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HomeMy WebLinkAbout0051 MERIDETH WAY - Health 151 Merideth Road Centerville A= 147-116 No. 42101/3 ORA ESSELTE 10% 0 © 0 0 i i U No. Fee too THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS i ftplitation for Misposal *pstrm Construrtion permit Application for a Permit to Construct( ) Repair(4.� fJpgrade(/Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.r/ 016A/Q 0 r- 1.1 W14 el Owner's dame,Address agd Tel No. Assessor'sMap/Parcel _ GHRIsTiaN �'anoi;a I taller's e,Address,and Tel.No.6101r /2 0-973$ Designer's Namq,Address,and Tel.No.,S"0$�3li 0—33// os�p �0, ways;,e w Type of Building: Dwelling No.of Bedrooms .3 Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title z Size of Septic Tank Type of S.A.S. Description of Soil .Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ne Date Application Approved by Loq Date 45 Application Disapproved by Date for the following reasons Permit No. Date Issued No. ' t. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: I PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4plication for bispbsar 6pStetn Construction j3ermit Application for a Permit to Construct( ) Repair(Z-KUpgrade(4-Y"Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.S-/ !'vI E/Z/D Owner's Name,Address and Tel.No. Assessor's Map/Parcel/ _ //(o /sN i//j/r s� s I staller's�larr�,e,Address,and Tel.No.$Og-5/2 O- %7.3$ Designer's Name,Address,and Tel.No.5-6 a os�elO r3,afio 5 �,=c�r2 r-Son —vc, �Gf//�Li Type,gf Building:- Dwelling No.of Bedrooms 3 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 gpd Plan Date Number of sheets Revision Date Title +` Size of Septic Tank Type of S.A.S. Description of Soil 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 Board of Health. gne L Date Application Approved by ,! t f ,r Date Application Disapproved by ` Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(La Upgraded(�^ Abandoned( )by J, 5 eoGI /LC a -/ /� l'/_= 0111: has been cons in ac aflt;e with the provisions of Title 5 and the for Disposal System Construction Permit Nc� dJd Installer,/O.54/119L/ Designer #bedrooms -3 Approved desiguXow �/ _ gpd ^ / The issuance of this i shall n t be c strued as a guarantee that the system t./funjA;/,E(EdessignedDate Inspector 1/ �(.� /;mot/ol� r U No. r � Fee ✓ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(4-)- Upgrade(44— Abandon( ) System located at `Gf/6�G/ 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:Costs ctio t 6e ompleted within three years of the date of this permit. Date Approved by ' TOWN OF BARNSTABLE JLOCATION SEWAGE# 20A/- VILLAGE ASSESSOR'S MAP&PARCEL /11'7 INSTALLER'S NAME&PHONE NO. SQ$-y101735 A,5ea6 QE�r�Os SEPTIC TANK CAPACITY /000 LEACHING FACILITY.(type) 2-s019 (size) 2SX /3 NO.OF BEDROOMS 3 OWNER c PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY x� 2Y „ �9 - 3= 302., z 23, a 3 . P 0 14 FU 0 4 F N1 Town of Barnstable -X Regulatoiy Services Richard V.Scali,Interim Director IMIIl, MMA LE, ti Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,IVU 02601 Office: 508.862-4644 F&,:; 508-790-6304 Installer&Desiguer Certification Forin Date; Sewage PermWF Designer: VA W-4 Installer., Address- Address: On -was isg--,itd a pe-rmit to install a (date) (=ta bee) bas�,d on a df,.signdrawri by septic System at (address) L1 dated designer)h I certify That the septic System l k"mced above was instal"ed substantially according to the wLelimay include minor approved changes such as lateral relocatiou ofth�- distribution box and/or septic tank. Sttip out (if reTaizedi was iaspecied and Ow sw,15 were fecund satisfactory. I certify that the septic system referenced above was inst�Aled -with major changes (Le. greater than 10' lateral relocation of the SAS or any vextical r�locatiun of airy aoinponent of the septic system)but in ac.cordanc.e with State&Local.Re�,iilatious. Plan revision or ecrtified as-built by designer to follow. Stfip out(ifraqairad) was 111spcCttd.and the Suit were found satisfactory. I ceilify that the system ref6rtmed above. w, as ecus-micted. in compiiaiLre with the t(-,rins of the Lk appro4l letters(if applLAile) Jr CA M, (T�Z_e 6— staller's Signature) cr's signiture) 4NITAO Fcie)'PLEASE RETURN TO 8 STABLE PUBLIC HEALTH DA"ISION. CERTIFICATS OF COMPLIANCE WILL NOT BE ISSUED IFN fIl, CDTI$ M VS FORM AND AS- BUILT CARD ARE REfFTNU IRlr TITE BAR NSTABLE PUBLIC U. ALIM.DI"..SION. T YLX Y 0 V'4 Q;'SS,1pti_"M"igacr Cenffikladon 5orm Rev 84 4-13.k`ce TOWN OF BARNSTABLE LOCATION ( 1MQ('e�Qi � sm=E#-n S� ,IAVL1 1GE Gn¢.e ASSESSOR'S MAP&PARCEL ' NAME&PHONE NO'. r C,k (�4 SEPTIC TANK CAPACITY E LEACHING FACILITY:(type) t (size) JC00 CZ NO.OF BEDROOM"SS 3 OWNERS°T. PERMIT DATE: DATE`,$P Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ft!