The URL can be used to link to this page

Home My WebLink About0037 OLD FARM ROAD - Health 37 Old Farm Road G'erl-'erLAI IL e A=251 218 UPC- 12534 3 0� (&-) No. p ^ 3 ✓ Fee ` v THE COMMONWEALTH OF MASSACHUSET_TS Entered in computer: PUBLIC HEALTH DIVI&ON -,TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[ppYication for �Digozal �&p!5tem Construction Permit Application for a Permit to Construct( ) Repair(4<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addrysp�or j,pt No. n cr Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address and Tel.No. Designer's Name,Address and Tel.No. >ZGH r✓ Sy S%C ?—:r D A.-) /-V Type of Building: Dwelling No.of Bedrooms Lot Size ' (o b sq. ft. Garbage Grinder Other Type of Building S No.of Perso s Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re uired)� 3_3 gpd Design flow provided �s �� gpd Plan Date Z!", Number of sheets Revision Date Title Size of Septic Tank /S o d fo� d Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4.1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. f " ne Date �� Q O_ clr Application Appro i Date n 10 Application Disapproved by.: Date for the following reasons Permit No. poi-i- (!o 3 5 Date Issued ------------------------ ..� „.,,,,e, ,�✓__ .. - " " .: ,:- � � ,—., y' .-. cam: .. �� rh� No. C Cco �p '� 3.✓ Fee /CD THE COMMONWEALTH OF;MASSACHUSFT,TS Entered in computer:f. Yes PUBLIC- HEALTH DIVIS O M 'TOWN OF BARNSTABLE,,MASSACHUSETTS Rpprication for �igpozar �§vaem Con!5truction Permit Application for a Permit to Construct O Repair(,j Upgrade( ) Abandon O ❑ Complete System ❑Individual Components Location Addr ss.Lot No. . Owner's Name,Address,and Tel.No. -7 d/ems/1/9 2 �C% �� Al 7 E r 1)11 F at$,27 Assessor's Map/Parcel S^- f / j /,_��Z�,� 1,2 Installer's Name,Address and Tel No. Designer's Name,Address and Tel No. f36a Type of Building: Dwelling No.of Bedrooms 3 Lot Size o2 6 b sq. ft. Garbage Grinder (G� Other Type of Building Irz No.of Persons Shpwers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ' 5� / gpd Plan Date a 4 1;2-6 Number of sheets Revision Date Title �. -- Size of Septic Tank Type of S.A.S. Description of Soil 4g. c Nature of Repairs or Alterations(Answer when applicableY r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code an&,6t to place the system in operation until a Certificate of 'Compliance has been issued by this.B, and of Health. Si ned�''��~ Date ApplicationApprovedby.- == Date Application Disapproved by: Date for the following reasons r' f Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of �tCompliance • THIS IS TO CERTIFY,that the On-site Sewage Disposal System,Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by at :3 /"�i ''' r/ r has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No. dated ' Installer �-j d e- '1� a Designer Al,/9 #bedrooms 3 Approved-design flo ' gpd The issuance of this permit shall not Jbe construed as a guarantee that the system will functi nasddsigned. Date Inspector l No. I Fee 06 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Miopoal �§pztem Cow uction Permit Permission is hereby granted to Construct ( ) Repair ( /; Upgrade ( ) Abandon ( ) System located at 3 and as described in the zCoove Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special condition . r rovided: Construction intist be completed within three years of the date of this pe it. Date / b ! Approved b-e 4 i TOWN OF BARNSTABLE I.JCATION 3 -2 SEWAGE# V)LLAGE 7f40,Ile ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE SEPTIC TANK CAPACITY /5 6 LEACHING FACILITY: (type)3 -e O r/�a��=/�s(size) /3 X o� NO. OF BEDROOMS OWNER J�z=�E S�U v�r3 r✓O PERMIT DATE: �i �/d COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY f'Sb ash P G,2 Cr t N�=' 13 /V®7 TO` ,S(f 9 41 SITE PEA. I, OLD o'l /� y a 9 \ i3- a\ ��\ G � .