HomeMy WebLinkAbout0042 MAY LANE - Health My Lane
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147-007-017
SMEAD
No. 2-153LOR
UPC 12534
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SOURCING WXVGRMILGM?'
TOWN OF BARNSTABLE
LOCATION V Cjt SEWAGE#. St 0 �J —
VILLAGE ASSESSOR'S MAP&PARCEL DU 7 ��
INSTALLER'S NAME&PHONE NO." 'S W\k F lf�� —k
SEPTIC TANK CAPACITY ',Q_`< \ 1A �U l7 Q
LEACHING FACILITY:(type)3r "1 O %A 1 C 1'�t(J (size) ®��..� � . (a [ 10
NO.OF BEDROOMS
OWNER
PERMIT DATE: I CZ COMPLIANCE DATE: t-. 13b l Uq
Separation Distance Between the: N h(
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) �;t� P k cam,.. Fe�A
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) VC& Feet YIN
FURNISHED BY "�
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No. g,00q_ q Fee !00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: %
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for Nsposaf bpstem Construction permit
Application for a Permit to Construct( ) Repair(upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. U a M by LCnnZi C_,,wA%j{owner's Name,Address,and Tel.No.
Assessor's Map/Parcel / _ U ) _ (� 7 3c�t�C +,_`(� Cdr6
Installer's Name,Address,and Tel.No. .I-()r a ci Designer's Name,Address,and Tel.No.
S coC vl_G `t t_ S C V�- �n 3 �cC7 1.2
r.o k,_" 3
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 3 ({0 gpd
Plan Date j ( 3-3 (6 ti Number of sheets Revision Date
Title
Size of Septic Tank <t,X k S /U b() Type of S.A.S. : Cc,, S„n E�-k� IT-A-U/.r (A) Is+a-
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Add �,C-71 ,JcA I d U Lj E+u,.<_ 4j-UJ.-d
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 Health.
Signed Date
Application Approved by w Date /,2-
Application Disapproved by Date
for the following reasons
Permit No. ®1 ' y Date Issued
Tl� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Disposal *pstrm Construction Permit
Application for a Permit to Construct( ) 'Repair(upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or ot No. LA a M�y L v^t, tOwner's Name,Address,and Tel.No.
L-e— -4 4 Cor6:c'
Assessor's Map/Parcel y'� U U ? -- v 1 -7
Installer's Name,Address,and Tel.No. cr�,j p p L Designer's Name,Address,and Tel.No.
S cv\� �ti..,vC S�tE'er
C�
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(,vc))
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 3 ({() gpd
Plan Date 1 `6 Number of sheets Revision Date
Title
Size of Septic Tank f'Sc S 1 U b o Type of S.A.S. 5 c c,0 /,5-
Description of Soil otzl
Nature of Repairs or Alterations(Answer when applicable) Add 1-4 d O W 5-�V—< ri'-uv-d
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 Health.
Signed Date
Application Approved by r Date &I
Application Disapproved by Date
for the following reasons
Permit No. 9-009 _ L!1.2— Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( I4 Upgraded( )
Abandoned( )by 5,-, A
at L�� G, C-?_�kvuy\'1 4as been constructed in accordance o,
with the provisions of Title 5 and the for Disposal System Construction Permit No.AO a dated 1.�
Installer SC O ��,�V( Designer
#bedrooms Approved design flow �17 gpd
The issuance of this permit
shall not be construed as a guarantee that the system will h'on as designed.
Date �' ( � I Inspector '
No. d o0 "_ y�y Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION BARNSTABLE, MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair(V� Upgrade( )`— Abandon( )
System located at U M C, C_�
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:Construction must be completed within three years of the date of this permit_
Date �2` oZ��� Approved by
TRANS. NO.:
CITY/TOWN:
APPLICANT: P?
