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HomeMy WebLinkAbout0015 OREO LANE - Health LA := 15 Oren Lane — Andrea& Val.Clea ning rville 4" — 141 — 001 oftndaffor i 1521/3 ORA 10% P2 t TOWN OF BARNSTABLE LOCATION /,5'0)Z 0 L h P E SEWAGE# .201°'' C.0 VILLAGE ASSESSOR'S MAP&PARCEL aq-7,: ..00J INSTALLER'S NAME&PHONE NO.zk>,� A SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF.BEDROOMS 3 OWNERi�.x.) PERMIT DATE:_;$"—/+/—/�.� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 0* Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �� �r�a f A 'D a -77 �-56 2At K • a 2 No. l Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTHDIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftphration for Misposal 6pstem Construction Vermit Application for a Permit to Construct( ) Repair(;//Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addres$or Lot No. 0 r e 0 �_Al Owner's Name,Address,and Tel.No. (,e. j,.e tv0 1-e "'Due jn7 Assessor's Map/Parcel �L 4 7-. fie/l 04 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size /11V 7Y N sq.ft. Garbage Grinder( ) Other Type of Building _�c2ose— No.of Persons 3 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �3 30 gpd Design flow provided gpd Plan Date 5% (� -/�j Number of sheets Z Revision Date Title Size of Septic Tank T`S pt,..` Type of S.A.S. 2 Description of Soil Nature of Repairs or Alterations(Answer when applicable) ec,clot 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. C sigaw Date Application Approved by Date yJ h Application Disapproved by Date for the following reasons Permit No. ���(,�`6 O Date Issued y -?-Vl r N. L b w [J 5 �, � Fee / THE COMMONWEALTH O'F MASSACHUSETTS47, Entered in computer: Yes s PUBLIC HEALTH DIVISION -TOWN OFtBARNSTABLE, MASSACHUSETTS i Yication for Disposal 6proem Construction Permits Application for a Permit to Construct( ) Repair(/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components . Location Addres or Lot No. /S C)(C.O L AJ Owner's Name,Address,and Tel.No. Lr�ke ev,1�-,- Assessor's Map/Parcel Ijn'ssta�ller's Name,Address,and Tel.No. � 4/C�7l S S Designer's Name,Address,and Tel.No. oS,G S A 7,;,(Cx+ol Type of Building: Dwelling No.of Bedrooms Lot Size , r;/ /7Q'4/ sq.ft. Garbage Grinder( ) Other Type of Building ,�,' No.f Persons 3 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �3 10 gpd Design flow provided gpd Plan Date $-- -/�� Number of sheets. .a_ Revision Date Title Size of Septic Tank 1CYI Type of S.A.S. (S G Description of Soil i Nature of Repairs or Alterations(Answer when applicable) S t l A lec j,) /i ec, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of thd 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 d. Compliance has been issued by this Board of Health. ` Sig Date S_by-'/�-� Application Approved by mac' Date / Application Disapproved by t .__Date'' ; for the following reasons Permit No. 7- 1 6 o Date Issued S (�H ZOt y s THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( I-< Upgraded( ) Abandoned( )by jc s 41 IhJf)ul NX at / ;�rC� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.'&1 " 60 dated -6/14 ZO Installer_ �1 Gs A 1 i�r,�s •Cnx Designer #bedrooms 3 Approved design flow gpd P The issuance of this permit shall not Ve constru(5d as a uarantee that the system will function ed. Date Inspector --------------------------------------------------------------------------------------------------------------------------/ -------------- No. 0 Fee �C/�/ . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit -` Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at f7 t O 1,A) C e.-ol-rily,%1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit f Date �!fy/�I Approved by 05/16/2014 Oe:13 5Oe4775313 ENGINEERING WDRKS PAGE 01 ' e Town of Barnstable Regulatbry Services Richard V. Scali,Interim Director Public Health Division ro, " Thomas McKeaa, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax' 508-790-6304 ( Installer & Nsi er Certification Form Date: J i Sewage Permit# a O Assessar's MaplYarcel vi 7 —pA 1 00 t Designer: :"_,We* 's IM_t Installer, Address: Z. W. Cms e 1.01-Ed Address: P C` z'K e d�Qet,l� f"'bl� C912 Ca 1 Y Cer►i-e,nr:LL,C 0 02 QA .&-a-Jv. tkc was issued a permit to install a ( te) (installer) septic system at �e --�.- ►^`�*'`''^ Based on a design drawn by (address) 1-e e dated CT (desi�er I 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. Strip out (if required) was inspected and the soils were found satisfactory. 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. Strip out (if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in complia ith the terms of the I1A approval letters (if applicable) i 0p f T',1 T. McEW E a er's lgnature} 11 6 CIVIL ,} plt;Qesi gner's Signature} 1x Designer's PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE pF COMPLIANCE WILL NOT SE ISSUEzI >1`1TYL BOTH TIUS FORM AND AS- BUILT CARD ARE RECEDED BY TIE BAI 'VSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:lsepticMczigner Catifieation Form Rev$-14-13.doc Town of Barnstable P# Department of Regulatory Services / F Public Health Division Date 6yIRy 200 Main Street,Hyannis MA 02601 Date Scheduled i ILVO'L s.flpf 1 .Time_ Fee Pd. ( t7a UU ^/ . 20 f Soil Suitability Assessment`fI o©r Sewage Di�spotsa1�l Performed By: ttk � -6e Su#(5-�Z By —C— MC, �� S LOCATION&GENERAL INFORMATION Location Address `S' Q—e p '� Owner's Name�7eJ 5-:C= CR.r4y8r�fil� Address V O, i3a)C (00 q -G1v w�3 Assessor'sMap/ParceL 2'"s ` � 00 l ,Engineer's Name :�G`-Q/-�I�-�j1,+.e,( a x 7 NEW CONSTRUCTION REPAIR Telephone# �Q —7 7�--tl 7 land Use Slopes(%) Surface Stones Distances from: Open Water Body �— ft Possible Wet Area 0"14--ft Drinking Water Well "-r ft rU v Drainage Way ft Property Line l 2V ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Peru tests,locate wetlands in proximity to holes) 6�3— Parent material(geologic) l.)/ V"C, Depth to Bedrock AJ/A Depth to Groundwater: Standing Water in Hole: J 2S Weeping from Pit Face A-Y n- Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date Time Observation Z, Hole# Time at 9" Depth of Pere Y ) ((,, O Time at 6" Start Pre-soak Time Q G X Time \ ff%6") End Pre-soak Rate Min./Inch Z� Site Suitability Assessment: Site Passed (Y Site Failed: Additional Testing Needed(YRN) Original:Public Health Division, Observation Hole Data To Be Completed on Back— w ***If percolation test is to be conducted within 100'of wetland,you must first notify the " Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC r. � x _ i DEEP OBSERVATION HOLE'LOG Hole:# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(m.