�X o, Dom` ;..• ��.C�L�w� CCFn�/ \\ I I �e<Ti76.Ce'JZ 1 & le �w�T oa , \ � C a 3-7 V 6�� 0 2 2 lz�li-- 2 0. G�G1�.1� i490 'C a♦ c � r v v M1� , .._ .. I . . . I �. .1�.- �. , . . �j�,!-',�. . -,-! ''. . i�l� 1; \ . :, .:, ., 4- . ��- P.: -`� .i: - ,, I 61. . . ,.\ � - 1. . � , / * , .., ,t � � � , � . ,.. .t 1. . . , o ��. .�:.,-- -.. —.. ." . � � ,. .. 1 . � � , . —i'— .1... . . . 11 1, I — ,.,..:i: , .� , �! . I .1 w �,., I �i - i I . i � . 1-1 — I.:�' —.— I . . , . — — — � — �. � �. . . o 11 ; I 4 - 4 - : *1 : , �:- � ., r ... --� . : ...- - I � , : ;..,I.. I .. V. ;r. �. . — b I.: :!—i— - t ,:Z , -� I . I �� . . . . .—i : — . � — trlm . . �:o� � . N) . . . - . 1. � -%)/ — 1� —�,�If 1�'�. - — - .. "". . -T �, .-11-Wi — , —� — —,.1I .. . . �:.. }i. JI.— I I f ,if. , % , , �i:,T-,r..�.� ` :F, ., . .:... ..�� I, * , . . . � � I ) �' �^ , . , , �. �/ .: . :��.. I � . � , `� 1 , ' FAhl14�1 Gr�M {IC pF ! �' ' ll % \ L ,I;. K„ceo Pal \ >> —I U C� 1. { 1. to d1. 1. ;�, �I f�' I 5�ilf IaPov[ v �E1 I.t a l;}a { . I �►' �1Gall�,t. :If.:! �I, %), .i�'. :- ,- *�A , , / 1 �' ' v i I � & : . ;.� Iz, . %I I I-, -� : ,* _ ,nUN . n. 41 ^�� : .v U \l Wr I I e 1: I. �(� ; !' 1. I I t' I. ' I' Vn (cP , _ (;;t.. 1 1—, ?` Sa 1 1:1 .�• r a E -',P;lAv GPI uk 1ST' 3 "{.I t I , 17E¢K 1 i t < �; �dq Y� 1 t k, t * r n(�� 1 V' r? p wXI� f.`� filJGTI��t' F �, `% �S 1t�. 1. �kR ` i 4 I i' r' t i t -y ,.t I t r i M 'ta ' t s`I t 1 �i - tY r.. I e .h,;� ' �.. :..,L.i0tc�,,l,-''?•�..i& i I; i' I a ft 4x I I'`t !4j , 3 �, tY , .. r ' d i 5.,:.'7 HL kt.'I. L �'. }�4 S ,t rt. -t fit { '! il {ri s ,�:{ t t k., : r .: Y L S7. y ,: )rf I. I. ` ; r .",,7�`' r P ,r'y i)f a -. `� O. 1 5 '—t r i h ` •k l ,� , Y i L $ , 5 J L.$r'714 r i I " a1 i. r :) ] { t 4r '} H t I I ;F, ° o-, t�,{ a s s+ S f 4 irs t Y '�''- {i �,.` A ,� }` S 1 SCALE: - ' APPROYEP 9Y: .' DRAW Y 5 h 4 a DAME 6 ARt�'h'M`•R e,t. r f di s OflAWrNO NUMfl{ Town of Barnstable 1"E tOw Regulatory Services P�' C * Thomas F.Geiler,Director * BARNSTABLE, 9�A MASS: A�m Public Health Division rFn '� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Desiener Certification Form Date: -Ze" Designer: Sj/= T's"'.7 l� Installer: �/Lc� ��✓Si Address: 6 �� ``-S/� GcY� Address: 8 X S�� On / 4 /�l'Gel was issued a permit to install a (dat (installer) septic system at 3 7 0/YI;�9jLA based on a design drawn by / (address) 5T�TSo•✓ ��/�ll dated . (designer) certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. / of hiq (Ins 1 r's Signature) _ y Eb5►� Q EVALvp�o esigner's Si a e) (Affix De amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form Town of Barnstable CF 114 Tpw do Regulatory Services sARvsrna Thomas F. Geiler,Director Eo 39. Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 April 13, 2006 Mr&Mrs Stuart Eveland 37 Old Farm Road Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 37 Old Farm Road, MA,was last inspected on March 28th, 2006 by, James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: The leach pit was in hydraulic failure. You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. Fomas STABLE HEALTH EPARTMENT A. McKean, R.S., C.H.O. Agent of the Board of Health 1 , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 -OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 37 Old Farm Road Centerville, MA 02632 Owner's Name: Stuart&DeDe Eveland Owner's Address: sR� ra Date of Inspection: March 28, 2006 i Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford _ Mailing Address: P.O.Box 49 LL-r Osterville.MA 02655-0049 ' W Telephone Number: (508)862-9400 CERTIFICATION STATEMENT co r', I certify that I have personally inspected the sewage-disposal system at this address.and that the informat n reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes N ds Further Evaluation by the Local Approving Authority ✓ F it Inspector's Signature: Date: April3, 2006 The system inspector shall sub it 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 ""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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe.Eveland Date of Inspection: March 28, 2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of.Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.. Comments: 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: 2 i Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within.50 feet of a bordering vegetated wetland or a salt marsh 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 aseptic 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: 3 i Page 4 of 11 ;i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28 2006 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the.ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the 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 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.] Yes (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the 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 II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 i Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 37 Old Farm Road Centerville, M4 Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was'provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS,located on site? ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ — Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe:Eveland Date of Inspection: March 28, 2006 RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design): N1a Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 4 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n1a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently o- ccunied COMMERCIAL/INDUSTRIAL Type of establishment: Design.flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/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: Pumped 10 vears azo-per owner 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 ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy-of the current operation and maintenance contract(to be obtained from system owner) 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 7124186 ti Were sewage odors detected when arriving at the site(yes or no): No 6 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: 37 Old Farm Road Centerville, AM Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron 40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 12" Material of construction: ✓ concrete _metal _fiberglass _polyethylene other(explain) 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. Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle: 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: Measuring stick Comments(on pumping recommendations, 'inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): The liquid level was above the outlet nine and W to the cover. Liguid was backing uDfrom the leach pit Note: Septic tank is H-10 loading and under driveway needs to be H-20(heavy duty) GREASE TRAP: None (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.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/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: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Above Comments(note.if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): D-Box was under rock wall.Used camera to ins ect. D-Box was under water backink Up from leach pit. PUMP CHAMBER: None (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.): 8 I y .s. Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Old Farm Road Centerville, MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1-4'x 6' 600 1.w/3'stone per as-built leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): The leach pit was under water backing up into septic tank The leach pit was in hydraulic failure CESSPOOLS: None (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: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Old Farm Road _ Centerville. MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 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 w"here public water supply enters the building. W o r ��.. LA O 7 16 Fr nT -CY o� .. oo C3 o. N 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Old Farm Road Centerville. MA Owner: Stuart&DeDe Eveland Date of Inspection: March 28, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15+/- feet Please indicate(check)all methods used to determine.the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: Topographic+water contours snap Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable Topographic and water contours maps. Maps are showing approximately 15'+1-to groundwater. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees,.either expressed,written or implied,relating to the system, the inspection and/or this report. 11 - - - Town of Barnstable CF THE�p� do Regulatory Services Thomas F. Geiler,Director w: BARNSTABLE..'+ ' Public Health Division Thomas McKean, Director 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 21, 2006 TO WHOM IT MAY CONCERN: RE: 37 OLD FARM ROAD, CENTERVILLE,MA This dwelling and septic system are both designed and rated for four(4)bedrooms. <LkcKean.,R.S., CHO Director of Public Health No...... .. � Fps.. .......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �' ►� oF.....-..-.. �w. s Appliration for Uhip aiial Works Tomitrnrtion thrutit Application is hereby made for a Permit to Construct t� ) or Repair ( ) an Individual Sewage Disposal System at: ocation• ddress �— or Lot s C� �p P� 5 -......T..._. .. 1�� ............................ ...__._...._ ..� _.. -..B.V. .�x. Owner Address w 1 1r - e/4 . --------------------------------- -------------••--•••-••-•-•••---•-•- Installer Address Type of Building �j 5 Size_Lot7-�§34?®_____Sq. feet Dwelling�o. of Bedrooms..........................._----------------Expansion Attic ( Garbage Grinder ( } P4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ____________________________ W Design Flow_____________________�s�.�_____._____.gallons per person qay- Total daaly i ow.._._.____�s?___._. __(`2_._____________0 ons. WSeptic Tank—Liquid capacity_PiX�_gallons Length__.___'____ Width__-:-d�__. Diameter________________ Depth_` __-�__- x Disposal Trench—No_ ____________________ ��idth..................... Total Length_______.___________ Total leaching area....................sq. ft. Seepage Pit No---------t---------- Diameter........... Depth below inlet....... Total leaching area__77-.,O.C�...sq. ft. z Other Distribution box (e.--)-- Dosin tank ( ) aPercolation Test Results Performed by.- ____________________ Date.... Test Pit No. 1...�____'I-minutes per inch Depth of Test Pit___-;._ ....... Depth to ground watere_>%J'_____170 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......-................. a' •-----•-•------------- ................................................................ ,.... O Description of Soil-•--('�—a"A--------- '�'�a!!. f....S _aa.,o---------•-�%-- _�• 1� W UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ ---------•------------------------•-•--•-----------•--•---•----••--•-•-------•------._.._._._..._--•----------------•-------....------•-----•-••----•-------------------•-••--------------•-•-•-----••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIIL LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation u till a CCeerrti ate of Compliance has b een iisssyuEE of health.,� S ned_L� .[e._- -._-..Date__...Y.-•-- Application Approved BY Date Application Disapproved for the f ollowi reasons:--------•-••--•...