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Home My WebLink About0047 MARIE-ANN TERRACE - Health (2) 47 Marie-Ann Terrace:!,, Centerville . A= 189 =097 UPC 12534 No.2...,v 1� HASTINGS,MN I Commonwealth of Massachusetts IV-Ll�T W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °< 47 Marie Ann Terrace Property Address Jim Hill �. Owner Owner's Name :.j information is required for every Centerville MA 02632 7/20/2017 page. Cityrrown State Zip Code Date of Inspection :a 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. General Information on the computer, /02 S-01 use only the tab 1. Inspector: key to move your cursor-do not Paul Martin use the return Name of Inspector key. Cape Cod Septic Services „y Company Name 350 Main St Company Address > W.Yarmouth MA 02673 Cityrrown State Zip Code 508-775-2825 S15016 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/27/2017 Inspector'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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system_owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pag 1 of 17 t4F vS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Cltyrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: System in working condition. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments •at . 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. City/Town 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments < 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Cityrrown 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 cesspool is less than 6" below invert or available volume is less than '/Z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments � 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is Centerville MA 02632 7/20/2017 required for every 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 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. 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 El ❑ 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 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110x5= 550gpd t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �( 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No 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 ears usage d 2015=216gpd g ( y g (gp ))' 2016=230gpd Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date 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 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "( 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: No Records 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts v. a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is Centerville MA 02632 7/20/2017 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2008 Per BOH records Were sewage odors detected when arriving at the site? ❑ Yes ® No 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: +10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): Line checked with sewer camera and was found to be clean, properly pitched with no sign of root intrusion. Septic Tank(locate on site plan): Depth below grade: 16"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: 1000Gal and 1500Gal Sludge depth: 6-811, 1-211 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts u r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments dY 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 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 Scum thickness 8-1011, 0" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estimated Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1000Gal tank in good structural condition. PVC tees in place. Tank at normal operating level. Covers 6" below grade. Recommend service of tank. 1500 Gal tank in good condition. PVC tees in place and clean.Tank at normal operating level. Covers 10"below grade. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 117 Commonwealth of Massachusetts Title 5 Official Inspection Form a a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °r 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Citylrown 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i; 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Cityrrown 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.): H-10 DB-3 with 1 line in and 2 lines out in good condition. Box is clean and level with no solids carryover.Outlet inverts equal. No sign of overloading or hydraulic failure. Cover 15"below grade. 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: t51ns•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number.: ® leaching chambers number: 4-500Gal ❑ 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.): 4-500Gal Leach chambers with stone. 13'x42'x2'. No standing effluent in chambers at time of inspection. No staining. No sign of overloading or hydraulic failure. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 0 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "t 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. Cityrrown 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.): t51ns•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name Information is required for every Centerville MA 02632 7/20/2017 page. City/Town 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 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 N Commonwealth of Massachusetts v r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells +11' Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from.system design plans on record If checked, date of design plan reviewed: 2008 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: Test hole data per plan on file at BOH. Test hole did not encounter water at 11'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 47 Marie Ann Terrace Property Address Jim Hill Owner Owner's Name information is required for every Centerville MA 02632 7/20/2017 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 Qisposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCATION COA &nA I rra(R SEWAGE 1i VILLAGE_ ¢rl�-tA w L�t ASSESSOR'S MAP&PARCEL f ^ 09 7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY M0 0,c) q'`Ft 5 6,.P t- t S0 0 1k to LEACHING FACILITY-(VAX) 4) G.C.rvn (Size) t3,e (12 NO.OF BEDROOMS S OWNER 1AM PERMIT DATE:_�-Z R Uo8 COMPLIANCE DATE: f 2-L 3— 2 0 la Seppration Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 91 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) Feet FURNISHED BY .e..r i r'"5 LX— A 1 39 �--� Az 4o 45 ys' v tS A4 Y),S 3i cc • BZ t3 S V �3 13.0 t3y h�.5 4r 55 7 C B� 31 3ti 49 C> 3(q eb a9.s- c� 31.0 TOWN OF BARNSTABLE LOCATION 41 (lAct-k &AA )a rdaaco- SEWAGE# `260'6 s o 3`1 VILLAGE U( ASSESSOR'S MAP&PARCEL 09 7 INSTALLER'S NAME&PHONE NO. `c�()ewt�Q `�'w�2.�n✓lS c �f Z�l �Oa1�' SEPTIC TANK CAPACITY 1DbO l{ t (SO C) lk to LEACHING FACILITY-(type) (cf L.0 S'o' (size) t3,� Na NO.OF BEDROOMS , OWNER PERMIT DATE: COMPLIANCE DATE: Z—Z 3— 2 0 lA Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Mo 0 (1 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) Feet FURNISHED BY ' Pam'' c� 14.Qi5 L(,C, Al AZ 4 o s'` �. 4 3 YS v A Ay y),S 31 aq 1e,5 3s 3S ? C 3� 31 3� v 9 C 3 3c� c� 31. i f 5� No. � Fee HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es Rpplication for �Dio ooal 6yotem Con0tructiou Permit Application for a Permit to Construct(X Repair( ) Upgrade( ) Abandon( ) 2rComplete System ❑Individual Components Location Address or Lot No.Ll 11ArV %e. Ann Te C-rkL:, Owner's Name,Address;and Tel.No. Assessor's Map/Parcel ( 9 =D I Installer's Name,Address,and Tel.No. Des,',, 's Name,Address and Tel.No. t=ey'nut�y �a�l v Sa -`iZE-3S4 Type of Building: Dwelling No.of Bedrooms 5 Lot Size 0.,47 rv_ -M-ft. Garbage Grinder (00) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S S Q gpd Design flow provided e5(F I gpd Plan Date '�u wft;r--, 2-11,i!cnl� ,Number of sheets Revision Date Title 'Fcd 5 S K Size of Septic Tank I506 (.,'lt n Type of S.A.S. 4-5M Cas\ C z >< .Z t;e Description of Soil i��1t`7 c7-Zi C t L(- -3 i P JE 5A,33 (.nt�k.