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HomeMy WebLinkAbout0129 LONGFELLOW DRIVE - Health 129 Longfellow Drive Centerville P A = 189 112002 No. 4210 1/3 ORA Pendaf lex 100/ e t� pt c�c�ress COMMONWEALTH OF MASSACHUSETTS ExEcurrvE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL-PROTECTION JI FZrC ��►°I�.fa L' G�' JAN 0 6 2004 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A / n / CERTIFICATION caq Property Address: / �- 7 MAP PARCEL • 9 12 a 2 Owner's Name• Jo Owner's Address: d-/ LOT 1' #h oo Date of Inspection: P- Name of Inspector: (please print) P)^- �e Company Name: d—'TL'G H Mailing Address: P0 to yC Id,- w.r4- A 4ad4 Telephone Number:(5o — y�[f 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 11000� The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature:_IV—G4lq en4d, Date: 0 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,0o0 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does net address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40n AOw 12r Owner. G3 Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete an of Section D A. Sy"Passes: I have not found any information which indicates that any of the failure criteria descn'bed in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 2:or Conditionally Passes: more system components as described in the"Conditional Pass"section need to be replaced or repaired The system,upon completion of the replacement Or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined'please The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is struchually sound,not leaking and if a Certificate of Compliance indicating do the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Oh Fe/ ai ,�✓ r Ile Owner. 1491►7 Date of inspection: al- Q C. h er Evahurtioa is Required by the Board of Health: Conditions exist which require fiuther evaluation by the Board of Health in ores to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 11303(i)(b)that the system is not functioning in a manner which will protect public health,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 any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within I00 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. 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 distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered A copy of the analysis must be attached to this form 3. Other. Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 07 -Z O nei 1-cr/ 0 t l Owner: #n&,10 V7 Date of Inspection: D. System Failure Criteria applicable to all systems: You most indicate"yes"or"no"to each of the following for all inspections: Yes Npr _ V ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool y Liquid depth in cesspool is less than 6"below invert or available volume is less than/z day flow Required pumping more than 4 limes in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped :!�Airy 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.Any portion a cesspool or privy is within a Zone 1 of a public well. ✓ portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the wen water analysis, performed at a D"certded laboratory,for coliform bacteria and:volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis mast be attached to this form.] (Yes/NO)The system faits.I have determined that one or more of the above failure criteria exist as described in 310 CUR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following feria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tribunary to a surface drinking water supply T _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone H 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 CIMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B J CHECKLIST Property Address: Id Z®0 Fe�A o r,I Owner: a► f b Date of Inspection: 7 Check if the following have been done.You must indicate`yes"or"nor as to each of the following Y No _�Pinnping information was provided by the owner,occvpaK or Board of Health 1/ W of the system components pumped out in the previous two weeks yr received normal flows in the two system � 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?d?