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HomeMy WebLinkAbout0211 MONOMOY CIRCLE - Health 211 Monomoy Circle Centerville P A 191 220 No. 4210 1l3 O an 1000 G O a �1 'Fee$50. 00 No. - / v r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zippricatiou for Migaaf bpgtem Com5truction 3dermit Application for a Permit to Construct( )Repaii:%X xl Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot Not 11 M o n o m o y Circle Owner's Name,Address and Tel.No. Centerville,Mass . 02632 Francis Kirk Assessor's Map/Parcel 191/220 Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—2 7 3—0 3 7 7 J.P.Macomber & Son Inc . JC,Fngineering 5 Roundhill BLVD Box 66 Centerville ,Mass. 02632 East Wareham,Mass . 02538 Type of Building: Dwelling X X No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinderg0 ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 350. 9 G P D gallons per day. Calculated daily flow 3 X 110=3 3 0 G P D gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1000 Type of S.A.S. 2-500 gallon leaching chambers . 25 X12. 9 'X2 ' Desfription of Soil 0-8"=Loamy sand , 8"-24" Sandy loam 24 '-120"=Me —C Sand 25% gravel . No ground water Nature of Repairs or Alterations(Answer when applicable d d i n g two 500 gallon leaching chambers packed in 112" stone . 25 'X12 . 91X2 ' 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 an ,not to place the system in operation until a Certifi- cate of Compliance has been issu by this Signed Date 7/2 /0 2 ' Application Approved by _ Date Application Disapproved for the following reasons ellPermit No. Date Issued + , TOWN OF BARNSTABLE �- LOCAT -3N �Z Clot SEWAGE # 20" VILLAGE C e,,Arr P. 1//1 L e ASSESSOR'S MAP & LOT 11211- 2 a INSTALLER'S NAME&PHONE NO. ) 41 A C 0 0 fl e X fi SEPTIC TANK CAPACITY O ©O G L/0 LEACHING FACILITY: (type)A— /7R V w eZ LS (size) NO.OF BEDROOMS BUILDER OR OWNER r lc PERMPTDATE: 3 a COMPLIANCE DATE: t? G.x 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 v(1 LM 4N.. ,., ., Fee$S0'.00 ~ Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH�,DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS 'sy tcatton for Mtn opal stem Construction er t nt t Application for a Permit to Construct( )Repairl(X X Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No21 1 Monomoy C i r.c.l a Owner's Name,Address and Tel.No.' f Centerville,Mass.02632 °Pranc.is Kirk Assessor's,Map/Parcel 191/220 Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—2 7 3—0 3 7 7 J.P.Macomber & Son Inc. JO.Bngineering 5 Roundhill BLVD Box 66 Centerville,Mass.02632 East Wareham,Mass.02538 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinden't0 ) Other Type of Building No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow 350.9 G P D gallons per day. Calculated daily flow 3 X 110=3 3 0 G P D gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1000 Type of S.A.S. 2-500 gallon leaching i chambers. 25 Des ri tion f Soil 0-8"=Loamy' sand,8"-24" Sandy loam X12.9 XZ j 24�'P120"=Me —C Sand 25% gravel. No ground water Nature of Repairs or Alterations(Answer when applicable)A d ding two 500 gallon j e a c h i n g chambers packed in 11" stone. 25'X12.9'X2' 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 an not to place the system in operation until a Certifi- cate of Compliance has been is su by this B'az�&�fa7/2 /0 2 { Signed ,t Date V Approved by _ r/ �, ,{ r_ ! Date VApplication Disapproved for the following reasons d v Permit No. r Date Issued THE COMMONWEALTH OF MASSACHUSETTS _ BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS XO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired X Upgraded( ) Abandoned( )£by J.P.Ma c o m b'e r & Son Inc. at 211 M o n o m o y Circle C e n t e r y i l l e,Mass. has been constructed in/accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.;4A)a' 3 1 k dated Installer 'J:P.Macomber & Son Inc. Designer JC Engineering `The issuance)of this permit shall not be construed as a guarantee that the sys will function as esigiped. Date / Inspector 1 ---------------------------------------- E 