-. Ink y 1 z 11-48" 'R y�au� Wie, Sti r Nature of Repairs or Alterations(Answer when applicable) 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 and of Health Si e - Date Z- 7A,1 Application Approved by �flll W��- -V Date Application Disapproved by: Date for the following reasons Permit No. 9ff Date Issued No. Fee is o HE COMMONWEALTH OF MASSACHUSETTS Entered'in computer. PUBLI6HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0� ZI ` rfcation for io aal � mem Cootruct p tonerrrYtt Application for a Permit to Construct(� Repair( Upgrade(") Abandon( ) Complete System ❑Individual Components Location Address or Lot No.y1 mGr%e �n�Te CCq l 2_i i Owner's Name,Address;and Tel.No. L°e rvie SomeS h. t 14,es L 4%%% 5 : 1 ti�m� ,r cf 41 Z�n Assessor's Map/Parcel I$ 9 `X �a Installer's Name,Address d Tel.No. n 'l Designer's Name,Address and Tel.No. 1' ►101<-Tt,7 SQkX%\r.r\ In ,nur Sv�� astir•�� r+!'>F� oz�ss Sod-�IZ8-33y Type"of Building: Dwelling No.of Bedrooms Lot Size 0.4.7 AL sq:ft. Garbage Grinder (PO) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures _ Design Flow(min.required) 550 gpd Design flow provided 5C4. gpd Plan Date '10 am" 7-11(-qpR ,Number of sheets I Revision Date —' Title PolfgF� i —ter Size of Septic Tank I506 (c lon Type of S.A.S._4 500 C6, rs lZ-Ip' x4 i;M Description of Soil ice#- 12'104'1 0-Z.J" (:'I L . Z I-31 r kU7 SAN3Y Lon wN ItA ` jr- It'd' R IoV S/(Q y'3-13 Z"f C rnt-o SaN� 10y e,Tr r Nature of Repairs or Alterations(Answer when applicable) 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 rd of Health Si e C Date Z V 0 'Application Approved by t9 Date Application Disapproved 1: _ Date for the following reasons S �. Permit No. ————————Dal Issued ——————————————— —— ———————————-- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compt artce 9 THIS IS TO CERTIFY,that the On-site Sewage Disposal System Construct d (.,.�- Repaired ( ) Upgraded ( ) Abandoned( )by 1 at q{ Mtkrt2 Ann�CQ ff t e (�e 6c u&e. has •een con ructed in c/c dance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer #bedrooms Approved design fl1a*w gpd The issuance of this perinit shall not be construed as a guarantee that the system,�I uric on as desibed. Date +73 /Q Inspector 1� s ——————————————————————————————————————————— e� S�No. THE COMMONWEALTH OF MASSACHUSETTS Fee PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1wt000l *paem Congtructton Permit Permission is hereby granted to Construct (_-) Repair ( ) L�g�ade ( ) AbandonSystem located at H1 l�ckrtf_ l\rr\ �QCcc. ,_ 4 Cc _ /b r,ice, (110 --z— and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be co = leted within threertyears of the d e of f this pe• t Date .W I Approve byy ' t A m l` V d Oo � O os- INI Cr) _ . . . . . . . . . . . . . . . . . . '. - . . . . . _ . . , . . . . ` Closet if ld- - - - • - - - : ; . . . . . . . . . . . . . . . . . New -Stair-Oak-Tread N : f : t Jul : : : : ; //V . _ . . . . . ' . Teruo Wall 'Double ide _ . . . . . r . - . j� 3 6. 1 6x!'2 . . . . . . . . . . 36x42 -Double Hu n. . . . . . . . . . c . . ;�� rtd r. . . . . . . . _ . . . . . . . . . ' : O . . . . . . _ . . . . . . . : :47 aKi ,n n Terrace, C ent r lle.- . . _ . . . . . . . . . . - - . . _ . . _ . . . . . ., . . . . . . . . . - - - - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . _ . . . . . . . . _ _ . . . . . . _ . . . . . . . . . . . . . . . . . . . . . b Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 0201 Office: 508462-4644 Fax: 508-790-6304 Instaner& Des a Certification Form 23 IQ�Sewage Permits 03 Assessor's Map�Parc Date: � I �-- _ . Deli x: ,V 4.SlV A 46 Installer: Address: P619ASt Qe,e Address• Q. 9 p7 c-3 i was issued a permit to install a (fie) er) C.