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 5l® um DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. �p Consistency.%Gravell A VS 9 cj ya I(Z. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Stuface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency_%Gravel) Flood Insurance Rate May; Above 500 year flood boundary No_ Yes Within 500 year boundary No , Yes \Within l00 year flood boundary No X Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring perviou ma erial? Certification i at.4q I certify that on 1'i (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required tr ' ing,expertise and experience described in 310 CMR 15.017. X; Date I 4a Signatures" 'S QASEPTIC\PERCFORM.DOC } Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is 26 2009 April H Hyannis MA 02601 required for Y every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. ImpoWhen filling A. General Information When filling out forms on the onlycompthe tab key r,use 1. Inspector: to move your David D. Coughanowr cursor-do not Name of Inspector use the return key. Eco-Tech Environmental Company Name 43 Triangle Circle Company Address Sandwich MA 02563 City/Town State Zip Code 508 364 0894 1328 Telephone Number License Number B. Certification certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑' Fails ❑ Needs Further Evaluation by the Local Approving Authority ply Aril 26, 2009 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 required for y April 26, 2009 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Inspector's Note==> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed in section D. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for p every page. City/Town . State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N FIND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for y P every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09/08 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26 2009 required for Y P , every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a. mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. (Sins•09/08 Title 5 Official Insperfion Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 A rll 26, 2009 required for y P every page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3-assessor DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form. _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for Y P every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 290 gpd g ( Y 9 (gpd)): Detail: 2007-2008 Sump pump? ❑ Yes ® No Last date of occupancy: undeterminedDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G,M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for Y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): l5ins-09/08 Title 5 Official Irspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for y P every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Age: 2 years. Certificate of compliance for repair issued 5/9/2006 (Permit#2006-206) Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): No evidence of leakage or backup into dwelling was observed. Septic Tank(locate on site plan): Depth below grade: 0.5 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5 ft x 5 ft x 5 ft(1000 gallon) Sludge depth: 6 in t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 417 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for Y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28 in Scum thickness 2 in Distance from top of scum to top of outlet tee or baffle 9 in Distance from bottom of scum to bottom of outlet tee or baffle 13 in How were dimensions determined? Permit application Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not required at this time but maintenance pumping is recommended within and every two years. Tank and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was observed. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is rll 26, 2009 Hyannis MA 02601 A required for H Y P every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.)`. *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�M ,�•''F 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 April 26 required for Y p �il , 2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert at outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box appears structurally sound with no evidence of leakage in or out. Few solids in sump. No staining was observed above the operating level. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form ;. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for Y p every page. City/Town State Zip Code Date of Inspection D. System Information (coot.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 1 ❑ 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.): Soils above leaching gallery appeared unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. An observation hole was dug into leaching gallery stone and no standing effluent was observed in the stone or overlying soils. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top.of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 Aril 26, 2009 required for y P every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 A rll 26 2009 required for y p , every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately LEACHING GALLERY 3 ° ° ° LOCATIONS Z A B SEPTIC ANK I 22 FL 27.5 FL °t 2 27.5 FL 32 ft 3 46.5 FL 36.5 ft 8 A EXISTING DWELLING # 15 W Z J Of W F 3I NOT TO SCALE OREO LANE l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 A rll 26, 2009 required for y P every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20+ 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. 5/4/2006 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Approved design plan on file with the Board of Health shows bottom of system to be 7.17 feet above the bottom of a witnessed test pit in which no water was encountered. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Oreo Lane Property Address Edivaldo Gonsalves et al Owner Owner's Name information is Hyannis MA 02601 April 26, 2009 required for y p every page. City/Town state Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 COMMONWEALTH OF �,r" ,,1v11�bS ACHU SETTS EXECUTIVE OFFICE OF ENwiRO'_v'MEN-T-, , 'F S DEPARTMENT OF ENVIRONMENTAL PROTECTION 1 q1 ©° TITLE 5 OFFICIAL INSPECTION FORM, —NOT FOR VOLUNTARY,-ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A nn CERTIFICATION Property Address: Z—C1 he-- Owner's Name: Owner's Address: / 5 S.D 1— G rt e Date of Inspection: Name of Inspector lease print)- Rr� Company Name: /I/!