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Home My WebLink About0270 NYES NECK ROAD - Health 270 Nye's Neck Road ; Centerville A= 232— 006 °F CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory �sseKi, Report Prepared For: Report Dated: 5/24/2007 Ronald Palma Order No.: G0740541 P O Box 274 Centerville, MA 02632 Laboratory IID#: 0740541-01 Description: Water-Drinking Water Sample#: Sampling Location�270 Nyes Neck Rd.Centerville MA Collected: 5/22/2007 Collected by: R.Palma Map 232 Parcel 006&003 Untreated Received: 5/22/2007 Routine ITEM RESULT UNITS RL MCL Method 4 Tested Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 5/22/2007 Copper 0.12 mg/L 0.10 1.3 SM 311113 5/23/2007 Iron 11 mg/L 0.10 0.3 SM 3111B 5/23/2007 Sodium 8.0 mg/L 1.0 20 SM 311113 5/23/2007 Total Colifonn Absent P/A 0 0 SM9223 5/22/2007 Conductance 120 umohs/cm 2.0 EPA 120.1 5/22/2007 pH 6.2 pH-units 0 SM 4500 H-B 5/22/2007 Based on the results oft&e parameters tested,th.e water is suitable for`7lrinki�ag,,but may present aestlieticproblems(taste,odor; (staii:ng)due to Iron. - ~—�`r`� — -. - C ca � r C7 -� -ti Cb• —� ��. W � � J rn ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Page: 2 Barnstable County Health Laboratory �ssncHts�/ Report Prepared For: Report Dated: 5/24/2007 Ronald Palma Order No.: G0740541 P O Box 274 Centerville, MA 02632 Laboratory ID#: 0740541-02 Description: Water-Drinking Water Sample#: Sampling Location 270 Nyes Neck Rd.Centerville,MA Collected: 5/22/2007 Collected by: R.Palma Map 232 Parcel 006&003 Treated Received: 5/22/2007 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 5/22/2007 Copper ND mg/L 0.10 1.3 SM 3111 B 5/23/2007 Iron 0.14 mg/L, 0.10 0.3 SM 3111B 5/23/2607 Sodium 27 mg/L 1.0 20 SM 3111B 5/23/2007 Total Coliform Absent P/A 0 0 SM9223 5/22/2007 Conductance 180 umohs/cm 2.0 EPA 120.1 5/22/2007 pH 7.4 pH-units 0 SM 4500 H-B 5/22/2007 ----.,gym` �.� ___ r Sodium level is above the maximum contanmzant'level. Those opt a[ow sodiunz'ilet rimay wist o`nsult.a physician -- -- Approved By:_ � ?(La irector) 117 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 P Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments UV Property Address d9bnO.4 Owner Owners Name information is /,2— required for every page. Ctty/rown State Zip Code Date of I on Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important When filling out forms A. General Information on the computer, use the tab 1. Inspector.to m key to move your ( „ cursor-do not �Te�F2e use the*arum key Name of Inspector Company Name Company Address City/I own State Zip Code �? - Telephone Num6er 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: asses ❑ Conditionally Passe? ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority pecto 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 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. "'*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. ts+n.-11110 Tide 5 Oedr Wapeubn Form:Uba#U s.ww•DI spurn•Pop i of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary.Assessments Property ddmw O it CG L Iti Owner Owners N me information is Fee 1 r�.,�yi/�Q� required for every Page. City/Town state DipCode Date of inspection B. Certification (cunt.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) Sys 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: B) System Conditionally Pa ❑ One or more system compon is as described in the"Conditional Pass'section need to be replaced or repaired.The syste , upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes','no'or"not determ d'(Y, N, ND)for the following statements. if°not determined,'please explain. The septic tank is metal and over 20 years old*or septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration tank failure is imminent. System will pass Inspection if the existing tank is replaced with a complyin eptic tank as approved by the.Board of Health. *A metal septic tank will pass inspection if it is structurally sound, of leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is avail e. ❑ Y ❑ N ❑ ND(Explain below): 15in"•11/10 TIN 5 US"Inspecdon Form&bturfacs sewKe a.po."I syrom•PW9 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s2�v /t��•eS ti�� Gt• Property A p Owner Owners Name information is required for every page. Cityfrown state Zip Code Date of inspection B. Certification (cont.) B) System nditionally Passes(cont.): ❑ Observation sewage backup or break out or high static water level in the distribution box due to broken or o tructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection (with approval of Board of Health): ❑ broken pip ) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is r oved ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is veled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than times a year due to broken or obstructed pipe(s). The system will pass inspection If(with approva f 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 He h 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 accordan a with 310 CMR 15.303(1)(b)that the system is not functioning In a manner which wil rotect 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 t5m•11/10 TWO 5 OI6dW InspecOon Fom Subsurface Sevape Disposal Systwn•Pape 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Vol tary Assessments b es P,54 Property A 0;!