-----•---••------•--•-•-•---•-•-••---...----•---•------•---------------------•-••••-••-•------ ..........................................••-•-.__....---••-----...-•---•-...--•---------...-••._...••---'----••--••-•-- Date PermitNo......................................................... Issued........................................................ Date i t f f S NO...` Fxs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.........................:..._..................... --------•------................._.... Allp irtttinn for Bhgvnnal Worku Tnnitrnrtiun Famit Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at: p�a�• «_.......... b...,........ { .t__1 - .�..,r.....•------•:.......-.^. .....• "••••-•••-••-'-----r,.._-____----•-�••"-"_!`_"_-___-__........�--•-•••- .....'. ..._....: ......_# .Location.-.aA...d"d?r e.s.s , .............................. or Lot" ........................... ..:...__....... � Owner •--------------------•----•----.Address t.cl.............. c�1:}.:�fir.-........�.-�s..�:►� ..._.._....-----......- ------------ -....__....--------- ------.......... Address Installer "- -.7 Type of Building,,. Size Lot------ >� .......Sq:.zfeet Dwelling No. of Bedrooms--------------------------------------------Expansion Attic ( Garbage Grinder (} ,� WOther=Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -�--------••-••-••-••••-••••-•---•-------------•-•....-•--------------------•-----•-•-------•--------- W Design Flow....................._ ..............gallons per person Rer day. Total daily flow............�z..� ..... .................gallons„ WSeptic Tank—Liquid capacity. �;':?J.gallons Length_ _':-t .__. Width__`'."T___ Diameter________________ Depth.`.:(,t,... x Disposal Trench—No..................... Width....................... Total Length......... ......... Total leaching area....................sq. ft. Seepage Pit No---------I.....___... Diameter..........7..... Depth below inlet............'........ Total leaching area.. '°2...sq. ft. Z Other Distribution box (+ Dosin tank ( ) � a Percolation Test Results f Performed by C:.P "�_�:__f .. 1 t ` '______. _.................................c- ------------- Date----- Test Pit No. 1-____'"__.....:minutes per inch Depth of Test Pit___°_ F__........... Depth to ground watery �a �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a+ ••••_•• 2 --•---------- •-- .A_»__.._.__ i ,,{ /.C" .... T 4,! .vr:t t,., � t7 •` •dry jj �Ki-•Y\.3 O Description of Soil--•-�=-••---`r----�---------===-=-t"=�--'---------a------==--- --------------- -A........................................:.:__.....................• - rJf •---------------------=-•-•-----•---•••---•---•-------------•-•-•••------------•----•---••-------------------•--------------•--............................................ W UNature of Repairs or Alterations—Answer when applicable___________________________________________________________________________•_-_------------.--. -----------•--------•-------•--------•-------------==------------------------------•--•----------------------------------------------------------------------........................................ Agreement: The undersigned agrees to inst4ft aforedescribed Individual Sewage Disposal System in accordance with t ro ons_o T' LL p 4 5 of the Sty nitary Code— The undersigned further agrees not to place the system in i�YiY ate of Complian e has rbn issued by thg bo d of health. Si ned._ j� �. �� lJ� _ l__". .:. .............•-- -------- -------••-•-------._...--••---•-------•• ••-- --••-- Date Application Approved By-•-----•--•----•-----• "+4A-)•_"�--- --------- ------------• ---------:3_ 14- Date Application Disapproved for the f ollowing-reasons---------------------------------------------------------•---------------------------------••--•---------------- •----•----•----------------------•-•----.......