-Ar rew 1 CA.,& M septic system at 47 Ik t �►t based on a design drawn by ( s) S'�t„wwirw ►¢ 1waC dated 2 .... ...... ..... ......... — I certify that the septic system referenced above s i wanstalled substantially. -- m- according to the design,which may include minorapprro changes such as - - "�-latetil relocation of the distribution box andlor septic tank, I certify that the septic system referenced above was installed with major changes (i.e.grester than 10' lateral relocation of the SAS or any vertical relocation of airy component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. Of s Signature) KTER $UUJ1AAf1 .Na 2" O (� Affix Designers tamp Here) es ee s Signature) ( -. _---- $ N CERMECATi. COMP'LWCE WILL NOT BE LSSUED UNTIL BOTH THLS FORM AND AS BUILT CARD ARE RECEIVED BY THE.BARN$TABLE PUHLIC HEALTH DIVISION.THANK YOU.. Q Hesltls/SapticJDeeignac cerdoca m mm 3-26.04.6oc 7n 7C)HJ ntiiT Mki-I kl"AT��nr i Tnrn7"nnf Tn i T nTn7 /r 7 /7T Town of Barnstable P# Department of Regulatory Services F MUMSTAW Pu blic Health Division Date 01 ity 200 Main Street,Hyannis MA 02601 0 S,k a /'Time �Date Scheduled I .r d L4 Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: L IM� Witnessed By:•Dtr►ncti Z. I_"Or �' Location LOCATION& GENERAL INFORMATION [[�� Address pp '1 T� A Ai�xG-Awj "]�, zr_AC ci, Owner,s Name' `M K 4 G` (X Address t(-? A, Assessor's Map/Parcel: i � Oct 7 Engineer's Name NEW CONSTRUCTION REPAIR Telephone# 576 4 Land Use eem:dun1-.c. !Slopes(96) -r,,,—L(.' Ia Surface Stones Distances from: Open Water Body 500 ft Possible Wet Area 5oQ ft Drinking Water Well SCn ft Drainage Way 5,L ft: Property line $b ft Other WA- ft i SKETCH:(Street name,dimensions of lo4 exact locations of test holes tit pere tests',locate wetlands{n proximity to holes) J 4V1 43 k"( 2 Parent material(geologic) QJ� �� Depth to Bedrock Depth to Groundwater. Standing Water in Hole: 1VOINt Weeping from Pit Face Nor. Estimated Seasonal High Groundwater (EL l S) der T.at3, Coru,,rcl�w�� ;Q DETERMINATION FOR SEASONAL HIGH WATER TABLE _...__._Method Used:.�i)-u&' — -e Alm _ @ Depth Observed standing in obs hole: - - in, Depth tti soli mottle!: 1 In Depth to weeping from side of obs.hole: in, Groundwater Adjustment „_ ,, Index Well# Reading Date: Index Well level _; Adj.Wtot— Adj.Groundwater Le„ Vol•,,,e ` PERCOLATION TEST Date Thne It_— Observation Hole# z _ Time at 9" U sow Depth ofP�erc .� 40 Time At6" lt)t�5 Sou ' Start Pre-soak Time 0 ZS t,A4..5 J �_... Time(9 •6 ) _,,._._„_ r,; End Pre-soak i mr A y - Rate MinJlnch Site Suitability Assessment: Site Passed t� Site Failed: Additional Testing Needed(Y/N) J 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. QASEPTI0PERCFORM.DOC DEEROBSERVATION HOLE LOG Hole# Depth from Sol[Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, Gravel) b�-Z��t F I t_L • Z — 37 v lkff SA�.�I I OF�V►� I (� 3 -SY LLr'%"'''7 5N-3-0. M I Q.5 DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ns u I . yell P I t_L 2 t-3 I ►� SaNTI I �� I t9�1�K Z —.18�' loiY' Sly I S DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. IConsistency. DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, O —Z. �t 5A�t�o I"f,S Flood Insurance Irate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No`� Yes Within 100 year flood boundary No✓ Yes Death 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? YeA If not,what.is the depth of naturally occurring pervious material? _.__ _....._. Certification I certify that on I (date)I have passed the soil evaluator examination approved the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 10 CMR 15.017. Signature Date Q. EPMOPBRCFORM.DOC LOt kTION SEWAGE PERMIT NO. VILLAGE Ceovreews ��gm INSTJA LLER'S4. NAME & ADDRESS B U I L Ya6raw R OR OWNER DATE PERMIT ISSUED �/ �b 7 DATE COMPLIANCE ISSUED �/ /3 /7 1; . � r, � '�� I I y� `\ 0 - _ �� .