HomeMy WebLinkAbout0702 PHINNEY'S LANE - Health 702 PHINNYS LANE, CENTERVILLE
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UPC 12534
No.2-115,3 QR
HAMNGS,MN
RECEIVED
NO V 0 4 2000
TO HEALTH DE�FASLE
COMMONWEALTH OF MASACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET BOSTON MA 02108(617)292-3500
TRUDY COXE
Secretary
ARGEO PAUL CELLUCCI DAVID B.STRUHS
Governor
Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Address of Owner: 702 PHINNYS LANE CENTERVILLE,MA 02632
Date of inspection: 10/24100
Name of Inspector: JOHN GRACI
1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536
Telephone Number: 608-564-6813 FAX 508-564-7270
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 inspection;The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal,systems.The system:
X Passes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: Date:10/24100
The System Inspector shall su mit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
"The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.M.
inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life."
THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE SYSTEM NOW AND EVERY ONE TO TWO YEARS TO PROLONG THE
SYSTEM'S USEFULL LIFE.
revised 9/2/98 Paoe 1 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10124/00
INSPECTION SUMMARY: Check A, B, C, or D:
A. SYSTEM PASSES:
X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not
evaluated are indicated below.
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 o
the replacement or repair,as approved by the Board of Health,will pass.
Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. e
n/a The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the
septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure
is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved
by the Board of Health.
n/a Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)o
due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
_broken pipe(s)are replaced
_obstruction is'removed
_distribution box is levelled or replaced
nta The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass
inspection if(with approval of the Board of Health):
_broken pipe(s)are replaced
_obstruction is removed
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P226 L049.
Name of Owner HEATHER FEENY
Date of Inspection: 10/24/00
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
- X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
- X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
- X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
- X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
- X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped nLa.
- X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
- X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
- X Any portion of a cesspool or privy is within a Zone I of a public well.
- X Any portion of a cesspool nor privy is within 50 feet of a private water supply well,
- X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water
quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic
compounds,ammonia nitrogen and nitrate nitrogen.
E. LARGE SYSTEM FAILS:
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:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health
and safety and the environment because one or more of the following conditions exist:
-7
Yes No
- X the system is within 400 feet of a surface drinking water supply
- X the system is within 200 feet of a tributary to a surface drinking water supply
_ X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of
the Department for further information.
revised 9/2/98 Paoe 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner: HEATHER FEENY
Date of Inspection: 10/24100
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
Yes No
X - Pumping information was provided by the owner,occupant,or Board of Health.
X - None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that
period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X - As built plans have been obtained and examined.Note if they are not available with N/A.
X - The facility or dwelling was inspected for signs of sewage back-up.
X - The system does not receive non-sanitary or industrial waste flow.
,ir .
X - The site was inspected for signs of breakout.
X - All system components,excluding the Soil Absorption System,have been located on the site.
X - The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material
of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site
has been determined based on:
X - Existing information,For example,Plan at B4O,H,
X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)]
X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal
Systems.
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revised 9/2/98 Paoe 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10/24/00
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 110 g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual): n/a
Total DESIGN flow: 330 gpd
Number of current residents:3
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): NO t` If yes,separate inspection required
Laundry system inspected(yes or no): NO
Seasonal use(yes or no): NO
Water meter readings,if available(last two year's usage): n/a gpd
Sump Pump(yes or no): NO
Last date of occupancy: n/a
COMMERCIAIJINDLICTRIAL
Type of establishment: n/a
Design flow: n/a gpd(Based on 15.203)
Basis of design flow:n/a
Grease trap present:(yes or no): NO
Industrial Waste Holding Tank present:(yes or no): NO
Non-sanitary waste discharged to the Title 5 system:(yes or no): NO
Water meter readings.if available: n/a
Last date of occupancy:nla
OTHER: (Describe)
n/a
GENERAL INFORMATION
PUMPING RECORDS and source of information:
1998
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped nla gallons
Reason for pumping:nla
TYPE OF SYSTEM
X Septic tank/distribution box/soil absorption system
_ Single cesspool
_ Overflow cesspool
_ Privy
_ Shared system(yes or no)(if yes,attach previous inspection records,if any)
_ I/A Technology etc.Attach copy of up to date operation and maintenance contract
_ Tight Tank Copy of DEP Approval
Other:n/a
APPROXIMATE.AGE of all components,date installed(if known)and source of information:
1983
Sewage odors detected when arriving at the site:(yes or no): NO
revised 912/98 Paoe 6 of 11
its
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10124/00
BUILDING SEWER:X
(Locate on site plan)
Depth below grade: 30"
Material of construction: _ cast iron X 40 Pvc _ other(explain)
Distance from private water supply well or suction line: n/a
Diameter: n/a
Comments: (condition of joints,venting,evidence of leakage,etc.)
