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Home My WebLink About0010 MICAH HAMLIN ROAD - Health r 10 MICAH HAMLIN ROAD C aterville A = 170 - 174 UPC 12534 1&2.153L Commonwealth of Massachusetts G u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments61 10 Micah Hamlin Rd Property Address 0 Earl Batesa Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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. filling out forms A. General Information S/4t fillip out forms on the computer, `��`„I"OFrU4��i,,�� use onlythe tab .�`a1 •' ' ' ' q ', 1. Inspector: :• c+ key to move your0 p: .SG cursor-do not James D.Sears =,g: JAMESus �:m= kee the return Name of Inspector =c�s y. ompany Na me Enterprises A;x, 0 o :o* 153 Commercial Street *z� e Company Address Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S 1623 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 8-21-17 pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systeme 1 of 1 ,C�•Pag� vs C7(7 Commonwealth of Massachusetts w - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is Centerville MA 02632 8-21-17 required for every page. City/Town 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: The system is a 1000 Gal. Tank D Box and pit. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. Cityrrown 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.doc•rev.6/16 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 �M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in 4110M is less than 6" below invert or available volume is less than '/2 day flow PST' t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 ❑ ❑ 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.doc•rev.6/16 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 GM , 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal. Tank D Box and pit. Number of current residents: 2 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 years usage (gpd)): 2015-96,000Gais 2016-89,000Gals Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commerciallindustrial 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 r Commonwealth of Massachusetts w W Title 5 Official Inspection Form _ e Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 I - _ Commonwealth of Massachusetts u r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1986 Permit # 86 -867/8-2017 New D Box Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 28"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40. Septic Tank(locate on site plan): Depth below grade: 17" feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal. Precast H-10 Sludge depth: 2" t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 12" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Tape Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank at 17" below grade w/both covers at 4". In tee out baffle. No sign of leakage or over loading. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 2' below grade w/one line out. Box is new 8-2017 w/cover at 6". 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: t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 f Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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 is a 1000 Gal.precast pit w/1' stone. Pit at 3' below grade w/cover at 2'-. 2'water in pit. W/no sign of over loading or high stain line. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts w r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 l EAR I Q 1 .O C � G -B_ i =3 g �$ 3 , /4 4L, - 31 'S"' /3- 3 ,, t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts w - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is Centerville MA 02632 8-21-17 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: .❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells N® P r 9 9 Estimated depth to hi h round 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: 4-29-85 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: T.H.on Design plan 4-29-85 no G.W. at 12'. Bottom of pit at 9' below grade. Bottom of pit at 3' above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 10 Micah Hamlin Rd Property Address Earl Bates Owner Owner's Name information is required for every Centerville MA 02632 8-21-17 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 N0.X119 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS RpPIicatiou for Misposai 6pstrm Construction permit Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑Complete System kIndividual Components Location Address or Lot No. 10 M(A14 14AML_I 6J ,M Owner's Name,Address,and Tel.No. ,/ �e4A L $1.lzT'l: Assessor's Map/Parcel 170 d-)`t `1Cf l.