ADDRESS: q 2 h � E
DESIGN FLOW: gpd
REVIEWED BY: DATE:
N/A OK NO
k � 4 � k roar
�N
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)]
Locus Provided [310 CMR 15.2204(t)]
Plan proper scale? (1"=40' for plot plans, 1 '=20' or fewer for
components) [310 CMR 15.220(4)]
Easements shown [310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is required [310 CMR 15.412(4)]
Location of impervious surfaces (driveways,parking areas etc.)
[310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220(4)(c)] F✓
Location and dimensions of system components and reserve areas.
[310 CMR 15.220(4)(e)]
System Calculations [310 CMR 15.220(4)(0]
daily flow
septic tank capacity(required and provided)
soil absorption system (required and provided)
whether system designed for garbage grinder
North arrow [310 CMR 15.220(4)(g)] /
Existing and proposed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes (existing grade el. on
each test) [310 CMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and (i)]
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(1)]
Percolation test results match loading rate? [310 CMR 15.242]
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)]
Address �ov'1/6/17 Sheet 1 of 7
N/A OK NO
Location of every water supply,public and private, [310 CMR
15.220(4)(k)]
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water supply
within 250 feet of the proposed system location in the case
within 150 feet of the proposed system location in the case
of private water supply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. [310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] (if water line cross see 310 CMR 15.21l(1)[1])
Profile of system showing invert elevations of all system
components and the bottom of the SAS [310 CMR15.220(4)(0)]
Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 310 CMR 15.405(1)(k)]
Test hole adequate to demonstrate four feet of f suitable material?
[310 CMR 15.103(4)]
Test Holes adequate to-confirm adequate groundwater separation? IX
[310 CMR 15.103(3)]
Benchmark within 50-75' of system [310 CMR 15.220(4)(q)]
Materials specifications noted? [various sections of 310 CMR /
15.000]
System components not> 36" deep (unless Local Upgrade
Approval or LUA requested) [310 CMR 15.405(1(b)]
I
Address ���aG-7 ( °1 7 Sheet 2 of 7
N/A OK NO
Size OK? [310 CMR 15.223(1)]
Inlet tee located ten inches below flow line [310 CMR 15.227(6)]
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR
15.227(6)]
Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)]
Separation between inlet and outlet tees (no less than liquid
depth) [310 CMR 15.227(2)]
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5)) or permitted for
upgrades under LUA [310 CMR 15.405(1)(k)] ✓
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (by 7/07) [310 CMR 15.228(2)]
Access to within 6 " of grade - one port for systems<1000gpd,
two for systems >1000 gpd [310 CMR 15.228(2)]
All at-grade covers secured to unauthorized access? [310 CMR f
15.228(2)]
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done [310 CMR 15.221(8)]
H-20 Where appropriate? [310 CMR 15.226(3)]
Setbacks from resources [310 CMR 15.211]
Required when other than single-family dwelling or flow>1000
gpd [310 CMR 15.223(1)(b)]
First compartment 200% daily flow; Second compartment 100%
daily flow [310 CMR 15.224(2) and (3)]
"U" pipe through or over baffle, outlet of each compartment with
gas baffle or approved filter [310 CMR 15.224(4)]
Address ���'Z/617 Sheet 3 of 7
i
N/A OK NO
BUILDING°SWER AND OTHER IP S f ' ' �"
� �. .�.. IN� t�m .� . _ F�rr� .
Located at least ten feet from any water line? [310 CMR f
15.222(2)]
Disposal piping at least 18" below water line(when water and V/
sewer cross, see 310 CMR 15.21l(1)[1])
Cleanouts required/provided ? [310 CMR 15.222(8)]
Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
1310 CMR 15.222(6)]
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)]
Siphon problem/ (leachfield below pump chamber)
Endcaps or vent manifold specified?