(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,owluding the SAS,located on site t/ Were the tank_ septic miwvered,openect and the mtenor of the tank inspected for the condition of the es or teen material of construction,dimensions,depth of liquid,depth of sludge and depth of scum Was the facility owner(and oiecupants if different from owner)provided with information on the proper maintenance of a sewage dispDsal systems The sue and locadoi}of the Soil Absorption System(SAS)on the site has been determined based on: Yes " Existing information.For example,a plan at the Board of Health. Detetinined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is mucceptable)P 10 CMR 15.302(3)(b)} Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C l C� SYSTEM INFORMATION Property Address: Owner. /T�v►So v� Date of Inspection: 02 6 W CONDITIONS RESIDENTIAL, Number of bedrooms(design):3 Number of bedrooms(actual)) DESIGN flow based on 310 TR 15.203(for example. 110 gpd x#of bedrooms): Number of current residents- Does Does residence have a garbage grinder(yes or no):141�O Is laundry on a separate sewage system es or no):7� [if yes separate inspection required] Laundry system inspected(yes or no): O Seasonal use:(yes or no): S Water meter readings,if (Last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy:�. COMN ERCIALANDUSTRLAL Type of establishment: Design flow(based on 310 CUR 15.203): apd Basis of design flow(seats4xrsons/sgft,etc.): Grease trap 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 occupanq/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: o9 0 0 1 Was system pumped as part of the inspection(yes or no). eL-O If yes,volume pumped:_gallons—How was quantity pumped determined? Reason for pumpiW TYP�..WSYSTEM Septic tank,disinbutiion box,soil absorption system _Single cesspool _Overflow cesspool —PH, _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 swotl=of information: Were sewage odors detected when arriving at the site(yes or no):�,� Page 7 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM (Continued)INFORMATION(Contim Property Address: oz Fe 14 ILj v Owner: /-tciifc h Date of Inspection: 0 WELDING SEWER(locate on site plan) Depth below grade: / 9 // Materials of construction: cast iron k0 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition afjoints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locat�pn site plan) Depth below grade: /� Material of con _metal fiberglass_polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Sx� ShWF Distance from top of sludge to bottom of outlet tee or baffle: �3 Scum thicimess: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom / tee or baffie: f How were dimensions determined: A o s L-&✓l c e Comments(on pang reoom�adatio�,inlet and outlef tee or bale condition,gructural integrity,liquid levels as related to outlet invert,evi of Image,etc.): ivy v`► ,� o .C.ec�c� o��' -f-Ll,;f 7�i '`�t; ; h It'll-i - �� r _ yoa moo G�• .o 17 GREASE (locate on site plan) Depth below grade: Material of construction_concrete metal fiberglass_polyethylene_other (explain): Dimensions. Scum thicimess: 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(on pumping recommendations,inlet and outlet tee or bale condition,structural integrity,liquid levels as related to outlet invert,evidence of IeWmge,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C � SYSTEM INFORMATION(continued) ss: /U`7 Property Addre )(� zl o - J'_l,/ Owne, a r►J0 Date of Inspection: TIGHT or HOLDING TANK: (tank must be pumped at time of inspwUion)(locaie on site plan) Depth below grade: Material of construction concrete metal fiberglass._polyethylene, other(og"n): Dimensions: Capacity. �alions Design Flow gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOyG if( present must be opened)(locate on site plan) Depth of liquid level above outlet invert 14 0 f✓h---j 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,c to.): le % It'd 4_ PUMP CHAlVs ER: /!/ (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.