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HomeMy WebLinkAbout0050 PATRICIA STREET - Health 50 Patricia Street Centerville A = 246 - 053 IN SMEAD No.2-153LOR UPC 12534 Sen"d.cam • Mwb In USA SFI OF n*SRMUM ° CERIIFlED SDURCING MNVWSFVM)C KKON TOWN OF BARNSTABLE LOCATION © cskt�C i e,� S� SEWAGE# 0 0 1 B ,3 7 7 VILLAGE ASSESSOR'S MAP&PARCEL kq G INSTALLER'S NAME&PHONE NO , SEPTIC TANK CAPACITY I MC* LEACHING FACILITY:(type) S-)O�'&Mb( (size) NO.OF BEDROOMS LI OWNER W& (5 PERMIT DATE: COMPLIANCE DATE: 01 a 7 18 __ll Separation Distance Between the: A300C (9(,X0)A)Y((�J 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 B_�O C� VJ OUT-- out- )& 2 - 30 - 3 - 32,5 3-3C7 3 = No. Fee l✓U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pliLation for bisposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(,') Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lo{ o. - ��'Y JG(G, 5 t- rOwner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 V& Woote�S Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling . No.of Bedrooms Lot Size /,Z,9q0 sq.ft. Garbage Grinder( ) Other Type of Building /t°$i cJ fj HC�I No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) t1 y0 gpd Design flow provided 115-G1r 7 gpd Plan Date // -2C)~ I jq Number of sheets Revision Date Title Size of Septic Tank /,5­a0 h -1 0 Type of S.A.S. �3 lD kym bim Description of Soil Nature of Repairs or Alterations(Answer when applicable) T nor,}Cti I sC 3ov Qc.110,j I CkA),-) ors 1 cV.9 I 1 1 -1 D 65 er4 t-C 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. tgne Date Application Approved by Date 1— Application Disapproved by Date for the following reasons Permit No. C Date Issued M No. �r ? a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTHtDIVISION - TO•WN`OF BARNSTABLE, MASSACHUSETTS Yes ftP Yitation for 3ksposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. c�N+� u I 11-e T "ctrr is f(" 5t Assessor's Map/Parcel 2 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �e�1�SA �ravv�l � ac Sob-yG�:�`-7/S�1 ',r ,�:°Pr;w G�✓/rS Type of Building: Dwelling No.of Bedrooms Lot Size /,2, N� sq.ft. Garbage Grinder( ) Other Type of Building (f;t C�A) fCj No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `/1/0 gpd Design flow provided q,S qi y gpd Plan Date // -?O-- 19 Number of sheets 2 Revision Date Title Size of Septic Tank / O Type of S.A.S. S CaU � h- 10 o t C Description of Soil }: Nature of Repairs or Alterations kA_nswer when applicable) „c.,}W, °/ �, T,,�,✓/c d b 3 kAmkf en s sh OLA) or 1 u 10A �� 11 '9-� - I 0 l�� Date last inspected:;` Agreement: , The undersigned agrees to ensure the construction and mainfenance-of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and-n ",ot to place the system mi in operation t1 Certificate of Compliance has been issued by this Board of Health. t St`gned`'"k' ' Date Application Approved by Date ' Application Disapproved by. f Date hfor the following reasons 1j Permit No. j .� �� Date Issued } - ----------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS i Certifitatt of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired((.�/ Upgraded( ) Abandoned( )by J G5 4 aLCR I)A) _ at A-*&j l I 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No j}?- dated Installer _ c 1 G S A 1 f ovj,� �-1j C Designer #bedrooms Approved design flow gpd The issuance of this permit sha• not be c-h trued as a guarantee that the syst will fimctio as deli >ed. Date Inspector, `. �.....-- ------------- -- -- -- -------------------------------------------------------- No. r Fee /ea THE COMMONWEALTH OF MASSACHUSETTS y PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Nsposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair Upgrade( ). Abandon( ) System located at 0 }QC,i`/ 1 I e't�'f �� 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 c/oemplleted within three years of the date of this per t. �, --�--�- 7 Date <:.Approved by •' I i "THE Town of Barnstable of r� yP� Regulatory Services BA Richard V. Scali,Interini Director � RNST1iBLE,M� "{�0 39. Public Health Division 39• �� APeDMA�" Thtfmas McKean,Director 200 Main Street,Hyannis,MA 0260.1 Office: 508-862-4644 Fax: 505-790-6_04 Installer & Designer Certification Forin Date: )���GI Sewage Permit# Assessor's ��a.p\Parcel Z`4T -�'-�� c Desi11 gner: t �tcrxflc� l�t� Installer: �_ A Address: )Z Wi C /cJ P— r-- Address: `� f /,� � �lLrSr