Size and orientation of discharge holes specified? (not smaller
than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310
CMR 15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe /
types allowed)
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steep pitch of gravity sewer) [310 f
CMR 15.323(3)(a)]
Riser if deeper than 9" [310 CMR 15.232(3)(0]
Inside minimum dimension 12" [310 CMR 15.232(2)(b)]
Minimum sum 6" [310 CMR15.232(3)(e)]
Watertight cover if<2000gpd); waterproof manhole if>2000gpd /
[310 CMR 15.232(3)(d)]
Capacity(emergency storage above working design flow)? [310
CMR 231(2)]
Proper setbacks [310 CMR 15.211 (same as septic tanks)]
Watertight 20-in mimum access manhole at least 20" MUST BE
TO GRADE [310 CMR 15.231(5)]
Service components accessible (not too deep with piping,
disconnects accessible)
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. [310 CMR 15.231(6) and (8)]
Stable Compacted Base [310 CMR 15.221(2)]
Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)]
Address 1-7 �as 7 Lo t. 'j Sheet 4 of 7
i
N/A OK NO
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)]
Required separation to groundwater? [310 CMR 15.212)]
Aggregate specified as double washed [310 CMR 15.247(2)]
System Venting required/provided? (system under driveway or /
>36" deep) [310 CMR 15.241] e/
Inspection ports specified and within 3"final grade? [310 CMR
15.240(13)]
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document] ✓
:GALLERIES PITS C
E
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. [310 CMR 15.253(6)]
Each structure with one inspection manhole (if>2000 gpd must
be to grade) [310 CMR 15.253(2)]
Aggregate 1' minimum- 4'maximum. [31-0 CMR 15.253(1)(b)]
2' sidewall credit maximum [310 CMR 15.253(1)(a)]
In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)]
RENCHE 3i0'Cl�' R25`251 & h � 6 �� � � � IRV
Wi
Width 2' minimum 3'maximum [310 CMR 15.251(1)(b)]
100 feet -maximum length [310 CMR 15.251(1)(a)]
Minimum separation 2x effective depth or width whichever /
greater(3x if reserve between trenches) [310 CMR 251(1)(d)]
Situated along contours [310 CMR 15.251(2)]
Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document]
'pj mp- ,i.,z `t^ yi9t 'va.-w*
BED SAS (Maa�imum size ofedhofieldS00() d _ ��>minimum 2 distribution lines [310 CMR 15.252(2)(a)]
Maximum separation between lines 6' [310 CM R15.252(2)(d)]
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)]
Aggregate depth below discharge pipes 6" minimum, 12"
maximum. [310 CMR 15.252(2)(g)]
Separation between beds 10' minimum. [310 CMR 15.252(2)(0]
Bottom area used in calculations only [310 CMR 15.252(2)(i)]
Address 7? D®- 1-7 Sheet 5 of 7
I
N/A OK NO
"✓S' *'..� 'f' r 5n.rhxey ?a. c "�a ,F��`
DID THE PLAN.INVOLYE` � 3 ; ems ds;;
Pressure Dosed System ? Provided pump and piping
calculations as required [310 CMR 15.220(4)(r)]
Pressure dosing required on all systems >2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and UA
Remedial Use Approvals]
If used in gravelless system -make sure jet is directed as not to
scour soil interface [Guidance Document]
Inspections once per year(systems<2000 gpd) or quarterly
(>2000gpd) good to note on plan [310 CMR 15.254(2)(d)]
Construction in fill - Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255(3)?
Impervious barrier and/or retaining wall ? [Guidance Document]
Impervious barrier installation must be supervised by
designer [310 CMR 15.255(2)(b)]
Retaining wall must be designed by Registered Professional
Engineer [310 CMR 15.255(2)(a)]
Side slope not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document]
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended) [310 CMR 15.255 (2)(e)]
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
-77
AlteritativeSepttc.System jzi�AppYo:val Letters]M � � °i " -t77`�� ��Zc� ���
Was D7..<. .� ..,n.:.z o^ a�n-f .,✓.. _ s^L-w+za,a.A.k, kwesi..l"3du,or ..`&.,£a>-w "M,_ �a:.,
EP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a copy of a maintenance
°s$:: ;v:,a`*s�r+'.."3F gg`` r :ur-�z t'^..y - �+ nr ry & #"i r^, -.a P n, `z°'+ scv -T •.