-•-•-•-----------••--------------------.........---------•._....._..........-•------------------------•-----------•-•------------•----•----•-•---•-•_-••-- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD DF HEALTH ...........OF............ ....:......................................:.... Tn#ifiratr of TnntpH anre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( >' or Repaired ( ) by-------•--••----•-------••-•-••-••-•••••--•-.W_a. ±P ...........1 L'-1w)`-----..................•--•--••--------------------•-•---..........••-----•----•-----------•----•-- Installer .�-----------t_`�l 1 ..........fivi.tY_1.........r--------------_- has been installed in accordance with the provisions of ""!7' j of The State Sanitary Code as described in the application for Disposai Works Construction Permit No.- -___F'�-._�?-___-_-______ dated-__. �17 .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE q AS A GUARANTEE THAT THE SYSTEM WILL FUN TIO SATISFACTORY. DATE. __• .....................••-------:__............... _ Inspector----=-----=-= THE COMMONWEALTH OF MASSACHUSETzTS - ) OA k-HEALTH. r. Q ...........................................OF...........-....................................... --•••-•--.........--.. No... (� FEE........................ Disposal Work.5 Tn iArnrtinn rrntii Permission is hereby granted `-'±--_�✓------ = w t -------------•----.......................................................... to Construct (Y) or Repair ( ) an Individual Sewage Disposal System at No.--•-•-......---••-..---•�`'-''t--.__ �. ------- ?1'....... -t-/"'t"=-` f .................................Irf'`�" Street r as shown on the application for Disposal Works Construction Permit N _DV0ated......_ �— f G �____.._____•._______._.�^ Board of Health�- DATE-------------------•---....-•-- --•-------------•-•---- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - , � 4 S/GV- ZQW 7�t S/N6L:E F,4iy/L Y ^� 3 E3E0.2oON1 - /VO� GLI�E'B�GE G�/�OE.2 330 SEpT�C TANK = � 334X/Sn"o =`f9SG.P,O. O/.S�S,4L �/T•-USE /400 6.4/_ .t/OELdeLL Ae-2 5.4 AV Bo7Totil.4.eE.,cl _ Sa 5.,� F cam. S�T� nL,4_,� ffaf OF s�cy` PETER. , +O .:WILLIAM Gutfy o $UWL AN C,. No.W0 N Y E y 4. `-No. 19334 .off c�4FST6a�0 �Q �QNAL F 11 E-q n�v�e.E�� iz m0VG All. U' 45UMhtLe PrQ+�`C�--QU,L i � �J� G T3sE 6.4G. BOX /N✓• GAL. F�E'.8 W-/�.5pv• p ' G'E,2T/F/EO' JAG OT pL,4.t/ . .4T.E Eti�y 78,0 Lei 3 / GE.er/may TN,4T TyE' )Rt,-oj=' A�bS'vow'v iyE.�Eo v CGtMPLY.S l�ir�/TiyE Si42-11:'Alme ,4M0.fET�AG,� .2E4V/�F-TENTS o� Th/E ,e.Evisr�.P�O.t.�o stievEY�tP.s ToJ f/iS/ GL� /3 4)ZN'ST4&l6a, W /.S NOT LOC•QT�O y(//Ti4�/iV Tf/.E �LG1o0PG.Q/iV, If �� A.�,G�cavr- T//lsPt,.sv /s ,tro aasE Gn/ _T O .4iV/iY.ST,e - t� z , Ir - F _ : t - vi J � Z. .1.."-i._'}--,. � _r. t +_pQ/� �. i� _ j �, � �-I�I •�}/ i j �1/ -� � r-r P i I , .. � I t , t- G,AFI �-1 i L�+ j -li 1/(� 1, I ; l��•- __t I 4--. �4� � P�• i--, , � : I , III I t LJ-T7_.._-f' _1 l 1 ' i .�_'i'T- 7 , -1--, � -I- -- 1 I L- -ice_ Et- 1-4 r , , l • -OF lid _! NT y �a�p sA.• �O`�r`V ....r_, _.... i. 1r { - i i - ��.�_ PET _ r TT c). , ULLI LLI Ho:29133 . . AL I 1 �ES/G/V 0.4 rA- S/.v6LE-F,4iy/G .; OA/LY //D X 3 t 33D G.P.o • � ��/SE /,000 G�1G. � O%�i�i2s L �/T:=:USE �a 04 6AL• ;,^ %_..�,.,,,_._�/�- - AV, To!t' ,P �= Si 7—Z-F TOT.QL..iy'4�G y�La1�/= .3.3a G..�o• OE.S/G�i/ �E.eCGL,4T/.Gbt/,-.�T�• �N OF PETER �SN WILLIAM G,y: SULLIVAN c' No 29733 sic t '.N Y E 9 i9334 tST 150 or 19 • � - t 1345E FL,-- io.o i T _ •� - 6Ae.. /N✓. ' i � t�♦fcti,oar �A� SE'PrrG z , G'E,2T/F/EO p1-.441 4zel p.QT,E p /z eLIEV 78,0 L:6=7 r3 GE.er/ 1�c14 x/ � 237 ,yam'S/o��✓it/E B.sXrF,e yE;.,V . 4iS/O._: fETlAG•� .2E41J/�F.-MENrS o� 714 TON!.t! � .2.Ewsr�,eco.G�vo slier QF: 3;4TL�/ ,T.dE .�►�v� /& L4C!�TE.Q�W/TiS�/!V Tf✓E. .�LGbOPI�Q//�/,- ' en A.