ress: i` -C L Oil I a. — ( _ � R ..1 was issued a pertnit to install a (date) (installer) septic systt;in alb#` C ��C �, 4-t iv based on a design drawn by (address) Tn4eer'e79 tics:�1Cs ./tee dated { i b (designer) - OC 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 with the terns of the RA approval letters (il'applicable) ���y1a �SSgC� n.staller's Signature) cML No.35109 GISI (Desigler's—signature) (Affix DesiC, ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. C.ERTIFICAT:E OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORAM AND AS- BUILT CARD ARE RECEIVED BY THE B.AR VSTABLI PUBLIC :l L'ALTII DIVISION. THANK YOU. Q:'septi;:tvesigner Certification Form Rev 8-14-13.doe Engineers note:This certification is limited to an as-built inspection of system components as installed prior to backfill.The engineer did not supervise construction of the system.The installer assumes responsibility for all materials,workmanship,backfilling to specified grades with proper compaction and setting,isers.:covers as shown on tl;e design plan. ©0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pphtation for Misposaf *pstrm Construction 3permit Application for a Permit to Construct( ) Repair(,1 Upgrade( ) Abandon( ) ❑Complete System %Individual Components Location Address or Lot No. 5o PATP jCl#4 5•T, C``,/c Owner's Name,Address,and Tel.No. Assessor's Map/Parcel a 4P X1�Pa ° Installer's Name,Address,and Tel.No.$p:j-q77-8977 Designer's Name,Address,and Tel.No. CAVGLJl'D& GpIrcXT105% i -. - tJ!A Ga5.1,. .� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ). Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 0740G,95 Mac , u L26 F94ac i4 a(2s-e 150 GAS kd r a 6 k)P 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. d Date j - (3 o10(57 Application Approved by ' Date Application Disapproved by Date for the following reasons Permit No. t) -7 Date Issued Ql / No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitation for ]Disposal 6pstem Construction J)Prmit Application for a Permit to Construct( ) Repaire'(X Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. 50 pi#'(R ICI,} 5-I- e,IV,[d d Owner's Name,Address,and Tel.No. Assessor's Map/Parcel a 0-6 J0P, P'��' xX5P6kX ' Installer's Name,Address,and Tel.No.5og:-If 7 7-$&77 Designer,'s Name,Address,and Tel.No. r Type of Building: t Dwelling No.of Bedrooms s Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) C'tf�,���-r r�- r � ,��>..�t•-F dus€ rt-o, �S®oar,, f4�D Date last inspected: Agreement: i 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. ed A / Date j -l 3 -oZ0 15 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. / `� y Date Issued 2 --------------------------------------------------------------------------------------------------------------------------------------- �Q THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS C_ Certificate of Compliance THIS IS TO CEERTAIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by at 50 Ng712I 0 A F" C£Wmy&hl rhas been constructed in accordance / with the provisions of Title 5 and the for Disposal System Constructioonn?"JppNo;�)/7 Cq ated Installer (� Wl d �L��S (.(�G Designer N/A #bedrooms Approved design ow J gv The issuance of this permit shall not be consfrued a`s,a guarantee that the sysfe}n willifunct_ion as designed. Date Inspector fl %' , w Fee CD THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem (Construction permit Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) Abandon( ) System located at 5o 7?4'r-'R t ei A 2u 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. 5 Provided:Construction must be compl led withinhree years of the date of this permi. Date 3 �.3 /� Approved by 1ar231 09:11a p.1 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Ownefs Name information is required for every 5@ �rta /gj��� MA 02672 3-21-15 page. City/Town Stale 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 and of the form. Important.When A. General Information filling out forms /r/, use onlython the e tab ♦�``�`` OF IMgs7��� 1. inspector: .0`'4 sqy key to move your (/ 2 cursor-do not G use the retum ,lames D.Sears JAMES key. Name of Irrspector j ; CapewideEnterprises,LLC *' Company Name isl''rRTi�'O �- 153 Commercial Street �%;F.s jNSpEi;' `'0 Company Address Mashpee MA 02649 CiVrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 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 3-21-15 pectors 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. 