�/1LG J_ Owner Owner's We information is required for every >°h./ page. City/Town Stag ZIp Code Date of Inspection B. Certl cation (cunt.) 2. Sys te will fail unless the Board of Health(and Public Water Supplier, If any) determine at the system Is functioning in a manner that protects the public health, safety and a Ironment: ❑ The syst has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surfac water supply or tributary to a surface water supply. ❑ The system h a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a ptic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank a SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply ll'". Method used to determine distance: *"This system passes if the well water analysis, rformed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presen of ammonia nitrogen.and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure 'eria 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 ❑ ,L`�1/ 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 99 P ❑ Liquid depth in cesspool is less than 6"below invert or available volume is less than'h day flow t5ins•11/10 T10s 5 OfedW hspecdon Fonrc Subvx%w sewogo pWosW System-Psgs 4 ar 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 7d /vim c s' A) Property AM-1 Owner Owner's Na infortnabon is ,2- i/i/! i/�y//�� ' — ��5�2 required for every page. Cityrrown State Zip Code Date of Imi5edion 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 collform 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- 1 pd. ❑ Thehe 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. design flow of 10,000 gpd to 15,000 gpd. For a systems, you must indicate either"yes'or"no'to each of the following, in addition to the question ' Section D. Yes No ❑ ❑ t ystem is within 400 feet of a surface drinking water supply ❑ ❑ the syste ' within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is I d in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a m ed Zone II of a public water supply well If you have answered"yes'to any question in Se ' n E the system is considered a significant threat, or answered'yes'in Section D above the large syste as failed. The owner or operator of any large system considered a significant threat under Section E or 'led under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system o should contact the appropriate regional office of the Department. t5iru-11/1 o Title 5 Oltldai Inapacbm Form:Su sewage Dleposai system•Pape 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for V ntary Assessments 7o Property Add a Owner Owners Name information is required for every lam/ page City/rolwn state Zip Code Date of InspecUon C. Checklist Check if the following have been done.You must indicate`yes'or'no"as to each of the following: Y No Yes ❑ 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? 2/ ❑ Were the septic tank manholes uncovered,opened, and the'intedor 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. (A5-5eelirJ ❑ 12/ 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: No aeS�g n � Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): —�-�— t5ins•11/10 TWO 5 OftW hspecd-Form:Sub—f—Se"N OWPOW System•Pape 6 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth-Not for oluntary Assessments Property Add Owner Owner'ss me � p- information required for every page. Cityrrown State Zip Code Date of Inspe ion D. System Information Description: Seer,� �N�C 7>• s?!?i�ic�fo.� T,�o�_ Lel�if �IGL.a� . 3 Number of current residents: Does residence have a garbage grinder? ❑ Yes Ef"'No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Ye.1 E No Laundry system inspected? ❑ Yes 2-/No Seasonal use? ❑ Yes LAY No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes No Last date of occupancy: Cu/ZI'Pe. pcG�i,pj� Date Type of Esta . ent: Design flow(based on 310 5.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,e . Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ No Water meter readings,if available: Mine-11/10 TNN 5Oftd hspsdw Form SAAW fam Sewage Disposal S7slan•Paps 7 d 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Volunta�/Assessments 7� N >✓S �� ;c y � Owner Owners Nameinformation Is required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date o ancy/use: Date Other(describe below): General Information Pumping Records: Ste. y�/ Source of information: �—/�.c u s�,•i eie o!�'Qf S , Was system pumped as part of the Inspection? ❑ Yes M""No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of yssem: 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/Altemative 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): t5im•11/10 \ TIU b O94W YnpKdon Form SubwAaa S*w*p DNpos Sywm•Paps a of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora' UIVSubsurface Sewage Disposal System Form-Not for Volun ry Assessments A) Property Address &^ Owner Owner's Name Information is required for every page. Cityrrown State Zip Code Date of Inspedbn D. System Information (cunt.) Approximate age of all components, date installed(if known)and source of information: / eAAS - ry�.J�occl Were sewage odors detected when arriving at the site? ❑ Yes M/No Building Sewer(locate on site plan): Depth below grade: feet Material of construction;�40 El cast iron PVC ❑other(explain): /� �- �f26•+^ Wecl �ReSSu2-e Distance from private water supply well or suction line: feet Liti� Comments(on condition of joints,venting,evidence of leakage, etc.): 77 r izl 191�e'A(z a �u r 1�e✓r�2 �� L eR-�G/� e Septic Tank(locate on site plan): 4'f T—W 42� Depth below grade: feet Fte ' I of construction: crete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain) 9 'f tank rmetal, lost • year Dimensions: Sludge depth: tSins•11/10 TiW 5OfAdW Impecdm Form SuWwreoe Se%e D vo*W syWm•Pop 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form lion--EW Subsurface Sewage Disposal system Form-Not for/Voluntary Assessments ;2-76 �C Property M OC C j Owner Owners Name information is / //� rl,,./1 b�3Z ��Gj/jX required for every �� /--r page. CRy/Toavn State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle Ole —O — 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 / How were dimensions determined? y*,J Comments(on pumping recommendations,Inlet and outlet tee or baffle condition, structural integrity, liq 'd levels as related to outlet inve ,evidence of leakaa e,etc.): T,r,-� s So c•o-QS' f�� ate- /ti-,,oeX "A'c*t so c,dT -Pc.4e, r r IN .Pa% 61/rt c(c*r t ua� ` ra s r c odi v^' ihT/� o,--.,—Ze << i n 1-7ye._ Depth b grade: feet Material of cons n: ❑concrete ❑ me, ❑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 dou•11/10 TIN 5 Otidd Impacbm Fam:aubartam Swwp OWpmW sywm•Pap 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments � 7a GIJyeS �e�k �z.