-.4 Al , :S�b K/it/fj/E.e�4/✓..Sfv�GL/G��pT GTE USED n- INA -- 97. 87 N t:. . 1^ E��'• ss, ems- 8 oz _ o H OF qs PETER ti o SULLIVAN V i No. 29733 ADO ��►ST£P�O �� 0NALL S,Z9 9•ZA-scp I Tow^ XN OF BAnRNSTABLE �,,CQCATION , �`G R� SEWAGE# VILLAGE _ Ca/ri—it l , ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY QM LEACHING FACILITY: (type) �I�X�o �o� GAI. (size) 1 NO. OF BEDROOMS 1 OWNER V d A, ci PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY__ ��IS(�Gv'1 i b�1 J �lw Lj 'ca d° Fr AT 7 Qo 00 - a 0 W TOWN OF BARNSTABLE LOCATION Q'G b r SEWAGE # _LAGE 8/d�Ph y' '�"L e- ASSESSOR'S MAP & LOT gig &PHONE NO. Q I—O�'CI SEPTIC TANK CAPACITY - LEACHING FACIL=: (type) � - (size) NO.OF BEDROOMS 4C u B�OWNER S-Z ItO he 2)t-_ E{ sej,QlJ PERMITDATE: COMPLIANCE DATE: zsr Separation Distance-Between th Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by SSESSOR'S MAP NO asl�'a K PARCEL �-- 20 2 ki CAT ION J SEWAGE PERMIT NO. PILLAGE G a NINST 'S A M E A ADDRESS 08 U I L D E R OR OWNER DATE PERMIT ISSUED DA.T -E COMPLIANCE ISSUED �, ate/ LT r - � a //o 0 �® " O Ail � o . x:sxs.:_ s 'baca;w-s .:.x." u.zasc:n.^•arasxx ..^-c' ::, • ...:':. ' .,_ ._._._,.:. _, ._..,—., ..,mom._._. —._........ _..,.._.....r.._...,_. _.—..............,_.... --"....... f _ , SITE PLAN 37 OLD FA.PM I CFN TFI- O .1_ / E" FOP �1 DEIDPE EVE. AND i DCU. � � �; I •fi..�C✓:.�..�ac',��'�.�� F�F'-+J,.;. ,.�"r</o�/,✓ /as s'r�7 �`,� /�✓,�,��."..� / s"�a��'-.��.��.�"/ �R�c��. �/8 _ l �6�� 0 � r :-_/pi �E�.S'. INN t �'.� � ' ,_•".., ' , -�c i ��'�=+9.r� >`;. �,�,c�' L� i� /�/ is c��/� // { La1 - r� /� O(� �--;— /� y.SadiaG AFC t 0 15 \ 1 2G4 TOP OF FOUNDATION CONCRE�� COVERS _ r� ,� --___---__�D / "I." I QFe. Tv✓ tsr�7/3G'� r, 7 t i ni ,tICArSTA ON O'f 1 � �l ��/r'/�/�'1,9h' ^"'�.---^• r ��S 7�J OR SGHEDUf,.E �#0 � 9r•' • -.,.,.. .,. �-�:r.. ;. + i f;V.C.PIPE MIN. 4 SCHEDULE 40 P.V.C. (ONLY) 9."141PP7 . LEACHING TRENCH tREQ. „J - --{- • �- PIPE h!1N. " U 367MAX. _CD C/-�t-'rCon� � u,� o /j- ;rr PITCH IJ� PER.FT. 9 !/e - I/2 WASHED STON - PITCH I/4 PER.FT ,sueYL_v9 1 �� t /aLG L'll , I F 1ilVEi T 41 �. 8� • � , a a 67 . �' 777 �G�� E e I� : _ I �sC�l�t�.� •S, -75�% 'jf'�:+r')d(,:lr.� 9° 5�P-'';C ,BANK ELr,�, �71ST. {V��r t .C��'& `t 7rk�/:I��'�f Crtar�7 ?,• � 241r r ( .� 5' T _ v _ A INVERT - t W ' BOX � J i�tt e,Jld�(�i��_l t l°s lJ�� i �f, `� Q + I "� '� b "-w. F� . .+ ....6-. ... ... GAL.. INVERT_ ! -_ .- . .. ..- .. aX oo a %5 � L W, C/E<J /' ' 'a EL, L7,y _ . EL,.� INVERT n 'n / - 2 E Precast 500 Gal.Leach .6t,CR.II, HED STONE EL ) REQ. Chamber WASHED "ONE ,. � ' 1 I �� i ��CST" � ��,� �.�,�,•: � /r�ls�,,c�r �Q'r-�j / .., .,_._.._. ._......._. � 3 1 �. 470 ` ,, PRORLE Of ••• GROUND YIATER TABLE T� r171 X4 � SOIL LOG l SEWAGE DISPOSAL SYSTEM TYPICAL '.OS; SECTION I li /L� ! DAT�.�.�J��Y!�,r�F�>TIME /C .. No SCALEL�� No L TRENCH . CH I N' T CH TEST HOLE 1 TEST }iC>L.I 2 DESIGN DATA . , - 1 wry{ED 36"MAX. NU}dFsER Or BEDROOM'S . . .�.. SUNE 2t1 I TOTAL ESTIMATED FLOW ... GALLONS/DAY[l ^J) BOTTOM L_4CHING AREA• r - / �G T9ftl f�+ � + a! y e� ✓r / j}, q .^S a 411 Y' /3.Ja 8 " 24 1�z7 SIDE LEACHING AREA. ./,64.r.3t?SQ,FT./TRENC}{ / ---- - �-sr GARBAGE DISPOSAL ... .r,L'J.,(50% AREA INCREASE Ot,�L LEACHING .. . . . .r t. ' x. yi2Gf /ay"'G/�L _ PERCOLATION RATE'... ;?,n!•.. ... -R.INCH V. / LEACHING AREA PER PERCOLATION RAT E'.`/.-�,.,fe SQ.FT. _ r �; A,� _ rr - r F / ` ems. //�` ,%1�� EL d2 r /3d _£G�7L G/ i�.> +71 _ 7�ro_ _ V C� /�j �G� f7 _ /.� U /•l 'a . . . APPROVED . . EQARD Or HEALTH Gr :)ND WATER T�.LE .vrATE� ENcouNTEREo DATE. AGENT OR INSPECTOR 1 WITNESSED . e ;-�'':��/�fr.�• / _n_ ,OARD OF HEALTH . . . . . . . . . . . . . , . . FNGINE:rt . . . . . . . . . . . . . . . . . . . ' . . : : + . , . , ... . . . .. . . .. . PETITIONER . . . . . . . . . . . . . . .. , . . � EVAI��`��Q • f � 4 _ I