ...----- Date---`� •- a . .a Test Pit No. 1.....�..�'minutes per inch Depth of Test Pit...I��..... Depth to ground water..r:��..'t..... f=, Test Pit No. 2-...__•.-..--•-.minutes per inch Depth of Test Pit.... 3 fr_. Depth to ground water.13.. a •---••••-•------------------------•-. .........--•--.............................................................. 0 Description of Soil......... --------� i ✓ = ''� ............................................ V --------------------- •--------------------------------------------------------------------------------------- ••-•--------------------------------W •--••---------- v Nature of Repairs or Alterations—Answer when applica.ble............. ........ -w-P---- ••••••....---••••••••-•--_..._..•----•...-••••••••••••••---•-•-•••••-•- ••--•-...........................•-••••--------•••-•--•••••--•---••••••--•-••••-•••--.:........................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LITi LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee psueq Vthe o rd of health. t ned. X �M/ Date Application Approved By............ -_ ........ ........................ at e. ........ Application Disapproved for the following reasons:.............................................................................................................. Date '1 Permit No....---•-•-•-•--••-��......... ._...._. Issued........................................................ Date 1 Fmc.. .......... THE COMM!�NWEALTH OF MASSACHUSETTS 8OA R D OF H LT I-I \rr i -77 y�--......OF....... � 2 NL3 LC �,," , .��r�rlirtt#inn fur • i,��ru,�ttl urku > ' at��rttr�iu�t �rruti# Application is hereby made for a Permit to Construct ( t<or Repair ( ) an Individual Sewage Disposal System at: Locatio Address - G. e b e S a��4,........ �o ✓e f l 3 J....oJ.1 t� .. - ..j��p/�.Z•�/� .�� � owner Address -z a .✓... .... J.... .ef-.............................. ...........•-••......•--..........._....... _.._...._......__......•-•...._..:._......._..... Installer / Address � p Type of Building 3 Size Lot._i�_I ..713.�..Sq, feet a Dwelling—�No. of Bedrooms ___. _.___Expansion Attic_(—)-- _ Garbage Grinder_(—)- � . �'_ __:_ No. of ersons.________.. _ a Other—Type of Building p �_____________ Showers,(--) Cafeteria---(---)-- d Other fixtures ........- W Design Flow........................__�--�.�......gallons per person per,day. Total daily flow........... - _ ..............gallons. WSeptic Tank—Liquid capacity_�!� allons Length___` L__ Width-.-__. .:�"__ Diameter_..I____.__.-__ Depth__ x Disposal Trench—No..................... Vidth.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.............1..---•-•, Diameter.______ �.g-----"- Depth be low inlet____? STotal leaching area___:3_P.7sq. ft. Z Other Distribution box Dosing t --- Date_._._ Percolation Test Results Performed by �� co D__. P In - / a3� Test Pit No. 1...... .2Zminutes per inch. Depth of Test Pit _ Q e t to ound water.._._._.. (� Test Pit No. 2....._—_......minutes per inch Depth of Test Pit----I....... Depth to ground water.. D�r -----------------•----•---------- .............................