N
Are the variances listed on the plan ? [310 CMR 15.220 V/
(4)( )]
RLS Stamp necessary on plan if a component is within five
feet of property line [310 CMR 15.412(4)]
New construction or increased flow proposed- [Refer to 310
CMR 15.414]
Address ► `f'7 1 OZY7 1 6 1 7 Sheet 6 of 7
N/A OK NO
t} {,' - a u,g, i 4
?Vitro en tiSe`tsztzve Areas 4 g y ;q _ r
Is the system in a�Designated Nitrogen Sensitive Area(Zone 11 for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and V/
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ?
1310 CMR 15.214(2)]
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1)]
�
:--�' b.€�„ �w.uXt_�i.l,.,be�lw f.�;• a,i' ;�'' ,�..� ,�x, i:€t t'a. ), �"+L.'�'��,aY��m,�`'''"� `..8� w,ra$�.a"
Pumping to septic tank ? [ 310 CMR 15.229]
Shared System [310 CMR 15.290]
Address ? CiG Z l /7 Sheet 7 of 7
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
MAM
Public Health Division
Thomas McKean Director
200.Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
r
Installer&Designer Certification Form
Date: Va t 3 b log Sewage Permit# Q�6'1A y da Assessor's Map\Parcel `/ �' 0 6 t .7
Designer: MP l-4 �, Installer: ,Y_gzTr &�t.
Address: 9 L3 P,&,�;m &A Address: 113 at--b '{/ 4446-c gb,
_YA-A-140vTt+FbP--i, MA- aZ.1,77<' i� M��.s�S, �.�A, 62r" 1
On ra 1 a I 0 i.,(. /N,�� was issued a permit to install a
(date) (installer)
septic system at �, M y r-"-p, based on a design drawn by
(address)
5 K PNbI-s A- 1�E dated ;a a 3 i o ti
(designer)
I.certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
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.
Zit OF
WORM
A._4
(Installer's Signature)
No.354ii'(
L .
(Designer's Signature) (Affix Designer's Stamp 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.\Septic\Designer Certification Form Revised.doc
TOWN OF BARNSTABLE
LOCATION ?%Z SEWAGE #
VILLAGE ��'dI Te/'✓���� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS
BUILDER OWNE C��`de
PERMITDATE: COMPLIANCE DATE:
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) Feet
Furnished by
,�
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Town of Barnstable P# 1 7 ff
Departinent of Regulatory Services
Public Health
autxsrestE, ' D1V1S1oII Date /d p i639. �e� 200 Main Street,Hyannis MA 02601
J rFD tM't�
Date Scheduled Q Time�i1 Fee Pd. 6d
►—
Soil Suitability Assessment for Sewage pisposal
Performed By: 5 �w
Witnessed By:
Location Address
LOCATION & GENERAL,INFORMATION
L(,, - C.AkVvi\V Owner's Name - CC cv—'r r�2,
Address •-.^G v Gam, C.:/t
Assessor's Map/Parcel: l� — D 1'l Engineer's Name
NEW CONSTRUCTION REPAIR Telephone# ��3 p,� Y1-3
Land Use Slo es(%) Z. Surface ,Z r
Stones
Distances from: Open Water Body A)11+ _ft Possible Wet Area ---
ft Drinking Water Well ft
Drainage Way ft Property Line /U + ft Other
ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
rt i
�Z
Y
C
Parent material(geologic) Gy7�r�S rl Depth to Bedrock ZG, 4-
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face //-
Estimated Seasonal High Groundwater /L.O.1A
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: PO-41(= e-j-C.cry
Depth Observed standing in obs.hole: in, Depth to soil mottles:
Depth to weeping from side of obs.hole: in, Groundwater Adjustmenk ft.