� property Mreptoy- " 6 Owner Ownees Name 'intonnatlon Is required for every page. Cityfrown 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 lated to outlet invert,evidence of leakage,etc.): --.. Depth b w grade: Material of co ruction: ❑ concrete metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity, E ons Design Flow gallons day Alarm present: Yes ❑ No Alarm level: Ala 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 t5am•11/10 TIN 5 oA W WPOCOM Forth:&Mwfaw SW~MWOSW Sysoem•Paps 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owners Name information is yen��`j A� 4 2 0 3� /j/�V1 required for every Page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Distribution Box(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, (moo X GV�� R'T ��e T r� o!G /n�S/0�'G�;0✓1 Tb ��r4-L (IGGate OR sets PlaR); Pumps in rking order: ❑ Yes ❑ No Alamis in working o ❑ Yes ❑ No Comments(note condition of chamber,condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 2 �eLpGJ �jfla T� tNrts•11110 nw 5 Oftal Inspal m Form Subaurfam Sewspe Olapood System•Pape 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments J"7r, Prope70', dress p /�— owner Owner's N information is required for every -;*rreA`L �J� L_!_L O}-6 ! page Cityrrown State Zip Code Date of In pedion D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number. ❑ leaching galleries number: ❑ leaching trenches number, length: leaching fields number,dimensions: xIT ' ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,etc.): r/JL 4 S 41?-xvee C., N v s'•G� D F .Lk/P-� . /'�c� Pow�,h !� �yK H � . sa I L �iS �� } 1,G��?7at�O✓l I s noog�r" +1L- . Num nd configuration Depth—top of liq ' to Inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction ' Indication of groundwater inflow Yes ❑ No t5ins-11/10 Inge 5 Oft W VAPOCS t Form:S'uNula a So~ SyVAm•Paps 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments Property A,31 ,was Owner Owner's NInformabon is a a nnn required for every page. Cdy/Town tate Zip Code Date of Ins ection D. System Information (cont.) Comme ote condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): Privy(I on site plan): Materials of cons on: Dimensions Depth of solids Comments(note condition of soil,signs of by lic failure, level of ponding,condition of vegetation, etc.): t5iro•11/10 Title 5 Oft W KSPOOM Form;&"Uftoe&MW O DWP06W system•Pape 14 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '2 70 Propertyxqae-J- Owner Owners Name - information is required for every page. Cityrrown State Zip Code Date of Ins edion 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 whe public water supply enters the building.Check one of the boxes below. and-sketch in the area below ❑ drawin attached separately fj K-e 4P H a VLA r We'll /0 e S4 � I Al A Iv- s77Z, 13u17o7 a- Se�rG ivk, df0>11 9 ouT r I I was•1 r n o Tile s 0WW h vecion Fomr.Subax1vw Se""Di Sy.e,-Pp"1 e or r 7 Commonwealth of Massachusetts Title 5 Official Inspection Form UVSubsurface Sewage Disposal System Form--Not for Voluntary Assessments e-5 A"ek lZa Property Address Owner Owner's Name information is /� �A required for every -f - w 7e` ✓i/4'_0 ,OVN#1 D�1XI /� 941.-. ow page. CRy/rn State Zip Code Date of 16speWon D. System Information (cont.) 7Sits am: Check Slope [Surface water Wicheckcellar Shallow wells , Estimated depth to high ground 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: pate ❑ 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�t}e high ground water elevation: �7-iQar,r)6-6t✓u-T6,n 6F "Qdf AojIm.gzu .2 4 Cc To I�Tfio-c To �okh j�pQ'�'� 3 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11 M 0 TUN 5 OftW InspecOm Pam:Subsurtacs SO"P Dlgx"SysNm•Paps 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I --70 ��eS Ne. Property Arasa a�stG Pa4',A Owner Owners N e Information is required for every ��4_ �y��f'e— page. City/Town State Zip Code Date of InsTped no 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 R� t5ins-11/10 Me 5 00"InspecUm Farm:SuWwl"Sewapa Dbpotal System•Pape 17 of 17 Table 3-2 Do's and Don'ts of Private Septic System Management DO... DON'T... b Do not use the toilet or sink as a trash can by have the on sites stem ins y Do a y inspected and pumped a licensed professional approximately every 3 to 5 dumping non-biodegradable material (cigarette butts, years. Failure to pump out the septic tank can cause diapers, feminine products, etc.)or grease down the system failure. If the tank fills up with an excess of sink or toilet. Non-biodegradable material can clog solids,the wastewater will not have enough time to the pipes,while grease can thicken and clog the settle in the tank.These excess solids will then pass on pipes. Store cooking oils,fats, and grease in a can to the leach field,where they will clog the drain lines for disposal in the garbage. and soil. Do know the location of the on-site system and drain Do not put paint thinner, polyurethane, anti-freeze, field, and keep a record of all inspections, pumping, pesticides, some dyes, disinfectants,water repairs, contract or engineering work for future softeners, and other strong chemicals into the references. Keep a sketch of it handy for service visits, system.These can cause major upsets in the septic tank by killing the biological part of the on-site system and polluting the groundwater. Small amounts of standard household cleaners, drain cleansers,detergents, etc.will be diluted in the tank and should cause no damage to the system. Do grow grass or small plants (not trees or shrubs) Do not use a garbage grinder or disposal,which above the on-site system to hold the drain field in feeds Into the on-site tank. If there is one, severely place.Water conservation through creative limit its use.Adding food wastes or other solids landscaping is a great way to control excess runoff. reduces the system's capacity and Increases the need to pump the on-site tank. If a grinder is used, the system must be pumped more often. Do install water-conserving devices in faucets, Do not plant trees within 30 feet of the system or showerheads and toilets to reduce the volume of water park/drive over any part of the system.Tree roots will running into the on-site system. Repair dripping faucets clog pipes, and heavy vehicles may cause the drain and leaking toilets, run washing machines and field to collapse. dishwashers only when full, and avoid long showers. Do divert roof drains and surface water from driveways Do not allow anyone to repair Qr pump the system and hillsides away from