( (® MICA H (-IA�t R/ P-b CtE - �L LL6_ Installer's Name,Addwss,and Tel.No. j(f.12-q-r7- 8 5j'7 7 Designer's Name,Address,and Tel.No. CAPc-w1 DG C't�aT�Z( PQLS N /A —1151 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building R4S50&AJ7 tAA_ 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) _TM! °TAB CSC_ 14 -1() 61K_ W Cra Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea Si ed Date �q.- 1 Application Approved by Date l Application Disapproved by Date for the following reasons Permit No. r Date Issued No. ` �l 81 Fee "" THE COMMONWEALTH,OF MASSACHUSETTS Entered in computer:�\ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye 01ppliLation for Misposal *pstem Construction Permit " Application for a Permit to Construct( ) Repair(,() Upgrade( ) Abandon( ) ❑Complete System ;Individual Components Location Address or Lot No. 1QM RAmLi h j kb Owner's Name,Address,and Tel.No. EAR Assessor's Map/Parcel I,7O 1"a 4 C`YrU. 10 Mt4CA�AWt I iV Xt> Installer's Name,Address,and Tel.No. `T7" 8 S 77 Designer's Name,Address,and Tel.No. CA �t tt�lDF L-&3T 1>04S&S ,I Type of Building: p Dwelling No.of Bedrooms Lot Size—A sq.ft. Garbage Grinder( ) Other Type of Building RESOGIJ7/AA.,,,,, No.of Persons ~' Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd y 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) XJLJIST4LiL IQ 0 -a 011L. W CrO Al5 M 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. _ ^'""'-" Date �^af Application Disapproved by Date ' for the following reasons r' Permit No. -yam/ Date Issued THE COMMONWEALTH OF MASSACHUSETTS `, - BARNSTABLE,MASSACHUSETTS `(Urtif irate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X Upgraded( ) Abandoned( )by C A1 PEW I D& 6X)T tliZ PX1<e_S -- at 1 a M 1 CA H 14A Ek LI A) AD d'Vi L4LG has been constructed in accordance with the provisions of Title 5 and the for-Disposal System Construction Permit No`��:�,t"_ yy�,, t' dated Installer�,�`tp6Wln,! j`myx'pgk:� Designer tv1A #bedrooms Approved design flow gpd The issuance of this permit shallfnot be construed as a guarantee that the system will'f mic"t`id�n 8 designed. Date z/ �/ lnspectolr�l\ ----------.-------------------------------------------------------------------------------------------------------------------------------- No.t- � �?v� Fee ! THE COMMONWEALTH OF MASSACHUSETTS --` PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted toAACoJonstruct( ) epair(X " Upgrade( ) Abandon( ) System located at I 1't 1 C.Ial 14 "A MC,•!/V ( , vf L-e—(5- 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 , �`' Approved by''�.. =._y_ .a TOWN Or- BARNSTABLE �J LOCATION/- 07 6 lF � - � � f� 't'�' IfjSE AGE # ;� V` LAGE,r'�'! _-✓r=/ ` - ASSESSOR'S MAP 6z LOT' - (` INSTALLER'S NAME & PHONE NO.�P,' 0t�C SEPTIC TANK CAPACITY ,-J LEACHING FACILITY:(type),P/ (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC_W. BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ,.�-- r /'"� j r�.. � I ;, � � � �, _- '� -, � � � �___.� �d7 TOWN OF BARNSTABLE LOCATION QY�l1`-� �,�'`�C3�1� �J SEWAGE # VILLAGE ASSESSOR'S MAP & LOT 5 LM _. INSTALLER'S NAME & PHONE NO. qq c\ SEPTIC TANK CAPACITY tlo t� LEACHING FACILITY:(type) k7—\ G*(o (size) NO. OF BEDROOMS PRIVATE WELL OR �BLICWATE BUILDER O OWNE DATE PERMIT ISSUED: 4- DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No z 1 - -4 �r �;I 3a 46 1 ?o_r� q FEB . .... .............. THE COMMONWEA�L_THOF MASSACHUSETTS BOARD OF HEALT.H F........ ............ ...............0 ................................. Appfiration for Dhiposal Workii Tonstrurtion ramit 1 Application is hereby made for a Permit to Construct (X or Repair an Individual Sewage Disposal System at: ... ........ ................................................................. 'LocaZtion- resS or N ........................... .......... ........................................ Address .......... . ........ 0... ......................................... .. .V Installer 7i -------------------------------------------- Type of Building Size Loth&.,,oA.-V-_0...Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( lVe P-4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( OtherfixtuEes_............................................................................................................ ----------------- Design Flow........7V_' ....................gallons per person per day. Total daily flow...........................................gallons. 1:4 Septic Tank—Liquid capacity{_ Length................ Width.........._..... Diameter---------------- Depth...::........... Disposal Trench—No..................... Width....._.............. Total Length._.:.............. Total leaching area....................sq. ft. Seepage Pit No.,�_ �6. Diameter.................... Depth below inlet_................... Total leaching area..................sq. Z Other Distribution box ( ) Dosing tank ( ) . Percolation Test Results Performed by._...4-t..11N. Date...4--Z - -------------- Test Pit No. I................minutes per inch Depth tT__e_s__t---- Z------------------Depth p__-t-h----to ground w"a"ter..-W, 4q Test Pit No. 2................minutes per inch Depth of Test Pit............__._._.. Depth to ground water___.................____ 9 ............................................................................................................................................................. 0 Description of Soil....................................................................................................................................................................... U ........................................................................................................................................................................................................ W ........................................................................................................................................................................................................ :V4 U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .................... ..................................I........................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Cqrtiffcate of Ompliance h ..-been * sued by the b ar f health. Signed----- . ... . ...... ... .................................... .......... .... ......... ............ Date ..............X Application Approved By. ...!........ .................... ......................... ............. Date been * sued by ... . .. - ------ . ........ .......... ............. Application Disapproved for the following reasons:............................................................................................................. ......................................................................................................T................................................................................................ Permit No....<aj�f' - `&(, 7 .........................Date ................................... Issued................. ............. Date ------------ ———-----—--------------------------------------- FEs... ........ THE COMMONWEALTH Ox MASSACHUSETTS _ BOARD OF HEALT -----!�'. _t._... ....OF........, _.... Appliration for Disposal Works Tontrnrtion Vrrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at, ff..c 1 --G--- f--_�.....---------- ------------------•--•--------......------ Location-Address - I j 1 �♦ or Lot. .. • -!• ....................... L ....................................... Owner - Address a �, �. ...._r 1�.........-•----•-•-•-----•-•--•-•---••-•. ---•.......... ... ';e.4 A--?_-.:: ............_....__ •. _____...__C._ v.............. PQ Installer Address d Type of Building _ Size LoiZ, ...Sq. feet aDwelling—No. of Bedrooms........ ..............................Expansion Attic ( A)a'"' Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) o d Other fixtures W Design Flow...... ....................................gallons per person per day. Total daily flow..................'...:ffL.:_n..........gallons. W # Septic Tank—Liquid capacity... Ai,-,,+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 ( ) a Percolation Test Results Performed by.....�. .. :_ 9- Date... :72_j._--9., . Test Pit No. 1................minutes per inch Depth Test Pit....2........... Depth to ground water....0/.,tk....►----- fsl Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------_................. 0 Aa .---•--------------------------------------------•-•-------•-....