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HomeMy WebLinkAbout0545 LUMBERT MILL ROAD - Health 545 Lumbert Mill Road Marstons Mills A= 146-027 SMEAD No.2453LOR UPC 125u • waft In UaA TALI 1� iwu�oMwNoauQw r� TOWN OeF,eBARNGSTABLE LOCATION ;�L 5 �..U04 L61-i AN/ Avg SEWAGE# y tot n XILLAGEC9,✓l f erIl I ASSESSOR'S MAP&PARCEL,/J/,3LU ►Gkb p 7 INSTALLER'S NAME&PHONE NO. (*wJC, 1-fvaJP r1QJ1.se_S LLC- 509-477 77 SEPTIC TANK CAPACITY JWOGe�- LEACHING FACILITY. (type) 21MC36 HC)li--&0 (size) Sa 5 �y( 3 NO.OF BEDROOMS 3 OWNER OaiV W t UgCJr/ C/� zew_Sk ` PERMIT DATE: 1 a 10 COMPLIANCE DATE: /® Separation Distance Between the: A/C) ArAru1j-cif' Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility OL efl/eck`t� lair Feet Private Water Supply Well and Leaching Facility(If any wells exist on , site or within 200 feet of leaching facility) 130 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _A' A Feet FURNISHED BY � � o �-1�36` B-1-d,3 . A-a=3�' 13 a A-3=7� C3 3=30' - `J 6 . h c Commonwealth of Massachusetts Title 5 Official Inspection Form „ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 545 Lumbert Mill Road f*;+ Property Address ; Robert Downer ' Owner , Owner's Name information Is F-^` required for every Centerville MA 02632 5-1-18 page. City/Town State Zip Code Date of Inspection X Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important When filling A. General Information 00 �l on the computer, O \`����4�N OF ttjyAn�iiii, # � 3 use only the tab key t0 move your 1. Inspector: S cursor-do not JamesD.Sears _ =��:' JAMES ;m= use the return Nome of Inspector u: :c,_, key. Capewide Enterprises �'•. o dp Company Name � �� •. � �e�� 153 Commercial Street �/�j r51INSPEG���`��\ Company Address Mash pee MA 02649 City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number = B. Certification I certify that l 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 15.0D0). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5-2-18 pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection, If the system 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. t5ins.doc-rev,6116 Title 5 Omclal Inspection Fcrm:Subsurface Sewage Disposal System•Page 1 of 17 9 a6ed xeJ dH Z942 91,0Z 20 AeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f; u 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-1 t3 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E l 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: The system is a 1000 Gal. Tank D Box and 21 chambers. Note: Inlet cover under paveing store's B) 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. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. 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 structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.srs Title 5 Oftial Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 61• a5ed x2J dH 29:2 KOZ ZO AeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Y Y Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page, Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(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 15ins.doc•rev.6116 Tille 5 Official Inspeden Form;Subsurface Sewage Disposal System-Pape 3 of 17 OZ a6ed xed dH £S:2 81,0Z ZO AeW I Commonwealth of Massachusetts k Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments L" 545 Lumbert Mill Road Property Address Robert Downer Owner Owners Name information is required for every Centerville MA 02632 5-1-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 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. ❑ 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 fecal coliform bacteria indicates absent 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® Backup 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 ❑ ® Liquid depth in is less than 6" below invert or available volume is less than '/Z day flow ,, EAeNiwd t5ins.doc•ray.6116 Title 5 Official Inspection FDrrn:Subsurface Sewage Disposal Systam-Page 4 of 17 6Z a5ed xed