00 v THE COMMONWEALTH OF MASSACHUSETTS / PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'j ltzpozal *p5tem Construction Vermit Permission is hereby granted to Construct( )Repair( )Upgrade(X X)Abandon( ) Systemlocatedat 211 Monomoy Circle Centerville,Mass. II and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local rovisions or special conditions. Provided:Construction must be co mplete w' 'n three years of the date of thi Date: M '� Approved by TOWN OF BARNSTABLE ` I LOCATION 2 /Z Al nA/d M 0 y C SEWAGE VILLAGE �'�Te l: .11—/e ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 4m c o 4/1 isle it t S peV SEPTIC TANK CAPACITY / O 00 6 L 67 LEACHING FACII,ITY: (type) -e 1 L S (size) NO. OF BEDROOMS �. BUILDER OR OWNER �+Ic PERMITDATE: D L COMPLIANCE DATE: -2� 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 - — i i a \ II 0 S /te4r 1N1 Un��v CO`1.%10'\X%-EALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS _ DEPARTMENT OF E:�VIRONNIE\TAL PROTECTION ONE WINTER STREET. BOSTON. NIA 0_105 61?-=S_•S:C�Q ,' r a � TRC'D`i CO? WlLLI A"F.WELDr- Govemc DAVI ARGEO PAIjL CELLUCCI `"• :' "- f_ D:B STRtK Lt.Govcmoi SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO " Comrrsissian:� PART A CERTIFICATION Property Address; 1l Widd Mo� CL K, ` �u� Address of Owner• aovscLS�Q -��� 'c -Of different) Date of Inspection: ..��Z�I t �1 Name of Inspector: 1`>'. �...-o i� I 1 E��Ceo �t rni 1 V l"t I () am a DEP ap roved system inspector pursuant to Section 15.340 of Title S (310 CMR 13.000) Company Name: / Mailing Address: e-37?!�j . H ASA/o2sL H IT 0 2-.6'4-47 Telephone Number: rs-C 2�,-z !�69-P6- /4 Zo CERTIFICATIO% STATEMENT I ce.^.i4 that I have pe•sonall inspected the sewage d:srosal systern at this address and tha: the information reported be!oN,is true. accurate and cornolete a: of the time of inspectoo-. The inspectxn was pe^ormed base- on my training and experience in the proper funeicn and ma-ntenance o;on-'site sewage dispcsa: systems. The s•stern: Passes _ Concit.onaii% Passes Neecs Furthe• Eva! ^ BN. the Local Approving Authority Inspector's Signat Date: 19, T ie SvS.e-r Insrezo• shai' submit a cop. of this inspee,on reocr, to the Aporoving Authcrtt� within them (30) days of completing this inspection. If the s\stern is a shared cvstern•o• ha; a des,gn floN. of 10,000 god or greater, the inspecor and the system owner shall submit the repo tc the aporopriate reglor.al office of the Department of Environments' Protection. The crig:na! should be sent to the systern oµne- and copes t-•ic to the buyer, if applicable. and the approving authority INSPECTION SUMMARY: Check A, E, C, or D AI SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 13.303. Any failure.criteria not evalyated are indicated below. . COMMENTS: �`�t.rn �� r��alrir� �tyi� �'icN�' �'f kLlc�� u Va.��.jn '� y'�`:'\CW1 Qtf1C,`rC'C kUt/1 Y ey" B] SYSTEM CONDITIONALLY PASSES: One or more system components as described in the 'Conditional Pass' section need to be replaced or repaired. The systern, upon completion of the replacernent or repair, as approved by the Board of Health, will.pass. Indicate yes.no, or not determined (Y, N. or NDi. Describe basis of determination in all instances. If'not determined', explain why not. The septic tank is metal, unless the owner or operator has provided the system inspecor with a copy of a Certificate of Compliance !attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection: or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming-septic tank w approved by the Board of Health, (revised 04/1s!f7) Page 1 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � t PART A CERTIFICATION (continued) - Property Addwss: - Owner: Date of Inspection: - 81 SYSTEM CONDITIONALLY PASSES (cont,n-jt d Sewage backup or'breakout or high static water level observed in the distribution box is due to broken or obstructed pipe;s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(wit fi approval of the Board of Healtht. Describe observations: broken pipe(s) are replaced --r-�,.T obstruction is removed distribution box is levelled or replaced The stem r u�red pumping more than four times a year due to broken or obstructed pipe(sl..The system will pass s} eq inspection if twith approval of the Board of Health): broken pipets; are replace: r. is removed _.. obstruction - C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require furthe•evaluation by the Board of Health in order to determine if the system is failing to prote the public health, safe--.