-----....------•--••----•---••-.......................................................... Description of Soil.......................................................................................................................................................................... - V •--•--...--•---•----------------------•---------•-•-•----------------•--•----------.....---------------....-------- -------------•-------------•----•-•-------------------••......................... 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 TITU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a C sate o ompliance has been Issued by the board of health. Signed.............` �r: ' .:.:..`':.. �.. "� ............ ........................ = � 7 f Date / Application Approved BY 11 .. . ........... ....e..------------------------- L i � �, ,,,, { f Date Application Disapproved for the following reasons::'------# -----------------•----------------------------•----------------•----------...--•-----....._.__.. --•-•-•--------------------------•-•-•--••--•-----...----------•--••---`-••--•--------.......----•- .................................................................................................. Date Permit No.--- yam- __ -- ---- ------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (9rdifiratr of Tontplianu THIS TO 7ERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( )K byG ............. l_�. __.=.._.................................................................................................................................... Installer at.......LSa......... --------- rzL- c... ------- lias been installed in accordance with the provisions of TfTLE 5 of The State Sanitary Code jadescribed in the application for Disposal Works Construction Permit Nor ^__- �,.(a.�.. dated.....__ �Q� --- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARTEE HAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................... ..�._. l_ _ .. ............................. Inspector.-- ....... -- - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF......... ... ....... ........ No` ...... � ... _ FEE.. ... . Disposal Vor TonTtructionYrruti# Permission is hereby granted. ; -••-----. °+ F at Constr> t ) or pairr��( ) an Individual Stwv ge Disposal_System at No. , -- .��1�0 - +:._ Street p as shown on"the application for Disposal Works Construction ,ermit No.`s:,:,`�+�;;__ ate NY.I f(nG............ .... oa H ; ' d of ealth r -.... .. ....... FORM 1255 A. M. SULKIN, INC., BOSTON - '? f f i VIr51 C'm12 TA G88 r:7 ; 33a 6PD ...c 1 S E'PnC.Ti��t�C : 33D ntsaX s g956�P'� �. � _ �'�•;:�,�j \ \ tlsE toara G CA.Li.0►J SGQn�tA,►.�K •j - Iti v.ts:r: L.PI-1 fq \c L'kvacrr!>>so s F c z is 131 S Gro ^''� O" yr it. so C�v�c.m�•spsa .`.o _ so GPM 1I To-r4 L 'I7>a4 l be s:i ''L o v.�_ 425 Et p� r µ a i 2'9 7 3t 7DNL`{ Tz�.owa q 33O Ec'PD —'t r-tCALkr1ai1��4TL VVZOv t ,1 t 1�l 'L 1'1lI.t•OQl,fe/S �.._ ��4Cn( Ar �•`�.,� RiCHARD p.. `Js� Yy Q > A. x G fro 44i`:+Z {x i TE.5T NCLE 4-1 I>jO §..,. . I � i=Cz 5�,0 T•U 5(01 8 TG P OF FNt7 I � a [t.4, +IL_PINY u�( TD LLH INt/r74,0 5r�c �IIJ PT1' v5-44 TAUK TR 1�!Of C ERTIFI ED pLz3T pL.AN EL 1_o cAT 1a1�1; _:- 1 G� P1-AX R1=Fg:RtrNGG L-07 Ggcj i c �3T t C.EZT'IF`( -rHxrT1-�E SHz�wt•1 1�E615 Rt� tyz1 SLI��I z� 1t�11-T'1••i 774F- 51T1E L-11,1� -�V1 L �.1bC"aFzms ANT? 5�`f�t3�K "�i�Cl��E�4�NT'S C?F-1'�-1 E �'�T��1�1 �.1..�.•-+-• t�h� , r'ovc/►.1 1.1"M t S �..t ..t' A1�L1 fl AL1 !A ':- a�A �1 1T41m -rH,F- "�'1-aUL �7t ht THis R.aN is Nt�T 13A5tR "AN INS7RIJM NT > _861 5UKyCY AND T HE OFF5Er5 5HOWN 5HOUL-D r14T $E US EQ -ra ESC•A,7 5 L15 H I_Z-'-i' L 1 N E S. IV X 10 TU'.1 HE :P.:,: AsBuilt Page 1 of 1 .ATOWN OF BARNSTABLE LOCATION (fie T �l IC:�l t� 1�/C��SEr AGE # - �G ASSESSOR'S MAP 6t LOT' INSTALLER'S NAME & PHONE NO.yv; i SEPTIC TANK CAPACITY J` LEACHING FACILITY:(type) (size) NO.OF BEDROOMS PRIVATE WELL OR PUB LIC`_ E&J R BUILDER OR OWNER DATE PERMIT ISSUED: f -C;t� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No q h� http://issgl2/intranet/propdata/prebuilt.aspx?mappar=170174&seq=1 7/20/2017 s Nod Fss.. ��...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH --....T�N.--......OF..... 5�' 1.-.• ........................ Appliratinn for Bispviial Marks Tonsiru.r#inn Vautit Application is hereby made for a Permit to Construct (v}'or Repair ( ) an Individual Sewage Disposal System at: ... ...._-•--- Location-Address or Lot No. ............................................. .....:!4 ro 7' ................................................. Owner G� �'� .. Address �;. ........... ro 9± -------------------------------------------- . ..... . wJ �11 ...................................................... Installer Address -�G� q Type of Building Size Lot../.............. ......Sq. U Dwelling—No. of Bedrooms................`?`... ._..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .--•----•-•---•----------------••--•-•----------------.................................................. W. Design Flow•......................._.......__..gallons per person per day. Total daily flow----------------------C9...._............gallons. WSeptic Tank—Liquid capacity_! P.gallons Length...K..... Width........`6��.. Diameter................ Depth..__-`..'_ ./. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 14 Seepage Pit No.-______Z_.._... Diameter._..../�_...... Depth below inlet............_.__ Total leaching area.._43 4!..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b ._��XZ'$-�Ae L-5 �i/c '¢ _.. Date-- £� y y _' ,l � ----....•-------•--. Test Pit No. l....G._Z...minutes per inch Depth of Test Pit..... .. Depth to ground water.._......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---•-••--••---------------------••..........•--•-•--•-•.......•-•---•.....-•-•--•-•-••••••-------••.--.._..---•-•-••.._._....•--•--•-••---.....-••-----••-••. 0 Description of Soil........ -`��-. _`�.....l' '->1-?---, SiC�'—S'bf G.... Z5e'P°--/4L4� ................ ...........--•------------.........--•-•••••-----•--••. U -� W V Nature of Repairs or Alterations—Answer when applicable............................................................................................... •••.......................-............................................................................................... -•---•-••----•--••-•••-•--................................................. Agreement: I .The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE: 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha ee issued bthgtssai of health. at Application Approved By.......... �'• 1�....Date Application Disapproved for the following reasons:.............................................................................................................._ ---........•--•-••-•----•--•..............•----•...-••••••-••••----••-••----•-••---••-•--•••-•--...•-----••----•--•--........•••--•-••---•=•---••••-••----•••••-••--•-----•-••••--••••--.....•-•--_-•--- �� ✓'�.. Date Permit No......c � -...... .. ..�----•- Issued....................................................... I No..&::-3--339---- `Y3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.,ti/ .....OF..... r33� ��5— c 6 ............... ...................... .................................------............................................ Appliratiun for Dispsal Works Tonotrurtion rrutit Application is hereby made for a Permit to Construct (t,�°—or Repair ( ) an Individual Sewage Disposal System at: ..............._.....................--•-••---•--•----.............--------•-•--••--------_._... .....-•----..........----•--•.....-----••--•-•-----••--...------.......--••-----•--•••--.......... �^ Location-Address yy or Lot No. 72. r Al .....-------••---. ---._.....••----•••--•-•-•-•-•••---•-•................•---••---•----_.... -------------_.... -•••-•-•----•...•-•--..........--•......_.......................... Owner - Address W � Installer Address � U Type of Building Size Lot.. ... .................Sq. feet .�v 1—I Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................ . W Design Flow...................-� ____......--..gallons per person er day. Total daily flow............................................' gal �? Ions. Ye"W Septic Tank—Liquid capacity_ .... gallons Length__-G_-_�°.... Width..` .-`'/._.. Diameter................ Depth....., .,. x Disposal Trench—No. .................... Width.................... Total Length........ f.._ Total leaching area....................sq. ft. Seepage Pit No----------!?-...... Diameter.._...q....... Depth below inlet........:.:......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) s / aPercolation Test Results Performed by.... 7�7-.