dH £S:2 860Z 20 4eW Commonwealth of Massachusetts Title 5 Official Inspection Form 'Q Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name informations required for every Centerville MA 02632 5-1-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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 of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis,performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system fai . I have determined that one or more of the above failure criteria exist as described in 310 CMR 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area —IWPA)or a mapped Zone Il 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, 15ifls.doc•rev.6116 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 22 a5ed xe:1 dH t g:2 81.0E EO AeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. Cityt7own State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes" or"ho"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? z ❑ 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 NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? l ' ® ❑ 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 ro er maintenance f p p o subsurface sewage disposal systems. The size and location of the Soii 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)] 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 l6ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 '� EZ abed xeA dH bg:2 860Z M XeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: 1000 Gal. Tank D Box and 21 chamber's. Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ® Yes ® No Water meter readings, if available (last 2 years usage(gpd)): 2016,202,000Gal 2017-151,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/lndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seatslpersonslsq.ft., etc.).- Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc rev.6116 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System,Page 7 of 17 bZ a6ed xeJ dH 99:2 860Z 20 AeW Commonwealth of Massachusetts Title 5 Official Inspection Form t,, Subsurface Sewage Disposal System Form • Not for Voluntary Assessments v 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information Is required for every Centerville MA 02632 5-1-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cons) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: NA 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): 150e.doc•rev.SI16 Title 5 Offidel Inspectloi Fort:Subsurface SewaEe Disposal System•Page 8 of 17 5Z a6ed xed dH 55:2 960Z M 42W Commonwealth of Massachusetts U. ,� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments G� 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. CItyrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Tank NA/D Box and chamber's 2012 Permit#2012-393. Were sewage odors detected when arriving at the site? ❑ Yes ® No Bullding Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain). Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH -40. Septic Tank(locate on site plan). Depth below grade: 26"feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal. Precast H-10 Sludge depth: 3" tbins.doe•rev.ells Tile 5 Official Inspectlon Firm:Subsurface Sewage Disposal System-Page 9 of 17 gZ abed xe� dH 99:2 960Z ZO 42W 6\ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a� v 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required For every Centerville MA 02632 5-1-18 page, City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 8n Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt- Plan Tape-Sludge Judge. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and inlet cover at 26" below grade w/outlet cover at 8". Inlet baffle- outlet tee. No sign of leakage or over loading. Note: Inlet cover under pavein stone's Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6116 THe 5 Official Inspection Form:Subsurface Sewage Disposal System•page 10 cf 17 LZ @lied xed dH 99:2 860Z ZO XeW Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Farm- Not for Voluntary Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No I5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 gZ a5ed Y2J dH 99:2 91,OZ ZO XeW Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-1t3 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): D Box is 16"x16"-23" below grade w/cover at 6". Box is clean and solid w/three line's out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order,system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ine.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Dispose)System•Page 12 of 17 E a5ed xed dH 99:2 860Z ZO AeW Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Forth -Not for Voluntary Assessments uv 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. City/town State Zip Code hate of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 21 ❑ 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.): Leaching is three row's of 7 Biodiffuses per row. 21 Chamber's, Stone less system. Ck D Box and camera out lines. No sign of over loading or solid carry over. No sign of holding water. 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 scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 0117 06 aged xe� dH 99:2 8602 ZO XeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments P 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information o r e Centerville MA 02632 5-1-18 required for every page. CityJTown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic 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.): 15lns.doc•rev.6116 TAIe 5 Official Inspection Form:SuDSuffQ09 Sewage Disposal System•Pzga 14 of 17 6£ a5ed xe� dH L5:2 81.0Z 20 XeW Commonwealth of Massachusetts Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 545 Lumbert Mill Road 1V Property Address Robert Downer Owner Owner's Name information is Centerville MA 02632 5-1-16 required for every page. City/rown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately /3 -/ -7 �L7 3r c•3 pgvF- sr�'zs a o � t5ins.40e-rev.61'6 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 d 17 E£ a5ed xe� dH L9:2 860E EO AeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 10 Estimated depth to high ground water: 10'4° 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: 12-7-12 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: T.H. on Design plan 12-7-12 10'-4" no G.W.. Bottom of chamber's at T below grade. Bottom of chamber's at T-4" above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc rev.ellf Title 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 16 of 17 EE a5ed xeA dH L9 6Z 81,OZ ZO 42W Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v%p 545 Lumbert Mill Road Property Address Robert Downer Owner Owner's Name information is required for every Centerville MA 02632 5-1-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information —Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins.doc•rev.6J16 Title 5 Official Inspection form Subsurface Sewage Disposal System-Page 17 of 17 �� a6ed xe:1 dH L9:2 860Z ZO 42W Town of Barnstable P# Department of Regulatory Services '"LX r Public Health Division MA,� Date J r16 9. 200 Main Street,Hyannis MA 02601 Date Scheduled Time / Fee Pd. Soil Suitability Assessment for e Disposal Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address Owner's Name DAVI D b Tup Y <fAgt F <--eikdTEXVfL,(r Address Jr�S (•C�dit"W—T 4 t LL, C4 Assessor's Map/Parcel: I o /OR 7 Engineer's Name CAPrae>tp,� NEW CONSTRUCTION REPAIR Telephone# Land Use: 12-2,�S-jw ztL Slopes(96) _ —�{ Surface Stones Distances from: Open Water Body 2__ ft Possible Wet.Area��ft Drinking Water Well G � g 7c C- ft Drainage Way v—!'—ft Property Line /S ,KS_ ft Other —�----� ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands fn proximity to holes) L-5-/ 7ROJ9 q Parent material(geologic) ` Depth to Bedrock /J ` Depth to Oroundwater. Standing Water in Hole: A2 AL . Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: In. Depth to weeping from side of obs.hole: In, ©roundwater Adjustment 1<. Index Well# Reading Date: Index Well level _ __., Adj.factor— Adj.Groundwater level,, PERCOLATION TEST bate . Time Observation Hole# Time at 9" Depth of Perc p vt f Time at 6" Start Pre-soak Time @ 2— Z M'nIlk'r- Time(9"-6") End Pre-soak S�lS '� tlC/ t Ar`f Ce✓t S is�1 ti Rate Min./inch Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soii Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,,Boulders. onsi ten y.%'Gravel) 1A 4/7 Zy tog z"s.y 1- �18 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o sis en %Grave LS LO 42 L (1'F-tzy L s,I Lam--- ,5-y s/3 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders, Consistency. Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring:Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on l (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature �M Date J-� Q:\S.EPTIC\PERCFORM.DOC Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION =TOWN OF BARNSTABLE, MASSACHUSETTS applitation for Veposal *pstem (Cunstruttion Permit Application for a Permit to Construct( ) Repair(X) Up rrade ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 54 f S t k0W_t Mj LA,PO Owner's Name,Address,and Tel.lyo. � tco DPW) E, TUDY CASH Assessor's Map/Parcel (o p of"j L.0 6" tG`9U') CG`I T. Installer's Name,Address,and Tel.No.506—(471 v g 9 77 Designer's Name,Address and Tel.No.f©$-yZl>5313 Sr MA60Pei5 t Wks r n k&_S Type of Building: Dwelling 'No.of Bedrooms Lot Size of sq.ft. Garbage Grinder( ) Other Type of Building RE5lD0,,M 0r L No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3c) gpd Design flow provided 5�a�., gpd Plan Date 1'a--"I X01 X Number of sheets C;L Revision Date Title 545 W M OX MIL(— Tkb C_(a?j-rr_y\ji LLJL Size of Septic Tank 1000 664. 5.T. Type of S.A.S. O'ko D lOZ)jj 1 0 Description of Soil kez— 6 (W A4" / per(kQ Nature of Repairs or Alterations(Answer when applicable) U S C7 E211M ; CoDf' G*(J,� _56 01(4 T >e_ _2) Ntnt2 0-60K TA q Rows 6P MCI)!. f-IU7` 41Q ! - fdDiF L&Egg rt44 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt igned Date �L —to l- Application Approved by Date �•2 J Application Disapproved by Date for the following reasons Permit No. /o-'— Date Issued vim- d J No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION'"=}1'OM OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Disposal *pstem (Construction Permit Application for a Permit to Construct Repair�) •�ra Abandon ❑Complete System ❑Individual Components Location Address or Lot No. ��''c f 14`(,(,,`"v Owner's Name,Address,and Tel.No. / 0Av(n E, sVbY C45K Assessor's Map/Parcel 14�(a1C XII �'� (u-� s" 4 u_;v4se*,,T Attu. RJ*3 Installer's Name,Address,and Tel.No.So 6-( 71-88 7I Designer's Name,'Address,and Tel.No.SIC)R A471,5 313 dwpalrs S Pt co � 41,�teSr M SN pe' 1i W F6-r� as Fr&-1b Rn Type of Building: Dwelling No.of Bedrooms 43 Lot Size I la j$q0 sq.ft. Garbage Grinder( ) Other Type of Building R-E51 D(_21JT1 A(,.. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 3 S�'t�. gpd Plan r Date - 7, 1 �t,Ql Number of sheets "r1• Revision Date Title 54_S LOA-G CT I LL. RD C,MJ170LV t Lkj.—: Size of Septic Tank 'A 000 GAL_ 5.-1, Type of S.A.S. oA0 B(ODl�t�]�CC, Description of Soil *uez $1(mm 4 Aq-"�-F Q( / i Nature of Repairs or Alterations(Answer when applicable) US(= f')C/-STIo�JC� lD ( �LdtL) �HD7fL �I'lEftiY�.. Nc= !J- 6y1G rn QowS 6 1='iuE' Alec Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of r Compliance has been issued by this Board of Healt Signed ` ' Date a + 110 Application Approved by Date 2 %- Application Disapproved by Date for the following reasons ° Permit No. /r'3 `� -3 Date Issued / �) G/I ---------------------------------------------------------------------- .. i Tl i F COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance { THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by (!APC(A..XDC bJT Z I�E:S t.LC at 545 f1.VWZ0AX Kt I.). P.0 <AXJTQW1lA..Chas been constructed in accordance J with the provisions of Title 5 ands the for Disposal System Construction Permit Nam-/- - �� 3 dated Installer CAPEWtbE &0M?