-and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM 15 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. Cesspool or prn� is within 50 feet of a surface water-. Cesspool or prnN- is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The systern has a septic tank and sail absorption system (SAS) and the SA< is within 100 fee;to a surface water supply or tributan• to a surface water suppiv. _ The system has a septic tank and soil absorption system and the W is within a Zone I of a public water supoty well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and sail absorption system and the SAS is less thar. 100 fee: but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) _ OTHER (revised 01:I5/3'1 Page 2 of 10 -z RFACE SEWAGE DISPOSAL M INSPECTION SI,BSU OS L 5157E E O FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: D] SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: 1 have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The oasts for this determination is identified below. The Board of Health should be contacted to determine what will be necessan• to correct the failure. Yes No Backup of sewage into facility'or system component due to an 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. Stain 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 1/2 day floe. Required pumping more thar, 4 times in the last year NOT due to clogged or obstructer pipes. Number of times pumped _. Anv portion of the Soil Aosorption System, cesspool or priv'• is below the high groundwate• eievatror. An% portion o:a cesspool or privy is within 100 feet of a surface water supply or tributary to a suriace water supply. Any portion of a'cesspoo! or privy is within a Zone I of a public well. Am porio- c:a cesspool or pricy is within 50 feet of a private water supply well Am por.or. o!a cesspool or prey is less than 100 feet but greater than 50 feet from a private water supply well with no accezable water qualrtm analsis If the well has been analyzed to be acceptable, anach cope of well water analysis for cohiorm bacteria volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The foliow:r,g criteria aopi16 to large systems in addition to the criteria above: The system serves a facilm with a design flow of 10,000 gpd or greater (Large System; and the system is a significant threat to public hea!th and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/35/97) Page 3 of 10 ' t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Properti Address: �� IMUK�O W1U� Owner:Wce1 V Date of Inspection ,: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes Ng Pumping information was provided by the owner, occupant, or Board of Health. }( None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recentl% or as part of this inspection. 4 As bull: plans have been obtained and examined. Note if they are not available with N/A. The fac:lm or dwelling was inspected for signs o**sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. The site vas inspected for signs of breakout. All 5vgem components. excluding the Soil Aosorption System, have been located on the site. n _ The septic tank rnanho;es Nere uncovered. opened. and the interior of the septic tank was inspected for condi.tion of —'� baffies or tees. materia' o' construction, dimensions, depth of liquid,depth of sludge, depth of scum. The size and location of the Soil Absorption Svstem on the site has been determined based on The facdm owne• ;ano occupants. if dirteren: trom ov.