__9 Vy(� __._.._ ! .._... Date... 4-7'- � 4~_ Test Pit No. I.... ..°'__.minutes per inch Depth of Test Pit....."6 .p.. Depth to ground water......."'-............ (Xq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 -----•.................•--...._.......--•---------•-----.......---......._........----- 0 Description of Soil....... .. 5!..13:Sv<= l`._-/ -- � r- 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.....................1. --=--------------------•------. ---------•----•---•--------- -•----------- ------------------ Application Approved By......... _d. ... --- - . Date Application Disapproved for the following reasons-------------••------.........---•--------------------------•-----------...------..._...---------------••------- .--------•-----------------•----------.....-•-------------•-------------- •-----------•----------------•-•----••-•----- Date PermitNo.-----.... �._.�z.✓�(�r-------- Issued--------------•-•-----.._..-----.....---.-•....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................TG L^.fn�.....0F.........�f %�u� ?/-''3G "7 .... .................................................................. Trrtif irate of Tontpliana THIS IS T CERTIFY, That the Individual Sewage Disposal System constructed (4-or Repaired ( ) by----------------------- -d--}-•4 - --— �� =......-----••. Install-; ........................................... .......... at.............L. 01F. ... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code des ribed in the application for Disposal Works Construction Permit Nb.._l:' -#:. ' ....... dated------- , .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SAT FACTORY. DATE...............�- --- Inspector......_ _ - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o K/nr......0F......... "•S✓'�'J.' G F� FEE ?. Biopsial_Works Tonotrurtion f rrn it Permission is hereby granted.........___.(-4J ------ a_Nl X7! _•_.................................. .............................. to Construct ( Loror Repair ( ) an Individual Sewage Disposal System atNo................1 .-. . .t.i .t-C .................................................... as shown on the application for Disposal Works Construction Permit Street N 3 . .ated_...__.t/).1 'hC........... .................... Board of Health DA E._........ L )-1 . FORM 55 A. M. SULKIN, INC., BOS,TON 0 r �j Al _ 4�5Z&V. 7vp of C-lAIC. $ovAIP �7oa HSS�ti� r A� V rs ' = LnT #�87 L� -j 3z pi7- n� pn3cw � O Resr'ave try v FGui/D= TgHe6 O 48•IR 8oX I �2d Po fill Ak' e�s�8vr 1 LOCATION C'GTN� SCALE ..�. <= 30 .. DATE 9"w. PLAN REFERENCE . G . { EDWA EY I CERTIFY THAT THE ..... .. . . . . . .. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. DATE . . . . ..... . . . . . REGISTERED LAND SURVEYOR y SNE�7- Z o Z S'14lea-9's t. 48.co .... _ TOP OF FOUNDATION ' CONCRETE COVER CONCRETE COVERS 4"CAST IRONZsck .� OR SCHEDULE 482 MAX. 12"MAX. P.V.C. PIPE 4 SCHEDULE 40 PVC-(ONLY) PITCH 1/4-PER. PIPE- MIN. LEACH PITCH 1/4"PER.FT. PIT NVERT PRECAST ►' • a �'- LEACHING •� EL..gs�rp. INVERT INVERT : w ��; PIT OR �•� INVERT SEPTIC TANK EL .gcso/„ DIST. EL447G EQUIV. BOX = 3: EL..'1444 /Soo.... GAL. INVERT G'�•�' a; 'i: •'r ELF-1 INVERT W W 3/4"TO I Vf ••• EL I`Q �' WASHED .;. � • I ••. U.W •t,' •.• �° I ¢ ' '• STONE fill 6'DIA. Ala F p.o' DIA. t i�.a�x �n PROR LE OF _ E- - GROUND WATER TABL SEWAGE DISPOSAL SYSTEM NO SCALE •¢/8 8 SOIL LOG WITNESSED BY : DATE Z9�98STIME. /o:oo)e � , , '*-/4A/. _ , , BOARD OF HEALTH TEST HOLE I TEST HOLE 2 �>�iiXT7G N�/E T-riC. ENGINEER ELEV..ILL,-9�o. . . ELEV. .... . . . . . . . . . . . y . . . . . �� . . . . . g�'� sag-S DESIGN DATA vc. ' E2'44, NUMBER OF BEDROOMS CL TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA 78 Ste. . SO.FT./PIT�G;P,D. `Sn SIDE LEACHING AREA . .�BB; �. SO.FT./PIT147/G,RD. �SL�cffT ' GARBAGE DISPOSAL .Na^-� .(50% AREA INCREASE) TOTAL LEACHING AREA . .4347. , . . SOFT 3..,e PERCOLATION RATE 1�55. �/ ; 71+!o MIN/INCH Nn .WATER ENCOUNTERED LEACHING AREA PER PERCOLATION RATE .b�R.. SO.FT.�G,RD ... NUMBER OF LEACHING PITS . :✓Q P/75 Wig T1Nv ��.'7 : o/= STDn/6� o�i1GL•S/DES APPROVED . .. . . . . . . . . . . BOARD OF HEALTH . . , , , , • DATE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AGENT OR INSPECTOR VA" OF OF @llcs EDA. ETs E' i R.H H AXELLEY ° M/C,q,y, •��G/N y. v14N0. 20100 �'' c/ST�� 9F�1SiER� '��, saNnaa�a� PETITIONER ; �UU�.T�� `/NAN •