// O / E G Aj 77 Mailing Address: O QOX / ^ Telephone Number -5 0- ;,-, CJI i- CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my C 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 R 15.000). The system: Passes Conditionally Passes ire �er Evaluation by the Local Approving Authority Fails Inspector's Signature:Ins P g 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. 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 VOLL'INTTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A / CERTIFICATION (continued) Property Address: !,j (� 2 p L4 eye—_ // Owner: .1 — N 6-i,gyp Date of Inspection: p Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D Alf SSvvstem Passes: Y I have not found any information which indicates that any of the failure criteria described in 310 C_-MR 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 exfiltradon 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).T'ne system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed N-D explain: Titlo G Tncnortinn T•'n'rm(./1 S/7M(1 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESStiIENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ` nn CERTIFICATION(continued) Property Address: /J (�/�eO z—"V Owner: N G✓cam Date of Inspection: 0 6 C. Further Evaluation is Required by the Board of Health: / Conditions exist which require further evaluation q 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 CINM 15303(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 ?. 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 e SAS within a— Zone 1 of a pubhc water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply weH. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSYIENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: ©K z_-IL Owner: I Lf l)a 6 Date of Inspection: zc l 6 D. System Failure Criteria applicable to all systems: You must indicate "yes"or"no"to each of the following for all inspections: Yes 10 -Backup of sewage into facility or system component due to overloaded or cloaQved 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 cloQcred SAS or pool _✓ Ldid depth in cesspool is less than 6"below invert or available volume is less than %day flow _�Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number Mimes pumped _ ✓�Y 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 �Wzrfer supply. ✓_ fly rtion of a cesspool or privy is within a Zone I of a public well. _✓ y 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 analvsis. erf p ormed at a DEP certified Laboratory,for coIiform 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/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 Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• 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 drinldng 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 C'va. 15.304.The system owner should contact the appropriate regional office of the Department. Titlo : r­ o,*;,., �.�,,,�i�:i�nnn 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNT_-'tRY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: / Reo G S 1 � l '4 Owner: (4 kl::�T,1-0 Date of Inspection: Check if the following have been done. You must indicate"yes"or"no"as to each of the follow-ing: 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 ? _v = 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? J Were as built plans of the system obtained and examined?(If they were not available note as Was the facility or dwelling inspected for signs of sewage back up? c� Was the site inspected for signs of break out? v— 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 o _ o 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)) T tlo S incnAr*inn Fnr,n 1./7 VIAnn 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: �v1 dlc�rp Date of Inspection: of p RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design):---? Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: oI— Does residence have a garbage grinder(yes or no):/4 Is laundry on a separate sewage system yes or no):T� [if yes separate inspection required] Laundry system inspected(yes or no);/ Seasonal use: (yes or no):ZU/J Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): /Ub Last date of occupancy: cf t4 COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CIMR 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 INFO ON Pumping Records Source of information: Was system pumped as part of the inspection(yes or If yes, volume pumped: gallons--How was q antity pumped determined? Reason for pumpi &� TYP 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 f information: sir � Were sewage odors detected when arriving at the site(yes or no): IfIV Titlo f fncncntinn Fn�m (./1 S/7(1(1(1 6 t Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNT_4RY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM I/NFORMATION(continued) Property Address: / QP�� G—I-L/'/ 2 Owner: �(,l v►c��2 �rj��l ' �iJ Date of Inspection: Of BUILDING SEWER(locate osite plan) Depth below grade: l Materials of construction:_cast iron _4 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: 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) � X " , Dimensions: Sludge depth: Z/- Distance from top of sly/ge to bottom of outlet tee or baffle: Scum thickness: dZ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom ooptlet tee or baffle: f How were dimensions determined: `o.e 2(,4 C Comments(on pumping recommendations,inlet and outlet t e or baffle condition,structural integrity, liquid levels as r)ated to outlet invert, v>dence of eakage,etc.): � G�� a �� o� ties GREASE TRAP (locate on site plan) Depth below grade: Material of construction:_concrete_metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments (on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity; liquid levels as related to outlet invert, evidence of leakage,etc.): Tit,- : Incnn r;nn Rnrm 4/1</7nnn 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: 0 Owner: L—C4�/TG✓p Date of Inspection: p TIGHT or HOLDING TANK:&(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal_fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/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: �(ifpresent must be o en / p ed)(locate on site plan) Depth of liquid level above outlet invert: (�►✓t 55 B� d 7 Comments(note if box is level and distribution to outlets�equal,any evidence of solids carryover; any evidence of leakage into or out of box, etc.): PUMP CHAMBER:i (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.): Tilo S Tncnortinn,Fnrm �/7�;7M(1 8' Page 9 of 11 OFFICIAL INSPECTION FORIM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORIM, PART C SY STEM INFORMATION(continued) Property Address: !