\+.,.•�f•�f4f\/\+4F\f\f\F~�t yl\l\lyl\l\r yfyfyfyl\fy+ O t t \ 4 \ 4 \ 4 4 \ 4 � f f I f f I F F F f f + F f f F ! f ! / f F I ! ! f I ! + ! J ! \ 4 4 4 \ \ \ 4 4 \ \�y \ 4 4 \ \ +. t t t \ +, \ \ 4 4 \ 4 \ 4 \ 4"\'\ \ t \ •1 \? f / f f f i f ? ? ? ? ? ? ? ? ! ? ? ? ? ? f f f ? f f J ? ? ? ? !\ k \ � \ t M \ \ t t \ l \ \ 4 4 4 4 4 \ t \ t t 1 4 k 4 1 y t /w•_ N. 4 y Y / f f f / f f f / F f / f f J F f F f F f f I / ! f f e [I[I`fy�,���NN�`r''�((����11lyyJJ/��.. 1 f f J\ t \ 4 \ 4 \ 4 \ 1 4 \ 4 trt f ! / t \ \ \ t t t \ t ti t '. t 4 \ \ t 4 4 k ••. \ t f r' / f f f J i f / f f J f ! f ! F f f ♦ f f k t \ t \ t 4 \ t t 4 1 \ \ t t \ \ t k t \ \ 9 40 39 ~ I Town of Baanst able. P# Department of Regulatory Services ,�„� Public-HealthDivision Dat / �b 4 tee$ 200 Main Street,Hyannis MA 02601 3M1 A011— Date Scheduled ¢ : ^ _ i Time' I' ,w lJ t tabilitAs I 'for S eDgpoFoil u y r � s r ' Performed By: �"' , �G�c ' Witnessed By i A'd i LO CATION & GENE_ RAL INFOlR1Vf ATION Location Address" 1 r ��1 � Owner's Name, . 1 tJ,� AddressN� ' Assessor's Map/P4rcel: � � I I Engineer's Natn��e\\�/���n,e i �M- & J v C. NEW CONS1RUt ON REPAIR T Tel _ , Land Use Ve C V -t � Slopes(g'o) Surface Stones Distances from: Clpen Water Body ft Passible Wee Area ft Drinking Water Well l ft r ,Drainage Way > ft Property Line ?!6// () ft Other ft SKETCH:(Street name,dimensiods'of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) Ste serff C, y S 1e kfC1y tr' � i Pl01V\ CtA 1 jl3 1 , j a - I i K i 5p, Parent material(geglogic)�a� X+'1 Depth to Bedrock ?� --- Depth to Groundwaker. Standing Water in Hole:' #J LA Weeping from Pit Face- Estimated Seasonal;High Groundwater DtR +RMIN ! TION FOR SEASONAL HIGH WATER TALE Method Used: . ' I In. Depth C b�served standing,.'n obs.hole: _in. Depth to Sall A Adjustment s: Depth toiweeping from side of obs.hole: i in, Groundwater AdJuetmr nt {t ! _ A •ACtor. ,._4. Ate.Groundwater Level.,,,,o, Index Well# Reading Date Index Well level - - i PERCOLATION TEST D Ite per'[D�t1 'r am Observation I Tiine at 9" . Hole# ILI Depth of Perc � ' Time at ti" .....------ Start Pre-soak Time.@ _ Time(9"-V End Pre-soak Rite MinAnch 2 � i Site Suitability Assessment: Site Passed____X— Site Failed; Additional Testing Needed(YIN) Original:.Public 1141th Division Observation Hole Data To Be Completed on Back— ***If percolafiign test is to be conducted within 100' of wetland,.-you must first notify the Barnstable C44servation Division at least one (1)wedk prior to beginning. DEEP OBSERVATION HOLE LOG Hole Depth from ( Soil Horizon Soil Texture Soil Color Soil I Other Mottling.Surface(in.) (USDA) (Mansell) g Structure,Stones,Boulders. Consistent %Gravel INVI DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) L 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# f4 LA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency, ra I fe Flood Insurance Rate May: 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 Envirorm ental Protection and that the above analysis was performed by me consistent with the require g,a ertise and experience described in 3,10 CMR 15.0 7. Signature f1 Date Q:\,SEPTICIPERCFORM.DOC i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 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 A. General Information forms the R r ���/� computer, r,use 1. Inspector: h(/1 _ I only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name VV r� 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508.428.1779 SI 12855 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 March 1, 2011 Job# 11-24 In pector's Signatur 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 ownershall 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. Lt6,-, �-/I I t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal J tem•Page 1 of 17 f Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown 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: ® 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: Tank is not in need of pumping at this time, leaching pit had no standing water or evidence of surcharge. 