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HomeMy WebLinkAbout0028 MANNI CIRCLE - Health 28 MANNI CIRCLE Centerville A = 169 - 125 S M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT 1090 CertifiedFiherSourcinp POST-CONSUMER wwwdipropremorp 6"12vo MADE IN USA GET ORGANIZED AT SMEAD.COM Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments F 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is Centerville ✓ MA 02632 10/10/2020 required for every page. City/Town State Zip Code Date of Inspection 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 out forms A. Inspector Information 5l-ir-- Ikfg43 on the computer, use only the tab A.Riker key to move your Name of Inspector cursor-do not Cape Dig Inc. use the return Company Name key. PO Box 726 r� Company Address South Yarmouth MA 02664 City/Town State Zip Code 508-776-6460 SI-4590 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 2020 Ins Date ctor'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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 1000 gallon septic tank ,distribution box and 500 gallon chambers inspected with no failures observed or repair required. System was observed to have been installed by a professional . 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspedon Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle ,V Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City(rown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts rn Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 151nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® The system fails. 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. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 33 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 GPD Description: Number of current residents: 2 Does residence have a r garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 2018=124 GPD 2019= 116 GPD Detail: Sump pump? ❑ Yes ® No Last date of occupancy: currentDate t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: homeowner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: n/a t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a t � 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: Tank was original with contruction of house. D- box and SAS installed 09/2018 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): dry with no stains observed t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1.5 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: 9'x5'x5' Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? 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.): level at correct inverts with no defects observed t5insp.doc•rev.7/26r2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts :41 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert equal to both outlets invets 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.): riser on with speed levelers with no carry over obserevd and stain line not visible above inverts of outlets. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 13 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2x chammbb galloners ® leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): chamber was observed to have no standing water in base with clean sand still visible in base of chamber with no indication of standing water 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.doc-rev.7126=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City(Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 A S� I a t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 c , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: no water 10.5 '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: 08/27/2018 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: test hole on file with soil logs ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: test hole on file with engineered plans and C.O.C. with engineer certification . Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form In Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 Manni Circle Property Address Jana Despres Owner Owner's Name information is required for every Centerville MA 02632 10/10/2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF BARNSTABLE LOCATION SEWAGE# 36401 -d4l' VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. AA SEPTIC TANK CAPACITY ,re JG -Im LEACHING FACILITY:(type) size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: 0-71,6LIbeiff— Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �s/fA Feet FURNISHED BY / I flew' i a � f� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Mispo8al *pstrm Construction Permit Application for a Permit to Construct( ) Repair-( ) Upgrade( ) bandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /,4,A AA t'�';v c LO/CZ,,Jly Dwner's Name,Address,and Tel.No. Assessor's Map/Parcel & Instal�leer's Name,Address,and el.No. PC .30 X 7a?f0 Designer's Name,Add ress,and Tel.No. p 8 �1���` L-.e.CCI� �f�.�'T�t"</�f�� �• ��se/f sa.."�l"'� �,..1 to�cY' c°^f a°h CP.0 4�'°� S'. I'�'�✓1►•S I'J/��( Type of Building: Dwelling No.of Bedrooms I r'�C Lot Size l&J 6,05e 7 sq.ft. Garbage Grinder( ) Other Type of Building j 'vS.49Cs-A^ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requ'red) gpd Design flow provided -� J S 9 gpd Plan Date 01 $ Number of sheets Revision Date ka 7 of Title rr��Size of Septic ((.•a Tank_ is���.�. „ j�0�� Type of S.A.S. or^ ©0 �,l ]�'Sr,�t Description of Soil `� SCC �G� �'I IaG i1 /A�r1d Nature of Repairs or Alterations(Answer when applicable)] ff �;',nS I� 4 y"Z - e X 06d ke? m G3 YF L.e� �/b1,Pf�� 1ni/ ,r?d �.1 Ptcr.SJl ►'► crL. n 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 Hea gne n a Date 0 Application Approved by 17 Date Application Disapproved by Date for the following reasons AA Permit No. Date Issued No. NA, K• Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pprication for Midposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) grade( ) Abandon( ) ❑Complete System ElIndividual Components ' Location Address or Lot No. �;?81,1^An COY c � -owner's Name,Address,and ryTel.No. Assessor's Map/Parcel �7 `rws IT�l• �� ,6• ,lAC- Installer's Name,Address,and Tel.No. a0 Be)r Designer's Name,Address,and Tel.No. Ki le 1�e r yt✓"«,-f .�i,ste �/' ? �N h $'• � 't/1 rs M,,� Type of Building: Dwelling No.of Bedrooms Lot Size Xi_G405.7 sq.ft. Garbage Grinder( ) Other Type of Building �t.Aberi+ No.of Persons Showers( ) Cafeteria( ) Other Fixtures ��ll p Design Flow(min.required) V gpd Design flow provided 3 3.5� 10 gpd Plan Date y s!$ Number of sheets Revision Date Za 7 a of Title 1 Size of Septic Tank �x�Sll.� ,� �aoy Type of S.A.S. ��5/0 Description of Soil �l Nature of Repairs or Alterations(Answer when applicable)) r✓&k)l A r•r..1 d-1 t X AA sg A V`1 k1ek by J SjAnC J) ftfJ)1 N 7 LeL r, n '4 7 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 Hea k .. Igne , n , -4 Date Application Approved by �I/ X V / J Date Application Disapproved by / 1 r Date for the following reasons AA n Permit No. ' Date Issued f v /L000,1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired K) Upgraded( ) Abandoned( )by- �:Kee- L,, ,4 C1^S�j A,e .�.4 i - Yt - k� / has been cons act x a�nce with the provisions of Title 5 and the for Dis osal System Construction Permit No r flt g' Installer jq. Designer -��ee+g:f ,/" #bedrooms 7—h/". Approved design flow and The issuance of this permit all not be construed as a guarantee that the sy ell ct of`n a"designedA��'"" Date Ins p cto• r -- -------------—--- _ ,.