TOWN WATER
SEPTIC TANK: X
(locate on site plan)
Depth below grade: 24"
Material of construction: X concrete_ ,metal_ Fiberglass_ Polyethylene_ other
4,J
explain: nla
If tank is metal,list age Is age confirmed 6y;Certificate of Compliance(Yes/No): NO
Age: n/a
Dimensions: 1000G L 8'6"H 5'7"W 4'10"F'
Sludge depth: 1"
Distance from top of sludge to bottom of outlet tee or baffle: 33"
Scum thickness: 1"
Distance from top of scum to top of outlet tee or baffle: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: 0"
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of
leakage,etc.)
THE SEPTIC7ANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING NOW AND EVERY ONE TO TWO YEARS
TO PROLONG THE SYSTEM'S USEFULL LIFE.
GREASE TRAP: _
(locate on site plan)
Depth below grade: n/a
Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other
Explain: n/a
Dimensions:n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of,outlet tee or baffle n/a
Date of last pumping: n/a
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of
leakage,etc.)
n/a
revised 9/2/98 Paoe 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
�s
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M261 P226 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10124/00
TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nla
Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other
Explain: n/a
Dimensions: n/a
Capacity: n/a gallons
Design flow: n/a gallons/day
Alarm present: NO
Alarm level:N/A Alarm in working order:NO
Date of previous pumping: n/a
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
n/a
DISTRIBUTION BOX:_
(locate on site plan)
Depth of liquid level above outlet invert: n/a
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
n/a
PUMP CHAMBER: _
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): NO
Comments: . t a
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
n/a
revised 9/2/98 Paae 8 of 11
V.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10/24/00
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
n/a
Type:
leaching pits,number:(1)1000 GAL 6'X 6'
leaching chambers,number: (n/a)n/a
leaching galleries,number: (n/a)n/a
leaching trenches,number,length: (n/a)n/a
leaching fields,number,dimensions: (n/a)n/a
overflow cesspool,number: (n/a)n/a
Alternative system: n/a
Name of Technology: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAD V OF LEACHING LEFT AT THE
TIME OF THE INSPECTION.RECOMMNEND RAISING COVER TO PIT.
CESSPOOLS: _
(locate on site plan)
Number and configuration: n/a
Depth-top of liquid to inlet invert: n/a
Depth of solids layer: n/a
Depth of scum layer. n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nla
PRIVY:
(locate on site plan)
Materials of construction: nla Dimensions: n/a
Depth of solids: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nla
revised 912/98 Paae 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10/24100
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
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gar�
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revised 912/98 Paoe 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 702 PHINNYS LANE CENTERVILLE, MA 02632 M251 P225 L049
Name of Owner HEATHER FEENY
Date of Inspection: 10/24/00
e,
NRCS Report name: n/a
Soil Type: n/a
Typical depth to groundwater: n/a
USGS Date website visited: n/a
Observation Wells checked: NO
Groundwater depth: Shallow_ Moderate_ Deep_
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
_ Shallow wells
Estimated Depth to Groundwater 12 Feet+
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observed Site(Abutting property,observation hole,basement sump etc.)
Determined from local conditidhsd
Checked with local Board of health
Checked FEMA Maps
Checked pumping records
Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS•12+FEET
s
I
revised 9/2/98 Paae 11 of 11
LOCATION :o SEWAGE PERMIT NO.
VILLAGE
I N S T A LLER'S NAME i ADDRESS
t U I L D E R OR OWNER
DATE PERMIT ISSUED
D A T E COMPLIANCE ISSUED
g
?6 13'
....... Fimim t?...............
THE COMMONWEALTH OF MASSACHUSETTS �
BOAR® OF HEALTH
l®� .............OF............
Appliratiun for Uiipuutt1 Works Tuntrnrtiun rrutit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: ,
Locationss or Lot No.
.................. _�5......2 1 ��-s...----•---•--....------••---...... l�[ �C :......