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 SN Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 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 El ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins-09/08 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 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 _ every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *'This system passes if the well water analysis, performed at a DEP certified laboratory, for 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_day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is Centerville MA 02632 March 1 2011 required for , every page. Cityrrown 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 ❑ ❑ 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•09/08 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 _ l5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? cif yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Less than oneweek. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): u n Ga o s per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? 0 Yes F1 No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: — t5ins-09/08 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 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown 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: Tank had been pumped regularly. 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): l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Compliance dated: 2/85 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: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 8" Depth below grade: 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: 8.5' long x 5.2'wide- 1000 gal. / Sludge depth: 2„ 15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown 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 28 Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees were found intact and clear. Liquid level was at bottom of outlet invert. 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is Centerville MA 02632 March 1 2011 required for , every page. Cityrrown 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 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 10-1 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every 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 11 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.): Liquid level was found at bottom of single outlet pipe. No solids or high stains present. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: One 6x6 pit. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching pit had no standing water at time of inspection, presence of small roots to bottom of pit indicate pit had not had standing water when house was occupied. 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 l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every 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.): t5ins-09/08 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts • Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form Not for Voluntary Assessments 51 Merideth Road ------------------------------------------------ Property Address Estate of Susan Roberts Owner Owner's Name -----_-------------...--------- ----- ---- information is Centerville _MA 02632 March 1, 2011 required for —__ every 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 9 16 n, 40 39 A4i Meredith Road • Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 15+ 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: 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: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water below el. 35 and topo map shows property at el.50. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 • Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 51 Merideth Road Property Address Estate of Susan Roberts Owner Owner's Name information is required for Centerville MA 02632 March 1, 2011 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file K t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 L O CAT ION tjFrpd; j� VS E W A G E -PERMIT N0. VILLAGE �C�iiewu a � �N I N S T A LLER'S NAME i ADDRESS 1� (� IAIU fv r ©C,k 7 iry . g✓ S U I L D E R OR OWNER �o l yA 4es i- V DATE PERMIT ISSUED L DAT E COMPLIANCE ISSUED � F 14 '9f� /, (3 c z `(off f 2— F. Gps �� o- y o f 5_5� Ass' t4-H 1-6 �a� ........... Fxs.... .................... �P�ZN OF MSS THE COMMONWEALTH OF MASSACHUSETTS ROBERT cu �i BOARD OF HEALTH oE. ...............OF........... .lA.af�����r----••---........._......_. RAY P No. 7 . j1p1tration for Disposal Works Tonstrnrtiun ramit NAL �` cation is hereby made for a Permit to Construct () or Repair ( ) an Individual Sewage Disposal em at: ................_.._..... .��, ? T7 ..... �i� ................. ..................................�..o.�" 4 J ----------------........._..._........-- Lp6ation-Address or Lot N .....Yao4.._V1A.Y.. 11.429.1............. /+� Owner re 1 L f. 70.� ...........................•------------ -..1172.. Installer d Type of Building / Size Lot...../�..19`_ .....Sq. feet 'JL' U Dwelling—No. of Bedrooms...............5........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures --------------------------- ----------•--•---••-- W Design Flow___________;}5________________________gallons per person p� day. Total daily flow..............�_�„s+'_Q____.________-.____gallons. WSeptic Tank—Liquid capacity,®W.gallons Length�/4.-_6__ Width._5._-47fl Diameter................ Depth... x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..... ---------- Diameter...10.1. !1_. •_"__ Depth below inlet.... Total leaching area...,���.C2...4q-rA?,O Z Other Distribution box Dosing tank ( / '-' Percolation Test Results Performed by-_ C iG1 �l'rf/!-/�C'--------- Date---/5'l.6 2Y,�/``-Ll _. Test Pit No. 1.....9........minutes per inch Depth of Test Pit..... Depth to ground water_efC.(/�.s�eJ/�Qlsvi�� �X, Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ P4 ........................................................... ... -------------•----------•--•--... -------------• --•---•----- x . Description of Soil.... �%._.. ..:. --•, - s11 __ `� / 1. V '-•-..__.....••-•-•-•----•••-••--•---•-•......__....••--•--...•---•-•---------==-----•----•-•-•-•--••••-------------••-------•-•--••--•-----•••-••---•••---•-•-•••--•.._..•-•--------------...._._..---- 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 TLITH1. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue by tbfAb ea Signed -� - .,.._._.._ ` __D e ApplicationApproved By........ •-• _•--- - -••--- - ........................................ -- f -. �----- D to Application Disapproved for t following reasons----------------------------------------------------------------------------•-------......_..----•-......._-•---- .........................•--._..._._.__...--------------------=-------...._..------...----------...__....---...--------------------------------------------------------------------------------...--•--- IWI— Date Permit No....... ........................ Issued_...... �� ----------------------- e ^_ '�j� { i �♦ f ��I FES...�11taaleb�w.w�.� OF THE COMMONWEALTH OF MASSACHUSETTS o� ROBE �; � BOARD OF HEALTH gE. -�r� 'PIUi f „irt ... ................OF..........� / 7r E , " t pplir�ation for lark T tr r iltn er i# JINN Edon is herebymade a Permit to Construct or Repair ..1 ,,l��,. (�.') p ( ) an Individual Sewage Disposal System at:.........�:�,.`�"..� ... -...... ..... : �', .- -' ---......--•...... .................•----........... .. ------------•--------------------......-- anon Address -*-• or Lot No; Owner ,.tAddreps --------------------_--•- ........... 1� .. dy" Z/Z..<44 .- .. .....' Installer Address UType of Building Size Lot.:__ �.. �......Sq. feet -� Dwelling—No. of Bedrooms.............. ........................Expansion Attic ( ) Garbage Grinder ( ) aP4 Other—Type of Building No. of YP g ----•-•------•-•------------ persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ..--------•----------------------------------------------••-------.....------------ W Desikn Flow...........'` --------------------...__gallons per person per day. Total daily flow..............I gallons. WSeptic Tank=Liquid capacityA gallons. Length/_`.�r�___. Width._`2.~, ... Diameter---------------- Depth_. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....I.......... Diameter--l,a'r'1..... Depth below inlet....: _._._. Total leaching area...6.5.i ..I,�4 Z Other Distribution box (4—r Dosing tank ( ,/� '-' Percolation Test Results . Performed by--- _t"t4F2,,:r.�*I��"�'!v .w'.jr'1-�-,!,tonI......... Date...Aj4.:g`t�.Zf,-j ' N.] Test Pit No. 1.....��._........minutes per inch .Depth of Test Pit..... {`.... Depth to ground water r�_4.1,�I efPV7c?.ea f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... •.. . . ---------•-.....-----•.................... xDescription of Soil.... ""/_ �.. ��"= �__%... 1 ... r U ---....•-••-•--•--••----•--•-•-------•-•--•••-------------•-••--.......------......•••.......----•--•••-•---•----••------•--•-•••••••--••---••-••----•-••-•••-----•-•-••-.....---•-------•......-----••. W V 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 TiTT:;LL. ; p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issue by tlj4b ea r"1 Signed. .1,. ...a .. --- •. .. ... Z............................ --- D e Application Approved By...... --•••- ----.....-•--- .......... . ........./4.. Application Disapproved for t following reasons:.....................::.:.................. ........................•_..... ........................................................ .. --- �- --------•-----..._Date--•----------- , Permit No..... ---------_--------- - Issued_----.. --. �g �------------------_-- e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .*J,G�.................oF.:::. " J .��s .................................. Trrtifiratr of (Som tiaurr THIS IS TO ERTIFY, That:.the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY•-••-....... --•--- .ilk.-!•-------------------------------------------------------------------------------------------------------------------------------------- at ................ . : Instal -4 has been installed in accordance with the provisions of l _: 5.9f The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated-............................................... I. THE ISSUANCE OF THIS CERTIFICATE SHALT: NOT BE CONSTRUE® AS A GUARANT E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. t � ' DATE............. Inspector. ---- -•---....... s t THE COMMONWEALTH OF MASSACHUSETTS F BOARD OF HEALTH — S No._.S�Q -S 2 FEE ...................... Disposal Works Tonstruction Pumit Permission is hereby granted.--- (A--•------------------==-----•-----•-•-•-•-•••------•----•-•......------•--......--•........:...... -:., .. to Construct ) or Repair ( ) an Individual Sewage,'Disposal System atNo.. f�.>• \ .....O�t1� � -•SAS ?• --------•--------- -------•-----------•------------------------------------------------------------------ Street as shown on the application for Disposal Works.Construction Per it No._%3S-S_7._ Dated........ - -o------- r Board f H ealth DATE_ FORM 1255 HOB WARREN, INC'., PUBLISHERS - CENTERVILLE LEGEND g PROPOSED CONTOUR 98 PROPOSED SPOT GRADE EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE z W— EXISTING WATER SERVICE O � �60 100 TEST PIT LOT 14 `G%o AMES WAy AREA=16,962t S.F. tr M'LL RD. SCALE: 1"=20' (� LOCUS MAP LOCUS INFORMATION TITLE REF: 8K 25621 PG 320 PARCEL ID: MAP 147 PAR. 116 ��•'mil FLOOD ZONE: "X" COMMUNITY PANEL: 25001CO542J DATED:07/16/14 DECK SEPTIC SEPTIC SYSTEM \\ REPAIR PLAN LOCATED AT: _ 51 MERIDETH WAY CENTERVILLE, MA �J1 \ PREPARED FOR o \ CHRISTIAN DINOIA •��� w \\ 1i\ AUGUST 13, 2014 EXIST 1,000G \ O SEPTIC TANK OF MqS gARR N . 'E lsl- ` O ` \ p0 i S4NITAR\P 6' O y O Ik �2 L•P• \ g$� MEYER & SONS INC. , P. O. Box 981 E. SANDWICH , MA 02537 PH. (508)360-3311 pig ° fax (774)413-9468 meyerandsonsinc@gmail.com SHEET 1 OF 2 J#1680 T.O.F. NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE: PLACE RISERS OVER ALL COVERS W/IN 6" OF GRADE. 1 EL: 100.0 F.G.EL: 99.3 F.G. EL: 99.2 FINISHED GRADE (99.1) F,G.EL: 99.2 a � MAINTAIN 2°!+ MIN SLOPE OVER LEACHING AREA a• .D :Q 2" OF 3/8" DOUB7ABR 3/4" - 1-1/2- TOP TANK=EL. 97.0 STONE OR FILTER + DOUBLE WASHED STONE 6" ~ b~ 4" SCH 40 PVC 10"I 6 O ®®®® 14 7INV.95.43 1 (MIN.) ®®®®®®®®®®® A TEE'S ARE TO BE F ®®®®®®®®®®INV.95.60 2 E F. DEPTHMWO®®®®®®®®®®® 4" SCH 40 PVC INV.95.70 4' 2 X 8.5' 4' GAS 1 _ EXIST. INVERT BAFFLE .PROPOSED DB 3 , •. •.. ..:.. _ . DISTRIBUTION BOX EFFECTIVE LENGTH = 25 INV. 95.95 am AM Ark. INV. ELEV.= 95.28 EXIST. 