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HomeMy WebLinkAbout0334 NYE ROAD - Health 334 Nye Road Centerville. P A =. 148 .012002 1 COMMONWEALTH OF MASSACHUSETTS ExEcunvE OFFICE OF ENVIRONMENTAL AFFAIRS IDEPARTmENT OF ENVIRONMENTAL PROTECTION r TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A RECEIVE® CERTIFICATION Property Address: 334 Nye Road s F P 3 0 2002 Centerville MA 02632 Owner's Name: Vincent and Margaret DeMartino TOWN OF BARNSTABLE Owner's Address: Same HEALTH DEPT. Date of Inspection: September 25,2002 � Name of Inspector: PATRICK M.O'CONNELL MAP Company Name: SEPTIC INSPECTION SERVICES CO. PARCEL ZO`Z OOZ Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 LOT _ Telephone Number: (508)428-1779 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 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: X_ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 2S"�oZ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments Recommended pumping tank ****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. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of Inspection: September 25,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X_ 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: 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. Answer yes,no or not determined(Y,N,ND)in the 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 334 Nye Road Centerville Owner. Vincent and Margaret DeMartino Date of Inspection: 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(lxb)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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form 3. Other. Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of Inspection: September 25,2002 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool —X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X— Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. - X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface — water supply. _X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Ye&fNo)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 most serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each ofthe following: (The following criteria apply to large systems in addition to the criteria above) 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 11 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of Inspection: September 25,2002 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _ X Were any of the system components pumped out in the previous two weeks? X ____ Has the system received normal flows in the previous two week period? X Have large volumes ofwater been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as MIA) _X _ Was the facility or dwelling inspected for signs of sewage back up? _X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ 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? _X _ 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: Yes no X_ _ Existing information.For example,a plan at the Board of Health. X _ 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(3)(b)] i Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of inspection: September 25,2002 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no):— Seasonal use:(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): 243 Sump pump(yes or no): No Last date of occupancy: Currently Occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): apd Basis of design flow(seats1persons/sgft,etc.): 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/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Homeowner:Never been pumped Was system pumped as part of the inspection(yes or no): No If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X_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)No _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Installed June 1979 Were sewage odors detected when arriving at the site(yes or no): No i Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of Inspection: September 25,2002 BUILDING SEWER X (locate on site plan) Depth below grade: 18" Materials of construction:_cast.iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: 35' Comments(on condition of joints,venting,evidence of leakage,etc.): Pipe in good condition no leaks. SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction:_X concrete_metal_fiberglass`polyethylene _other(explainI) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 1000 Gal. 4.5'X 8' Sludge depth: 7" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 7" Distance from top of scum to top of outlet tee or baffle: 4" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined.: STICK WITH HINGE FLAP. 