L L / OOw/neer,
................/ ��K 4� .....L�.k! r l I�:--•----------------------- ........._... l�ljf�j�f3..... .............................
Installer j Address
UType of Building Size Lot___ ------Sq. fee
0-4 Dwelling—No. of Bedrooms..............3.................._......Expansion Attic ( ) Garbage Grinder
a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures -----------------
W Design Flow....................S,5.......--------gallons per person per d y. Total daily flow................ 3®-...............gallons.
WSeptic Tank—Liquid capacity/,OA?c gallons Length---AI Width................ Diameter_--____---_-__ Depth................
x Disposal Trench—No. .................... Width_...___...-......... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------/---------- Diameter......1- Depth below inlet........_....... Total leaching area.z6�1!. �Lsq. ft.
z Other Distribution box ( &,I Dosing tank ( ) 1 _
~' Percolation Test Results Performed ._�.��)Date.......... ..........
1019/6STest Pit No. 1.....<_. .._minutes per inch Depth of Test Pit------/A.._..... Depth to ground water-__-t �e..-
f14 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................
a •-------- - ------------------------------ -------•-•--•--------•------
. r
O Description of Soil.....................42-::�--- �T::._. �_ l ?- ,
W - ------------------- ----------------_--7�"���----_.... `.__f. '.-z! F1iI i -----------------•----`----
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
----------------------------------------------------------•-•------•----------•-------------•--•-----------------•----.•-----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of HTH-E 5 of the State Sanitary Code—The pndersigned further agrees not to place the system in
operation until a Certificate of Compliance s ssue by rd of health.
igned_ - ------------------••-------------------- f .��
--
ApplicationApproved By.........--. ..��_ ._" ........---•--....----•---•-----------------------------•----•------- .....��-------.............
Date
Application Disapproved f a t following reasons-----------------------------•-------------------------------.........................-.........................
-------------------------------•----•.....--------...--------...----------...----------------••---------------....-•------------------------------------•--••------•-•--------•----•-----------••-------
Date
PermitNo......................................................... Issued_..................-...................................
Date
Fmc..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TH
...................................OF.....--..... f
Appliration for Uhipoiittl Works Totuitrnrtton Prratit
Application is hereby made for a Permit to Construct (u`) or Repair ( ) an Individual Sewage Disposal
System at: ]� rr / ! /
r
..............
.:•-•Location-Address f r No.
........................................ ......... KIZ .. ..
/ Owner j Address/
,Wa __!.:...!. ........E.'`..� r.. t- 't^� _1 +7/J 1 7,E
r
Installer Address
Q Type of Building Size Lot.. ''': ......Sq. feet
Dwelling—No. of Bedrooms..............:'._........_._..__........_Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building No. of persons............................ Showers
Other—Type g ------•-------------•------- P ( )--- Cafeteria ( )
dOther fixtures ----------•----------•-••-----•--•-•------------•----..----------------------•--------------------•--•---------.---- ........_..
WDesign Flow...................... i...........•._.gallons per person per day. Total daily flow.................... :' ................gallons.
G; Septic Tank—Liquid capacity Z!�°<Z.gallons Length...` {".. Width................ Diameter................ Depth................
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No........ .......... Diameter....._/2........ Depth below inlet....::........... Total leaching area.e-z� 9=L sq. ft.
Z Other Distribution box (v ) Dosing tank ( ) / /
Percolation Test Results Performed by 13f 4.t_. __.:f�`' 1>`r/-/ 1"%*-�''� ✓� >z'�Date.__._.____ /f� �'_3.._.._._..
,'"t`1G —",-Test Pit No. 1....t=_"-....minutes per inch Depth of Test Pit___-- ....._____.. Depth to ground water........................
r3 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
R+ •---•----•-,.J----'--`-�-.-------------------....................... ------`-•---/--r-+--•-.-r•'-.-•l-P•-'-•----,---v-�--a-.c.-.t...=.............. �.=.`a.--t-w-c•-s--W---.....
----•-•--
7r;./ry1.o Description of Soil--------•---•--•---•----••..........._••-:_.._...... " � •--.�'Gy7-''"• -` •---•_.. ...• -- ?_ ------•-•_... j ...
l�V �,==-/�------ .�.� 1-----� . ......+ " s✓G -------------------------------
W
VNature of Repairs or Alterations—Answer when applicable_-..--•______________________•.................................................................