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(con inud)e Property Address: Ip� /-oh ?e llo I L/ +'r ✓V C 4 Owner. t p ? -72 Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: r."51eaching �pits,number:L /� �O ST C y leaching chanters,nomber leaching galleries,number leaching trend,number,length: leaching fields,num1w,dimensions: overflow cesspool,member: innovativelalternative system Typelname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): // � J�oN ,� �� �e J441h CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scam layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY:Zoocate 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.): Page 10 of I I e OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contimmM PropeirtyAddrem,_ J)9 oa ,c9,� -- Owner: {pis 0-7 Date of Inspectiom 49A-k SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of fhe sewage System including ties to at least two penmanent reference landmarks or benchmarks Locate all wells within I feet.Locate where public water supply enters the budding. 07r/� PON-f 1 w r 3 - 3� Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ° SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contiuua#. Property Address: (�j z©n -le"'Iltq L'/ cAi Owner.. 0(� Date of Inspection: oz 0 SITE"EXAM Slope Surface water Check cleft Shallow wells EAnkated depth to groundwater feet Please indicate(check)all metlio&used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: served site(abMng propertyfotuervation hole within 150 feet of SAS) Otecked"wah local BoaTd of Healtli-eexplain: Chedwd"wah local"excavators,installers-(attach docamenfation) Accessed USGS database-exphdii: You must be hOy you eratilshed the high ground�wa�devati> : �Q / 0oP-7� A0 P of (r,u de- Dm1 0 � - (-D C'Z�o 01, (0 /fib C9r-rV Q e��-4-er �' r , 3�3aQ M1 TO ; OF BARNSTABLE LOC,1710N Z�,, A'A'el !aw e0e,t"e SEWAGE # VILLAGE AS - SESSOR'S MAP Q LOT 0'\NSTALLER'S NAME & PHONE NO. ����n A 14a�ta ASEPTIC TANK CAPACITY /O00�, t� °LEACHING FACILITY:(type) ,p`f" (size) 61Y%0 %0. OF BEDROOMS. PRIVATE WELL OR UBLIC WATER BUILDERIR J, fy/'ee m e DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y � e) � q, a L � � 0c)2 FIc$...... �.�J....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..........._0F............ ll Avoration for Diupuual Works Tomitrurtiun Vamit Application is hereby made for a Permit to Construct ('-<or Repair ( ) an Individu a Disposal S tem at: ....�. Location.Address or Lot No. •• ..... ............. ! g7. 8Z1. T ��'r.N'4�4' �5,?dLS f�9 026 W O e� Address Installer Address Type of Building Size Lot------ WgA,....Sq. feet -, Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............... No. of ersons____-._-..-________-._-.___- Showers t� YP g ------•------ p ( ) — Cafeteria ( ) a' Other fixtures ................. WDesign Flow...........................................gallons per person per day. Total daily flow............. _��...___............gallons. WSeptic Tank—Liquid capacity.100..gallons Length.g_"..(-". Width.-4.-:719" Diameter................ Depth.Z-':-Z.`.�. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area_-_.-•------.-------sq. ft. Seepage Pit No.......i..___ ' 'r " _.._.. Diameter._�O_-:C]._..... Depth below inlet_.(a-Q....... Total leaching area..�`'�.`f°.1.:7..si�$D e6 Other Distribution box ( 'r Dosi tank ) a Percolation Test Results Performed by. .RQ__ _e............ Date �3 Test Pit No. 1........4. ......minutes per inch Depth of Test Pit--- . Depth to ground waterlbW.............. r=, Test Pit No. 2.......2......minutes per inch Depth of Test Pit....W--.___._.. Depth to ground water.0GY_14........... o 'FP.#!------�' -noI s01� .� :. Description of Soil -'61�.A+1a�,......-1.4......1.2...:.J EDJ. A J —--- '� U Nature of Repairs or Alterations!Answer when applicable_________________._...__._____-__.-_______-..__-___-..__._.______.__--------_____.---.-.-.--.__. ----------------------------•-------•--------.....---------•-----•-----------------------...-----••---•-••-•--•--•••----•-------•-•-•-•--------•----•••...----•••••--•-•-••-•--••---•••.......-----••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b "ued the board of health. Signed ---------- ------------•-•-----•--------------------- .*�-- ... •---------------- Date ............ Application Approved BY ------ .... ..................... V� Application Disapproved for the following reasons:................. ••-•-------..Date.............. i ............•••--•-••---------••••••-•••--••-••-•-•••-•--•-----•-•-••••----•--••---••----....