15fns-3113 . TQIe 5 Offidat Inspection Fonre Subsurfaos Sewage t)ispoW System-Page 1 of 17 Mar 23 15,09:12a p.2 v Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name iequir efo is West Hyannisport MA 02672 3-21-15 required for every Page. Cityfrown State Zip Code Date of Inspection B. Certification (cont) Inspection Summary:Check A,B,C,D or E I always complete all of Section D A) System Passes: ® I have not Bound 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: The system is two old block c pool's: 13) 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): t51ns•3013 Title 5 Official Inspection Form:SuDsurtaoe Sewage Disposal Sy9larn•page 2 of 17 Mar 23 15 09:12a p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name information is required for every West Hyannisport MA 02672 3-21-15 page. City/Town State Zap Code Date or Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cant): ❑ Observation of sewage backup or breakout 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 ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of 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 t5im•W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Mar 23 15 09:12a p.4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Ownees Name information is West Hyannis required for every Port MA 02672 3-21-15 page. cityrrown State Zip Code Date of Inspection B. Certification (corn.) 2. System will fall 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprn, 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 dogged 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 AI n ❑. ❑ Static liquid level in the distribution box above outlet invert due to an overloaded /7 or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than i4 day flow t5ns 3/13 Title 50lficial krspecdon Forst Subsurfece Sewage Qspoeal Syslem•Pape 4 of 17 Mar 23 15,09:13a p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name information is West Hyannisport MA 02672 3-21-15 required for every page. Cdyrrown 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). (dumber 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 feeet 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 falls.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 I I 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. t5ins•3H 3 Title 5 OfficW Irmpea6on Fam:SubtWOw Sewage Dlaposal System.Page 5 of 17 Mar 23 15 09:13a p.6 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System.Form -Not For Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name information is required for every West Hyannisport MA 02672 3-21-15 page. cityrrown 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 manholes uncovered, opened, and the interior, inspected for the condition of the 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): NA Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): .440 t5ins•3/13 Tf OM CM 5 OtrcM Inspection Form:Subsurface Sewage Dlspasal Syslem•Page 6 0117 Mar 2315 09:13a p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is West Hyannis ort MA 02672 3-21-15 requited for every P page. Cityrrown state Ztp Code Date of Inspection D. System Information Description: The system is two old block c pool's. Number of current residents: NA Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes No Seasonal use? ❑ Yes No Water meter readings, if available(last 2 years usage(gpd)): 2013-13,000Gais 2014-15,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: PresentDate CommercialAndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seatstpersons/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: t51n3•3M 3 Title 5 Otfldal In SpeCtlOn Form:SubsulfeCe Sewage 01spos2i System•Page 7 Of 17 Mar 23 15 09:14a p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 3-21-15 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: NA 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 ® 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): 15ins•3113 InUe 5 Offidal Inspection Form:Subsurface Sew qp Disposal System•Page B of 17 r� Mar 23 15 09:14a p.9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface sewage Disposal System Form -Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 3-21-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components, date