�e0 '/_4z �s G 'Its D Owner: '/_C4►A GvW Date of Inspection: 02 D SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: �eachingpiis, number:_ leaching chambers,number: leaching galleries,number: leaching trenches, number, length: leaching fields,number, dimensions: 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.): CESSPOOLS: cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no):- Comments(note condition of soil, signs of hydraulic failure,Ievel of ponding,condition of vegetation, etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation etc.): T;tic ; Tic.... 411:/7nfln 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORyi PART C SYSTEM INFORMATION(continued) Property Address: /J Owner: L— U V1,n1-O Date of Inspection: a 0 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.Locate where public water su ly enters the building. w lL/ a r, i 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORNI PART C SYSTEM INFORMATION(continued) Property Address: LS �geo Z_e_ Owner: ��dLt~0-,o Date of Inspection: C, SITE EXAM Slope Surface water Check cellar Shallow wells , r Estimated depth to groundwater feet Please indicate (check)all methods used to determine the high ground water elevation: Obtain om system design plans on record-If checked,date of design plan reviewed: O rved site(abutting property/observation hole wi 50 feet of SAS) hecked with local Board of Health-explain: CS -7 Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation, � v�7 tn'rA;1C j CiC(-- D''1C71 Titio G inenortinn G'nrm�ii si�nnn 11 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems. Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM herebycertify that the fy engineered plan signed b me p � Y dated- e7lZ' tx, concerning the property located at V 5 0Z E0 LJAJ � U) �riiT T meets. all of the following criteria: • This failed system is.connected to a residential dwelling only...There.are.no.commercial or business uses.associated with the.dwelling. • The.soil is classified as.CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests.at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwat er table using the. . . Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) ,,a© B) G.W. Elevation 5 +adjustment for high G.W. _ DIFFERENCE 7TWEEN A and SIGNED : - DATE: 2, Q NOTICE Based upon the above information, a repair permit will be issued for bedrooms s maximum.. No additional bedroom are authorized in the future without engineered septic system plans. M C gASepdc\percexemp.doc h � s _ TOWN =2= LOCATION 1�R►E0 A SEWAGE# C9�" VILLAGE Ji ASSESSOR'S MAP&PARCEL 1Y1 INSTALLERS NAME& HONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)V,- (size) NO. OF BEDROOMS �'` OWNER /�2✓� PERMIT DATE: OMPLIANCE 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 t - - F S3 �� ' No. '�ti��� t Fee 00 — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for 3h5pont i§p5tem Cons�trurtion permit Application for a Permit to Construct O Repair( Upgrade O Abandon O :,p_e ompiete System kindividual Components Location Address or Lot No. ! Q e-E© L p tJ`le Owner's Name,Address,and Tel.No. Assessor's Map/parcel -4- O-® Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: 2 Dwelling No.of Bedrooms 3 Lot Size 1 s GOO sq.ft. Garbage Grinder Other Type of Building rA CK1a No.of Persons Showers( Cafeteria Other Fixtures LCasJC��c �. yc�kCs� ,�1� �3�j(1c Design Flow(min.required) � �® gpd Design flow provided �►�© gpd Plan Date ` Z'C)lo Number of sheets ' ttRevision Date Title Ci t�a�2 �C �`40ZM 0 WALl CCQ Size of Septic Tank �" t�^y. �,pQ® c"ca` Type of S.A. J1�l�il,--u�y-mszs Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: / Agreement: f 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 nvironme �ed not to place the system in operation until a Certificate of Compliance has been issued by this Board of alth. Sign _ o ate Application Approved by ate Application Disapproved by: Date for the following reasons Permit No. i Date Issued No. _q Fee Go _. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: � ..PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z(ppYication for �Digogal *pgtem Construction Permit Application for a Permit to Construct O Repair Upgrade O Abandon O ,Momplete System�Individual Components Location Address or Lot No. I Jr EZ O L IW►,3 Z Owner's Name,Address,and Tel.No. lam• ia�ratiNtSPO1t� ` Assessor's Map/Parcel 2—Li-4- 1 1 41 ' op, V 1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. if C 0v. S, CS , A Lk Le-Ze ob 5 b"( 9 Uto Type of Building: Dwelling No.of Bedrooms Lot Size US ,bOO sq. ft. Garbage Grinder (J /#N Other Type of Building No.of Persons 3 Showers( k).'Cafeteria { Other Fixtures ('Var-, IFS\<-A-- Design Flow(min.required) � gpd Design flow provided ������ gpd Plan Date .5` Z"C) Number of sheets ' Revision Date TitleC � Size of Septic Tank &t S� l,00O ( A Q Type of S.A.S. ! Description of Soil I X -6 X 1 Nature of Repai s or Alterations(Answer when applicable) W. e @ 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 nvironmental CC od—`e and not to place the system in operation until a Certificate of Compliance has been issued by this Board of 'pith. Sign / oi j- ate S k Application Approved by Uv/ ate } Application Disapproved by: Date for the following reasons i Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTI Y, hat the On-site Sewage Disposal System Constructed ( ) Repaired ( Z) UPgraded ( ) Abandoned( )by o ene l at UgeD L,,7 has'been copstructe4 i / ordance with the provisi ns of Title 5 and the for Disposal System Construction Permit No. — 4l/ dated Installer ✓G/f79Gy f/Sy G!