Index Well# — Reading Dater" —Index Well level °�; Adj,factor Adj.Groundwater Uvel
Observation
PERCOLATION TEST bate Thne,.e�
f
Hole# I Time at 4"
Depth of Perc 4
Time at 6"
Start Pre-soak Time @ Ai' Time(9"•6'7
End Pre-soak LK _
Rate Min./Inch L2--
Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(YIN)
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:1,SEPTICVERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole# _
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
o iste c ravel
/ Olt 4 S /0 '/L
it
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenev.%Gravel)
L it �
Ze,
YL
z y �Xe-
r �r 4-S
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.
Consi ten
e -
Flood Insurance Rate Man: .
Above 500 year flood boundary No— Yes ._
Within 500 year boundary No"� Yes
Within 100 year flood boundary No,✓ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not, what is the depth of naturally occurring pervious material? _.
Certification
I certify that on = (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required trainin Oxpertise and experience described in 310 CMR 15.017.
�O
Signature Date �� J
Q:\.SEPTICIPERCFORM.DOC
ACCESS COVERS MUST BE WITHIN INSPECTION MINIMUM. INVERT ELEVATIONS .- DESIGN CRITERIA : GENERAL NOTES :
6' OF FINISH GRADE rPORT 3 ' MAXIMUM COVER
FIRST 2 ' TO INVERT OUT SEPTIC TANK. 99. 95 DESIGN FLOW:
BE LEVEL MIN 2' OF PEASTONE INVERT IN DIST. BOX- 98.57 3 BEDROOMS AT 1 /0 G.P.D. PER ! . THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
OR F I L TER FABRIC INVERT OUT DIST. BOX. 98-4 BEDROOM EQUALS 330 G. P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY.
4' D/AM PIPE 3/4 ' - I 1/2" DIA. INVERT IN LEACH CHAMBER: 98. 33
99 9 98. 4 10" I %° DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 97. 5
NO GARBAGE GRINDER 2 VERTICAL DATUM /S ASSUMED. FOR BENCH MARKS
BAFFLf� 57 � 98. 33 $ ADJUSTED GROUND WA TER: N/A SET. SEE S! TE PLAN.
L__j SEPTIC TANK REQUIRED:
3 OUTLET 5 HIGH CAPACITY INFILTRATOR OBSERVED GROUND WATER: N/A 330 G. P.D. X 200x - 660 GAL . J. ALL CONSTRUCTION METHODS AND MATERIALS AND
EXISTING CHAMBERS W/3.5'. STONE AROUND POT TOM OF TEST HOLE *1 : 90 5
D-BOX MAINTENANCE OF THE SEPTIC SYSTEM SHALL
1000 GAL / IO 'w x 38 l x 10"d SEPTIC TANK PROVIDED: 1000 GAL . EXISTING
SEPTIC TANK L CONFORM TO MASS. D.E. P. TITLE 5 AND LOCAL
6 " CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
COMPACTED BASE DESIGN PERC RATE C 5 MIN/INCH
PROFILE -' NOT TO SCALE SOIL TEXTURAL CLASS - 1 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
N'T EFFLUENT LOADING RATE - 0. 74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
330 GPD / 0. 74 GPD/SF - 446 S,F. REQUIRED THAN 3 ' IN DEPTH SHALL BE CAPABLE OF WITH-
STANDING H-20 WHEEL LOADS,
PROVIDED: 5 HIGH CAPACITY INFILTRATOR
I
CHAMBERS W/3. 5 '± STONE AROUND. A-460 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
460 S.F. x 0. 74 - 340 GPD APPROVED EQUAL.
6, SEPTIC TANK AND D-BOX SHALL BE REINFORCED
SSOLKpO \\ SOIL TES T P I T DA TA PRECAST CONCRETE OR APPROVED POLYETHYLENE,
/ INDICATES INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER
m\ PERCOLATION _ OBSERVED TESTED FOR LEVEL WHEN THERE /S MORE THAN ONE
o TEST - GROUNDWATER�'' OUTLET.