the on-site system. Keep sump without first checking that they are licensed system pumps and house footing drains away from the on-site professionals. system as well. Do take leftover hazardous chemicals to an approved Do not perform excessive laundry loads with a hazardous waste collection center for disposal. Use washing machine. Doing load after load does not bleach, disinfectants, and drain and toilet bowl cleaners allow the on-site tank time to adequately treat wastes sparingly and in accordance with product labels. and overwhelms the entire on-site system with excess wastewater.This could flood the drain field without allowing sufficlent recovery time. Consult with an on-site tank professional to determine the gallon capacity and number of loads per day that can safely go into the system. Do use only on-site system additives that have been Do not use chemical solvents to clean the plumbing allowed for usage in Massachusetts by MA DEP, or on-site system."Miracle"chemicals will kill Additives that are allowed for use In Massachusetts microorganisms that consume harmful wastes. have been determined not to produce a harmful effect These products can also cause groundwater to the individual system or its components or to the contamination environment at large. rmp://www.mau.pov/deplwetar/roso�xzea/Impqulde.dot 3-17 July.2006 m TOWN OF BARM4TMI.{� o � MAN r^•. n-0.� (i. �� Q s. II II E o - X§ c �\J a '010 �E zi I �\ 4 ,� m 8 LU 9 co ;- D_ --- C II 11 W , La II J II II II � Q Q E m N Q Q rNOTi:SONOTUBEFOOTF"" BEFCATED AT BOTTOMOFSEPTICTANK IF OSER THAN 5'-0"TO SEPTIC TANK. 4 4 4-0" 7 g° 11'-T ---------------------------- - w APPROXIMATE LOCATION CC OF SEPTIC TANK PER A.M.WILSON Z Y G ASSOCIATES SKETCH. W w J __ 12"CONCRETE FILLED Z ` ---------------------------- ,' SONOTUBE4'-0°BELOW W (A 1 • - GRADE ON 24" W CC BIGFOOT FOOTING. } LU Z Q Z Q w ------------- C7 N U ------------------- I f • . -.-- Y ._ t ® C e , 1 ` f "APPROVED No................-...... Fins..../00..... Barnstable Conservation CommissMi COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH signori 0606 TOWN OF BARNSTABLE f Appilration for Uispv6 al Works Tomitrnrtion ramit Application is hereby made for a Permit to Construct ( X ) or Repair ( ) an Individual Sewage Disposal System at: _270 Ny_es- Neck---Rd; ,_ Cent_e_ryi 11_e Ma_p___232 3&6 ............ ... ................................•- Location-Address Lot o. Juan-ita Sweet 270 Nyes Neck loa - ......._... _ -_-........ -- --------------------------•----•----._.._....... -•---••-••••-...........---...--•-----•--••-------------._..........................-- Owner Address W Installer Address Type of Building Size Lot___5 0 5 3 0+.....Sq. feet Dwelling—No. of Bedrooms_____4.....................................Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building ____________________________ No. of persons____________________________ Showers ( ) — Cafeteria ( ) a' Other fixtures -----------------••-----------------•- W Design Flow.....X:�.P.......1 10_____________gallons per 4RA� lay. Total daily flow------------------------4 4 0--- -•--••----gallons. WSeptic Tank��,�uid capacity___1500-gallons Length-----1 .______ Width---9........... Diameter-__----------- Depth------______-- * Disposal 'Ic*MMXXXWo_____________________ Width---- g............ Total Length....3X........... Total leaching area-594............sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet____________________ Total leaching area..................sq. ft. ZOther Distribution box (X ) Dosing tank (( ) Percolation Test Results Performed by....... J011y, P:E.......................................... Date___6-13-91 ., Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water _______________-. Test Pit No. 2.......z-------minutes per inch Depth of Test Pit.....15�_________. Depth to ground water _ ----------------------------------•-----------------------...__....-•------------------...-----••------ ................................................... O Description of Soil...........2' Topsoil-subsoil 13'_ medium coarse sand 3, ------ --- ---------------------------------------------------- x U --------------------------------------------------•-----•----•--- W ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------•---------.._..--•-----•---•-•----- U 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 Environmental 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 .. ------�----- ------ -------'-'------------------------------ Date ApplicationApproved By ........ ._ . ---------------------------------------------------- ----- .................-----....--------- Date Application Disapproved for the following reasons- ---------------------- --------------------------------------------------=------ -- ----.......................................... ----------- --------------------------------------------- ------ ------------------------------------------- . ------------------------------------ ...Date-------------------- Permit No. ---- -- ---- ��-.....3_67............................... Issued ..................................... ---------. ... Date 7"i, Ag CC- No._--..........._....... F�s....-0 =4,. THE COMMONWEALTH OF MASSACHUSETTS ,, % BOARD OF HEALTH TOWN OF BARNSTABLE . rliration for Disposal Works Toustrur#iun ramit Application is hereby made for a Permit to Construct ( X ) or Repair an Individual ,Sewage Disposal System at: } .......... _Map 2 3.2--•3& -- ............=................................... y__--.._.._.. Location-Address or Lot No. Juanita Sweet ___.....O N+.e s N..c..k R o a d ........................... Owner•-------------•-----._--_.---.....-- -.._..------•------------•----•----------.._...-•-•----- ------•------------------- Owner Ce n Address a ........-• --•--•---- ----------- Installer Address U Type'of Building Size Lot---5 0 t.5.3 0+ _ Sq. feet Dwelling—No. of Bedrooms.....4....................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin a —Type g ____________________________ No. of persons........... Showers ( ) — Cafeteria ( ) dOther fixtures -----•------•---•--------................................"=='----------••-•••------••-----------------------•••--------..._--------•--•.......