� Designer #bedrooms Approved design flow -�C�> _ gpd f t ^«»I The issuance of this permit shall not be construed as a guarantee that the system will fui ction as e g d Date /9 Inspector �� vw- — ——————--———————————————————————— ———---——— — Fee THE COMMONWEALTH OF MASSACHUSETTS ` PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS =igpogall*pgtemt Con!truction Permit Permission is hereby granted to Construct ( ) Repair (✓) Up r de b o ) System located at Xs 45%2e0 �;;, ? and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty and the following local provisions or special conditions. to comply with Title 5 PY g p Provided: Con c-i u t be completed within three years of the date of th a it Date Approved by I� Town of Barnstable °Ft"E'°', Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, MA SS.9. � Public Health Division p'fa"A°�A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: S-9— b(p Designer: Shay Environmental Services, Inc. Installer: Address: P.O. Box 627 Address: East Falmouth, MA 02536 c-CUA3-�CV LA A On Mo � -N was issued a permit to install a (date) (ins 1 er) septic system at \ 5 n 2C.o (�A I V\-c„PcN ks based on a design drawn by (address). \-- Shay Environmental Services, Inc. dated (designer) I 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�yp) but in accordance with State & Local Regulations. Plan revision or certified a fbu'7R,�'�. designer to follow. N OF MgSO� . a CARMEN YfWaller'lNgnature) E. �-A SHAY � No. 1181 0 GISTS s PN ( esigne ignature) (Affix Desi p 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 LOCATION 15 QRE0 L4 SEWAGE# (9—e;10� •r. VILLAGE ASSESSOR'S MAP&PARCEL /y/ c�®/ INSTALLERS NAME& .HONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �G� (size) NO.OF BEDROOMS OWNER / Z+ PERMIT DATE: OMPLIANCE DATE: s Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet..of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY i *T ---� T-, S i 9 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall). DATE: t)&I I j6 J 0( fill in please: APPLICANT'S YOUR NAME: \PRc-ev-i-A Mc12Gf A .y e v S � BUSINESS YOUR HOME ADDRESS: 1.S OP— L-ni (50 66-Lill 3 #yA MA/ 5901Z.I M. A- TELEPHONE # Home Telephone Number: (-<CA) w60 -L4'1 it 3 NAME OF NEW BUSINESS tf Cit cur TYPE fJF EUSINESS # t� ,u peT 1S THIS A HOME t;3CCUPATION? YES T N`Have you been:given apprs v l frQm the burld�ng'd�v�s on? YES NO "- ADpRES OF BUSINESS ` -� `"� I PM.R" a .. Mf'�IF* IEk, NUN(RER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMM NER'S OFFICE This individuWen irtfor pf any permit requirements that pertain to this type of business. �uthonzed Si a re** COMMENTS: �U rU,� 2. BOARD OF HEALTH s i med f the permit requirements that pertain to this type of business. This individual has b en for p q p yp Autliorized ignature** COMMENTS: _ r S r� C 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ham en i med of jjll gg requirements that pertain to this type of business. Authorized Signature** G�- tf COMMENTS: J r „f xF Date: y /0 / a6 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS:8/20",4 V U--gjA Gu.vj'NG-, BUSINESS LOCATION: S OP-EO 1.N \PC--SI AyXyn,;sfbrcl-A,,,a 22 6a49Z INVENTORY MAILINGADDRESS: 1S G9-EU LAI — WEST Hy,4A,,,,,sPop-7 ?4p OaG Q1 TOTAL AMOUNT- TELEPHONE NUMBER6,M) 860 - Li '1 9 CONTACT PERSON:0ACey-i A 1AEN0E S EMERGENCY CONTACT TELEPHONE NUMBER:_-7714 - L101 _8 3 S1 MSDS ON SITE? TYPE OF BUSINESS: i-IOUSC- CLEAiiAIG, INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous.waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint & varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers J ,f nu i r 6Li2 A 4, A- , +-cy-i 4-Ga /) /Q,4itcluding bleach) � -k :G r(Avi. ti1fYKja►t.)IA#AO Spot removers &cleaning fluids IISf n All Ma j3.-ts,Z� n o /IQOd� (dry cleaners) I'SU012-SX i Other cleaning solvents (,t Q A4 Mom, Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS ITOWN OF BARN STABLE F' LOCATION_ �-� Z O C e6 SEWAGE # VILLAGE 6C T ASSESSOR'S MAP & .LOT INSTALLER'S NAME &,.-PHONE NO, a -� ��v -77 1'3(ol 7 SEPTIC TANK CAPACITY I , U �► '� ����" S LEACHING FACILITY:(type) L.Q kGL'1 `4 t (size) (0®o J ltj 'i S QNO. OF BEDROOMS PRIVATE WELL OQt PUBLIC WATER BUILDER OR OWNER G 4`�ev�\"J "?u° C�<0 DATE PERMIT ISSUED: v DATE COMPLIANCE ISSUED: r VARIANCE GRANTED: Yes r - 0 L of Z THE COMMONWEALTH OF MASSACHUSETTS _ BOAR® O H SALT Apptiration for Bispoiial Works Tomitraar#ion Vamit Applicati n is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: �Locat�ion- dress �j //��,p�{or t /No. ....................""--..._.. '" Y a.... • .. ............................. A�-- /....kl. � _ ow Addsg�s /� � ..... .. •-••-"-""--'-'- ................... r .......... .... ---- Insta ler Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms... P ................Expansion Attic ( Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow...............: . --gallons per person per day. Total daily flow.........................S.... .__..gallons. WSeptic Tank—Liquid capacity.thOUallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter............---..... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) •-' Percolation Test Results Performed by.......................................................................... Date.........................--•-••••-- 1.4 Test Pit No. 1 .minutes per inch Depth of Test Pit.................... Depth to ground water----_ 44 Test Pit No. 2-----�a`...minutes per inch Depth of Test Pit.................... Depth to ground water......................... 19 ................................. •. --I- Descriptionof Soil......................................................................... -----------------------•-••---••....... W ------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ U Nature of Repairs or Alterations—Answer when applicable................................................................................................ Z.. •------------------------------•-•------------------•--•---------•----------------.......-----•----------------------------------------•-•---••--••-•••-•••-••........._......----•-••................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI 11,L 5 of the State Sanitary Code— The undersigned furfher ag es to place the system in operation until a Certificate of Compliance has been issue by the board o h lth. �j Signed ------------------ = O--...-•-••••.•-•-....-- '•-•••• �'... .....-- Date Application Approved By-••-•-••-•--`� .. _ ,.... -------••••••. . ate �P- J Date Application Disapproved for the following reasons:-----•--------------------------------------------------------------------•-----....--•-••......--•••----•''••. --------------------•----••--•-----•------•-'.........--------••--....---•--------........-•--------...--••---•••----•••--•••---•--•------•------••-•••-------••----••-•-•-----••••••-•----••-••---••--- Permit No........ �� 1- ._ Issued_________________________ ..)k............Da.e ........... ..^�-----•-------- Date �......................... No.