_P&C&-r CC d. Designer uNC�t1.J(��►e�OJGc WQPAeS ZNG #bedrooms •.3 Approved design flow ( gpd The issuance of this permit shall of be oonstrued as a guarantee that the system ill func n e igned. Date / / t- Inspector ----------,-----'------------------------------- - - - � j ------------------------------•-------------Fee---/-0 G-------- No.c — / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(N Upgrade( ) Abandon( ) <' System located at 54 (,,.0/V(1C' N(1�.4�. (2,�f�b -iE1VZ -RV1L.(..�" and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. i� Provided:Construction must be complete within three years of the date of this permit. Date / �/��// Approved by\._____.,� TOWN OF BARNSTABLE LOCATION LU-AI L61—i ,�9,�� ��� SEWAGE# Z o i2 - act 3 VELLAGECerl¢erll, Ili ASSESSOR'S MAP&PARCEL lv7;3LU Jq-G�_C7p�7 INSTALLER'S NAME&PHONE NO. l lcispow e l�, �a��, f iS�s Li C: g--i72— "r SEPTIC TANK CAPACITY LEACHING FACILITY: (type) kiQ 6 HC) (size) 3 1r NO. OF BEDROOMS OWNER 4)ekV (i1 -fi CTtJG��/ �cASI'1 PERMIT DATE: i a - 10 - 1 COMPLIANCE DATE: t - Separation Distance Between the: ✓�1 ^'=fir 4r`T�c/' Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ��c nl�i t``4 ►Gi'r Feet Private Water Supply Well and Leaching Facility(If any wells exist on , site of within 200 feet of leaching facility) 1.30 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _A A u Feet FURNISHED BY t B-1ga3 . !3 3030 G r:,,.eeN,Fr" .. i Town of Barnstable IM J Regulatory Services $ Thomas F. Geiler,Director Public Health Division . MM Thomas McKean,.Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: t a,-1 v - t 2 Sewage Permit# `Z-0 iZ - 393 Assessor's Map/Parcel 146-0 1-7 Installer& Designer Certification Form Designer: E,.,b n.¢A N',�� LNo r1As, )nc . Installer: Address: )z W. Crb s S ;e l_al 12d, Address: lS; : rw M A- a z y y N.SxeLt ►(`1 0Z 16 y`7 On 1 a " -1 vewrc�n- `c� �� � was issued a permit to install a (date) (installer) septic system at Sq belt- V ( Cep based on a design drawn by (address) 'pttt��. N1e £K1 ee irerxiated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (ire. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as=built by designer to follow. Stripout (if required) was.' cted and the soils were found satisfactory. "OF A. � o PETER T. �N WENTEE (In ler's Signatk6 CIVIL W No,35109 'o TS�s o (Designer's Signature) (Affix Design re) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CONEPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\office forms\designercertification fonn.doc LOCATION SEWAGE PERMIT NO. VILLAGE �� ; �r f INSTA LLER'S NAME i ADDRESS 14 r c A C'o -h -P 7" BUlIDERYR OWNER ' ff 11 Y DATE PERMIT ISSUED 1 � - �� - 77 DAT E COMPLIANCE ISSUED � � i �. h ' f G �� �� �� �, �� � �- �� s � C No..---..y ..-x..., Fx. ...... .................... • THE COMMONWEALT;#•uf MASSACHUSETTS BOAR® OF EALT,1 - OF............. .... ... .. 1 � � r Appliration for Diipooal Morks. Tonarnrtion ramit Application is hereby made for a Permit to Construct (-or Repair ( ) an Individual Sewage Disposal System at: �II Locati ddress�+ or Lot No. Owner Ad espy A ------ --- --- -- Installer Address Type of Buildin��g�� Size Lot............................Sq. feet �-, Dwelling�O�No. of Bedrooms____..._._.2...........................Expansion Attic ( ) Garbage Grinder-(-) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures .----•------••. ••------------- . ----------------------- Design Flow.............. ...........gallons per person per day. Total daily flow--_-.... ............gallons. WSeptic Tank—Liquid capacity/� gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-_--•-•--_-------••sq. ft. Seepage Pit No............Z...... Diameter..I.P-.57. Depth below inlet......6 e...... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by...... .Q- r.�__. a. _... r .._._4'e!._.... Date....... ' ` ........ Test Pit No. 1.... ......minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 4....... -------a ------------- Description of Soil------ �•- /! 'i't�.. ' �-.... 2� x U ....-•••-•••........-•-----••--•-•••-•••--•-••-••--•••---•---•-•-•-••-•-••---•-•••---------•-••••-•••.....-••-••••----•••-••••-•----•----•---•--••••-----•••-••-•.............•-•......--•-••-•------•-•- w x ------•-•--•--------------------------••-------•••••--•--•-----------•-----•••---------•--......--•- ---••-------------------•------•--•---•-••------•--••-••---------------•-•-•-••-----•-••-••••_...-- 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 TITI U 5 of the State Sanitary Code— The undersigned further agrees not to place he s stem in n .operation until a Certificate of Compliance has be 'ued by r a of alth. Application Approved B Date PP PP Y ....... .....................•--- ....... Date Application Disapproved for the following reasons:......................-••••--.................................................•............................... ..---•-•-••--••-------...--•-•----•---•-----------••-------------•-------•-•---------------•----------------------...---•-------------------------------------------------------------------------- ' Date - ��-� . Permit No....... Issued................•.----...n.... ..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 '>�•..�•......:O F.........../. ..................V....... ......... (9rdifirate Of -TRIM- p atit' r THIS IS1 TO CE TIFY, at the In ividu 1 swage Disposal'Syste ons.tructed ( r Repaired ( ) by ......................... •..................St has been installed in accordance with the provisions of •5,o1 e Sta e anitary Code a�described in the application for Disposal Works Construction Permit No......................................... date d-_-.x-.-.�------_7#.................... THE.ISSUANCE OF :THIS CERTIFICATE SHALL NOT BE CONSTR D AS A GUARANTEE THAT THE SYSTEM� WA LL FUNCTION SATISFACTORY. DATE: --••--••... ...`..1.._7 ...... Inspectors:_ THE COMMONWEALTH OF MASSACHUSETTS BOARDfJF HEALTH .........O F ...d� No. ........ .......'`.'' FEE.,/✓��............ Perm>ss>onereby anted - ------ to Con!tr ( Re air ( Aa" � u eja�� Dis ` ..... --•--- - ........................................................ •-----•---•--••- Street .� ass own on t e application-for D isposal Works Construction Pe t o Dated............................. - Y .......... Board o alth DATE..................... •--- l FORM 1255 HOSES & WARREN. INC., PUBLISHERS - 0 •'t No ........ Fss.............................. THE COMMONWEALTH OF_MASSACHUSETTS �5 BOAR® OF SALT ". :- O F .... ............. ......... .. � v AVV trafiou for Dtspngal Works Toustrnrttnn permit" Application is hereby made for a Permit to Construct (�14r Repair ( ) an Individual Sewage Disposal System :.. ................i.. t. .. kjcC •------- x /. / Locati ddress { � ...._ .. , .e.... .. j� 4' '--t-----•. --- Lot N .-----•--•-- 0 Owner. / �,. !J Sw..f• ...___ - t Addre sI Inst11(er e• �` Address Type of Building g/ Size Lot----------------------------Sq. feet a Dwelling XNo. of Bedrooms............ _____________________Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other .fixtures - {M-=-•----------------------------------------------------------------------------------------------••---------- w� W Design Flow.............. _,,' . . g lons::pei-•.'il F.. person per day. Total daily flow........ ............gallons. W Septic Tank—Liquid ca acit C __g Qns'' "Length................ Width................ Diameter................ Depth................ Disposal Trench—No_ ___.__._________md h.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------l------ Diameterl__.0•__.S_. Depth below inlet___._.._'_...... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.._.__L _._ Date___ 40_ Test Pit No. 1....2.......minutes per inch Depth of Test Pit____________________ Depth to ground wa er.................._...... r1r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ----- _ W Description of Soil......................... ` . =�!