1,000 GALLON SEPTIC TANK �� �F ' s GAS BAFFLE TO BE INSTALLED ON � s9�, BREAKOUT OUTLET TEE AS MANUFACTURED BY o� DA, M ELEV.= 96.28 TUF-TITE, ZABEL, OR EQUAL o VA� TOP CONC. ELEV.= 96.28 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING No. 1140 INV. ELEV.= 95.28 E3E@ n ®® PIPE INVERTS PRIOR TO CONSTRUCTION ®® ®®®® . 2) D-BOX SHALL BE SET LEVEL AND TRUE TO '�G/SiE- ®®®®®®® GRADE oN A MECHANICALLY COMPACTED SIX Sq \a� BOTTOM EL.= 93.28 ®®®®®®® INCH CRUSHED STONE BASE, AS SPECIFIED IN NITAR 3,75' 5 FT. 3.75' 310 CMR 15.221(2) 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK SEPARATION 5.08 FT. EFFECTIVE WIDTH = 12.5' WITH 1500 GALLON SEPTIC TANK IF FAILED,DAMAGED, OR UNDERSIZED. SEPTIC SYSTEM PROFILE 4) INSTALL INLET & OUTLET TEES W/ ADJUST. GRNDWATER EL: 88.20 4 SOIL ABSORPTION SYSTEM (SECTION) GAS BAFFLE AS REQUIRED (500 GALLON LEACH CHAMBER) GENERAL NOTES: - DESIGN CRITERIA 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS P#: 14445 BOARD OF HEALTH AND THE DESIGN ENGINEER. NUMBER OF BEDROOMS: 3 BEDROOM DESIGN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DATE: AUGUST 7, 2014 LOCAL RULES AND REGULATIONS. DESIGN PERCOLATION RATE: <2 MIN/IN SOIL EVALUATOR: DARKEN MEYER, CSE 1614 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR WITNESS: DONNA MIORANDI BARNSTABLE HEALTH DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE , DESIGN ENGINEER. GARBAGE GRINDER: NO (not designed for garbage grinder) 4. ANY CONOITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXIST. 1,000 GAL. SEPTIC TANK FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Elev. TP- 1 Depth Elev. TP-2 Depth ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 99.2 0" 99.3 0" 330 LEACHING AREA REQUIRED: ( ) = 445.94 S.F. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF FILL FILL .74 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 98.20 12" 98.14 14" HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. A A USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4' 7. WATER SUPPLY PROVIDED BY MUNICIPAL WATER. LOAMY �D LOAMY SAND STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 97.95 15" 97.80 18^ TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. B B BOTTOM AREA: 25' x 12.5'= 312.50 SF 9. IT SHALL BE THE RESPONSIBIUTY OF THE CONTRACTOR TO VERIFY THE LOAMY SAND LOAMY SAND THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING IOYR 6/6 IOYR 6/6 SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF CONSTRUCTION. 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. 8orroM 96.12 C 37 96.14 38" TOTAL SQUARE FEET PROVIDED = 462.50 vs. 445.94 REQ'D REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. PERC ® EL 94.5 MEDIUM C MEDIUM SAND SAND DESIGN FLOW PROVIDED: 0.74(462.50 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 2.5Y 7/3 2.5Y 7/3 PROPOSED SEPTIC SYSTEM UPGRADE P LA N 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 13. NOD IS NOT ABUTTINGTO BE PRVATE WELLS DERED A WITHINWITHINPROPERTY LINE SURVEY 150' OF PROPOSED LEACHING. 88.20 132" 88.30 132" 51 MERIDETH WAY, CENTERVILLE, MA 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. PERC RATE <2 MIN/IN. ("C* HORIZON) NO GROUNDWATER OBSERVED Prepared for: Dinoia 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/Fi (UNLESS SPECIFIED) System Design and Topography Plan by: SCALE DRAWN 1. Darren M. Meyer. R.S., CSE, hereby certify that I am currently approved by MAOEP pursuant to 310 CMR 15.017 MEYERSONS,INC. N.T.S. DMM to conduct soil evaluations and that the above analysis'has been performed by me consistent with the P0 Box 981 DATE SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam In October, 1999. EAST SANDWICH,MA 02537 CHECKED 50-362-2922 08/13/14 DMM 2 of 2 f�r7eweuovrssvuamaanum.s ++nsm. .....n *s+�'Rtl�I!CryM1°4"-r37R1@B4'tf: i► r-?'".'+x�w*"'. n• axMNsw6asissae� mmNax)h�rru»+qqw.a.«.agm!+w++wwaeneltlg1'Y'i,'r+s+J"f{?"., 9':aR!'S#. 'aeer+riS.- ; �r r,{� 1•^'G�� `�; y,.�..sT�!'. �-'{ �{` _ .�._ - �__..-,.ram ,} [. 4'rF..�i d:. ►-�.�». �'roa ss l i..."� trk "� r _ __. j da.i .s A. r rt ► f :, fy&* F�.=r, r�,- 7 �E_ i .:.... _ --. .a� .. _ t _ 471�1 ,A.i.ti Cw tilr6, �."..•.^ -e-r..y........_..,��,' I i 1;. " d !.'-+ ..\e r.,,_` fwl�.,> .a�Yw, 7!-1Y!,.'vi;i.:.��,. 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