--- Fps...... j`.....: ` THE COMMONWEALTH OF MASSACHUSETTS _ BOARD Off` HEALTH - 1 -. :..........oF............... �� S�,, 5�`Q.............................. ApplirFation for Uhipmal Works Cnomitrnrtinn Vrrmit Application is hereby made for a Permit to Construct (4� or Repair ( ) an Individual Sewage Disposal System at Location-A dress or Lot No. ................................. n,.....c.K a.✓/ d= �t-._.�ls�.... f' . WAd dressOwn...... ................. .......................••-...g ....... er YInsta-ler Address Q Type of Building Size feetq.Lot............................ US Dwelling—No. of Bedrooms.........it-..` .._................Expansion Attic ( Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — CafeteriaOther ( ) Q Designfixtures .....------•----•----•.................•----•--•------........-------------•--•------••--.........-----------•-•--••----•----.......•-----...--------- allons per person per day. Total daily flow._ -�- g P P P Y• Y �- .�---l-� ---dons. � Septic Tank -_----Li ui� � --• - ------------------ -- �}-- p q capacity..�Fi gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.........._---------sq. ft. x Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.................................•-••-----------•-----------------••••---- Date........................................ Test Pit No. 1_<:n.$�5.minutes per inch Depth of Test Pit-------------------- Depth to ground water..._..rr ! � fs, Test Pit No. 2......<y�minutes per inch Depth of Test Pit.................... Depth to ground water------_................. -•------•....................••-• -..---- o ® _ C:'i ti; 54�-------------------- Description of Soil f --- ----- - -- -------------- W VNature of Repairs or Alterations—Answer when applicable......_......................................................................................... ---------------------------------•-•-------------------------------------------••••---------•....-••---------------------•-------•-•-•---------•-••-----------------•--••••••--•--•-----........---•-••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 'T:IE 5 of the State Sanitary Code—The undersigned furtheyagr..-es of to place the system in operation until a Certificate of Compliance has been issued by the board oiealth. Signed _ ' - <�fTT t4 ...... Date Application Approved By............. ' ------------ " Date Application Disapproved for the following reasons______________________________ ._ .............. --------------------•--.....-•-----•----............---•-----._........----------.......------------•---......•..-•------•--------------------•-----•------•-•------------•------...-----••-----....----- Date Permit No.------ -�f Issued---------------------------------------------------•••-- Dste THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r :- ..........OF................. . ;. . � .1- / ....................... Trrfifiratr of Tomph anrr THIS IS TO CERTIFY, That the Individu Sewage Dis al System constructed ( or Repaired ( ) by................................... . . ' ......................•----------....----._..._.......... --- ................... -�, _ Inst ler _ 1 �1.. /f -� &�,�rt.ft.�. has been installed in accordance with the provisions of TIT Z 5 of The State Sanitary Code as described irP the application for Disposal Works Construction Permit No........ _-._ _...._ dated------ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CON;�R ED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. i DATE....................(. .'..3. , ............................... Inspector............................ ..................................... THE COMMONWEALTH OF MASSACHUSETTS r. BOARD OF EALTH r' .)4,V OF ��Y l �............... a ...../q,�. .. ................... .......... ..,....;.. No....��..: FEE.....>.�....... RspoiiFal Works O'EkIanitrnrtion rmit Permission 's hereby granted..................... "-!j.........�J-UA- .......................................................... to Construct (, ') or Repair ( ) an Indivi ual Sewage Disposal System at No. - Street as shown on the application for Disposal Works Constructio ermit�jNo.-j�c_�O..C/._ AD :___........ oard of BS FORM 1255 O & ARREN, INC., PUBLISHERS t —— ——EXISTING CONTOUR St LOCUS N x 100.98 EXISTING SPOT GRADE F9_71 PROPOSED CONTOUR O f \II/ EXISTING WATER SERVICE o a --+JGVN--UNDERGROUND WIRES Pena o T Way = TEST PIT _ o a BENCHMARK a 3 LEGEND Chadwick Ave Craigville Beach Road v7 X 7 G(ee(\ Dunes v � m LOCUS MAP NOT TO SCALE ABUTTING HOUSE IP FND 98.17 ' FENCE. 98•81� 100.00' x 98.83 _ __ 0 77-7 25' 97.41 'PROPOSED.S . P 1 00 \ ._ O 6 aN EXISTING S.A.S. (PER RECORD AS—BUILT) �ic 98A1••... TP-2' _ - ;�BZ TO BE ABANDONED I 34' SWING SET x 98,51 98.05 98, 9 // 0 0 / o SHEDLO 9 ,14 98,87 x � 98.57 98•4 BENCHMARK SET OUTSIDE CDR./BULKHEAD -- - �-EX/577NG'SEPTIC TANK — --� __ I- -_x 97.62.E-- _ _EL.=]00_84 - TOP OF TANK, EL.=98.58 \ I IN (OUT) 97.25E \ 1 / BM \ x 98,85 1 O 100.84 9 8 // TU0,1 ^) lOQS� x DECK \ k 98.96 \ EXISTING 00.27 1 HOUSE(#15) I IT.O.F.=101.8E r— x 98.61 �00.2 10b,33 �•100.28: 1 x — 99,48 x I x I 100.57 x 99.3 a GS KLOT 2 ::CONCRETE.: I MBL 247"l 41-001 X .DRIVEWAY. • I 99,71 x 14,7\\24 ±SF 100,29 � x —_ 100419 100,19' 100.00 100.00' 1��II — UTILI edge of gravel road 99.87 98.62 99.24 g 0R 1 0 LANE OF M4Ss9��G PETER T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN McENTEE CIVIL `� 15 OREO LANE, CENTERVILLE, MA No. 35109 £GISTE`�\� `� Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 �OF 0 NG� Engineering by: SCALE DRAWN JOB. NO. OWNR OF RECORD Engineering� Works, Inc. 1"=20' P.T.M. 148-14 (�, DUNN, JESSICA A P.O. BOX 609 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. I HYANNIS PORT, MA 02647 (508) 477-5313 5/6/14 P.T.M. 1 Of 2 0 q NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:96.0 FOR A DISTANCE OF 15' AROUND THE SEPTIC TANK PROPOSED D-BOX PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET & OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & COVER PROPOSED S.A.S. SET TO 6" OF GRADE INSTALL RISER & COVER OVER EACH CHAMBER AND T.O.F.=101.8t SET TO 3' OF F.G. TO SERVE AS INSPECTION PORTS F.G. EL.=100.2t F.G. EL.=99.0t F.G. EL.=98.7t F.G. EL.=98.7(max.) t>SNow 3'(max.) L = 41' _ 5® S=1% (MIN.) 4"SCH40 PVC 4`SCH40 PVC 2` LAYER OF 1/8" TO 1/2" 6" DOUBLE WASHED STONE 10"I ^ 14^ B as as (OR APPROVED FlLTER FABRIC) aaa BBB a®BBB®B EXISTING 48" LIQUID aaaaaaa -3/4" TO 1-1/2" DOUBLE LEVEL WASHED STONE GAS PROPOSED 4' 4.8' 4' INV.=95.77 INV.=95.60 INV.