� No. : > - Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC]/HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstettt Construction Vermit q rmission is herebted to Construct( ) Repair( Upgrade ) Abandon( ) M / System located at c S� 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. Provided:Construct o, ust b completed within three years of the date of this permit. Date Approved by wJ ' Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division .`erg Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Q1111Y Sewage Permit#cWS"-0 ly Assessor's Map/Parcel 1691125 Installer& Desi2ner.Certification Form Sweetser Engineering Designer: Terence M. Hayes, R.S. Installer: Riker Land Construction Address: P.O. Box 713 Address: P.O. Box 726 South Dennis. MA 02660 South Yarmouth, MA 02673 On IV/07Gm Riker Lane Constructiorwas issued a permit to install a (dat (installer) septic system at 28 Manni Circle, Centerville based on a design drawn by (address) Sweetser. Engineering/Terence M. Havedated Aug 14, 2018, revised Aug 27, 2018 (designer) x 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 (i.e. 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 inspected and the soils were found satisfactory. i ,�N OF 4fA � vSgCti TERENCE �N (Installer' ature o M.HAYES _ No. 979 (Designer's igna e) (Affix Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF .COMPLIANCE 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 form.doc Town of Barnstable P# oF� Department of Regulatory Services anttxslv►Br� Public Health Division Date4z�om5 1639. 200 Main Street,Hyannis MA 02601 Date Scheduled Time I 1 Fee Pd. P C„„fry kw.7 Soil Suitability Assessment for S e Dispos l Performed By: �r(�1L�'� Witnessed By: LOCATION& GENERAL INFORMATION ' Location Address _ _ Own.. _ n_,... .;. 28 Manni Circle er'sName _Christine M. Murtha Centerville - ' P.O: Box 427, Address Hyannis, MA 02601 Assessor's Map/Parcel: 169/125 Engineer's Name Sweetser Engineering Robin W. Wilcox NEW CONSTRUCTION REPAIR X Telephone# Land Use ��rQ�..�Ti Slopes(%) � fU Surface Stones Distances from: Open Water Body O ft Possible Wet Area I,l 40L ft Drinking Water Well ft Drainage Way rZs' ft Property Line 7/V ft Other ft \ SKETCH:(Street name,dimensions of lot,exact locatio "of test holes&perc tests,locate wetlands in proximity to holes) I IPA �� t� o ?91 Parent material(geologic) UTw%J'/ O f Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater G'54 3 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ ..-PERCOLATION TEST Date Observation ' Hole# Time at 9" If Depth of Perc _ _ T Time at 6" Start Pre-soak Time @ •Time(9"-6") End Pre-soak 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 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) I-If 6� �Jr DEEP OBSERVATION HOLE LOG Hole# Z- 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,%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,%Gravely Flood Insurance Rate May: / Above 500 year flood boundary No Yes v Within 500 year boundary No_� Yes Within 100 year flood boundary No Yes Depth of Naturally Occurrine 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 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that bove analysis was performed by me consistent with the required traini ,ex ise an experie a abed' 0 CMR 15.017. Signature Date Q:ISEPTIC)PERCFORM.DOC ASSESSORS MAP NO- T PARCEL NO.: �/—/ — . ..; ;�f No.. ... ._ Fitz. ................_........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................O F........................................----'---------------.............................. Appliration for Diopnottl Works Tomitrurtion Prruat Application is hereby made for a Permit to Construct (,/ or Repair ( ) an Individual Sewage Disposal System at: 28' ai^' Cie, .�----•-.�._...--�..........�`� ...._. _..1�......r� . ----.......... - ..... (L....... .. .................... ............ Loca on- dress ,� or Lo•N - - . ...................... .......................... ........-•-•---•----.........••_. ..._......__._ ... .. Owner Arddress — .... .......................0.............0........ .................. .....................................••---............••..............--- 1.4 Installer Address dType of Building Size.,Lot............................Sq. feet Dwelling—No. of Bedrooms...............—.0 .......0.._.._.....Expansion Attic ( ) Garbage Grinder ( p '4 Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ------•------------------------------------------- -• W Design Flow.............. .....................gallons per person peg day. Total daily flow........ �J ......................gallons. WSeptic Tank—Liquid capacityl��gallons Length--- Width_.�{.l�_... Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I.......... Diameter...... Depth below inlet...-.c. ......... Total leaching area..20.....sq. ft. Z Other Distribution box (✓j Dosing tank ( ) '-' Percolation Test Results Performed by �� 'T _.. Q� __ Date---...�..-�2 --�J-�--------- aTest Pit No. 1...... .......minutes per inch Depth of Test Pit..../2-2-........ Depth to ground water..Alb.............. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a _...._..... ......... .....p....................................................................................... 0 Description of Soil------..0. ..f......._....! ...............................................-..................................-............ VI -� ................ r4 { 1.....• r� fv......S�-x A�.....................................----------------------------- 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 TITLE 5 of the State Sanitary Code e undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' e y the board of health. Signed_. --• -•---• ................. ........................... .-- ......--- �—'�� Dat Application Approved By.. o- ��?'......... ....................------- ------ Date Application Disapproved for the following reasons:..............................................................................................................- .....................-....................-...............................-...........------.......-......................----------------•----•-...-------'-•--------------'-'-------------------------- / Date Permit No.--. is Issued_ �Date No.-s .-.�..._ ' FEB............._..........._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ..................OF......................................---................................................. A ppliration for 14spuoal Murky Tonstrur#ion rP mit Application is hereby made for a Permit to Construct 61/ or Repair ( ) an Individual Sewage Disposal System at: ............. Al 1.7 .........7-,?2 . .................... -----•• -� �2 Location�/-Address or t N- �G /z G-'•- /� ; ................................................am_ Lo `% _ Owner Address ...................�.....r7-� -- -• •• ............ Installer Address UType of Building Size Lot................ Sq. feet ►-, Dwelling—No. of Bedrooms..............,..-.........................Expansion Attic ( ) Garbage Grinder (J�JFJ a'4 Other—Type of Building No. of persons............................ Showers YP g --------•................... P ( ) — Cafeteria ( ) dOther fixtures .........--•----------------------••-------...........•.......-•-•-------••--•--------•-•---....................•........ -•--•....-- W Design Flow.............. ��._..................gallons per person per day. Total daily flow..........-'..�:.....................gallons. WSeptic Tank—Liquid capacity/�Y'�gallons Length......... ._. Width..(/.&/'. Diameter................ Dept h................. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No........./.......... Diameter...... ...... Depth below inlet.... .......... Total leaching area..7-Cl.