-----•--•--............................................ Description of Soil.......... ''��••v'"'-------....:�---• ''?fir` ------ v ................................................. ...................................-------------------------------------------------------- --------- W -=--------- - • Nature of Repairs or Alterations—Answer when applicable_____�_..._ _ --��.__'_ ........................... ------------------------------------------- •--------- _---------- •------------------------------------------------------ __------------------------- Agreement: r The undersigned agrees to install the aforedescribed�Individual Sewage Disposal System in accordance with the provisions of TITi1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee s �edq$rd of health. x.. ----- Tie - Date CAA Application Approved By.............r.:•-• :..: ................... .............................. ..... i Date Application Disapproved for the following reasons------ --------------------------------------•=----•------••-•-----._._...-----...---•••--••-•••••-•••••------- ......••--•------•--.......--••--•-----•.........--•y` •1•y-----•---`-yf•------•----................................. ......... ...--••---•--- Date PermitNo.--•-•-•-•-•••-•----..... - ................... Issued....................................................... ._.��..._�.,__..__._..._._..._.—._..._..-»,r_._s�.T�.._...,._.-._._.Date__,.,.•.�. �_�1.��..._—�._...__ THE COMMONWEALTH OF MASSACHUSETTS t` t� BOARD OF HEALTH "o,n�ilJ t i�z�/-S,% ................................OF.. . ............................ ..........................._......._.... l Trrtifirtt#r of Toutpliatirr THIS IS TO CERTI Y, That the Individual Sewage Disposal System constructed (I�or Repaired ( ) by......................... L. --•---------------•---•----- . --•------ ----________-•-•-•--•------_------••-------_--__-__--------__--_---••--•--_------•-------•••••- Instal ler at...... �? C J-J. L '`fin/ ��-- J.... ...•L-.... E......... has been installed in accordance with the provisions of TITLE 5 of The St to Sanitary Code as described in the application for Disposal Works Construction Permit No...... .�' .._. dated-------- ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A�GUARANTEE THAT THE SYSTEA+11 1 I. ' .. C ION SATISFACTORY. DATE........::........ ._. � Inspector-----...---......-•---•••---•--.._..•--- ------. ... 1 �n , 4 THE COMMONWEALTH OF MASSACHUSETTS J BOARD OF HEALTH f,:• y. .................d..tN..-.-.....OF........ ...-....-.._._........._._....N ._ ._..._...._.........:.... No.........................l FEE... ::4 4�-..'.. ._ �i��ro��t o�r�� �or���rttt#iun �rruti� Permissionis h by ranted___________ __ _ �_��.. .g _............------•-._...--J•--•....................�----•--•---•----...-------...................... to Construct ( or Repair ( ) an Indivi�. 