« +. 4 AL Ni •- (=/ .... Fxs.......... v.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OAF. - HE LTH ..........F .......OF.....404.�� ........................... 0 ` Atip ira#inn for Disposal lVorkS Tome rnrtinn famit Application is hereby made for a Permit to Construct ( ) or Repair (/wjo�n Individual Sewage Disposal System at: /1, [ter dam? S� 7 /I7a�c.r (�,�„ r ..... __ ................... - ............................................................ c ... Location-Addres d� ----------------•----•--••--•----------------Lot No. L Owner --------------------------------Address ` .. .. -•-----------------------------•-------•- --•----•-•- ------------------------------------------- I staller Address Type of Building Size Lot............................Sq. f t U Dwelling—No. of Bedrooms.___._...............................:Expansion Attic ( ) Garbage Grinder (/ ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures --------------•-•---•-•.............._......... W 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..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ a ................. O Description of Soil �'+_P�_ �"._ ..__....._.. ..... . ................. ........ x W ••--------------------------•-------------------•-------------.....---••--•-•--•••-•--------•---------------••-------•---------------. U Nature of Repairs or AI erationg—Answer when a licable___Idv ____ _ _ �-o•1..!........ .--__--._-___. L. �p Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT i y g g P y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has bDeCn issued b the board of health. &Si. d . ---------•-••---------•---•-•-------,� �. ,Application Approved BY ,Gd -•-•--X- / 7 ' Date Application Disapproved for the following reasons:....._. ............ ....... ...................................................... Date Permit No......................................................... Issued--- Date Jav -.46 �• r 104 w� s - tc" s, r� - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /' 'I k_ 44r 1, _w re�' C ..........................................OF.......`............... ......................................................... Tertifirab of Tompliatta THIS IS TO e Disposal System constructed or Repaired CERTIFY, That the Individual Sewage by...... ----------_------- ---------------------------------------------------------- ... ..... . ... ... --• ---- -----------------*--------------------- A-0 Installer el'�25'V at.....................................-------------i-------------_----7-------------------------*--------------------------------------- ........................................ has been installed in accordance with the provisions of TITIZ 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated__..._____._._______...__._...__................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE----........................................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS r___ BOARD- OF HEALTH W, ...... ................OF............ .. ........................ ...... .......... ........... .......................... ... NC) ...... FEE..........\:F�....... ....... 11isposat 11!rka 0.11ongtnution "Vamit Permission is hereby granted............................... -------------- --------- ----------- ............... to ConstruSk( Disposal stem _Y�_or Repair an I dual,Sew at No.."'.. rem ...... . .......... ------............... 7... . - Sfre as shown on the applic ation for Disposal Works Construction Pe I N Dated................................ "Al opy . ...... .. . .. .............................0 ...... ----**B6ard of Health DATE------. ......... ............... ........... FORM 1255 HOBBS 8i WARREN. INC.. PUBLISHERS Ni .......... r --•- Fis............... �.... ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HEALTH �•s. , t, .:r'?.,n ��,,��1 1. � 1 p F ti✓t..-• ;�r.. ., OF ...................... AppAir,allon for Dhipot l Works Ton,itrnr#inn Famit Application is hereby made for a Permit to Construct ( ) or Repair (4- 'an Individual Sewage Disposal System at: )) r� r ¢ �* ,,^ `_Loi ation-Address! „y,., or Lot No................ ................ 3c? 4 ... .-------•--•'•- ::: :..... ----------------------•--•--.----• •...----• ....................................... Owner Address 4 � ' Installer Address d Type ofitBuilding 7 Size Lot............................Sq. f t U Dwelling—No:,of Bedrooms...... ................................Expansion Attic ( } Garbage Grinder ( ) Other Type of Building g ........................----r No. of persons.......................:_:=-:Showers ( ) — Cafeteria ( ) Other fixtures ....................................----- --------------------------------_.. ------------------------------------------------------------ W ;.. Design Flow............................................gallons per person per.day. Total daily flow............................................gallons. 0; Septic Tank—Liquid capacity............gallons Length................. Width................ Diameter__'............ Depth............... Disposal Trench--No. .................... Width---------------------Total Length____ ............. Total leaching area-----_...............sq. ft. Seepage Pit No----------------------- Diameter.:.................. Depth,:below inlet.................... Total leaching area..................sq. ft. z ".-.,Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed bY.........................-.................................................: Date....................................... Test Pit No. -1_________________minutes per inch Depth of Test-Pit.,__:___............ Depth to ground water......................... GL, Test Pit No. 2.............;minutes per inch Depth of.Test Pit.................... Depth to ground water........................ ----------------------------''......._._..___...._---.--;--.-__.------------. ._..._..._...___......................................................... f p... "' Yiy...:! _+'� art ,:� r.• `- Description of Soil___:_._.. ..�..__.... V ....-------•------------------------------------------------------------------------------------- W ______________________________________________________________________________________________________ P -_ -. V. Nature of Repairs or Alterations—Answer when,oplicable f{ "`V c____ e' y'..l ,_ ' -' --- --------------- --------------••-•-- -------• -------- ---•---------------- ---- . -- ------------------- --- ---------------------------- - Agreement The undersigned agrees to install the aforedescribed Individual -Sewage Disposal System in accordance with the provisions of:T T LE 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 b fthe board of health. -- e�f r ✓ - D to Application Approved B` "" PP pP Y = < < �'ram/ ----------------•--•--•--- -• Date Application' Disapproved for the'f ollowing reasons:.................. -----•-------•.................. .....................----------------••---•----.---- .....................................•---....._..... ---------•-•- -------------------- ----------........... ------------------------------------------ Date Permit No.................. - " Issued. --- ull V �,,��.<<� PA.EL.44A I V� y � � 1N► ILI �kl d,( � yet tin ter ' r s lr F.G. V t� L ., 2?�J _ F.G.EL. LONE. RD-1 (RPOD) See Noft4(IM) Area (min. 87,120 SF w Frontagqe min) 20' s Width BF. 4 Setbackks: Im"mm Front 30' 5WGallon TOPM37Ao Side l0; Septic Tank ox Rear. 10 Flow diaea ' AaRegamod Leaching FLOOD ZONE: Zone C ry Bcddin&-ra,&Da11cb Community Panel No. as Per Ti&5 IfEnmmandRown&Rgdsce ANL'MulWeSostwiOinYof #250001 0015 C lsxNoteatiR9) T�ootaPerimetnrorT6eSy�tan a August 19, 1985 " 10'kfm.