installed(if known)and source of information: NA Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 21 feet Material of construction: ®cast iron ®40 PVC ❑ other(explain): . Distance from private water supply well or suction line: fleet Comments(on condition of joints, venting, evidence of leakage, etc.). Main line is cast iron, PVC pipe to main pool. PVC line main pool to over flow Septic Tank(locate on site plan): Depth below grade: 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: Sludge depth: t5ins 3M 3 Title 5 Official Inspection Form:Subsufece Sewage Dispose!System Page 9 of 17 Mar 23 15 09:15a p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Flame information is West Hyannis port MA 02672 3-21-15 required for every p page. citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) 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? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I 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•3013 711e 6015 aal Inspection Form:Subsunaw Sewage Disposal System•Page ID of 17 Mar 23 15 09:15a p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner owner's Name information is required for every West Hyannisport MA 02672 3-21-15 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 f5irrs•3113 TNe 5 official Inspection Fam:Subsutlaw Sswage Disposal System•Page 1 i o/17 Mar 23 15 09:15a p.12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street. Property Address Eleanor Palmer Owner Owners Name information is required for every West Hyannisport MA 02672 3-21-15 page. Cityrrown 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 Comments (note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): •If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 Title 5 Official Inspedlon Form:Substsface Sewage Disposal System•Page 12 of 17 Mar 23 15 09:16a p.13 Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name information is required for every West Hyannisport MA 02672 3-21-15 page. City/Town state Zip Code Date of Inspection D. System Information (cons.) Type: ❑ leaching pits number. ❑ leaching chambers number: ❑ leaching galleries number ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number. 1 ❑ 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.): Over flow is a T deep block spool w/cover at 20" below grade. Pool is wet bottom, No sign of over loading. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert 31 Depth of solids layer 2" Depth of scum layer On Dimensions of cesspool T Deep Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ins•3113 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Mar 23 15 09;16a p.14 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every west Hyannisport MA 02672 3-21_15 page. City/Town 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.): Main pool is 7'deep block w/cover at grade in and outlet tee's 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 3113 nde s 0111am lnapeclion Form:Subsurface Sewage Disposal System Page 14 0!17 Mar 2315 09:16a p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 3-21-15 -- page. cityfrown 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 i—I drawino attached seoarately 1 i -Jr 0 22 /3•�= 33-1 vL I�AY O ' o I5'm•3113 Tice 5 Offift Cepuftn Far:SwWfae Sampe gispwad System•pap 15 d 17 Mar 23 15 09:17a p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannfsport MA 02672 3-21-16 page. city/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells N� 12'+ Estimated depth to,high ground water. feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: 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: Area and abating property high. Bottom of pool at 9' below grade. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t6ns•3113 Title 5 Official hepec6on Fomc Subsurface Sewage Disposal System-Page 16 of 17 Mar 23 15 09:17a p.17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 3-21-15 page. City(rown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked I ® 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 t5ira-W3 TNe 5 0111rial irmpaction Form:Subswface Sewage Disposal System•Page 17 of 17 Town of Barnstable Barnstable Regulatory Services Department AFAM019MY BARNgrABM ms ' Public Health Division1639. ' '• 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO r s CERTIFIED MAIL #7014 1200 0001 2358 0284 January 7, 2015 Eleanor Palmer, 13109 Kumar Court Dale City, VA 22193 • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5. The septic system located at 50 Patricia Street, Centerville, MA was last inspected on 12/09/2014, by James D. Sears, a certified septic inspector for the .State of Massachusetts. The inspection of the septic system showed that the system "Conditionally fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.