_ o
TP s/ P*12788 TP *2 7, BEFORE CONSTRUCTION CALL D/G-SAFE'.
,00` COLOR` r� -- HORIZON TEXTURE HORIZON TEXTURE COLOR 1-888-DIG-SAFE AND THE LOCAL WATER DEPT.
S ♦ I 12' HOLL 0- l0/ . 0 0' 10/ . 0
A5 .+ 1 �� � FOR LOCATION OF UNDERGROUND UTILITIES.
C«.P4 �PLAEs �, 9q/1 FILL FILL
.��p - -_ ,� _
I00. 0 l2' 100. 0 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
60 A9 Sso a CHERRY TP.2 S' 12/ o °' LOAMY 1 OYR LOAMY /pyR DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
A
SAND 3/2 A SAND 3/2 OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
�� _ ```•
&' CONSTRUCTION INSPECTIONS.
+ 0-Box -s o 18 99. 5 20. 99. 3
o o` o p LOAMY l 0 YR j n LOAMY 10 YR
ro ��/ D D
ttt \cs SAND 4/6 9. EXISTING LEACH PIT TO BE PUMPED DRY AND
m\ BM. CENTER WINDOW - -- r u_ SAND 4/6
WELL, EL-102 97 5 HIGH CAPACI TY �. ocl, 28' ............. 98. 7 24- •• 99. 0 BACKF I L L ED.
INFILTRATOR CHAMBERS ABOVE GROUND r
oR C / MED I UM l o YR C I MED 1 UM 10 YR
W73.5•t STONE AROUND POOL \ SAND 6/6 SAND 6/6
441
f + �
EXISTING -
�� SEPTIC TANK
`. ST NG ' LEACH PIT 6 NO WATER NO WATER
pE�l I NG LOT 17 SjpGpPO 126" 90. 5 120" 91 . 0
DATE: DECEMBER 14. 2009
I5. 387+ S. F. TEST BY: STEPHEN HAAS
A 1t tp E \ WITNESSED BY: DAVID STANTON I Wish
PERC RATE: C 2 MIN/I NCH .1''; j (}c
GARAGE
�vs �.
C cnnz
pAVEp pP'�EwpY ` \66 8A `
�\ VEp PAD
/
/ Pp �� A6
m 5 60
N N
ti �
0
SEA 7- / C 5 Y' 5 7 E/liI OES / G/V
42 MAY LAVE . M,4P / 47 . PARCEL 007 O / 7
SA R M S TA S L E' < CE/V TER V / L L E MA
PRE-PAREO FOR
L EGEAD
LOCUS /V C O R B T T
-0 CB CONCRETE BOUND
i 4 TER LINE
SC,a L E
h YDRANT
to G•L '�;-lY
! '
"2 L-GAS LINE E A G E S �J R V E I I I V G I NC
C
H i QOS: OHW- OVER HEAD WIRES
LIGHT POST 923 Rc) u t e 6A
1 ERT -E- G-IDERGROUND ELECTRIC LINE Y a r mo u t h p o r t MA 02675
�� ��
-T- (.'-DERGROUND TELEPHONE L I NE 508 362-8 1 32�/� I 11�~ C �
-CTV- LNDERGROUND CABLEVISION LINE ����/ f ( 5 0 8 4 3 2-5 3 3 3
o I + 40. 4 SPOT ELEVATION
-40 EXISTING CONTOUR
LOCUS MAP 0 l 0 20 40 40 PROPOSED CONTOUR JOB NO: 09- l l 6 F l EL G:CFW/RBW CAL C: SAH/CFW CHECK: CFW DRN: AH