-Shb 201bi -FoUndafin DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM E413A Location Map Gramdw�Oer NOT TO SCALE '�'004 - PaTAH.C3omdw•shrMq ASSESSORS REF.: \ Map 189, Parcel 097 OVERLAY DISTRICT.- AP — Aquifer Protection District 3 As Shown on Plan Entitled CompWedFA "Revised Groundwater Protection wCR Overlay Districts" — April, 1993 z. AN14r-1/2' — Pa Slam EX'S GAR NG '' r New:,,md A E MCHM sane c11Ar�1.=R ( \ EXIST DRIVE�yq Y 41-10" Q17-10" CONNECT LAUNDRY CROSS SECTION OF CHAMBER TO PROPOSED NOT TO SCALE EXIST G SYSTEM DECK \ W EXISTING DW LLING SEPTIC NOTES DESIGN DATA EXISTING SYST MS %�^ 1.Location of utilities shown on This Plan Am X Approx.At Least 72 Homs Single Family-5 Bedrooms TO BE REMO V D B.F L' 41.0 Prior to Any Excavation For This Project the Contractor Shall Make With NO Garbage Grinder OR PUMPED, FILLED ' the Required Notification to big Safe(1-889-344-7233). Daily Flow=110 x 5=550 GPD / 2.The Contractor is Required to Secure Appropriate Permits From Town Septic Tank:550 GPD x 200'/a=1100 GPD &_ABANDONE PROPOSED \ • _. Agencies For construction Defined by This Plan. Use 1500 Gallon Septic Tank be Constrocted in coordbipfion With -- ' p �SE TIC TANK 3•COMMe Water shall be in Accordance eM1c 1.00-7.00 LEACHING AREA 0 J \ &310 CMR 15.00.The Water Line Shall be Sleeved Where Required. 550 GPD/0.74=743 SF ( L 4.Install Risers to Within 6"of Fb*&odGrade(4 Required), Raluirod Sidewall=2 12.83'+42 '—5 42._,_,�,_,� �/W �Alt t" �� —2 �. Rsz 4, 5.All Structures Buried Three Foot or More or Subject ( ')Z— 39 SF Bottom Area= 12.83'x42 219 SF }�n t d v^�"r '" / to Vehicular Traffic to be H-20 Loading.It is the Engrrloc's ( � /" t•�^ La I' q) Recommendation that FI 20 Always be UseL 758 SF Total Provided TH—3 b 6.Septic system to be bstalled in Accordance With 310 CMR 15.00& srp PROPOSED TH—4 SAS Board of Health PRO OSED 248 CMR 1.00-7.00 Latest Revision and the Town ofBarnstable LEACHING CHAMBER DESIGN �ZI z 3 t oAll Pipes to be Schedule 40.Use D—BOX 4-500 Gal.Leaching Chambers in 8.Inlet Tees Shall Extend PVC. of 10"/ Below the Flow Lase. 12.83'x 42'Washed Stone Fields as Shown / �p , 9.An Outlet Tee Shall Extend 14"Below the Flow Lmc, 03 M/ and Shall be Equiped with aGas Baffle. PERC TEST: 12,047 \`36 PP.RFORMEDBY:IOHNOVE&W.SUILIVANENGIN1000 WITNESSEDBY.-DONNAz.MIORMI P-&-TOWNOFBARNSTABLE DECBMBER I7.2007 TEST HOLE-I Ey 39A TEST HOLE-2 EL.395 TEST HOLE-3 EI-41 s TEST HOLE-4 -lam FILL FILL FILL, FILL � 29 �� ArEuxmlorn4n A/BLAYFR 0 loYR4n BLAYER1ovRsi6 DAM GRAYISH BROWN DARD GRAYISH BROWN FILL YELLOWISABROWN SANDYLOAM SANDYLOAM LOAMYSAND r..� SLAYER IOYR SM 8LAYPRIOYR Sl6 BLAYFR IOYR SJ6 40' PHtC,lEST 37A jF a YBLLOWISHBROWN YELLOWISHBROWN YELLOWISH BROWN TUG:(9'-676mx - C LAM IOYR614 36•ID �TESrr 365 CLAYER10YR614 CLA?YER10YR&4 G� LIGHT YELLOWISHBROWN 2S GALLONS IN 14 UK UGHTYELLOWISHBROWN LIGHT YELLOWISHBROWN p <21CINAN &S 1 1 M®SAND NOOAOUNOWA76R II�OOUNISRH) CLAYFR 10YR 6W NOOROUNDWA7BR13t7WQ71>3M NOOROUNDA'AT®tIIiCQ7NIfgED SU llCn LIGHT' YELLOW15RBROWN t MED.SAND 28.5 �0.257733� . NOOROUNDWAT8RIIJ0OURTIMED O TITLE. Proposed PREPARED BY PREPARED FOR: NOTES: 1. The topographic information was obtained Septic System Sullivan Engineering, Inca James. H. & Kris � �- �- Hill from Town of Barnstable G.I.S. At Po Box 659 47 Marie Ann Terrace �° Osterville, MA 02655 2.) The datum used is NGVD '29, a Fixed mean ~' 47 Marie Aran Terrace (508)428-3115 fox Centerville, MA 02632 Sea level datum. Bamstable,, �/� �+�+ 3.) The intent of this plan is for the permitting of a� /V/assAr septic system only. Cen terviNe Draft: SOD 20 0 10 20 40 80 4.) This plan is only valid with an original DATE.- SCALE: FP=20 P Review: PS stamp & signature. January 29, 2008 1 Proj• # 27031