•---•••------•----•--•-•••-••--••--••••--•-••--•---•-••-••••--•--------•---••---•--•----•-......----••..... p _ Date PermitNo.-----../ .. .......... Issued_....................................................... Date No....1..3. r1 FpB......��. ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • Appliratiun for Disposal Works Tonstrurtion Frrutit Application is hereby made for a Permit to Construct (4--f or Repair ( ) an Individual Sewage Disposal System at: —1, 4>ca � P �.Y' j � �- a .. . t S ... ........».................... ... ......................»...... ........,_ _____ .........�........ .._...._..............._...... ...... Location-Address or I,`ot N�^o i 13h I Y F .... { ✓.yt ! �I ) �P t W � O er Address � / _......». .... r G Installer. Address U Vype of Building Size Lot...... __.___Sq. feet a Dwelling—No. of Bedrooms............:`..............................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow................ _.......................gallons per person per day. Total daily flow............. ......................gallons. WSeptic Tank—Liquid'capacity l f✓-Q..gallons Length.--1... ._.. Width-:..... ___ Diameter_______________ Depth._M::__,_!..-. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. � Seepage Pit No.........:------- ----- Diameter..)_:x_-f:.......... Depth below inlet.�-2.=22........ Total leaching area.` ?-_L.sq. l' ci Z Other Distribution box Dosing tank,( ) Percolation Test Results Performed by ! :�-:- °---:_1Ca! x ?=!- ............................. Date +r._1---- .....a" .--.-t-'� Test Pit No. 1...... .......minutes per inch Depth of Test Pit...1.4.............. Depth to ground water-O.': ............... Test Pit No. 2....... -......minutes per inch^ Depth of Test Pit....!a........... Depth to ground water.?L'x: 1. 4 ...... ................. . ...1 !.� y F. +:..J F l(::;1?P f.l IZ .-*#�............. j) ..._..._____....___...._..-_....... _.. O • • l ay.�➢'.-......- t--- .' ......�k� { ..Y ... Description of Soil.....»� / 1 : �_._ .....-...... ...._.... . x .....----•-•••......-•-------------•_---•-- ar / t.i !r" i.rG+ - bf� ...............,1.31 `r. ..� , t� ►�jy ----------------- ------- .._____...-=-1-i"_. .:/ '"�.'__._ _..�.:.. ..�_.___._._ 4f 4 1 i k U Nature of Repairs or Alterations—Answer when applicable........................................................................................... -------------------------------------------•------------------------------------------'------------------------•-------•........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS; 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n is ed by he board of lealth. Signed...... ••-•-------•-• ••------- --------•-•-• ...................... Date Application Approved BY ....................................... Date Application Disapproved for the following reasons:................................................................................................................ --......•---•---•-•-•.....--••-•-----••------•-•--....-•------•-•••••--•------•••-•-•-•---...••---•---•.....•-••---- ---••-•------••----•----••-•--•-------•-•---•-•--'--•-----------••--------------•--- o Date Permit No........-/_._�.• & S ------... Issued---------------•---------------------------•--•----•--- , ----- - Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. j.:. :. ... ..l. w...,e.. Trrtifirtttr of Toutplianrr THIS IS CE TIFY, Th th Individual Sewage Disposal System constructed ( 1Jj or Repaired ( ) by . ----------------------------------------------•---•--------....---•----------..........---------......---- at ................................_•.. ... ..... .. .........I e^�..: ..... --!- >a^"` - has been installed in accordance wit I the provisions of '-1^1 `" of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__.._..._.!_._ ___-_ r...`�_.-...7 dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.... = —= �'�•`,-.......1 Inspecto ....... ` .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ee ro 7 ......w.<1.............OF...... 1.....r- f� �..... .---` l G o No...... .. .......