•--•- Desi n�Flow..... 01.......:I.0.._... gallons per eR"�on elmda Total dailyflow-------4 4 Q 440 ___:,. Ions. WSeptic Tank liquid capacity....5 .gallons Length_.._11 .__.-_- Width.... Diameter___--- . Depth_.. ------ x Disposal.W6MHK��fio..................... Width--_la..._......._ Total Length....33........... Total leaching area..594----__------sq. ft. Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (X ) Dosing tank ( ) ' \ Percolation Test Results Performed by.......6..Jolly',_-P.E.-----_------------------- ---------•--- Date---6-1q7%-----_.. ---- ----------- Test Pit No. I................minutes per inch Depth of Test Pit-_-__6�._._.__.. Depth to ground water 6-__;___.__---__--- Gi, Test Pit No. 2-------2._.._._minutes per inch Depth of Test Pit.....15�..._..._.. Depth to'ground water 151:_........................ ------•--------------------------------------•----•---.....---••-•-•-----............-•-•-•................................................'........... : O Description of soil...........?I._Topsoil-subsoil--•__-__-______ 13'. medium coarse sand ................................•..................--------- .�.. V ..............................................•--- -- -----.. ----- .....•-- •----•---------••--- ------ ----•••--------•-----........._.......-----•... ......_....--•- W U Nature of Repairs or Alterations—Answer when applicable................................................•....._....._...__.._.._....................... Agreement. j/. I� I t f r The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 -----.rZtmt. -t �A t_s :...---y}-------------- �............. ...--I _ ate .- Dale ApplicationApproved By .. �_ rn_ '...........:.................................... -------------------- ........................................ Application Disapproved for the following reasons- ------------ ------------------------------------------------------------------ ---------------- --------------- -------- -----------------5;t--..--------------- Dare PermitNo. .....�?../-------'-� ---------_----------_-_ Issued ------------------------------------------------ Dare THE COMMONWEALTH OF MASSACHUS NING ENGINEER MUST SUPERVISL- �'� IG BOARD OF HEALTH INSTALLATION AND CERTIFY IN WRITING TOWN OF BARNSTABE SYSTEM WAS INSTALLED IN STRICZ L CORDANCE TO PLAN. Cgertifirate of (fnxnylinure THIS IS TO ARTIFY, That the dividual Sewage Disposal System constructed ( X ) or Repaired ( ) by---------------------------------��-1.... � -- �--.�----------................----------------------------------...---------------------------...-----------------------------...------------------------------- Installer at .............. 7Q.-N�Ves_Neck_Road,..C,�i-1le.........................------- - - - 1 has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....../,/-....3..6..- ...... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE e SYSTEM WILL FUNCTION SATISFACTORY. �:.�. DATE.................. . . / Inspector .... T --------------------------------------------- l THE COMMONWEALTH OF MASSACHUSETJSSIGNING ENGINEER MUST SUPERVIE: BOARD OF HEALTH INSTALLATION AND CERTIFY IN WRITING. THE SYSTEM WAS INSTALLED IN STRIM 7 TOWN OF BARNSTABLE ACCORDANCE TO PLAN. / No.._........� ......,. FEE...l. l>......... Disposal Works Tun#rnr#inn Prrmi# Permissionis hereby granted....................`�.....................•---..................----......----•.......--•---....................-•---...-•--•••••---...... to Construct ( X ) or Repair ( ) an Individual Sewa a Disposal System at No................... R.AygL ... eck.Road.,.e.ntery i 7�e Street ��3 '7 as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... .... ••.....*•-•-...........�� -/�- -----•--•-•- -•- ------ a....................................... Board of Health DATE...............�:�."l.0..'.9/ FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS f TOWN OF BARNSTABLE , ypf TN E TOE OFFICE OF t HeHa9TeHL BOARD OF HEALTH MA6L de 1639. ` 367 MAIN STREET E MAY k. HYANNIS, MASS.02601 August 29, 1991 Arlene Wilson A.M. Wilson Associates 911 Main Street Osterville, MA 02655 RE: Variance for Juanita Sweet/270 Nyes Neck Road, Centerville Dear Ms. Wilson: You are granted variances, on behalf of your client, Juanita Sweet, to construct a replacement onsite sewage disposal system at 270 Nyes Neck Road, Centerville, with the following conditions: (1) The dwelling cannot contain more than four (4) bedrooms. Dens, study rooms, finished basements, sleeping loft and similar type rooms are considered bedrooms according to Massachusetts Department of Environmental Protection. (2) The "bunk house" shall be removed from the site. r (3) It shall be recorded on the deed that the "studio' building shall not be utilized for sleeping purposes. Architectual plans shall be submitted when/if the applicant applies for a building permit for any significant renovations to the "bunk house". (4) The septic system shall be installed in strict accordance to the submitted revised plans dated August 28, 1991. (5) The designing engineer shall supervise the installation of the onsite sewage disposal system and certify in writing to the Board that the system was installed in strict accordance to the submitted plans dated August 28, 1991. The variances are granted because the new septic system will replace an existing cesspool which is located only 50 feet from the onsite well. Also, the cesspool is located closer to the wetlands than the proposed replacement septic system. Also, the proposed septic system meets all the regulations of Title V, the State Environmental Code. Sincerely yourrsns,`` ( lJl�l �5 Ann Jane Es baugh Chairman BOARD OF HEALTH TOWN OF BARNSTABLE AJE/bcs A.M. WILSON ASSOCIATES INC. D VIRUS e �r n � 911 Main Street ' � • �� u �w O� �� OSTERVILLE, MASSACHUSETTS 02655 DATE q_rL J(�� !/y / JOG 205 lJ 7 < ✓ (508) 428-1450 - ATTENTION — TO RE. /vye5 A., cj eo.. VTYJIle WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: > g Shop drawings ❑ Prints Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑'Change order ❑ COPIES DATE NO. DESCRIPTION aLs�,� Sew ��s �SwC THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return - corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS - C S .Wet-� evt S Z-(. so Coxlw� a wl � j COPY TO SIGNED: C. / PRODUCT 2442 a ice.,Gmtm,MM mall. if enclosures are not as noted, kindly notify us at one . G ° r RECEN . OCT . 