-00) Due to the following: • Crushed pipes need to be replaced. 1 You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system with the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH • Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Conditionally Passes Ltr\50 Patricia St Cent Jan 2015.doc Crocker, Sharon From: Crocker, Sharon Sent: Friday, January 02, 2015 1:2 To: Flynn, Judith _ Cc: Crocker, SDI ar n Subject- FW: 50 Patricia St, Centerville Denise Coolidge called. Owner's name and address as of right now is: Eleanor Palmer, 13109 Kum Court, Dale City, VA 22193 Denise's phone 774-239-6781. Please email copy of letter to Denise once it is ready ...Mon 1/5/15 To: dcoolidge@kinlingrover.com Thanks, Sharon -----Original Message----- From: Crocker,Sharon Sent: Tuesday, December 30, 2014 12:25 PM To: Flynn,Judith Subject: 50 Patricia St,Centerville RE: Septic Inspection - Needs Further Eval. Broker: Denise Coolidge, Kinlin Grover, will get you the updated address for owner this week (Owner lives in VA and is selling property contingent on the letter you will be mailing for septic repair. Please email Dennis the letter once ready: dcoolidge@kinlingrover.com (Hopefully MONDAY, 1/5, if not, letter done by TUESDAY, 1/6) Thank you. Sharon 1 Vol. arcel Detail x f o 3 . y issgl2rir�trar�vt/propdataParce.IDet,Laspx?ID=ii126 APPs Imported From IE Parcel Lookup New Tab www,town,barn PPlication Center Su99ested Sikes € a. j BAH"$TAl#1 # * � .� �. Parcel Info Parcel ID 246-053 Developer Lot LOT 27 1 Location 50 PATRICIA STREET Pri Frontage 131 Sec Road ADRENA AVENUE sec Frontage 94 J village CENTERVILLE Fire District C 0 MM Town seweresists atthis address NO Road Index 121$ J Interactive Map ," . Owner Info owner PALMER,WILLIAM R& C0 %PALMER,ELEANOR E Owner streets PO BOX29 street2 J city WEST HYANNISPORT state MA Zip 02672 Country I r .Land Info Acres 0.29 Use Single Fam MDL-01 Zoning RB Nghbd 0105 Topography Level Road Paved utilities Public Water,Gas,SeptiC Location • Construction Info �J' Start R� Parcel Detail•Google Ch,,, � { 1ia29 AM q Computer name : HEALTH899JF User name : flvnni Operatinq Svstem : Windows NT (5.1) IV) (oAr. vo 0 T t . t Commonwealth of Massachusetts Inspection Form yx/p Q3 Title 5 Official Ins a� � - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ` 50 Patricia Street r; Property Address Eleanor Palmer Owner Owners Name� r-s information is =1 required for every Westd�laA ilsc�Ort ` oJ�����'�'u"" MA Zip Co 12-9of 4 • page. Cityrrown State Zip Code Date of Inspection W eu vl-A Inspection results must be submitted on this form.Inspection forms may not be altered In any fX1 way.Please see completeness checklist at the end of the form. Important:when A out forms . General Information -on the computer, I k ///JJJ►►► + ���``` \,SH OFr/. asSgc use only the tab 1. InS actor —T �r ••.L key to move your p ;��; JAM ES 't R, cursor-do not James D.Sears =use the return Name of Inspector r"_ key. * ' CapewideEnterpdses,LLC A Company Name �����q��F•5 I N SPEG��-. 153 Commercial Street ''�1•1 "`NOS Company Address M MA 02649 ashpee Cityrrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that l 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 16.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ❑ Fails ® Needs Further Evaluation by the Local Approving Authority 12-15-14 IeWectors 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•3/13 at,. pecNon Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Fore! Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Flame information is West Hyannis port MA 02672 12-9-14 required for every P page. Cityfrown State Zip Code Date of Inspedion B. Certification (cunt.) 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: Need to replace lines The system is two old,block c pool. Note: Needs further evaluation B.O.H. 4BR's. 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•W13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name informationfired is every West Hyannis re wired for eve port MA 02672 12-9-14 page. Cityrrown state Zip Code Date of Inspection B. Certification (cunt.