•nert were provided with information on the proper maintenance of Sub-Surface Disposal Svstem. _ Existing information. Ex. Plan at B.O.H. _ Determined in the field of an, of the failure criteria related to Part C is at issue, approximation of distance is unacceptable (15.302.3);blj (revised 04/25/97) Page 4 of 10 _1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR.tit PART C SYSTEM INFORMATION Property ddress,: �` lJOW10� Owner: C�VV Date of Ihspection: � FLOW CONDITIONS RESIDENTIAL: Design floe. :324) p.d.!bedroom for S.A.S Number of bedrooms Number o'current residents--Q Garbage g,, der (yes or not: 146 Laundry cor^ected to system (yes or no). Seasonal use ryes or no,: Water meter readings, if available (last two (2; year usage tgpd): Sump Pump (ves or no)- Lai: date o"occupanc\1 the Q,L46C-}a Zr�S(�ca�vtl COMMERC?4L'INDUSTRIAL: Type of establishment. Design fio%% ¢ahons/da,. Crease trap present. tveS or no Industnal.l'laste Holding Tani; present Ives or no ':on-sanitan waste dscnarged to the Tr,,e 5 system. ;ves or no \later meter readings, if a.ailabie Las:,date of in c;:panc, �e OTHER: .Descnbe Last oate of occuoanc. GENERAL INFORMATION PUMPING RECORDS and source of information 1� System pumped as par, of Inspection: (ves or no._ If yes, volume pumped ¢allons Reason for pumping TYPE OF SYSTEM _ Septic tan rsoil absorption system Single cesspool Overflow cesspool Pry y Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site. (yes or no)" � (revised 04/25/97) page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTE.41 INFORMATION (continued) Property Add►ess:5tkk t46ts6mt� Gl,,v" Date of Inspection: C`c1� i BUILDING SEWER: ` (Locate on site plan) Depth below grade. V Material of construction: _cast iron _40 PVC _other (explain) Distance from private water supply well or.suction It Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: J (locate on site plan Depth below grade--, Material of constructioni: concrete _meta _Fiberglass _Polyethylene _othertexplain If tank is metal Its: age Is age confirmec b� Cen:ftca:e of Compliance (lres.'No to � S — Dimensions Sludge depth " rr Dtsiance from top o; s!udee to bottom of outie; tee o• bar;e _ Scum thickness !Sit if Distance from top of scum to top of outlet tee or ba^)ef� Distance from bo tom of scum to boom o outlet t or ba�.e �— Now dimensions were determined I ci!U Comments. trecommendation for pumping, condition o; tniet and outlet tees or baffles. depth of liquid level in relation o outlet invert, structur inte nty, evidence of leakage, etc.r ' 1 "Cly (tj GREASE TRAP: (locate on site plan; Depth below grade: 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: Comments: (recommendation for pumping;condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.; (revised 04/I5:97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propertm Address: tat w� � 0%ner..Qa&�d1 a Date of Inspection: 2�S TIGHT OR HOLDING TANK: .lank must be pumped prior to, or at time, of inspection) (locate on site plan, Depth below grade: Material of construction. _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Capacm- gal ions Design floe. galions'da, Alarm level Alarm in .%orking order_ Yes: _ No Date of previous pumping Comments (condition of inlet tee. condition o-. warm and float switches. etc.) DISTRIBUTION BOX: (locate on site par: Depth of liquid level aoo.e ouoe: in.e^ Comments incite if level and distributor. is eoua'. evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER:�� (locate on site plan. Pumps in working order: (Yes or No, Alarms in working order (Yes or No, Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) page 7 of 10 i, A. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property ddr-ss: ,Qt NOV% Owner: W Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site.plan, if possible, excaJ ion not required, but may be approximated by non-intrusive methods; If not determined to be present, explain: Type. leaching pits. number. ,L'x leaching chambers, number : _ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimension: over-low cesspool, number Alternative system name of Technology Comments. (note condition of soli, signs of hydraulic failure, level of ponding, conditio of v' etation, etc., y .