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 in good condition,Bafiles intact 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(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 334 Nye Road Centerville Owner. Vincent and Margaret DeMartino Date of Inspection: September 25,2002 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: taltons Design Flow: allons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: NOT PRESENT (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): 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.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 334 Nye Road Centerville Owner: Vincent and Margaret DeMartino Date of Inspection: September 25,2002 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type X_leaching pits,number: 1 leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative(ahernative system Typetname oftechnology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): Effluent level three feet below inlet,no high water stains. 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 or no): 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.): Page 10 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 334 Nye Road Centerville Owner. Vincent and Margaret DeMartino Date of Inspection: September 2S,2M SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. GIs 38Sq 2d 33 Sv Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 334 Nye Road Centerville Owner. Vincent and Margaret DeMartino Date of Inspection: September 2.5,2002 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than>12 Feet Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed: June 27,1979 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test holes on plan show no Groundwater at 12' (7)? No......................... Ftzs..... -?.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---- _Town_ ..................OF......Barnstable......._-- ..................................... Appliratiuu -fur Difipuual Morks Tonfitrurtion Vrruiit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: a a*- ..C.ross...RiAg ......Nye...Road. X en.ter_vj 11 e ..........Le-t---#...Z----_-------- Location-Address or Lot No. ..61d.en_.d0 mes..-•--Inc..--------•-••-------•............................. .30x---310.....JYannis.t...Ma....02601-------------------- Owner Address w Ne-wti me..C(ns-truction------------------------------------- Maratons...Mi1Ls.>---Ma............................................ "� Installer Address QType of Building Size Lot....20,0$$--._---Sq. feet U Dwelling—No. of Bedrooms..-_3............. .. .--_-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures ---------------------------- w Design Flow............%........................gallons per person per day. Total dpLily flow__________---_---_3.:30_--.-..-..---gallons. WSeptic Tuck—Liquid capacity-10-O�__gallons Length--- Width_4_-:-1d-- Diameter--------- ...... x Disposal Trench—No. ................... Widtll...a_--_----_----_-. Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No.......i.._.._...... iameter...... o....V Depth below inlet_______ _______ T al leaching area.__ G--__sq. ft. z Other Distribution box ( Dosing tank - '' Percolation Test Results Performed by.... s.... ?_i-9T ....................................... Date___ _.._--------------__-_- �. aTest Pit No. 1." -......minutes per inch Depth of Pest Pit-------0-------- Depth to ground water----4 t4..._.. f1 Test Pit No. 2-1i.W3,___minutes per inch Depth of Test Pit.................... Depth to ground water__.--.-.--_-_------__-- 9 ....................-•-------------------------------------- .. •----------.............................................................................. ODescription of Soil--------p 9 �------- 0------.. -------------------------------------------------------------------------------- x U ----------------------------- --------- --•--------------------------•---••----....••--•-•-•--.....---••----------•-•-------•-•-----•-•-----...-----------------------------•--•-•-......---•-•------. w VNature 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ,,,b!!leen issued by the board of health. Slgne ...... .. ........••.......................................................... ........--•--'ate......-------- Application Approved BY --- ------------------ ------� — 7JC----D.. Application Disapproved for the following reasons:........................... ---- ---•-•-------•-------•-------------------------•----- Date --•---------- -----•---•--••------------•-•----------------•-------------------------•------•----•---------------•-•-•....--•--••-------•------------------- ---•-----------•----------•------•-•.......