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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): Need to replace line main pool to over flow. ❑ 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 ❑ ND(Explain below): El 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•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 3 or 17 1. t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. cityfrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fait 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 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 must be attached to this form. 3. Other: System is two 7' Deep old block c pool's. House is four bed rooms. Per Donna Bam. B.O.H. system is under size for four bed room's. 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 N14 ❑ ❑ 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 %day flow t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Ownees Name information is required for every West Hyannisport MA 02672 12-9-14 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ S 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 colform 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. t5ins-3113 Title 5 Mist Inspection Forth:Subsurraoe Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °< 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. Cityrrown 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? N� ❑ ❑ 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 upbaftift manholes uncovered, opened, and the interior a1i@NWmiN inspected for the condition of the Mdh ®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): NA Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner`s Name information is West Hyannisport MA 02672 12-9-14 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: The system is two old block c pool's NA Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑. Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): 2013-13,000GaIs 2014-15,000Gal's Detail: Sump pump? ❑ Yes ® No Present Last date of occupancy: Date 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-3/13 Title 6 Offidal Inspection Forth: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 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. Citylrown 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: NA 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 ® QMcesspool ® Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: NA Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' Depth below grade: 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.): Main line is cast iron and orange burge camera line clear, but old. Line main pool to over flow cast iron and orange burge.Bad spots in line-Need to replace line. Septic Tank(locate on site plan): Depth below grade: 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: Sludge depth: t5ins•3/13 Too 5 official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Farm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) 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? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal [I 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 um in P P 9 Date t5ins•3/13 Tide 5 Official Inspection Fonrc 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 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. Cityrrown 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•3/13 Us 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17 a y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. City/Town State Zip Code Date of Inspedion D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): 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.): *If pumps or alarms are not in working order,system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 We 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 s Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is required for every West Hyannisport MA 02672 12-9-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ 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.): Overflow is a 7'deep block cpool w/cover at 20"below grade. Pool is wet bottom. No sign of over loading. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert 3' Depth of solids layer 2" Depth of scum layer 0" Dimensions of cesspool 7' Deep Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments q 50 Patricia Street Property Address Eleanor Palmer Owner Owners Name information is West H annis ort MA 02672 12-9-14 required for every y p page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Main pool is 7'deep block w/cover at grade one line in,no tee. Cast iron outlet tee 2'water in pool. 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.): l5ins-3113 Title 5 Official Inspedion Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is West Hyannisport MA 02672 12-9-14 required for every State Zip Code Date of Inspection page. Cityltown 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 a:, C O 0 i TrW 5 offtdal Vtspecbon FoffrL Substdfaoe Sewage Disposal System•Page 15 of 17 t5ins-3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Patricia Street Property Address Eleanor Palmer Owner owner`s Name information is West Hyannisport MA 02672 12-9-14 required for every page. Cityfrown State Zip Code Date of Inspedion D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth g 9 th to high round water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: 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: Area and abutting property high Bottom of pool at 9'below grade. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "Y 50 Patricia Street Property Address Eleanor Palmer Owner Owner's Name information is West Hyannisport MA 02672 12-9-14 required for 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•3113 Title 5 Offiaei Inspection Form:Subsurface Sewage Dispose)System-Page 17 of 17 r — 98 --EXISTING CONTOUR LOCUS N x 100.98 EXISTING SPOT GRADE - 91 • aryl EXISTING WATER SERVICE °wy 0. G EXISTING GAS SERVICE H.bk.---OVERHEAD WIRES • - ,,,1�00 55' 1OL41 TEST PIT �_ Chadwick Ave BENCHMARK A Croigville Beach Road 00 CBDISK �3, P LEGEND N °9 101.62 e •P� of Creen Duneso y a 9837 r 100, N 63, 00. Maple Street 101,80,>j 40" 9= 3 ' 100.76 C �; LOCUS MAP w 1 NOT TO SCALE• x x 100.26 101,35 � z• LOT 27 . :. .... . \\ Q' 12,840 ±SF i01,a GENERAL NOTES: \ • �: • 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. x10.67 101.39 97,34 . \ 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \ x LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: 9842 • 99 85� Z` -310 CMR 15.405 1 b ::' 1) A 10' variance, S.A.S. to cellar wall(bulkhead), for a 10' setback. O O • SCREEN 99' 8 V' ' .` 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 99,41 PORCH I : 101.53. -,:...:c: TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ti DESIGN ENGINEER. • •d I x 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING o \" II \ 1.01,44 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �, � 97,15 63 ENGINEER BEFORE CONSTRUCTION CONTINUES. �� l 99,30 HO X/gT1 0 \1 // 5. ALL ELEVATIONS BASED ON AN ASSIGNED DATUM. + 100,26 / PROPOSED SEWER CONNNECTION 6 DESIGN ENGINEER RTOR OR OIS NOT THE RESPONSIBLE OF 94,40 G I T.O.F.=100.3f PIKE INV.=99.1 t (FIELD VERIFY) THE CONTRHEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. �j • \ - - -'' PROPOSED SEPTIC TANK 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. \\ 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. �/ \ �x 96.15 \ 99,42 �. 4� 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS Ql� 98,95 P�� .99.69 to d 40 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE \ \ `� + 0 DIRECTED BY THE APPROVING AUTHORITIES. • \ SPIKE BH 0 C 9 ,3 12 h 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY \ 97.03 BH/ M 70, FIREP T THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 92,47 + \98 8 2 CONSTRUCTION. • �� EXISTING CESSPOOLS 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS TO BE PUMPED, FILLED W1TH IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND / 93,58x TP-�.:. P \� \ S, 7 SAND AND ABANDONED, OR REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). REMOVED. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 91,66 95,65 O INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. �� 98 0 \�, ; TP 1'.:' "' F 98, 4 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND x ,05 \ �� .•..'..•::: :::' 12, NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. \� 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SHED SYSTEM COMPONENTS NOT SHOWN ON THE PLAN OF M 100 ,� N $ 00 � cy� BENCHMARK 74 so'10" �e 33 PROPOSED SEPTIC SYSTEM UPGRADE PLAN o PETER T. ✓' � McENTEE �, coR98.87 HEao E PARCEL ID: 246-053 50 PATRICIA STREET CENTERVILLE, MA 15 CIVIL "' EL.