1 Sew ge Disposal System at No..- / �_: _..... =.r. �_���_..cz.......--------- --- = - -------------- .._.. Street as shown on the application for Disposal Works Construction Permit Nor-� Dated_ V.�_ /�� ' ; •--•-_----- ------------ Board of l lc with ' DATE............. .................. -------------- ------------ -•a. r� n STAGE R� SOI L LOG _ trocus 1 A,A oar DATE: `` �`�c `�N� WITNESSED B Y: ,T'A �� c S G o �•/ G. C2 �l o 7 'r. F L 2 9. 4 a 7` N 2 E L.3.S d rE 7-0 7-IZ,-et? c L � L Z) L l' . - %p'7 h',F M Sa ,s +.s YE'yo;Z {/ - � 1/ E_ 4 FL 3 20 N0 J 5, / •� A.k,, C f7 IV ti �'N d r VIV �. 1• I 7 s /32 EL 24.o JGO > L �.7 _r� / -- �. - /J o Via "T"�=�Z �✓ G f? JAI T 2ED -- "" °� i .. MANHOLES AND COVER TO BE BUILT WITHIN '.:► E L E V. TOP O F �4 61• ,' n' 12" OF FINISHED GRADE . FOUNDATION —; e " DATION ,� ' .- M I N. 2� SLOP E 5 FINISHED 6 R A D E 4��CAST IRO .. 1' 4 PVC Sc 40 Z� �` p R .. .•.... ' .• 1ST ----,. � L o T t ay- PVC _ �4 L - � �, SCH. 40 PITCH 1_ ,�. FT 2 EVELS Aa1N. 2LAYER Y �� 10 1�8" _ t�2" PEASTONE PITCH / " p'•o••. /�`C i 2 9,SO :�• ( ¢~ F T. '�✓'/ 2 8. S 'Z J OOCD INVERT �' 2 u� GALLON INVERT DIST. O ---..: -..� �y` /� r;' INVERT SE PT 28./ BOX �;�p S' < _ � , 3/4 - 11/2 D1A . 7 � o ED T / .�'"" • . - . a _ .\.....-.•..•.• •., � INVERT — 2 ;•. WA H STONE /2 E R T O < ALL AROUND . F.,� -- jt •� 1 N V ii.� W E 3 :0 iq^7�Jv' le rn t R�' 1 O, G A R !!�A Q E 2 8 -—�-•� /4 •, L] EL W C) GnARi. 3• 1G, w i :.• lul 1 N. �' ZS 2ES J a• ✓ p � llr �e GRINDER - .�'. ELEV. BOTTOM Of P IT c r U S U/,/,A Z3 L 4. ,07 '�TZ �3 L � To W -- - 20'© ELEv GROUND D BL DTV , 1 7 - w j, C II %��M p V E,D. ,/d�.f�/ZOVN� P R O F I L E OF U WATER TA E A .S7. c �-7►. .Af � �' 1Z�"PFr� SAN 1TARY DISPOSAL SYSTEM _ NOT TO SCALE -DESIGN DATA ~Y,�;' " Rom•S�c-�V BEDROOM S -, 7�"a �� � • CONSTRUCTION OF SANITARY DISPOSAL DESIGN FLOW „330 GAL./DAY v 8 HALL CONFORM TO MASS . SYSTEMS LEACH RATE — 2• MIN./INCH ENVIRONMENTAL CODE TITLE 3L (REVISED 7- 1 - 77) PROPOSED LEACH CAPACITY : Ito AND THE TOWN OF L3 F� iZ n/.S 2 S(3.57�'t 4) 4- HEALTH REGULATIONS. D ,-zr-�,,� �l /' \ J --� • SEPTIC TANK, DISTRIBUTION BOX AND LEACHING PITTO BE OF REINFORCED CONCRETE : -3 8 GAL DAY � O7 S xV7- M1N. CONCRETE STRENGTH 3000 PSI i MIN. STEEL STRENGTH 20,0OGPSI / G H 10 DESIGN LOADING� l� '� • DRIVEWAYS N OTTO BE LOCATED OVER SYSTEM UNLESS H - 20 DESIGN LOADING IS USED. • ALL PI PES A'N D FITT I NGS TO BE WATERTI GHT AN D ,( TO BE OF CAST- IRON OR SCHED 40 P.V. C. Q� IS' SITE PLAN SHOWING PROPOSED CONSTRUCTION SH.!OF !SHS LEGEND L O C AT I O N� �. /Z�/.STD-'�l3.LF /�"E�2 �//LLt_= F O R 1.. - .S C? Z Q+•tr'... E V' L . C' C F�- tom- . APPROVED 19 SCALE: / =' � � DATE : 3// 0/8Z BOARD OF HEALTH BUILDING SETBACK REGULATIONS PER EXISTING CONTOUR —t6--- RE FE R E-NC E: Z_ o7- s :S /- c� `✓nl ice' BUILDING INSPECTOR OR BU1LDf`NG PROPOSED CONTOUR E­ MIN. DATE AGENT COMMISSIONER . Zon/C lZ C FRONT SETBACK � � EXISTING SPOT ELEVATION 17. 