�� c�1t l4 Zoti _QV bp- CESSPOOLS: ) (locate on site plar. Number and corfigura:.or Depth-top of liquid to inlet inyer, Depth of solids layer Depth of scum layer. Dimensions of cesspool " Materials of construaior Indication of groundwater inflow (cesspool must oe pumpec as par, of inspection: 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.) (revised 04/25/91) page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued; Property i M dress! 64�Ad� Owner: ���un Date of IhBpection: ICU �6 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) (revised 04'25/5-) page 9 of 10 SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropertN ddres-• Owner: U Date of Inspeclion:�' ` f Depth to Groundwaze'�O Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property. observation hole, basement sump etc.) Determine it from local conditions Cnec", %+rth local Board o• nea!t^ Chec'K FE.NAA ntaos Check pumping records Check local excavato,s. installers lase `Scs Da•a r• Describe in %ox o% o: no•.+ \o" es:abh<.hed the Hii& Groundwater Elevation. (Must be completed: b�dobSic (rev_aed 04.2519-. Page 10 of 10 i 2 3 V COMMONWEALTH OF MASSACHUSETTS I \S EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAI N RECEIVED DEPARTMENT OF ENVIRONMENTAL PROTEC NFEB 9 .1998 ONE WINTER STREET, BOSTON, MA 02108 ti17-292-5500 TOWN OFBARNSTABLE "FAITH nr?T otlj W'ILLIA34 F.VELD J 1►.'' TRUDY COXE Governor '�j 'Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM Commissioner PART A CERTIFICATION Harry Tompkins C oLtj 7l i�v 1l/0 8103 Town VdalTc Drive Property Address: 211 1`4onomoy Circle —Barable, 1` Address of Owner: Hamden, CT 06518 Date of Inspection: 01 Februaryy, 1998 / (If different) Name of Inspector: George M. Sherman I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Sherman Home Inspections, Inc. _ Mailing Address: P.O. Box 1328 — Middleborough, MA 02346-4328 Telephone Number: F 5081 947-7595 CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X Passes _, Conditionally P Needs Furthe val n By the Local Approving Authority Fail Inspector's Signatur Date: 03 February, 1998 The System Inspecto shall submit copy of this inspection report to the Approving Authority within thirty (30) days of completing this, inspection. If the system is a sh system or has a design flow of 10,000,gpd or greater, the inspector and the system owner shall submit the report to the appropriate re tonal office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: N/A 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. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is.replaced with a conforming septic tank as approved by the Board of Health. (reviiod 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:JAvww.magnetstate.ma.us/dep Printed on Recycled Paper 1 • � r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property rAddress: 21PMonomoy Circle - Barnstable, DIA Owner: Harry Tompkins Date of Inspection:02/01/98 ej SYSTEM CONDITIONALLY PASSES (continued) . N/A Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced r obstructedpipe(s). The s stem will ass _ The system required pumping more than four times a year due to broken o obst ct Y P, inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: � Q _ N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and.the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (saeiaad 04/25/97) Page 2 of 10 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 211 1`Monomoy Circle - Barnstable, DIA Owner: Harry Tompkins Date of Inspection: 02/01/98 D] SYSTEM FAILS: N/A You must indicate eir,er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 1/2 day flow. Required pumping more than 4 times in the last year-NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privyy 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: N/A You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revimed 04/25/97) Page 3 of 