>.....sq. ft. z Other Distribution box (, ,r Dosing tank ( ) Percolation Test Results Performed by.........................Ul I!fZ.. ....... Date..... Test Pit No. I......./.......minutes per inch Depth of Test Pit..... '?....._._ Depth to ground water..zL.(:............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-..................... P4 ............••--•-•---•-•••--•----------•------------••-•-------------------------------------------......................................................... 0 Description of Soil....... --- ..........k .a::l �` ._ ��'.?~c/L-- W .................... ................................ ..... titil/ _-_/c __ •-•---•----------------•---•------•-------•----------•-------------•--•--•---•..............•....----..... 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 TITIE 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 board of health. Signed...................................................................................... ....---------... -•----- Application A ....-- - D Approved B Y ::...... ......•-•-•---•--------------------.-..----------------------------- ....._�_.......... . ...----- Date Application Disapproved for the following reasons:..........................•......._.._............._.__......_.__._•..-_-......_..................._......- — .-..... — ... - ........ . - (�� Date Permit N ................... Issued...-----`�. - ...............n THE COMMONWEALTH OF MASSACHUSETTS BOARD=i,,�HEALTH AJ .........I...... ........................OF.... .............................................................................. (Intifiratr of To ttplinurr THIS]-$ T,O CERTIFY, That the Individual Sewage Disposal System constructed (X) or Repaired ( ) by = .. -- ...................................................- ------- --------•-- 1 �/ Installer i has been installed in accordance with the provisions of TITLE rib i the application for Disposal Works Construction Permit No.......- .5 of The State Sanitary ( ..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ - Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS _._ -- BOARD OF HEALTH ......... "-'....................OF:: :.............................................................. F$s.. -.JT.... �iu�ruuttl�- 'u^rku �nn�#��tr#iun ��rmit Permission is herebyanted.......: �..?.4'C.`( In:11........................................ €n' -�-sue--- .....-----•--.. ......'. •--•........................._.... to Construc ( ) or"Re air ( ) an Individ al�ewage D' osal System at No.......... ....... ..... . '.�_- --��..-- ..�.-��C -- .r v�.�`C ........... Street as shown on the application for Disposal Works Construction Permit No.. §....i:51)ated.....:? ?. ..�� .......... - -- -- ... -- . f. - Board oT Health DATE................. --------- ............................... FORM FORM 1255 A. M. SULKIN, INC., BOSTON IVY I W. /v . so; G f?D "7GT .5✓ / 1 Z sIda --x..c1T/kK/ 2472Z-7 s Z 07 - 7 G% ) -71 97 —; — t-u - i I T=1 r rs , 7t7— mow_._ - � �' AX, OF MORM •-'r I � .:: /'lam- " - , . Td � ._ . . I ' , 4 �� 4L _ .7 I C)0.0() p AI ON .Pf' MINIMUM FROM CELL� OR COA AR WL Sol TO ;OF,fOUND :OF: b�'t CLEAN SAND 10 FT. MINIMUM' Doit By 10 FT. MINIMUM FROM SLAB (ASSUMED) CONCRETE INSPECTION PORT ,H Et "OBSERVAMON OLE VERS LOAM AND'SrE6 4" SCHEDULE,40 PVC !PIPE IV MIN. PITCH 1/8 PER FT, 2' LAER::OF /INCH 75 �,IN`C!HES/8 , TO 'PERCO TION"R ATE, WASHED S TONE MOTT OTH MAX, COLOR "" ER P nLTER P A541C DEPTH 14ORIZ TEXTURE. 6 97.75 MAX. VENT 4" CAST ]RON PIPE ­44 FILL 7 2.70 95.50 MIN. 0 NO ROO TS FT. (OR .EQUAL) MINIMUM , 44-510 A,,' L6A �SANIJ PER FLOW PITCH 1/4 �LEVEL RS TEE Ll -�; 10YR6/6 5A�MY SAND R y7/4, 2. C 0 MY SAND PLOW'LiNt 6 loll t26" 0 13 cl co 0 ELEV. MIN. 0 C3 CO r_3 C3,13' NO WATER,ENCOUNTERED`�T ELEV. T loll 0 0 t3 rl 0 ELEV. -:0 m b ci C3 ci 07.5 SUMP ELEV' -nON: : LiVEL , a ELEV. ADD GAS ' I � ;. I _ " ��� ;OBSERVA ELEV. 0 C3 12 0 C3 13 0 C3 C3 0 Q, o 2 BAFFLE COLOR MOTT TH R,i� 0 0 DEPTH HORtZ" TEXTURE'. 