6 OF I!,ISS PROPOSED WATER SERVICE W MIN. SIDE SETBACK / O o s� MIN. REAR SETBACK f O TEST HOLE LOCATION L 'a ivi N 40. 27433 INC . F � C , R . SHORT., F . SIptJAt EN PROFESSIONAL LAND SURVEYORS L ENGINEERS o,r 1586 MAI N STREET (RTE. 6A) EAST DENNIS, MASS.. 02641 J,.N I S1113-JECT TO Ar ate P l^4., a1a; 00^91:i �:7r�J SOI L LOG D AT E: WITNESSED BY : -TOL4i'l- c G � r,f � � �,✓ o � � / ' / /J ..... t?1 � ,•._0 12 t-� '�� �=- r_. ,S 1? ,! . ':.i e� � =�,-/�:, � G l � s.�-vim r, E- ��,.� . 0 T /'` r r / 7-�-.. .sue'. �, , ? 4. - / - - _ _ F ✓E T-E- 3 MANHOLES AND COVER TO BE BUILT WITHIN ELE V. TOP OF q FOUNDATION --;' IZ OF FINISHED GRADE . --� , 1 ^`\` \.O . �.y' ` f �_% �' �Jl 4; ► . FIlV1SHED GRADE - RAIN. 27 SLOPE 4%A R O f r L PYC C PITCH 1 40 � I S I S T -T ! °' H. 40 - _ �4 FT. 2'LEVELi 10# MIEN. 2" LAY £ R �,/ �o - - PITCH :�'�` 1/8 - I 2PEASTON / r Z D. 1� / �.; //, • / `, / Z�.--- _ o r 29. 25' :.' 4�FT o��'"... 2e.7s 28.o�'r O ~ p t4. , I NVERT ,o: 2�j,OC� GALLON INVERT DIST. INVERT' :-� �� u f ` `� + �4.• INVERT 28./ BOX � ICJ a,St 3 4 - ( 2 DIA . b t SEPTIC TANK n' < Fir. - /2 ` - .••.•. : INVERT 27,,E �yO U tj WASHED STONE •T/ G INVERT �:Ap w < O�� ALL AROUND . �nA2• L ,,:�- '�, • 10 GARBAGE r --- 2 s --� �+--14 O d I I]." E L E V. BOTTOM p ` �v`'C` 3 MIN. GRINDER �'- - -----� t ., xQ S 2 V .•` - O F 1 J t .r P T c 2 0' MIN. _ 6��D I A •('-e- '",$srprlTi'V J{ 7'. .\ +}, •- if C'0 •. " 7 .1`..- :', .C�.;. .�j '1 Q V. 3C %Zt=/ iaVE-)D ii /zz:l ` r��2��J./,�j PROFILE OF GROUND WATER TABLE faDTVST, SANITARY DISPOSAL - SYSTEM .� i _ , y.a NOT TO SCALE DESIGN DATA •� ' '.r? v 7 `--'R,-- BEDROOMS �, '' ! \! A _ > ,�*• � =* M • CONSTRUCTION OF SANITARY DISPOSAL DESIGN FLOW G AL ./DAY SYSTEM SHALL CONFORM TO MASS . L � LEACH RATE -- 2 MIN. � f !� ENVIRONMENTAL CODE TITLE (REVISED 7- I - 77� /INCH AND THE TOWN OF C3�? ,-ews PROPOSED LEACH CAPACITY : �'•s(3,6J7 HEALTH REGULATIONS. _ >,; �- \ __ _ -� • SEPTIC TANK DISTRIBUTION BOX AND LEACHING ^ _ - 'I �24•� PITTO BE OF REINFORCED CONCRETE : .J.3 e MIN. CONCRETE STRENGTH 3000 PSI 41 GAL/DAY MIN. STEEL STRENGTH 20,0OCPSI H 10 DESIGN LOADING �\ /� ;=� • DRIVEWAYS NOTTO BE LOCATED OVER SYSTEM - UNLESS H - 20 DESIGN LOADING IS USED. •_ ALL PI PES AND FITT I NGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR SCHED 40 P.V. C. SITE PLAN SHOWING PROPOSED CONSTRUCTION SH.! OF !SHS LEGEND L OCAT1 0N: J IV.s F O R`• G ,U _ .._ a� ;�:� :-^., '..± � -r - 1 r�� y;= . A P P R O V C D 19 SCALE: DATE : BOARD OF HEALTH BUILDING SETBACK REGULATIONS PER EXISTING CONTOUR - --16--- REFERENCE L � �- f f-; ; ter � ,,,• / � : BUILDING INSPECTOR OR BUILDING COMMISSIONER . Z '� �IC Tz C PROPOSED CONTOUR 16 4- ' '✓ _ , , ?. DATE AGENT MIN. FRONT SETBACK � � EXISTING SPOT ELEVATION 17. 6 MIN. SIDE SETBACK / 0 PROPOSED WATER SERVICE W_ ofrrrq`rsq� MIN. REAR SETBACK / 0 ' TEST HOLE LOCATION SNOORO® o C y T G oo C R . S H O R T I, N C . i s�o/S1.ER�G\���� PROFESSIONAL LAND SURVE-YO•W' L ENGINEERS NALE 1586 MAIN STREET (RTE. 6A) EAST'xD .-, N I S, MASS. 02641 0 ��