10 Y � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 211 Monomoy Circle - Barnstable, DIA Owner: Harry Tompkins Date of Inspection:02/01/98 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yeses No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or y� as part of this inspection. H _ As built plans have been obtained and examined. Note 4 they are not available with N/A. V — The facility or dwelling was inspected for signs of sewage back-up. VZ _ The system does not receive non-sanitary or industrial waste flow. V _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. V _ The septic tank manholes were uncovered,,opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on'the proper maintenance of Sub-Surface Disposal System. V Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)J (revised 04/25/97) Page 4 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 211 Monomoy Circle - Barbstable, DIA Owner: Harry Tompkins Date of Inspection: 02/01/98 - FLOW CONDITIONS RESIDENTIAL: Design flow:110+ a.p.d./bedroom for S.A.S. Number of bedrooms: 3 Number of current residents: 0 Garbage grinder (yes or no):_Yes Laundry connected to system (yes or no)- es Seasonal use (yes or no): No 12/31/97 = 274 Water meter readings, if available (last two (2) year usage (gpd).: 1 94' 1,/C)9 = 1 q7 = 77nn rii ft x 7 5 = 57,750 gal/730= Sump Pump (yes or no): No 79 gal per day. Meter # -4599 — Acct # 4963 Last date of occupancy:December 31, 1997. COMMERCIAUINDUSTRIAL: N/A Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Info from Harry Tompkins, Jr. the owner: last serviced & pumped October of 1992 System pumped as part of inspection: (yes or no)_NQ If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM . X _ Septic tank/distribution box/soil absorption system rP Y Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Per owner built in 1975,_ 22+ — years of age , Sewage Permit # 75-64 issued 04/10/75, compliance issude 04/15/75. Sewage odors detected when arriving at the site: (yes or no) NO (revised 04/25/97) Page 5 of 10 v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 211 1`Monomoy Circle - Barnstable, PIA Owner: Harry Tompkins Date of Inspection: 02/01/98 A. BUILDING SEWER: (Locate on site plan) Depth below grader 25" Material of construction: _cast iron X 40 PVC_other (explain) Distance from private water supply well or suction line N/A Diameter 41, Comments: (condition of joints, venting, evidence of leakage,,etc.) No abnormal findings 02/01/98. -.--... SEP-TIC TANK: X (locate on site plan) Depth below grader 17" Material of construction: X concrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: 10 X 4 X 5' Sludge depth: + — 4" Distance from top of sludge to bottom of outlet tee or baffle:=25" Scum thickness: + — I" Distance from top of scum to top of outlet tee or baffle: +/— 2" Distance from bottom of scum to bottom of outlet tee or baffle: /---23" How dimensions were determined: measured Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Recommed Gystem be rums ed every 2 tn _71 area rs_ No .abnormal findings 02/01/98 GREASE TRAP: N/A (locate on site plan) Depth below grade: 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:. Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 u y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 211 Monomoy Circle Barnstable, DIA Owner: Harry Tompkins Date of Inspection: 02/01/98 TIGHT OR HOLDING TANK: N/A (Tank must be pumped prior to, or 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/day Alarm level: Alarm in working order_Yes;_ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: N/A (locate on site plan) Depth of liquid level a -)ve outlet invert: Comments: (note if level and dist it .ition is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER: N (locate on site plan) Pumps in working or (Yes or No) Alarms in working or r (Yes or No) Comments: (note condition of pu chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 211 Monomoy Circle.