=98.87 No. 35109 Prepared for: Justin Waters, P.O. Box 145, West Hyannis Port, MA 02672, GISZER�O Q INSTALL A 40 MIL POLY LINER Engineering by: SCALE DRAWN JOB. No. / E TOP OF LINER, EL.=96.0 OWNER OF RECORD 1"=20' P.T.M. BOTTOM OF LINER, EL.=92.5 WATERS, JUSTIN P Engineering Works, Inc. 274-18 —ve P.O. BOX 145 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. ( � CENTERVILLE, MA 02632 (508) 477-5313 11/20/18 P.T.M. 1. Of 2 NOTE: TO PREVENT BREAKOUT, INSTALL A 40 MILL SEPTIC TANK POLY LINER AS SHOWN ON SHEET 1. INSTALL RISERS & COVERS OVER INLET & TOP OF LINER, EL.=96.0 SCREEN OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D-BOX BOTTOM OF LINER, EL.= 93.5 PORCH INSTALL RISER & COVER PROPOSED S.A.S. SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND T.O.F=100.3t SET TO 3" OF F.G. TO; SERVE AS INSPECTION PORT F.G. EL.=99.8f F.G. EL.=99.5f F.G. EL.=99.Ot F.G. EL.=98.8t rJ MAINTAIN 2% SLOPE OVER S.A.S. -EX/STING ss HOUSE(#50) L - 1 1' � L - 18' T.0.F.=100.3E L = 22' / ® S=1% (MIN.) ® S=l% (MIN.) ® S=1% (MIN.) 2" LAYER OF 1/8" TO 1/2" 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC s" DOUBLE WASHED STONE 14" (OR APPROVED FILTER FABRIC) P gyp" am e ma s" B®gamma � aaa9sam LTI INV.=97.25 48" LIQUID amamaas —3/4" TO 1-1/2" DOUBLE ^? et 10 LEVEL WASHED STONE "�D INV.=96.47 PROPOSED INV.=96.30 4' 4.8' 4' SAS BAFFLE INV.=97.00 3 OUTLETS 12.8' INV.=94.00 01 �• 1) d` PROPOSED SEPTIC TANK 3-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN CONNECT TO EXISTING SUITABLE SEWER H-10 RATED 3" LAYER OF 1/8" TO 1/2" PROP S PIPE AT HOUSE, INV.=99.1 t verif DOUBLE WASHED STONE A.$, TOP CONIC. ELEV.=95.8t (OR APPROVED FILTER FABRIC) NOTES: BREAKOUT ELEV.=94.50 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & INV. ELEv.=94.00 amass SEPTIC LAYOUT ZONE mass INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. aasaaBaaaaa BOTTOM ELEV.=92.00 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 4' 8.5' 4' TRUE TO GRADE ON A MECHANICALLY COMPACTED 4' OF NATURALLY OCCURRING VARIES-REFER TO SKETCH SIX INCH CRUSHED STONE BASE, AS SPECIFIED PERVIOUS MATERIAL IN 310 CMR 15.221(2). 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION Ea 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM OF TEST PIT, EL.=87.6 3/4" TO 1-1/2" DOUBLE ®®® ® ®®®4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE WASHED STONE ®®®®®® ® ®®®® 33" AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. w#E3 ®z ®�®®®® ® ®®®® SEPTIC SYSTEM PROFILE 102" SOIL LOG 4" KNOCKOUT DESIGN CRITERIA DATE: NOVEMBER 16, 2018 (REF#15,835) OU DIA. COVER f--25.0--� SOIL EVALUATOR: PETER McENTEE PE(SE#1542) NUMBER OF BEDROOMS: 4 r--------IT WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT / SOIL TEXTURAL CLASS: CLASS I 1 PROP. S.A.S. 100 ELEV. TP- 1 DEPTH ELEv. TP-2 DEPTH 4" KNOCKOUT 4" KNOCKOUT 58" DESIGN PERCOLATION RATE: <2 MIN IN I BOTT. AREA I cv 0" o — 0 ( " 428.8 SF 0.74 GPD SF LOADING RATE M 1 = 1 I I 98 6 A 98'4 A / ) N I _J11 LOAMY SAND LOAMY SAND DAILY FLOW: 440 GPD 1 (" 10YR 4/2 ' 4' KNOCKOUT 6 97 9 10YR 4/2 DESIGN FLOW: 440 GPD 11 1 B B s 06 98 GARBAGE GRINDER: NO LOAMY SAND LOAMY SAND LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF If12.8' i� 96.8 10YR 5/$ 10YR 5/s 500 GALLON CAPACITY, H-10 LOADING .74 GPD/SF �-12 2' _I 22" 964 24" CHAMBERS PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY PERC PERIMETER=92.6' 25'/43" PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS SAS DIMENSIONS PROPOSED SEPTIC SYSTEM UPGRADE PLAN r USE 3-500 GALLON LEACHING CHAMBERS IN SERIES SKETCH M-C SAND M-C SAND 50 PATRICIA STREET CENTERVILLE, MA SURROUNDED BY 4' DOUBLE WASHED STONE-ALL SIDES 2.5Y 6/6 2.5Y 6/6 SIDEWALL AREA: 92.6'(PERIMETER LENGTH) x 2'(EFF. DEPTH) = 185.2 SF Prepared for: Justin Waters, P.O. Box 145, West Hyannis Port, MA 02672 Engineering by: SCALE DRAWN JOB. NO. BOTTOM AREA: 428.8 SF(BOTTOM AREA) = 428.8 SF 87.6 132" 87.4 132" Engineering Works, Inc. N.T.S. P.T.M. 274-18 TOTAL AREA:.................................................................................... 614.0 SF PERC RATE <2 MIN/IN. C" HORIZON 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. NO GROUNDWATER ENCOUNTERED DESIGN FLOW PROVIDED: 0.74 GPD/SF(614.0 SF) = 454.4 GPD (508) 477-5313 1 11/20/18 P.T.M. 2 Of 2