=97.25t D-BOX EFFECTIVE WIDTH = 12.8' EXISTING 3 OUTLETS INV=95.50 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED TOP CONC. ELEV.=96.3t NOTES: BREAKOUT ELEV.=96.0 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=95.50 ease ease INVERTS, PRIOR TO INSTALLATION. mamma mmmmm 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=93.50 GRADE ON A MECHANICALLY COMPACTED SIX 4' 2 X 8.5'=17.0' 4' INCH CRUSHED STONE BASE, AS SPECIFIED 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' IN 310 CMR 15.221(2). PERVIOUS MATERIAL 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL.=87.3 AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. (NO GROUNDWATER) SEPTIC SYSTEM PROFILE SOIL LOG DATE: MAY 2, 2014 (REF#14,359) SOIL EVALUATOR: PETER McENTEE PE(SE#1542) WITNESS: THOMAS McKEAN R.S. HEALTH AGENT EXISTING ELEy. TP-1 DEPTH ELEv. TP-2 DEPTH HOUSE(#15) 98.7 0" 98.8 A 0" T.O.F.-1 0 1.8f LOAMY SAND / FILL 10YR 4/2 98.3 g" B 95.7 C 36" LOAMY SAND 10YR 5/8 DECK _ _ __ 96 s -- - --- -- - - _ _ 24" MED. SAND C PERC 2.5Y 6/4 E 42"/54" SOME DEBRIS MED. SAND FROM OLD 2.5Y 6/4 TEST HOLE M C14 88.7 120" 87.3 138" ���` PERC RATE <2 MIN/IN. ("C" HORIZON) o, NO GROUNDWATER ENCOUNTERED SHED GENERAL NOTES: LO 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. ON 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS O. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE N LOCAL RULES AND REGULATIONS. ---- 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE a0 DESIGN ENGINEER. N' R OSED S.A.S. ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. f`-25' -I 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF S.A.S. LAYOUT THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. DESIGN CRITERIA 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS - NUMBER OF BEDROOMS: 3 BEDROOMS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY DESIGN PERCOLATION RATE: <2 MIN/IN THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. DAILY FLOW: 330 GPD 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS DESIGN FLOW: 330 GPD IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND GARBAGE GRINDER: NO-not allowed with design REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. .74 GPD/SF 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND EXISTING SEPTIC TANK: 1000 GALLON CAPACITY NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 15 OREO LANE, CENTERVILLE, MA SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. 471.2 S.F. Engineering Works, Inc. N.T.S. P.T.M. 148-14 TOTALAREA:..................................................... 9 9 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 4 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD (508) 477-5313 5/6/14 P.T.M. 2 Of 2 t i �fi. FES *NOTE: ALL PIPES ARE TO BE 4' SCHEDULE 40 P.V.C. SECTION A -A ALL ol11LET PBOX FROM THE pi oISRIBunaN eox sHA+.L BE 10' min. from PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET� Foe AT�T 2 FT. CONCREHE COVERhouse to s tic tank D-BOX cover must be ,A»Existing Foundation tattle coven must ba hip 6 in. of finshed grade 'r- _ 3-r ounu ; _• , "" M`Septic 3' of 1/6' - 1/2' Washed Peaston KNOCK01JT5Swndeifnp +` T.O.F. elev. 100.00 within 6 in. of finished grade Grade over D-Box-97.00 over SAS- 97.00 a\. "`- • Grade over Septic Tank- 96.00 � ��'Ode 3/4• to 1 1/2 ' Washed Crushed Stone dt Mrs. � /r/ s's• ounce t +r 4'PVC(CAPPED)MSPECIION PORT TO BE 'la S = 0.02 3 HOLE Tap OF Sywt -- Elev. -94.75 NSrAUID AND TO BE 1NhRN 6.OF GRADE _ +� L c 1i Vks•Llt (H-10) DIST. BOX 3' Moxirtemt Covert 155' �' ~ N 16. S-0.D1 or greats 0"Effecttvs Depth 1.75' Reds";�s �,^+Wr n EXIST. 1,000 GA S= 0.010" foot 0 +^ A° "a�v EXIST.PIPESEPnc TANK zs' PLAN SECTION CROSS-SECTION 1 0.83' (10 inches) C r r f / iMf t d O 7-10_ti-�/ H-10 c� 0 5 Units 2 625' = 30, 'o » CONCRETE FULL.RJUNCVI p g at at +� 3' :3 Sa 1 Av 3 HOLE H-10 DISTRIBUTION BOX , !! "'-' o N rn Ki 31.25 °•w l' r- of NOT TO SCALE a li tRd SYSTEM PROFILE o 3.5' 3.5' q 37.25 a ,t 0 uKNOM Effective Length Not to Scale 0 0' 'o SOIL ABSORPTION SYSTEM (SAS) GENERAL NOTES < Effect Ne Vldth e 6 ln.of 3/+'-1 1/2 of -% INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN NOTE. ° ALL COMPONENTS MUST HAVE RISERS TO WITHIN s' BELOW GRADE compacted atom1. Contractor is responsible for Digsafe notification, Verification of Utilities wBottom of Test Hole 1 Elev.-B6.0o m (OR EOUNALENT) Not to Scale and protection of all underground utilities and pipes. Groundwater Observed - NONE OBSERVED NOTE OVERALL HEIGHT OF INFILTRATOR IS 18' /EFFECnVE HEIGHT IS 10" 2. The septic"tank and distribution box shall be set level on 6 of 3/4"-1 1/2" stone. 3. Bockfill should be clean sand or gravel with no stones over 3" in size. 4. This system is subject to inspection during installation PERCOLATION TEST by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance Date of Percolation Test MAY 1, 2006 with Title V of the Massachusetts state code, the approved plan Test Performed By. CARMEN E. SHAY, R.S., C.S.E. and Local Regulations. Results Witnessed By: WAIVER (Per Barnstable B.O.H.) 6. If, during installation the contractor encounters any 96 soil conditions or site conditions that are different EXCAVATOR: Shay Env. Svcs. Percolation Rate: Less Than 2 MPI 0 36' TIT from those shown on the soil log or in our design ' installation must halt do immediate notification be 1'DO)�00 Test Hole Test Hole ,g6 made to Carmen E. Shay - Environmental Services, Inc. No. 1 No, 2 7. No vehicle or heavy machinery shall drive over the DEPTH SOILS ELEV. DEPTH SOILS ELEV. septic system unless noted as H-20 septic components. 0 97.00 0 97 00 // 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. Sandy Loam Sandy Lin TEST HOLE #2 �� 9. All Distribution Lines shall be 4 diameter Schedule 40 NSF PVC pipes. ELEV.= 97.00 �� 42.6' 10. All solid piping, tees do fittings shall be 4" diameter 10 YR 3/2 10 YR 3/2 ' 0"-6' A, 96•50 0'-6- Ae 96.50 ® �`��`_--- --'/ Schedule 40 NSF PVC pipes with water tight joints. 11. Municipal Water is Connected to ALL OF The Residence and Abutting Loam LOOM Failed Sandy TEST HOLE 11 Properties Within 150 Feet. am 10 YR 5/6 10 YR 5/6 Leach Plt ELEV.= 97.00 THE PROPERTY LINES ARE APPROXIMATE AND Ei"- 36'1 ee 94.00 6-_ 36- ee 94.00 , COMPILED FROM THE SURVEY PLAN GENERATED BY Medium/Coarse Medium/Coarse 37.25 BENCHMARK SURVEYING OF MASHPEE, MA Sand Sand D-Box ti_: ?