- Barnstable, MA Owner: Harry Tompkins Date of Inspection: 02/01/98 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: X leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Single pit +/— 8' deep x 61 rji amPf-Ar Pit cover +/— 28" hPl nw arar1P_ Too of inflow invert +/- 2" below nit rover- N gEanr•P from i ntrprt- Thnt- nm to StaZ4djz4g pit water = 58"- T\Tn art-irPYCP f j nr1j nQS11Y3-021/ 1-1/g•$ CESSPOOLS: _N/A (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_N/A (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.) (revised 04/25/97) Page a of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 211 Monomoy Circle - Barnstable, PIA Owner: Harry Tompkins Date of Inspection: 02/01/98 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) l -0 1 d O D.ISI'ANCES: Point A to: Inlet Cover 43'06" Outlet Cover 45' 00" Pit Cover 52' 06" Point B to: Inlet Colter 07'.'`02" Outlet Cover' _ _ 13" 00" Pit Cover 23' 06" (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 211 Monomoy Circle = Barnstable, DIA Owner: Harry Tompkins Date of Inspection: 02/01198 Depth to Groundwater Feet +/— Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps i i Check pumping records Check local excavators, installers X Use USCS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) 77he depth to groundwater was figured by Ed Eichner of the Cape Cod Commission. Fie obtained his data figures from the following sources: (1) USGS Quad map figures, (2) CCC Technical Bulletin # 92-001 Estimate of High Groundwater Levels for Construction and Land Use Planning [+/- 15 ft] , and (3) Approximation of depth based on the static level at the monitoring well- at Skunk Neck Road in the Town of Barnstable on January 12. . . .depth 12+ feet. (revised 04/25/97) Page 10 of 10 TOP OF FOUNDATION PROVIDE PRECAST CONCRETE EXTENSION 5" DIA. OUTLET(S) ELEV.= 99.43" FINISH GRADE OVER CHAMBERS = 98,5' RISER WITH CONCRETE COVER TO WITHIN REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM GENERAL NOTES 6" OF FINISH GRADE ABOVE OUTLET COVER FINISH GRADE OVER D-BOX= 98.6' 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4" TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE '�INISH GRADE OVER TANK EL.= 98.90 2" OF 1/8" TO 1/2" DOUBLE WASHED STONE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE TOP OF SAS 95.83' PLACE RISERS ON ALL CHAMBERS ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. - 36 MAX. 1 9" MIN. TO 6" OF FINISHED GRADE 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD .71 Jr r_1 F 9, l 95.00 36" MAX. BREAKOUT EL = 95.50+ OF HEALTH AND THE DESIGN ENGINEER. 2" DROP MIN. PROVIDE WATERTIGHT 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 3" DROP MAX. 3„ 9.. i BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 6" 3" � JOINTS (TYP.) 0 0 0 4" PVC IN FROM O o00 O o0 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS 10" SEPTIC TANK 4" PVC OUT TO 14" 95.97 0 0 o THAN ELEVATION = 95.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. z LEACHING FACILITY oo 00 0 oo UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO \ _ ' 95.37' N. 2 00 0 o ° 48'" VERIFY CONDITION OF ` OUTLET TEE 95.20 o Quo 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. TEES AND REPLACE 0 0 0 00 000 0 0 o0 AS NECESSARY 6" CRUSHED STONE o 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 22"ZABEL FILTER OVER MECHANICALLY _ o MODEL#A1801 HIP (GAS COMPACTED BASE 4' 8 5' I •• 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED BAFFLE ON BOTTOM) 4' _ 4' PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND 5 OUTLET DISTRIBUTION BOX 25.0' (T;P) READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED TO BE INSTALLED ON A LEVEL STABLE < 88.60' 12 9' WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH + GROUND WATER ELEV.= EXISTING 1000 GALLON CONCRETE SEPTIC TANK BASE. FIRST TWO FEET OF OUTLET 93.00 --� ++ ! PIPES TO BE LAID LEVEL. 2 - 500 GAL. CHAMPFPP 5' MIN. 