17 l� A.M.Wilson NAM DEPT. Associates VNDFBWK�V ABLE Inc. October 16, 1991 .j t C:;1 1"7/1 /Vtw+ Board of Health J* Town of Barnstable J" &i 367 Main Street Hyannis, MA 02601 ' RE: Sweet Residence 290 Nyes Neck Road, Centerville Installation of Septic System Dear Board Members: Please be advised that the subsurface sewage disposal system has been installed in accordance with the approved design plans of July 1, 1991, revised August 28, 1991, with the following minor modifications. As you observed during your site visit, each of the three 4" perforated leaching pipes in the field were accessed every 10 feet by a separate distribution line from the D-Box Our plan had shown cross pipes running through the field at 10, intervals. This revision was made to provide a more direct line of flow by eliminating right angles in the distribution line. In addition, the septic tank was reorientated toward the front of the house 11 ' off of the north corner of the foundation. This was done so the septic line could come out the front of the house and eliminate conflicts between the septic line and Plumbing inside the house. Please don't hesitate to call with any questions. Yours, A. M. WILSON ASSOCIATES, INC. CL�A n V Christopher Jol- y, P.E. 1091CJ1/csp 911 Main street Osterville/MA 02655 508 428 1450 FAX 420 1856 I Fee--- BOARD OF HEALTH TOWN OF BARNSTABLE ��Cicatioit,�'or�eCC �ort�tructio�t�er�tttt Application is hereby made for a permit to Construct (K), Alter ( ), or Repair ( )an individual Well at: -----/_1l__ £- D �►1I L �1/�Location �lA>}'_Z ZA--�APcsEseZss o�rs_-M---a--p3--a--n-d-d-- Parcel >�0�1 Pl rl1�— _ vA fir/ i,J i" %1 C �-�''' Grl i!/ �/�`►A '02 3 2. Owner Ad ress ------------------------------ --------------------------------------------------- ---------------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building PR1 a-- � n Dwelling-------------------- ----.l�-%100——46(�---------- Other - Type of Building-------------------------------------- No. of Persons---------------------------------------------------------- Type of Well--- ,I P I// ------44-- ------------------------ Capacity Purpose of Well --------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed---------------------------------------------------------------------------------------- -------------------------------------- date Application Approved By---------C }-- ------------------------------ -------� r' V date Application Disapproved for the following reasons:------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------- date PermitNo. --------W--- -------- ---- ------------------------------- Issued----------------------------------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate (Of Compliaitee THIS IS TO CERTIFY, That the Individual ell Constructed ( ), Altered ( ), or Repaired 9c) by lx- �W��2,1� -------We" - - - - -------------------------------------------------- lnstaller r a t- /'�- - -----1 lf,- �[YA ----------- has been ins Iled in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described to the application for Well Construction Permit N ated____________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL :. SYSTEM WILL FUNCTION SATISFACTORY. �1 DATEInspector -------------------------------------------------- F l BOARD OF HEALTH TOWN OF BARNSTABLE i Vell Cou5tructiouperiuit t / Q., I� No. ��---� ----�. ------ Fee Permission Is hereby granted------- -------- ------ -- ------- ---------------------------------- to Construct �), Alter ( ), or Repair (�-� an Individual Well at: No. --------------- -r" ------- � =~ �= ��-------------( -=l= -- -_;r------ '_------------------------------------------------------------------------------- r -- Street as shown on the application for a Well Construction Permit (I, No----------------------------------------------------------------------------------------------- Dated----------------- -------------------—---------------- _----------—-------—------—. __`___i_r,L�f----—------—------------------------------- �B and of Health DATE---------------------------------------------------------------------------------------- i 1 ,1*1 15 '92 10 020W 5PV I RO TECH I.AB 5,98 3457 P.1,= GiR13UNDWATER ANALYTICAL EPA METMODS 601 and 602 Volatile Organics (GC/PID/ELCO) ,. r Field 10: ET-113A Lab I0: 1700-01 x Project: Sweet QC Batch: VGA-813 Client: Envirotech Sampled: 07-19-91 Cont/Prsv: 40ml VOA Vial/NaNSO4 Cool Received: 07-19-91 Matrix: Aqueous Analyzed: 07-25-91 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL I Vinyl Chloride BRL 1 Bromomethane BRL 5 Chloroethane BRL I Trichlorofluoromethane_ BRL 1 1 , 1-Dichloroethane BRL 1 Methylene Chloride BRL I trans-1,2-Oichloroethene BRL I 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethane * BRL 1 Chloroform BRL 1 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane BRL I Trichloroethene BRL 1 1,2-Dichloropropene BRL 1 Bromodichloromethane BRL I 2-Chloroethylvinyl Ether BRL 1 trans-1,3-Dichloropropene BRL 1 Toluene BRL 1 cis-1,3-Dichloropropene BRL 1 1;1 ,2-Trichloroethane BRL 1 Tetrachloroethene BRL I Dibromochloromethane BRL 1 Chlorobenzene BRL _ 1 Ethylbenzene BRL 1 m+ -Xylene * BRL I o-Xylene * BRL 1 Bromoform BRL I 1,1,2,2-Tetrachloroethane - SRL I 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS Bromochloromethane 30 30 100 % 83 - 117 % Fluorobenzene 30 30 100 % 87 - 113 % 9RL - Below Reporting limit. * Mon-target compound. "Trace" indicates probable presence below listed Reporting Limit. Method References; Method 601 - Purgeable Halocarbons and Method 502 - Purgeable Aromatios, 40 C.F.R. 136, Appendix A (1986). nnrnn ntrnnntgn1un11nnm�lnlnllnhmtllNn mrmtrntn�nrllnnrt,tnnn lm1!w!IIIt11. ,.! 'ENiVIROTECH LABORATORIES Mszs. Cert. #;MA063 Sandwich,MA 02563 (50B) 888-6460 "9 Route 130 Sant! � 3 LA)CATION: ?amp ADDRESS- oft N t- .Neck Rd. �• - $s.Lnstable, MA 02630 7/18/91 TIME 9 AH COLLECT FD BY. All C re Wel SA�IPLt C)AT`. 1 91— tiAV,PIk I;)FT 113A DATE. RECLI ED. r._W - F. New Well DEPTH JOB ' .