-------•----. p Date Permit No......................................................... Issued...... ------------------------------- Date L__ No.------..y�.�......... Fz�s.... ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH N: _Town. ..._... --.....OF......Barnstable...................................................� lirttt�o�t -for Ubtip al Workii Towitrortion Vrruift Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at .-Cros.9---Ridge, 1ge...Raaa C=tervi_1e L-0t-- --2...............................................................------ Location-Address or Lot No. .Alden_-Homea,...Ia3a.................................................. Rox___310.....Hyannis-t...Ka..... 260_1.------...._...._.__ Owner Address a lextavae...C.Onstruation.... ................................ _MarB nns__ lla ---Ka.............................................. Installer Address Q Type of Building Size Lot...2P_r_M-------Sq. feet U Dwelling—No. of Bedrooms----3--------------------------------------Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type of Building ____________________________ No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- --- W Design Flow__________- __________________________gallons per person per day. Total daily flow..................3ao..............p1lons. WSeptic "funk—Liquid capacitV42CO---gallons Length.S4='(____ WidthA- 1 Diameter..........:----- Depth- '_?---- x Disposal Trench—No. .................... Width__-_______-_..______ Total Length____________v_____- Total leaching area....................sq. ft. Seepage Pit No.......I_____________ iameter._...OE?_-�-. Depth below, inlet...... _ tal leaching area-."Z 1�_._.sq. ft. z Other Distribution box ( Dosing tank ( ) 6 ' a Percolation Test Results Performed by.____ k I _____________________________________ Date....��'-.__:__�---�_____.��. Test Pit No. L<_ ......minutes per inch Depth of "Pest Pit......O............ Depth to ground water...�,S9t4E--__-... fX4 Test Pit No. 25619_E____minutes per inch Depth of Test Pit.,.................. Depth to ground G F ; �--`-------- -- water__-__-_-______-____---- � ----- ----------------•----•------------------------------------- Description of Soil-------- ....... C?. I� ---- - U ---•-----------•------•- -------•-------•------•-------•-••--1--==----------------•--•---------•-------•-----•---•----------------•-------•-•••--•-----------------------------•----•------------------- W x --- ------------------------------------•--•----------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.-________-----------------------------------------------------------__________________________- ----------------- -----• --•------•-• --------•-•----------------------•-----------=-----------•--•----•------------------•-------•-•---•-----••-•-------------------•--------------------•- ....... Agreement p, The undersigned agrees to i`�stall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the tate 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. Slgn :_ ..__._._•_.._ ------ -- -- - - Dat Application Approved BY-----... - -----=---------- - ".-. ------- 44/ ` Date Application Disapproved 'or the following reasons_________________________________________________________________________________________________________________ Date Permit No. Issued---------------------------------- ------------ - __ - Date ,.. _. ..� F .P • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........:.:......0F..... `1 � . � ............................ s .�., �e tifir fie of , ut43lialtre k TFII IS 'CERTI That f Indiv'd °al,8ewage Disposal System constructed (Y) or Repaired ( ) byL9 f ------------------------ ]er at-- - --- --------- s. t __ _____________________________________________________________________________________________________ has been installed in accordance with the Rprovisions of . r ' '�I of The State Sanitary Code d r'bed in the application for-Disposal Works'Construction Permit No._ :__.____� _____._.__ dated---_!r._. _` � ................. THE ISSUANCE OF, THIS CERTIFICATE 'SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... 1 7 --------------_-------------_ inspector*---f - ............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .��?.. .'...........OF...... Ae2l•1 ,T +ate No. FEE........................ Dispooal or �o tru toll rrmit Permission is ereby granted------j Gla,--•;; - -- -- --- ............................................................. ----------- to Construct yor Repair ) an Indi 'dual ewage posal stem at No. ` G4 -----------•-• --• ----- Stre as shown on the application for Disposal Works Construction Per t o_______ _______ D d___- _^�_----- / and of Health DATE-- --> 0 --------•--••------------= FORM 1255 moeBS & WARREN, INC.. PUBLISHERS s' kbsSe--t 3ft 3"-> 4 N, LOCATION SEWAGE PERMI 0,. #-z VILLAGE INSTALLER' NAME i ADDRESS awl Qxv w4t B U I L D E R OR O MER DATE PERMIT ISSUED D A T E COMPLIANCE ISSUED �I �� �� � ��� . t ,. �� F. F. 5 .o -� TYPICAL SYSTEM PROFILE AREA PLAN FDN TOP FINISH GRADE=5dL00 NOT TO SCALE SCALE : 1is= 30 ' ��' FINISH GRADE OVER TANK= 50.00 FINISH GRADE OVER PIT=SO'O0 r-- LOT* 2 NY E ROAD "CROSS R I D G E" - T PVC OR O O q8.o 7.67 ..