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.0' MSL OBTAINED LENGTH 8'-6" WIDTH 4'-10" DEPTH 5 -7 CROSS SECTION VIEW FROM A NAIL IN A TREE AS SHOWN ON PLAN. SEPTIC TANK PROFILE DISTRIBUTION OX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS CHAMBER END VIEW 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION NOT TO SCALE NOT TO SCALE NOT TO SCALE THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY j TEST DISCREPANCIES TO THE DESIGN ENGINEER. ! I E�7T PIT DATA 10 ALL JOINTS WHE RE PIPE ENTERS AND EXITS CONCRETE .r. "` �' .• 5� v " yr STRUCTURES SHALL BE MADE WATERTIGHT. � - �s• . r ',� _ INSPECTOR: a. x. SOIL EVALUATOR: John L. Churchill Jr. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR > ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN DATE: June 25, �.002 SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. TEST PIT#: 1 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS ELEV TOP = 98.60' LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH ELEV WATER= >10' BGS CASE THEY SHALL WITHSTAND H-20 LOADING. `�f' 'gig.�.,, � �" r z, PERC RATE _ � a I r r 2 MIN/IN 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. FINES. DEPTH OF PE RC = 24"-42" d ' �m `"" 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND TEXTURAL CLASS: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN w 0 98,6' COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN Loamy Sand ACCORDANCE WITH 310 CMR 15.255(3). 10YR 3/2 40 8" 97.g 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. g Loamy Sand 10YR 5/8 16. PROPOSED PROJECT IS LOCATED WITHIN: ++ ° c 24" 96.6' + b ASSESSORS MAP# 191 LOT# 220 _". * . PROPOSED 2-500 �� �r .-w� �`p �' `` � �� �'� , Perc MAP 191 : �► a GALLON CHAMBERS 42" 95.1' 17. OWNER OF RECORD: Francis & Rosemary Kirk LOT 220 ,p��,�, � ��,� *� �- �+ � ° "r� s�� x ; , y AREA= 18249 SQ.FT. •7I M , M w• m A , ADLRESS: 211 Monomoy Circle ;� r . I Centerville, MA 02632 �"" 1 e Med-C Sand w ,.� . ' 25% Gravel 18. °o ,-' r « :.,F C PLAN REFERENCE: 2.5Y 6/3 V �,_ PLAN BOOK: 272 PAGE: 58 �. #€ . / r�` * PI s 19. , DEED REFERENCE: 10" CHERRY TREE // +� �" $ �' s x TO REMAIN No Groundwater BOOK: 11250 PAGE: 260 ✓ z Encountered j 10" HOLLY TREE TO ! ' LOCUS PLAN 120" 88.6' + BE REMOVED �e�� 98x6 761 col J 86' QP X SCALE: 1" = 1000' -.,. TP#1 `' ✓0F , B.M. ��' 1 ✓� A OG Nail in Tree :.,� ~�}+j � � 4. ^� /A' GARAGE � DESIGN DATALEGEND Elev. = 100.00' a`� Y 2s� h Assumed ,. ry. PATIO f / `il Zc ^ O ✓ ✓ NUMBER OF BEDROOMS 3 X �' EXISTING SPOT GRADE NUMBER OF PERSONS 3 - - 50 EXISTING CONTOUR EXISTING / ^� / DESIGN FLOW 110 GAUDAY/BEDROOM 50 PROPOSED SPOT GRADES > >� 3-BEDROOM � ✓ .8-,� 8 DWELLING / ✓ ✓ TOTAL DESIGN FLOW 330 GAUDAY ' 6+h TOF = 99.43' DESIGN FLOW X 200 % - 660 GAL/DAY - PROPOSED CONTOUR ' 12 Y ✓ USE EXISTING 1000 GALLON SEPTIC TANK W EXISTING WATERLINE Cb PROPOSED"D"BOX --� `i' / / GAS GAS EXISTING GAS LINE t E/C -�-�-- EXISTING OVERHEAD UTILITIES EXISTING LEACHING ,,F , INSTALL 2- 500 GAL. CHAMBERS PIT TO BE PUMPED �61°S'S �,� p, Y / TELE ---- EXISTING UNDERGROUND UTILITIES AND FILLED WITH �S6 4�,, o,' �� SI DEWALL CAPACITY TEST PIT LOCATION CLEAN SAND 66' "'Y /� � 1, + (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (.74 GPD/S.F.) = GAL/DAY (25.0 12.9') (2) (2') ( .74 GPD/S.F.) = 112.2 GAL/DAY EXISTING 1000 `' � '�� 0 Q Q EXISTING 1000 GALLON SEPTIC TANK GALLON SEPTIC �0J 4" SOLID SCHEDULE 40 PVC PIPE TANK BOTTOM CAPACITY c� �`v �� / / (LENGTH x WIDTH) (.74 GPD/S.F.) = GAL/DAY Q DISTRIBUTION BOX O� \�O (25.0'x 12.9') (.74 GPD/S.F.) = 238.7 GAL/DAY UiLj 500 GAL. LEACHING CHAMBER TOTALS: TOTAL NUMBER OF CHAMBERS 2 / TOTAL LEACHING AREA 474.1 SQ.FT. TOTAL LEACHING CAPACITY 350.9 GAL./DAY REV. DATE BY APP'D. DESCRIPTION / PROPOSED SEPTIC SYSTEM UPGRADE PREPARED FOR: FRANCIS & ROSEMARY KIRK LOCATED AT 211 MONOMOY CIRCLE CENTERVILLE, MA 02632 RESERVED FOR BOARD OF HEALTH USE lCr 1 k,. tl i�o SCALE: 1 INCH = 20 FT. DATE: JULY 17, 2002 40 y7 0 10 20 40 80 FEET JOH Q o CiilJ 2C _........ .._...._.._...___ _ ._......_:._....JR. PREPARED BY: No 07 TC JC ENGINEERING r` ;<r 5 ROUNDHILL BLVD. Yr�' EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"=20' Drawn By: DS Designed By: DS Checked By JLC JOB No.243