•• FEE............. Disposal Works inn ttrttion Vrrmit Permission is hereby granted.. ----•-------•-•-----••••-- to Construct ( *or Repair ( } an Individual Sewage osal Syst at No........... _.. ! . --- __wz;C��e-v�.cJt NCO - ---------------------------------------------- Street '�- 7• - as shown on the application for Disposal Works Construction Pit No..0 _=_G�./ZI ed--_. / �g�� Board of Health DATE------------------ ...................... Board • FORM 1255 HOBBS & WARREN. INC., PUBLISHERS x- .44 "�v r77 A j GENERAL: NOT ES EST,:�PIT'-0-2 `5 -TOPSOIL *tbpsOIL. ri 7-1 ALL ELEVATIONS ,SHOWN.ARE aI4SED'uPON­ ASSUMED BASE. SUBSOIL SUBSOIL 2" UNLM' -INES,:A MINIMUM OF .1 8t' 0 2. 'PITCH 'At 1 -L FTr SPECIFIED. OTHERWISE� .00 0 @,o 0 000000 . MEDIUM 000 .,MEDIUM 00 0 0 0 0 @ 0 0 0 0.0 00 3. ALL- PIPES TO AND IN HE SYSTEM SHALL BE SAND SAND r­% I — — — — a 0000 0 0�0�0 0 0 0 000 'IRON 'OR SCHEDULE,40 PVC*., GRAVEL 00000.0000 000000 GRAVEL 0 4. ALL- SEPTIC TANKS)- DISTRIBUTION. B6XES,*. ANO,-� m ip 000000 000000 LEACHING PITS . SHALL BE DESIGNED FOR.H-20 W' EEL 000 0 b 0 (2) @ 0 000000 LOADINGS WHEN UNDER PAVING. 000 00 a @ @ 0 (D 0 0 000 11011, 000000 @ @ 0 000000 5. REMOVE ALL UNSUITABLE MATERIAL BENEATH'_THE,,,,� 14 3 000000 @ 0 0 000000 INVERT ELEVATIONS �'OF THE�, LEACHING PIT. -A 'DISTANCE '05. 1OFT. AND BACKFILL-WI H CLAY. , TYPICAL DISTRIBUTION BOX 000000@00000000 4'-0 -4 FREE SANDS GRAVEL HAVING A PERCOLATIOW,RATE LIQUID LEVEL MEDIUM MEDIUM NOr rO 5C.41_1 OF 2 MINUTES PER INCH OR LESS. 6 0 SAND SAND 2 12' 6. THE TOWN OF BARNSTABLE BOARD' OF HEALTH WrE-' DISTRIBUTION BOX AND 1000 MUST BE NOTI FI ED 'WHEN 'THE -SYSTEM IS NEAR`COMPLETION NO WATER ENCOUNTERED GAL. REINFORCED SEPTIC TANK BY AND PRIOR TO BACKFILLING. ACME PRECAST OR EQUAL. TYPICAL LEACHING PIT OBSERVATION PIT TYPICAL 1000 GAL. SEPTIC TANK 7. ' UNLESS OTHERWISE NOTED,,,:ALL SYSTEM COMPONENTS SHALL BE INSTALLED -IN ACCO DANCE WITH TITLE RATE'.<?-' MIN/INCH NOT rO SCA f" Nor ro scALE . OF, THE STATE SANITARY CODE'%AND,,ANY - TANKS REINFORCED THROUGHOUT WITH OBSERVATIONS"BY; JERRY DUNNING NOrE' RULES, WHICH -MAY APPLY. TOM OF BARNSTABLE - BOARD OFHEALTH ELECTRICNELDED WIRE WITH 24-1/2 11. OBSERVATION PIT TO BE EXCAVATED TO 4' 8. CONTRACTORAS -TO.NOTIFY ENGINEER, PRIOR-T011'tt' tNGINEER'-, ARO ENGINEERING INC. BELOW THE PROPOSED BOTTOM OF PIT EMBEDDED STEEL RODS- IN TOP Ek BOT- ON OF INSTALLATI SEPTIC 'SYSTEM, OP.-ANY" D.ISCREP'- DATEf, NOVEMBER�23,1993 TOM. CONCREn IS 4,000 PS.I. TEST. ELEVATION TO"VERIFY SOIL CONDITIONS ANCtES BETWEEN. TEST PIT RESULTS ­4ND F'ELD AND WATER TABLE. ENGINEER TO 13E CONDITIONS. NOTIFIED.OF ANY VARIATIONS PRIOR TO ES AND .,L 9. AGdESS MANHOL TO SEPTIC­YANKS EACH I NG,'l- THE START: OF CONSTRUCTION,.(IF NECESSARY) FINI -TO 12 INCHES 'SELOW SH PITS TO BE BUILT UP GRADE.' ' -PURPOS -S� -BE USED FOR SOLAR 10—NORTH ARROW.IS NOT TO TOP OF FOUNDATION INISH GRADE FINIS� RADE FINISH GRADE OVER ACHING ELEV.= 53+00 F LE FINISH GRADE OVER TANK ' OVER D' BOX AREA ELEV.- 50+5-, . ELEV= 52+0 ELEV. 51+6 ELEV.= 51+0 JA 00.w S 45*43*3 a w .24.43 28.82 001111w 49.1 51.00 P 0` 10024fsf 'WASH -STONE�:` INV.= 49+60 48+ 'ED T LOTZI I NV. 0 -= 48+80'- INV, INV.= 49+35 1000 9+10 GAL. DIST BOX CED x REINFOR �4 Y4 x �112' 14' (TO BE LEVEL ... WASHED.,STONE ,- 8 STABLE) 54 it oSEPTIC TANK T�IQF 80771, INV= 48t6 7V -0 +ro E (TO BE LEVEL 8 STABLE) LE W-01 '2' 21 CO) PROPOSED b b PIT DWE"G TYPICAL SEWAGE SYSTEM 'PROFILE' . 4#00 (TO BE LEVEL B 40 , S-b 0 'Nor ro sr-4LE Re 34'-0*0 LEGEND i7 80 Rill 'PARC N EL- HOI4 -A DRES MAP LOT_ : . 3E 8 EXIST, CONTOUR PROPOSED CO.EXIST . SPOT ELEVATION 8XO PROPOSED SPOT ELEVATION 8+0 H IfLOOD AZARD�� ZONING DISTRICT ZONE , R PERCOLATION TEST w 0 FICR OBSERVATION PIT �24.43" A VIL: -0 50.30 Rm POSED:"L CAT-1 �--43 -30"E-40L�00 N 46 ITS -A---Tg TS" EP EP DESIGN CRITERIA ' 'SEWAGE,-,--D,i a ft a UMBE 40 PERSONP EDROOM DWI` 2 p R OF, gtbRbomt L E 0T _ Y-LON�FEL E14 6 T. -3 d '�BARN ENT N -PER PERSON"PER , GALLON -6AY`:� �': � 55 - LONGFELLO DRIV8 LEACHING-0EQUIRED to,LEACHINO :F!ROVID 7 LSP -'DISPO A No t 'N A UIT:' RUST�' NC SQUARF_;. N WIT" STRIPER ENGINEERING11 -S IG, -SEWER -..DE 2 'got T. "2 8 k C FALMO 0 '0, -40 ZIDEWALL* 2- �d UTH IND IL 39 ' 2� 6 �:2.5 471 -20 'HF-ET. 1of 3' CALE-1WIFEET B DRAWN Y., �PPD�,,43Y�-, P INV'! �48-�97 1 EM EN HEICKED LAN'.NO syn Cp C44_ C LE 7 f