---- _z E. RESULTS OF ANALYSIS. lJnits Rur.0 r.menci�Tr! limit Result Parameter Y It 0 Cnifforli) bacteria , 100 m: (Mr. Metbod! �:. PH pH units ZL~' Conductance ;Irt,t 04 cry �. 5C Il — -- 103 3 y c Sodium mg L 200 12.9 y .- Nitr ate-N mg 1. 0.04 __.. Iron '---- —" Ipg,L .� 0•3 0.36 - Manganese - mg L -. . —0.05 3 Hardness mgi L as CaCO .3 500 Sulfate -.. - -• mg. L 250 Potassium mg/L 20.0 3 S 200 - Alkalinity74 m "L c Chloride ;L 250 _ NTU 5.() Turbidity - � c7 s Color APC units 15 Background $actsna 3 see L attached sheet None Detected EPA Methad 601/602 ug 3 COMMENT, Iron level is not a health hazard, 1,c)w pH indicates high corrosive characteristics, YES ,,O WATER IS SUITABLE FQF1 DRINKING PURPOSES FOR PARAMETERS ?F.STEb e �XX C /�l�c _. __. DATE ' iiiiiilduiIIi01,l 1 J tiiii{liIli(IliiliiillUlilWillIlaW1{ii1111►IIljtltiliiiliiiliiillll�` 11(ttuuuut►uutLUE ulutuuuulltllutuu►HIUut►111,1u11ilillttuu Ill ill Jiu unutuii1va+iiiULAWLii{iiiiiitiiiuili;�i No �T_ Ti - - -- -. .- - -- - - Fee---- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVell Con5tructionpermit Application is hereby made for a permit to Construct ()0, Alter ( ), or Repair ( )an individual Well at: RoA� _� ►ik i_1 Z -�---------P ---------------------- Location — Address Assessors Map and Parcel Owner Ad ress ------------------—-------------------—--- ---------------------------------------- --------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building PRE J� n Dwelling----- - - 1� 1 UL --------- Other - Type of Building-------------------------------------- No. of Persons--------------------------------------------------- YP o e Type f Well- -- --------------------------- Capacity-------------------------------------------------------------------------- -- - - Purpose of Well---- --- - --------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed---- ------— —-------------------------- date Application Approved By------ a - / ate Application Disapproved for the following reasons:------------------------_—_-___---—----------__---_--------_--------------------__------ --------------- --------------------------------------------------------------------------------------- ------------------------------- date Permit No.------- �=- - -— ---—-- Issued----------------------------------- - date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f (Compliance THIS IS TO CERTIFY, That the Individual _Well Constructed ( ), Altered ( ), or Repaired (�c) bY---------------- - %{-- - ------------------------------------------------------------------------------------------------ Installer at-------A/ -P-A Al ------ --------------- -- ------------ ------------------------------------------------------------- has been ins lied in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described.in the application for Well Construction Permit Dated-------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------------ Inspector------------------------------------------------------------------------------- ---------- r Fee-- = -_-_--- BOARD OF HEALTH fi t TOWN OF BARNSTABLE . Appritation for Vell Con5tructionAermit Application is hereby made for`a permit to Construct (K), Alter ( )', or,Repair ( )an individual Well at: -iil ='� t o A. ��l f �_ 3 ,� ' - -- - ► ---------------------- Location — Address Assessors Map and Parcel Roi -Pkw - -1VAA11TA-�-� ' "' - k' 9,CbW111 Ili,1#7A 024 3 7, t Owner Address. —— =—— —-----------—-------------—--------------------— -- — ' -- — — -- -- —_--__ _—� _ _------ Installer — Driller Address Type of Building j », Dwelling -___--------------------------------------------- Other - Type of Building --------- No. of Persons---.--------___�_:________��_________ Type of Well_ 'I v -�=--------------- Capacity------, -- / ) r 'r Purpose of Well— — - - --- �,----------- ............... Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of,The Town of Barnstable Board of Health-Private Well Protection.Rigulation — The undersigned further agrees not to place the well in operation until a Certificate of.Compliance has'been issued by the Board of Health,. Signed - --- --- .----- - ----- �, date Application Approved By--- d .,.r-I'�",.c-► ---- -- — - -p -- } n date a Application Disapproved for the following reasons— -----_---_—____—_--_— . . � date IAI5Vi - L�! Issued Permit No. --------- ----------- ---r-------- - -------- -- ---- -- ----- - - - ------- -- - - ' •date', t _= �..B4OARD'•OF HEALTH=:: t ti f a a TOWN: OF BARN'STABL,E Certifitate ®f Compliance. liance THIS IS TO�CE��R��TIFY, That the Individual.Well Constructed ( ), Altered ( ), or Repaired /E _ C� �Q raw►_, l� ., : r.. K• �. r by— Installer -- �`�-'_ -Q'° 2 - `- -- - —(`"n .�: ' ,yz X.tYp ----------------------— -- -- - - - - -- `'---- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private-Will Protection Regulation as described in the a licatlon for'Well Cons'g pp truction Perms ,No. - Dated---- --•------ - - - THE ISSUANCE OF THIS CERTIFICATE-SHALL NOT BE CONSTRUED AS'A GUARANTEE THAT THE WELL. SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------------- ---------------------------- -------------- Inspector- - -- - ----- ---------- r -... ..r -....-�....- -,....a n. �..._......3+A+..� ..»-°'-.r.i--_,....,.—��......1 i_..».�«.s. ..v.-r•.,.'-w...-,.'.'u..,...S a�..i..�w.�a .. < .'v t: ..... .. v .._ .,_..��.._e_ p BOARD OF HEALTH TOWN OF BARNSTABLE Very Con5tructionvermit r No. Fee-====-�-------- Permission Is hereby granted-----�-_ ---_-____� �__'t�10_____________ � __:l�<-�-•�•�._ to Construct 1/), Alter ( ), or Repair (>):an Individu�ajl Well at: UStreet as shown on the application for a Well Construction Permit No.