�-`.�--` x ---- - '"r4 -.'.� _..._.. w UNature 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 iI'iIL- 5 of the State Sanitary Code,— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by.the,-hoar-o � f h lth. + Sign c �--�C ..✓ �---...---•----.. l ate Application Approved BY +'.-- - ._ ...- • -•k "'✓" . �/ '--........ ..........................Date--•---- Application Disapproved for the following reasons: .---------•----•------------•-------------------•-----•--••----•-----•------•••----•-- ------•----------------------------------------------------------------------.................................... Date PermitNo...................................................--.... Issued....................................................... _ Date • • ;'4 EXISTING 1EACH PIT LEGEND N EXISTING SEPTIC TANK To BE PUMPED, FILLED WITH TOP OF TANK, EL.=98.74 SAND ANDJABANDONED. —— 98 -- EXISTING CONTOUR ® N V_umbe�t INV.(OUT)=97.41.f-, 11 Nl x 100.98 EXISTING SPOT GRADE N 46'3�1 31 W stockade fence N 55*0213 ♦ EXISTING WELL LUMBERT ° x 103,45 j 101 x 98.�5' POND/ x 98.62 26.49'x --O.H:W-- OVERHEAD WIRES 98.00 TEST PIT LOT 1 1 II / 1-8-5r BENCHMARK y e° I I -IT -1 Z o Mer eh Wy Cu ryber� Ry m MBLU 1,46-027 I INI °r°mOr / 1 I I _I LOCUS ? Rd 16,8gO±S.F. NIT -2 ° I I I I ° t 6 A0 T 0 i IUjI-I5--10' v'� Route 28 100.86 �\ L1�L I sz 99,15 x 98,72 1--�a 1 `�� LOCUS MAP x 103,16 �� 0 ` �`�\ + 1 �CLI; NOT TO SCALE Q I 1 LJ x 0 98.33 BENCHMARK SET GENERAL NOTES: OUTSIDE CORNERI80TT STEP 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ___J 0 `� ,A Z EL.=101.88 (ASSUMED DATUM) BOARD OF HEALTH AND THE DESIGN ENGINEER. iN �101,86 101.27 �� 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS M PATIO x 10 O OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE _ LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: It PAT/0 a' N —LOCAL REGULATION Chapter 397-8(E), Well Locations: 102------- X LAMP vc _ 9 89 1) A 20' variance, S.A.S. to Well (locus), for an 130' setback. GREENHOUS 10188 �'T'I 2) A 22' variance, D—Box to Well (locus), for a 128' setback. + 98,93 101.25 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR / TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE GARAGE 101 S DESIGN ENGINEER. EXISTING 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING Q a FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN HOUSE(#545) T ENGINEER BEFORE CONSTRUCTION CONTINUES. 101.04 100 L T.O.F.=101.5t /i 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 101.3 �P��� OF Mgss9C 6. THE THE DCONITRACTORGN NORR OWNER NOT TOENO�IFYIBLE HE F LOCAL BOARD OF OR THE FAILURE 99,94 OF D tiG HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. o PETER T. 1A,0,75' 8 91 o McENTEE 7. WATER SUPPLY PROVIDED BY PRIVATE WELL. CIVIL 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S. + �� \ + 100.01 No. 35109 IV�EWA Y:::. �; . 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS WALK 100,97 101.33EGI$ZE`��� AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 100,22. POF DIRECTED BY THE APPROVING AUTHORITIES. EXIST WELL v 1Q1,04 i "� 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY (Record) 00,22 v 1 2 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING Record i t�Jp..,, / x 9.9:61.... ...:. .``, / _ +.98,47 'Z�CIS� CONSTRUCTION. c 95.97 Tpci -!- 911 .0 5 ( 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS o _J 100.01 125.00' / IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND V _ REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). i, v�� � _3g" 99,65 v/ 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE x v `✓ INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. { xG 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 99,27 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. P LE 98 72 .97,96 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 545 LUMBERT MILL ROAD, CENTERVI LLE, .MA 97 45 -\98 02 edge of Prepared for: Capewide Enterprises, 153 Commercial St, Mashpee, MA 02649 98,63 Pavement 98.94 OWNER OF RECORD } 98,73 Engineering by: SCALE DRAWN JOB. N0. CASH, DAVID W & JUDY M "=20' P.T.M. 285-12 n inee ' r IInc. . PLAN REVISION 12/10/12 E g ring Wo ks, nc 545 LUMBERT MILL ROAD LUMBERT MILL ROA D CENTERVILLE, MA 02632 REVISE.