�. :•.� 1 1 O WOT i W T HE- FLOOD 1� L• A 1 tV C. I. TEES 47. • ' 47BSMT , ,.. .:. FLR 44�0 ��� GAL. 4�� ' 1 • 0 1 • • • 1 • • 0 1 t• ti T REINFORCED DIST. BOX ' N O GO I��0ZVA T t ©N 1 NV O LV .1� Tow N YYA E R? • e . . . ° CONCRETE —8 TO BE INSTALLED ON ° ' ' ' ' • , • ' ' o 1 : .a A LEVEL STABLE BASE o o • • 1 0 1 • e SEPTIC TANK TO BE INSTALLED ON A • • • • • • . • 1 • 1 LEVEL STABLE BASE - 2"-I/8'L 1/2 "WASHED PEASTONE ALL ' ' ' ' • ' ' ' ' ' ' BRICK a MORTAR COURSES AS AROUND FREE OF IRONS, FINES ' ' • • • • 0 0 • • REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE \ 24 "C.I . MANHOLE COVER a 3/4 " TO 1 -1/2 WASHED CRUSHED LEACHING PIT \ FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL IRONS, FINES AND DUST IN PLACE FOR FIN. GRADE SEE SYSTEM PROFILE \ \ SOIL AND PERCOLATION LOT 3 4" DATA STI . s�T S 8G° 15 , Oo" W Tk .,SET - - - .8„ -- -- - PERC. RATE ' < 2 MIN IN. - 50,00, 2-00. 85, �- - -- - -- - - — — — — IG SIDE I 4" FOR INV. ELEV SEE TAKEN BY ; C. D. SPOHR ° o , .. I T,�, INLET SYSTEM PROFILE ee , 50.00 �0•25' ( PRECAST COn7ctzrE� 6 - f,1 F'AUL At�lR k �iY 2 zO* LEACH I N4 P IT t ' LINE o ° A WITNESSED BY: BAFZNSTAELE, P,P• OF H -TH Q - READ,--SEE - ° OPENINGS W/4-1/8 „d I-- ° OUTERDIA. B, 1 -3 4 ° . B JULIE IQj79 ...• . 6.4 C FR4u''<`� PROF-i�£ G fltErA i►- / _ ° ,. DATE A, PRECAST CONCf21FTIE D-6 � � 7' � o � a INSIDE DIA . � = °. ° TEST PIT -GND ELEV. + �' 0 '� ----- PROPOSED I-V -SEE , �Rcplt-E ,g ' ' ° TOTAL o � d a H O ,OQo CwA PPLECAST �r) o p o AREA o 3 L0,4,w vs G a TO A G oN Cfu£TE. SIEPTI C. TA - ° o o ° o - ° ° , SU g. - S CJ ► L NO lJ ST LEDGE 0 �� a w tiyw TI~k. kP Ire z� SE. PkC)F ILA 9 ° ° o 0 o Z 8 S 5, �► R.P I.'WrA,FOR RE-�Erzv% Ver `l • . a 0 0 0 0 0 D o °` �. oP. W ATV—It— r� ° a o MEL7ILJKA O 26? 22 °' 0 0 0 0 oLu a o 0 0 Bt201/lf N - rP Q Q t GARAGE tee C� w �4 LOT # 2 i O �-` _- 6 - 6 ' olA . � ' 501 L �-- 01 -4 jlk z 104 E,'' EFFECTIVE DI A. BOT. PERC. HOLE 0 z :2 M �;� snc SST 5o.oa 12'�CSIDi� Zoo.9e` 2 050 8 8 , t" • DOWN O t� .0"um .� _.__ --- -- - S T'K . 5E.r LEACHING PIT - SECTION 12 N ply° 15, oo" -45 + NO SCALE Fz�QD.) DESIGN DATA : NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM NO. OF BEDROOMS 3 L T A- + - O DISPOSAL LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT 33() GALS. I . CONIC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANKI000 GAL. 2 . REINF W 6 x 6 At GA. W. W. M. 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES OWNER : GREATER DEPTH REQUIREMENTS 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN AL��N F'1G EJ ' �� NOTE . EXCAVATE TO ELEV. 401 OR LOWER AS ACCORDANCE WITH TITLE 5OF THE STATE SANITARY CODE DATED JULY 1,1977 8, ANY LOCAL RULES APPLICABLE. R 0 1 B()X I G2,0 REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR°D. BY THE C(:)T U IT , M A 0 2 G 35 MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD- OF HEALTH, AND CHARLES D. SPOHR. WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, S 1 DE AREA = 19 S S. F. .4 S. F./GAL 4`3 5 GALS NOTIFY THE ENGINEER FOR INSPECTION. BOTTOM AREA=$ 7 S. F.@ 1 - 2 S. F./GAL 9—GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. TOTAL AREA �85S. F. TOTAL GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN AREA PLAN -. APPROVAL BY CHARLES D. SPOHR. LEGEND 6 FOUNDATION INSPECTION READ. WHEN EXCAVATED. A F��� 1�'L-A t�1 P IZ�,PAS�D F RQ I�t S U!� � I�/1 S 1 O I~.t •} 50.0� EXIST. GROUND ELEV. P L A Kl OP L A N f.) 1 W BAR N S TA F3 L-. E C�.KITS f�V I L•L,E FOR ALIEN H01 F-S 14., ItC► cxO s R> I tDG�ie 50.0' FINISH GROUND ELEV.2'UNDERLINED" "A' 2-7JUNE-1 ;U�YISED L0CATto*1 OF- GAR AGR7 SCALE I " = GO ' 22 JUgE 1979 BY J. P. 00-�(LF R. L..S , 4750] PIPE INVERT. ELEV. REV DATE I DESCRIPTION o TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM 0 o SEPTIC TANK FOR A L DEN HOMES INC. E - M. NOT E : ❑ DISTRIBUTION BOX _Ma �� ALL ELEV5 BASED 0W 51-<, � M, E , c.o .�,AEQ> 4 " C. I . PIPE �` o ;� LOT -* 2 NYE ROAD "CROSS RIDGE @, .5 As v F.0 Co-C)s W E L-EVt 5 . Co �� iarlea D. BARN S TA g L E C E NT ERV I LL E MA. 1tth+ttl- 4 BIT. FIBER PIPE -TIGHT JOINTS <,Polo - -- - PROPERTY LINE ; DESIGNED: C.D.SPOHR DATE:$ juN>K 'ig D R A W I N G NO. 4K MIN. CODE DISTANCE DRAWN: C.S. SCALE:ASSHOWN Q g MAP SEC P CL LOT HOUSE CHECKED: C. D. S . (� `