-- -——__——_--_- -- ---------------------------- Dated-----------------�11 �` F/----------------------------------- — - -- — -- - -- -'- -— ------------—------------- (Board of Health DATE - -------------------------------------__- -- — L TOWN PF BARNSTABLE LOCATION ivy f1//�S //S/-cI< SEWAGE # -- T VILLAGE CLJ✓/�/��// C L>� ASSESSOR'S MAP & LOTIJ INSTALLER'S NAME,& PHONE NO. �,� el SEPTIC TANK CAPACITY /S'O U LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ,�VL �tTLi,A- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 10 VARIANCE GRANTED: Yes No 1 To _ Centerville N Revisions: DATE DESp 11PIM j 9Q Bearse Z 9 Pond � moo Stony Pt. Long Pt. / 0= Locus Scale: 1"=2083' c1 LOCUS Map References: Assessor's Ma 232 Parcels 3 & 6 P Deed Book 1683 Page 162 Assessor's Map 233 Parcel 28 Zone RD-1 Setback Requirements: Front 30' Side 10' '► , Rear 10' Notes: D2 Property Lines Shown Hereon Were Compiled P , AL From Plans Of Record And Do Not Represent " C9 �111� An' Actual Survey On The Ground. Elevations Are Based On N.G. V.D. AtL_ ., .; Project. Title: D Cs IL ,� � _. nl•►mil � ` . dL D4 D-5 C7du Swee t 42 41 A Ds Gael AL On ace C L Reside n ce B/o s lt� n 1 5 43 Con c. d \� 't!!' O/ / 44 locks ow Fo oh \ P o"d Cs Nyes 4546 � � Cesspool 40• . D 47 36 Neck V Clothesline \ AIL ' s 5 V� Proposed 4� X 8 1. 38 C5 li Rocd Flow Dlfffusors x I W/4 Stone 0 / Existing ville (Cen ter / 6a We!! C4 'lV` 13(gmst(3ble Existing / #2 \� 47 "Bunkhouse" x J x x 4 x \ C3 MG. 46 i 1 AL 1 Story iL l 1 /Wood Frame Flagstone PREPARED FOR: Dwelling Patio44 ,;p Stone & Albert Sweet � rill C2 Utility \ Pole C1 \ Prop 15 Gal. 4 \ 43 ' \ ` tl TOI!/C�-48 (" L \\ Q Sign \ 42 \ 47 Post `� 46 1 \ o 41 o _ I _ Past Rail o b 40 - - — - - - - - - - /� // F�nC � o - - - - - - - - - - - - - - 41 Tracks - T At,,�Stone ��/\ K Pillars ` \ Vehicle _ - _ �� dE 4-0 - - - - - - - - - - - - - - - - - - - - - - - - r T ��' A.M. Wilson GIVIL 41 42 ❑ -o 0 � — — — — — \ \ ) 40 ® ------` ASS 0 C I Q t 2 S � Na.35�, a y <11 p 39-� �STti`� o \ -- —o 0 0 0 \ #1 Prop Wall Inc. U I - otilit Post Fence -�'- o \ ' Pole / , \ `` - �, \\ \ 39�- ,� 1 40 \ I `\ ' \ �� 1IL 911 Main Street \ 3H I \ , 1 1 _ Osterville/MA 02655 �. 3 508-428-1450 A Drawing Title: ` o Bituminous 1'SI` r- Driveway t yr 3 0C� r� r_ Seasonal Floats'- Abutter's 36 \/y Z l, Well 3� d Permit _ �. . Plan fit` e /g 01 Legend V• Existing Contour i --- 45 ----- ' e Proposed Con tour ' Scale: 1"= 20' Wetland I' C ,L a 20 40 50 FEET Date: June 27, 1991 Dwg No: Design: A.M. W. Check: Drawn: J. V.B. Job No: 2.0550.0 Sheet 1 of 1 A` A`D Locus Mad O� ,lL v� a Ilfc C9 AL ,iL AL yr i� Gen tervflle Legend ALA AL 0 Exlstln Contour -- --45— — ' D ca 3 q A � � Proposed t_'onfour AL Water Elev.=35.2' / � / Z Wetland Flog Bearse (June 6. 1991) AL A AL 90 Pond Wetland AL JTfAL AL AL D4 r Water Elev. =34.8' s>G �o AL 5 �Ik C7 (June 6, 1991) cols a o0 AL AL AL AL AL AL D6 0 �i" J tom--- V a '.. AIL a� on $ St ny AL ,d� , Conc. AL Pt. AL AL l�5 locks f' AL PO PrWwod 46 AL D C, gALL Clofheslme AL AL LOCU PROPOSED 33 X 18X 6 'A. CS LEACHING FIELD 6 . : 2083 \_ p �L — iJ 4"PERFORA rE :, AL '�` Scale. 1,• • PVC PIPE - ExlsHng Ease OIGDE LEACHING (re so well C4 AL Project TiflC: awwo 0 \. FIELD) Bynkhou . l J #2 47 (Existin AL AL TOE '4 > AL MOVED \ AL Swee 46 A / f story \� AL � Residen rWood Frame O st ne ,, L/ a -+# - _ \ ✓ DwellJng .. 'Pati � A-`� I�� ,\ �\ sill`' � Ilk \ oved d` \ I �oaC S , e AL Utility- rill �• C2 On Pole \ O M^ \ JAL of (. co K 4 �� yes _ y...Sign - o Post / - p _� � I � _ � o� _ - - / Past & °- �- 40 - _� L_ — - T - — Neck �` _ — -/�\ Roil�eryo°— \p� stone—✓ / — — — — — — `. \. — — — — 4 vehicle Tracks lkp � Pillars ! - - - - - - - - \ - I 4 1 - -- - - :- � � - f / �i�• � Road L - _ -- � � #1 Prdpoa�d'NMN \ ° \l ° °— o_Utility f Post & Rail —_ Fence ° "O— Pole AIL AL 39 (Cen terville) 40 y i - AL AL AL AL_ 0 1 Ac' --A Bornstcble Bitumino ..... ..... us -- APPROXIMATE LOCATION\ a GATE►M70D FLAG .. Driveway � SeasonalFoots MG.Abutter's- 1. 5 Well �� * 3s :....... ...' P111pRXod For. Scale: 1"= 30 AL� •/ ,,L A` A` ° Juanita Swee t 0 30 60 75 Feat _ __! , ' _ ''�'` �' 11, e Top Of Foundation El.=48.0 Test P/t Data Indicates Indicates Perc • Groundwater 9 OUTLET iY . Test — (Observed) 4 PVWyP)45.7/ 4"PERFORATED PVC PIPE A (TYP) S=.C2/ Sep /c � T.Gl75% hy BoX - - 2 - 118 - V2 WASHED A.M Wilsotl Tank :, � ,,. , _ � .. ., .-, <., Ground El.= 39.5 1500 Gal. :ao oo~'n > �a.ti. ^d ''a: STONE Associates a Q. N 44.98 44.81 o .n o 0 o p c o o p o t 0 NO Y To soil 45.5/ 4534 44.67 n Inc. � ,`�'�` ;� Subsoil 37 5 Flit No. 314 -1112 WASHED S70NE 43.5 Test By. C. Jolly P.E. 8„CR1l5�lm STONE' Y I D Medium Test Date: 6-13-91 Bottom 911 Main Street Sand Witness: E. Barry O.H.B. �- 10' �-- 18' 9' --�-) 35.0 ADJUSTED HIGH OstwAle/MA 02655 33.5 Perc Rate: <2 WhAch Foundation - Tank D- D-Bo - now sor GROUNDWATER 508-428-1450 Design Flow: Drawing Title: 4 Bedroom O 110 OQJkdroom = 440 GPD Notes: 1. Unless otherwise noted, all construction 7 Existing Cesspool To Be Pumped And methods and materials shall conform to Backfilled, Subsurface Sept/e Tank Requirements: Tit/e V of the state envfr+onmental code E. Drywells To Be Provided For Roof Runoff. Adjusted High Groundwater = 35A and any applicable local regulations. 9. Property Lines Shown Hereon Were Complied 440 GPD x 15p = F60�;g1. 2. Precast concrete aepfic tank, d-box, From Plans Of Record And Do Not Represent Sewage Use 1500 GAL. TANK and /eachln facIlIt to withstand H 10 An Actual SurveyOn The Ground. Ground El.= loading unless under pavement, drfve4 10. E/evotlons Are Based On N.G.V.D. To soli 46.2 2 or travelled ways whe►re H-20 /oodfng I/• This Site Is Not In A "ZONE OF CONTR/BUT/ON` Disposal Subsoil 45 2 Pit No. Leaching Facility Requirements: shall apply. Per September 1989 "UPDATE OF TOWNWIDE ZONES Test By. JQ Jolly P.E. Town Of Bamlable ReE AA=440Gpd =.75Gal"Dey= J. All pipes In the system shall be schedule OF C0N77?/BU710N OF PUBLIC SUPPLY WELLS" Test Date: 6-13-91 587 Sf. 40 or equal ff 7r E -6G1NE INSTALLAT10N OF SEPT! Design Medium Witness: E. Bor1•v B.O.H. 4. No field modifications to the sewage Wr a_ -422- Perc Rate: S2 Min./lnch disposal system shall be made w/thouf Sand prior written approval of the engineer REVISIONS: and the local board of health. Date.: Jul 1, 1991 Dw No: Leaching Faclllty Provided . This system Is not designed for o 7-29-91 LEACHING SYSTEM 9 33'X/8'X I'D EP FIELD 5 8-26-9/ DESIGN FLOW, LEACHING SYSTEM Des@ n: CP.J 3.3 2 AA = 33'X/8 = 594 Sl= garbage disposal unit W D e /um 594 SF. x .75 &V 445GPD 6. 'STUDIO" NOT TO BE USED FOR f,-SIGLNTIAL - NOTES, LEACHING PIPES Check: Ine-Sand � Y - Drawn: J.V.B. 32.2 Note: Per Tltla V: 7Psla iNcr�Id H®aa c �al,� F� 84grPp P�tA'�sEs. Jo,b No:2.0550.0 Sheet 1 of 1