0 E DISTRIBUTION FILL ELEV. t: NO ELEv. ��97_C* LIQUID OUTLET BOX DEETH TEE� ROOTS: 2 500 4�5 'A LOAMY SAND. 4 FEET 14,INCHES GALLON ALLEYS WIT9 10 BE WATER TESTED 5 FEET AF MORE THAN ,ONE OUTLET 51 LOAMY SAND 10YR6 6 ROO 6 FEE T '�4 INCHES 'ON 19 -INCHES 1000 GALL STONE IN AN 13' X 2V X Z ; 'TRt TiON NLA NCH IF6RMA -i�!26 , C D 7 FEET 29 INCHES LOAM SAN .2.5Y7/A (TO BE,PLACED ON FIRM'tASE) 63 8 FEET 34 INCHES SEPTIC TANK- 5'5'00 ZONE 126" v. NO WATER�ENCOWTERED'AT LE 3/4" TO 1 1/2" CLEAN .!4 INDEX SOIL,- ABSORP11ON DOUBLE WASHED STONE . ADJUST, FREE OF FINES & SILT SYSTEM (SAS) USGS PROBABLE WATER TABLE ELEV. ONS ,' SEWAGE� DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE.t' F.LEV. -NUMBER,'OF. BEDROOMS DESION I CALCULA-71 NOT TO SCALE BOTTOM OF TEST,HOLE ELEV.. ISPOSAL UNIT­ FLOW TOTAL ESTIMATED' R.AAY X,,' �9R) 110 CAL AW�. GAL, 'REQUIRED SEPTIC TANK CAPACtTY '-ACTUAL SIZE Of-ttOTIC TANK GAL�,,' 4`,SOtL ,CLASsinCATION �DESIGN PERCOLATION RATE JOIN�IN _/D EFFLUENT-LOADING R ATE GAL� EA LEACHING AR SO. fT. :X'fZATE)LEACHING CAPA=1TY ?A R EA 477.001 .0.74 AL. AY RESERVE LEACHING CAPACITY NOTES _'M ATE Il, ALL�WORKMANSHIP AND RIXLS�SHALL' CONFORM TO-AND FOR', TITLE 5 -THE TOWN'S RULES,AND REGULATIONS THE'SU8SURFACE'DISPOSAL OF SEWAGE. 2. ALL COVERS To SANITARY UNITS SHALL BE'BROUGHT TO �WITHIN 6' OF FINISHED GRADE. -THE SANITARY SYSTEM SHALL'6E CAPABLE OF 3. ALL COMPONENTS -OF WITHSTANDING 4-10 LOADINC'UNLESS,THEY,ARE UNDER OR WITHIN �110 FTl OF DRIVES OR PARKINGAREAS, 20 LOADING SHALL BE 98.2 '-USED UNDER OR LOT 62 WITHIN 10.-`FT.� OF DRIVES OR PARKING AREAS." 16,605.7 -- 4, ANY MASONLARY.,VNITS .4jSM ,TO BRING tOVERS TO,,tRADE SHALL 'PLACE' 13E*ORTARIED'AN -AS 0 C MPLIA Ct-WITH 6 +*NO DETE091INATIO114 HAS BEEN IMAIDE' It "0 DEEDED OR ZONING'REGULATIONS. OWNER- APPLICANT-Is 10 �OBTAIN-SUCH DETERMINATION-FROM APPROPRIATE AUTHORITY. ' 6'UTILJTIES SHOWN ARE PPROXIMATE -ONLY,,EXCAVATION CONTRACTOR .: IS O,CALL "DIG-;�SAFE" T 1-888-344-7233 AT' AST:, I F 72,HOUPS ,- PR IOR ,To,COMMENCING WORK,ON S�f TE. ONS ,AS WELL A 98.7 7. CONTRACTOR,ISJO VERIFY GRADES AND ELEvATI SJTE.�ANY TE CONDITIONS PRIOR TO'COMMENCING WORK ON -BE 8 S TO DESIGN ENGINEER 1 ATION ROUC44T''TO THE�ATTENTION OF THE �'IMMEDIATELY.,-.:-� 7.8 B. PARCEL 'IS 4N FLOOD ZONE' S ,PARCEL . 123 9. LOT IS SHOWN ON.-ASSESSORS MAP 160 VIED FROM 'UNDE­R -A-- "FOR'-A MINIMUM 'OF,'5' AROUND SOIL,ABSORPTION-SSTEM AND BE 0. LL 98.7 -,,UNSUITABLE MATERIAL SHALL BE REMO D -::REPLA= WITH'MATERIAL,,AS,SPECIFIED INIO CMR 15.255:(3), 8.8 97.3 R A -MINIMUM OF, 48 HOURSz THE INSTALLER IS TO GIVE THE ENGINEE SELd kit WORKING DAYS) NOTICE,FOR THEFINAL INSPECTIONt (NUMBER. 12-EXISTING PIT IS TO BE PumPED AND BACKFILLED. 98.0 1000 GALLON�" SEPTIC TANK. OF WARD _,�.OF .-HEALTW" APPROWD T F�E 7.0 96.9 7; M. 8.3 in No 9 AGENT.. DATE 97.6 A Ac ESIGN ROPOSED`,��SEPTT 97.5 5. ENTERxn D. "M BAY R. 1 1NC 13OX LE .9 LIMIT OF 5' OVERDIG 9 4 iDoAt, 28 , MANNI CIR.�, ' OT �62 .­ 0 - OF&N :' BARNSTABLE, UAS S.,4. SOIL - CENTERVILLE OBIN TEEt T 1�1 00, WILLIAM WILCOX S W= MGDYZMWG' - 97.5, TEST 2____ No. 31G4 .203 SETUCKET ROAD G/s� 508- P. 0. BOX713 97.6 SOUTH DENNIS, MASS. � LEGEND: L 385-6900 02660 EXISTING SPOT ELEVATION 00,0 ALE 00---- :DATE EXISTING CONTOUR AUG. 14,' 20181 �2 0' .FINAL SPOT ELEVATION ORAIN,4CE FINAL CONTOUR—��_� lei EASEM \,4 Et47. SOIL TEST LOCATION REV. FJOB NO. 806 UTILITY POLE -0- W AUG.- 27,, 2018 1-OOL-i TOWN WATER —W CATCH BASIN �mj GAS LINE REV. ----C. LOCATION' MAP -,SHEET , CLEAN OU CESSPOOL C.P. 0 A14 00 -SAS C.,�58JPRO��8061 \8061 2.DWG 0 2018 SWEETSER ENGINEERING