- ENTITLED "CERTIFIED PLOT PLAN OF LOT #2 OREO LANE, 2.5 Y 7/4 25 Y 7/4 W. HYANNISPORT, MA, DATED OCTOBER 6, 1988 3s'- 132 C, 3s 132 G � • ;'-i r t• : -, �„ ; �_�t=`` AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN / C aii Lf' PROJECT BENCH MARK ,% r- IT SHOULD BE USED FOR NO PURPOSE OTHER THAN O I zz THE SEPTIC SYSTEM INSTALLATION. TOP OF FOUNDATION ga I I ELEV. = 100.00 (Assumed) I EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE 1 I -J zo' L_ EXIST. 1,000 GAL. `� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE SEPTIC TANK FROM THE EXISTING LEACH PIT TO BE DISPOSED OF AS PER BOARD OF HEALTH SPECIFICATIONS. TOT #3 rDE'C K '� O LOT #1 n-HERE-ARE NO WETLANDS ARE PRESENT WITHIN_200' OF THE PROPERTY Perc #1 Depth to Perc: 36' to 54" �� b Perc Rate= 2 MPI #f5 ASSESSORS MAP 247 PARCEL 141/001 Groundwater Not Observed LEGEND No Observed ESHWT Zb EXISTING ADJUSTED H2O Elev. = None O; 3 BEDROOM HOUSE 104X1 DENOTES PROPOSED � 2-18•DIAM. ACCESS MANHOLES SPOT GRADE g �tp �__ ,.,;, Y, �_. ._, :7 X 104.46 DENOTES EXISTING ,R --- .y -.j �. I I SPOT GRADE I I PL PROPERTY LINE 01J LOT #z 96P PROPOSED CONTOUR JET .� i EXISTING CONTOUR THE ACCESS COVERS FOR THE SEPTIC TANG, 15,000 Square Feet +/- - -- --a I EXIST. I DISTRIBUTION BOX AND LEACHIttG COMPONENT DRIVEWAY -97 SET DEEPER THAN 6 INCHES BELOW FINISHED -« :" ` '` �: ~• r GRADE SHALL BE RAIS To 1MTHM 6" OF ED I I ' STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE DEEP TEST HOLE & PLAN VIEW '" "'-L T"E-nT 01 E`"�BAFFl_Es°R E "`� = ® � I I PERCOLATION TEST LOCATION /-3-24• RfUCIV COVERS 100.00' 6 FOOT STOCKADE FENCE -Y min. clearance 13' IItET NLET Et" min T- 2'min. inlet to outlet s.mti.ever - -� - OUTLET 1�m� UWTT PLOT P LAN 5' _7• �5. -r am go" r =: b�Pth O R E O ;A NE � j (40 FOOT RIGHT OF WAY) OF PROPOSED SEPTIC SYSTEM UPGRADE _7 - - _ -, PREPARED FOR CROSS SECTION y END-SECTION MS . E LAI N E M O NTOYA AT TYPICAL 1000 GALLON SEPTIC TANK # 15 0 R EO LANE NOT TO SCALE y Both Bedroom Bath Kitchen WEST H YA N N I S P O RT, M A Design Calculations OF Number of Bedrooms: 3 Bedroom EXISTING Bedroom Bedroom y����N Sqc PREPARED BY: Garbage Grinder. No C E yG ' CARNEW E SHAY Leaching Capacity Required: 330 Gal./Day (MIN. PER TITLE V) Dining Living Room E. Septic Tank : - 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL Septic Tank. Storage Storage of 11 NVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of G2 min./inch Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons G� ER�� P.O. BOX 627 Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. 58 gallons 2nd Floor 1st Floor EAST FALMOUTH, MA 02536 Providing: = 331.80 gallons 0 20 4 50 ITAR °'� TEL/FAX : 508-539-7966 Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' of WASHED STONE 3 BR HOUSE FLOOR SCHEMATIC SCALE: 1„=20 DRAWN BY: CES DATE: MAY 2, 2006 ON THE ENDS. NO STONE UNDER. SCALE: 1"=20' PROJECT#SD911 FILENAME: SD911 PP.DWG SHEET 1 OF 1 20' MIN. 4 v M4 N J 10' MIN. l0 RINGER LA FW Ila I locus....... Q y BEACH RG. TOP OF ° ° FouNOA T�oN ° DESIGN C,�L CUL A TIONS __ _ CRAIGV,LLE ELEV.= RON 600 GALLON LEACH PIT -- ° WITH 4 ' OF 314"- 1 1/2" STONE INVERT NUMBER OF BEDROOMS 3 CENTERVILLE \� e ° ELEV= 5 J. Cl INVERT 12" MIN. COVER GARBAGE DISPOSAL no HARBOR � ° ELEV= 52. 0 0 a 4 ° e ° ° n e ° ° INVERT INVERT INVERT e = 51 . 70 49.50 53.5 \\ e ELEV- ELEV= So. 70 / ELEV= � TOTAL ESTIMA TED FLOW 2' LEVEL ° �` 2" 2 OF 1 4"- 1 (110 GAL./BR./DA Y X 3 BR. 330 WASHED STONE SEPTIC REQUIRED SEPC TANK CAPACITY 66o LOCH LION MAP e e ACTUAL SIZE OF SEPTIC TANK 1 0 0 0 ; 50.5o LEACHING AREA REQUIREMENTS e IN VER `` . e ° e ° ° ° ELEV= I I SIDEWALL AREA 2.5o GAL./S.F. 439.82 S.F. / 53.94 GALLON SEPTIC TANK DISTRIBUTION 4. 0 EFFECTIVE BOTTOM AREA I.00 GAL./ ACME ST1000 OR EQUIVALENT BOX DEPTH LEACHING CAPACITY (SIDEWALL-I-BOTTOM) 593. 76 . (175 . 929) (2 .50) + (153 . 94)( 1 ) 48'r 48 ,' RESERVE LEACHING CAPACITY 593 . 76 stone - stone ELEV= 45.5 NO TES: SEP TI C S YS TEM PROFILE j 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO THE D.E.O.E TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULAT NO SCALE IONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 14 ' EFFECTIVE DIAMETER 2. NO CHANGE To THIS SYSTEM SHALL BE MADE UNLESS APPROVED IN WRITING BY BENCHMARK ENGINEERING ASSOCIATES. 3. A COPY OF THESE PLANS SHALL BE KEPT ON SITE DURING CONSTRUCTION. 4. A COPY OF THESE PLANS SHALL BE FURNISHED TO THE INSTALLER. 'I 5. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF Wl THSTANOING H-10 LOADING UNLESS PLACED UNDER OR WITHIN 10 GINGSOIL TES T FEET OF DRIVES OR PARKING AREAS, WHERE H-20 LOADING SHALL Eiq � � L NE BE USED.g �• 7 JULY 88 6. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 12' DATE OF SOIL TEST OF FINISHED GRADE. W1INESSED BY PEM/J. DUNNING PERCOLATION RATE -<2min /Inch 7. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE 15 MORTARED IN PLACE. OBSER VA �ION HOLE l OBSER VA TION HOLE 2 8. BEFORE BACKFILLING THE SYST,Ekf, THE INSTALLER SHALL NOTIFY - BENCHMARK ENGINEERING ASSOCIATES OR ME BOARD OF HEALTH EL E VA TION= 53 . 5 EL E VA TION= . TO INSPECT THE SYSTEM AS CONSTRUCTED. LOT 1 I _ 0" 9. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME �4.7 loam & sand UNLESS OTHERWISE NOTED. -- Y sub -36r� 10. HEAVY CONSTRUCTION EQUIPMENT SHALL NOT TRAVEL OVER THE SYSTEM DURING OR AFTER CONSTRUCTION. C3� 4 9.2 71. ANY EXISTING CESSPOOLS SHALL BE PUMPED OUT AND FILLED WITH SUITABLE MATERIAL. 12. ELEVATIONS SHOWN ARE BASED ON AN 52.9 F: �� �.-, 50 s/. / W � ASSUMED 55 . 3 \ ✓ �52 I Q sand 8r gravel BM, 'ELEVATION OF 50, 00. \ . 00 i - 144 �- ` 3. J xl 5 2 , NO WATER AT 14 4 ELEV.= 41.5 WA TER A T ELEV.= 55.4 j / r M 1 / future 54. 7 / garage Il proposed dr: O 53.4 I -- j 14, 724 sq. ft. LOT 2.+� L 1 S r- / � ro 2 4.0' / I TF - 59.05 I•l0'... O 55- 0 52. 6 proposed --------4 0- _ --- w / proposed /�� A 25 M house Site rn 3 9 septic �� �� ------ -- . 46 a- Sys torn ) S F F. = / - - - 156i50 / 24.0 S !r)� Test hole 5k F s DATE DESCRIPTION DRAWN BY CHECKED 54-\ 54.6 C)T I-' SITE AND SEPTIC PLAN h OF LOT 2 O REO LANE 53 .6 GRAPHIC SCALE LEGEND - 5 7 I _ _ - 4 �o 0 20 ,0 80 WEST H YA N N I S P O R T, MA . 1500052. , FOR. I 52. 8 0 - 54 EXISTING CONTOUR GREENBRIAR D E V. CORP . 0 53 .5• • - • • EXISTING SPOT ELEVAT!r;rJ ( IN FEET ) W ---"--5� PROPOSED CONTOIJ 7r i inch = 20 rt. JOB NO. SCALE: 1" = 20' DATE: 7/14 / 88 Ot I 54.5• PROPOSED SPOT ELEVATION DWG. NO. 62 D-/ DRAWN BY: L H /CAD CHECKE :r EXISTING H O L, E sI s LOT 3 O JACK, r BENCHMARK �`+`I ���Ek N 52.6t I SURVEYING & ENGINEERING ASSOCIATESw BM/ TOP OF CB = 50. 00 (assumed) AT HERITAGE GREEN P.O. BOX 1409 MASHPEE, MA 02649 ".� �r✓� 617-477-9870 " <r i J o r I I ,r r S;