-S.A.S. LOACTION DUE TO 12 West Crossfield Road, Forestdo►e, MA 02644 DATE CHECKED SHEET N0. EXISTING LEACH PIT. (508) 477-5313 12/7/12 P.T.M. 1 Of 2 i r. NOTE: TO PREVENT BREAKOUT, THE PROPOSED f SEPTIC TANK FINISH I GRADE SHALL NOT BE < EL:96.3 .. PROPOSED D-BOX FOR A' DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET & 1 INSTALL RISER & WATERTIGHT PERIMETER OF THE S.A.S. OUTLET AND SET TO 6" OF FINISH GRADE 1 t COVER SET TO 6" OF GRADE PROPOSED S.A.S. t INSTALL INSPECTION PORT OVER END UNIT 1 t 1 � t 1O U7 1 T.O.F.=101.5t 1 Q t 1 � 1 F.G. EL.=98.3t EXISTING F.G. EL.=100.6t F.G. EL.=98.5t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. t 1 t ± Z INSPECTION ��16 d• 001 1 L 37' L = 10' PORT g t t M . . ® S=1% (MIN.) ® S=1% (MIN.) (0 (o 1 1 4"SCH40 PVC 4"SCH40 PVC 6 10"I e' 10.75:RTT O14INVE EXISITNG 48" LIQUID INV.=95.90 LEVEL ADD INV.=96.17 PROPOSED INV.=96.00 3 ROWS OF 7 UNITS AT 5.0'/UNIT = 35' GAS BAFFLE INV.=97.41 D-BOX EXISTING SEPTIC TANK EXISITNG SOIL ABSORPTION SYSTEM (PROFILE) ESTABLISH VEGETATIVE COVER GREENNOUS BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS NOTES: 1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BREAKOUT=TOP .:i:.' :;' '`• " ", ' GARAGE TOP ELEV.=96.33 j .. . INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=95.90 EXISTING 2) D-BOX SHALL BE SET LEVEL AND TRUE TO HOUSE#54 GRADE ON A MECHANICALLY COMPACTED SIX BOTTOM ELEV.=95.00 /T.O.F.=101.5.E INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' MIN, OF NATURALLY OCCURING N 2.83' 310 CMR 15.221(2). PERVIOUS MATERIALS i = -I 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE GROUNDWATER EFFECTIVE WIDTH=8.5' 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE EXISTING SUITABLE S.A.S. LAYOUT AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. PERVIOUS MATERIALS TO EL=88.5 MATERIAL 3 ROWSSEPTIC SYSTEM PROFILE NOESEPARATIONFBETWEENArc EACH6HC ROW & NOITH STONE 63.25" N.T.S. TYPICAL SECTION 1 34.5"6" DESIGN CRITERIA SOIL LOG_ d DATE: DECEMBER 7, 2012 (REF. P#13810) NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER iMcENTEE PE, (SE#1542) r WITNESS: DONALD DESMARAIS R.S. TOP VIEW SOIL TEXTURAL CLASS: CLASS I HEALTH AGENT 60" DESIGN PERCOLATION RATE: <2 MIN/IN Elev. TP- 1 Depth iEleV. T P—2 Depth END CAP END CAP 98.3 0" ' 98.3 0" FRONT VIEW SIDE VIEW DAILY FLOW: 330 G.P.D. A I A DESIGN FLOW: 330 G.P.D. LOAMY SAND LOAMY SAND REAR/TOP VIEW 10YR 4/2 10YR 4/2 97.6 8" t 97.6 8„ NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW GARBAGE GRINDER: NO B B TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF LOAMY SAND LOAMY SAND DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. 10YR 5/8 .1 10YR 5/8 mmozr)s 4640 TRUEMAN 0.74 GPD/SF 96•3 24" 96.3 24" HIILLARD, OHIIO e 026 T�/ c1 ; C1 . Are 36HC DETAIL ak EXISTING SEPTIC TANK: 1000 GALLON CAPACITY I ADVANCED DRAWAGE SYSTEMS, INC. PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED MED. SAND , MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 3 ROWS OF 7—ADS Arc 36HC UNITS WITH NO 2.5Y 6/6 2.5Y 6/6 545 LUMBERT MILL ROAD, CENTERVILLE, MA SEPARATION BETWEEN EACH ROW & NO STONE 88.5 C2 118" 88'5 C2 118 Prepared for: Copewide Enterprises, 153 Commercial St, Mashpee, MA 02649 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) SILT LOAM SILT LOAM Engineering by: SCALE DRAWN JOB. NO. (Arc36HC Units) 21 UNITS x 5.0 LF x 4.80 SF/LF = 504.0 SF 88.0 5Y 5/3 124" 88.0 5Y 5/3 124„ Engineering Works, Inc. NTS P.T.M. 285-12 DESIGN FLOW PROVIDED: 0.74 GPD SF 504.0 SF = 373.0 GPD PERC RATE: <2 MIN./INCH ("Cl" HORIZON-ON FILE) 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. / ( ) NO GROUNDWATER OBSERVED (508) 477-5313 12/7/12 1 P.T.M. 2 Of 2 .. 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