---••---•---•-•----•----•--•-•........................••....----•-...._..----•---------------............._..------------•---•-•--•-••--•-•...--•------••--•--.............._............---•--••-•_....
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
„1��
the provisions of`I T1:;J 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
igned. ..............•---•----.._.........---- ......... ;u ................
Application Approved By----- --. #'._ ........................................•---•--------•-•----•-- .... '5.'.-
f Date
Application Disapproved f r the following reasons:................................................................................................................
......................................................•-----------•--•••••.._.__.._..----------•----...••-------•-------------------•----•--------------------•------------•-•-•----•----------•--------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....................I.....................OF..........................................I.........................................
Cfrrfifiratr of Tomplianrr
THIS✓IS�'TO CE T,ZF.-Y, That the Individual Sewage Pisposal System constructed ( ) or Repaired ( )
s
by ``.,_ :•�' -------------•-•-----•---•----••---------------------•------._..._
Installer
at :� ..�. _. .,....,r...---- ......... •--- ��=� T. � •--•----------•---------
has been i stalled in accordance with the provisions of TITLE 5 of he State Sanitary Code a e cribed in the
application for Disposal Works Co�n�;tfuction Permit No. _". C. .............. dated i� _ -_______._........._.....
THE ISS ANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTERA W UNCTION SATISFACTORY.
DATE... . Inspector.... ----------•----------------------------•-•----••-••----------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
t4! ....� .........�j' ..........................................OF.....................................................................................
N Ll FEE...... ..............
iu r r Rrkt-to tutrudiun pamit
yg ," 'E , t
Permission is hereby ranted .!
to Constru or Repal ;' an-*Jn visual Sewage Disposal System
at No r
Street
as shown on the application for Dispo� VVorlcs Construction Permit No____________ __:..�- ated. .................
--------------------------- - -----4, ..........................................................
DAT Jt «�rlr ✓` " Ward of Health
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
SI TE PL A N T YPICA L PROFI L E
SCA L E — l " = 30 L �,;� 5 NOT TO SCA L E
18"STD. LT WGT C.I. MH COVER
r---- _
I ---- —
4"C.l PIPE T 4"B1 T. FIBER PIPE TIGHT JOINTS
FLOW L INE OUTLET LEVEL `
TO FIRST JOINT - - --
DWEL L ING t l ��� IO /4'T -- O O -_-__
lvl • UO w,�4
C.1. TEE C.I. TEE P,
STANDARD PRECAST I 4
CONCRETE'oDoGALLON
-�_ SEPTIC TANK
DI S TR/BU TION BOX ,
B TO BE INSTAL L ED ON
LEVEL , STABLE BASE.
SEPTIC TANK
TO BE INS TA L L ED ON
LEVEL , STABLE BASE
r 2"- 1/8" TO 1/2 WASHED PEA STONE LEACHING PIT
ALL AROUND FREE OF IRONS, FINES BASE TO BE LEVEL
AND DUST /N PLACE
BRICK 8 AWORTAR COURES
3/4" TO l-//2" WASHED CRUSHED
AS REOU,'RED TO BRING STONE ALL AROUND FREE OF
5 T �• P��G/�5�(" GoluC. /� COVER TO GRADE 2AND /FRAME MH COVER IRONS, FINES AND DUST IN PLACE
Is, loOo C.�4� 51E CpT IL. BAN
INLET4 — 8' FLOW L INE __ _^_ __ LEACHING PIT SEC TION--
!2 RIPE L _ I. CONCRETE TO BE 4000 PSI 28 DAYS
�, G --�-_„ 2. REINFORCED WITH 6" z 6" NO. 6 GA. W.W.M.
—Lb 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER
� - ,•.
�v�y® �► DEPTH REQUIREMENTS.
A ° �S C�• _ OPENING WITH 4-118 4. NUMBER OF PITS REQUIRED
`�voo��jj� ° _ OUTER DIAMETER &
�� �.�xr,l A ��20�• Q 1-3/4' INSIDE DIAMETER NOTE EXCAVATE TO ELEVATION Sl'S OR LOWER AS
J 1 �12 4$ - 3' REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH
PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN
GRAVEL TO DESIGNED GRADE
L e A� A �A g 1 tL.J �ij.5- N - .
LOT 4c) - - -- ----6 -6 -- - -Z
4 -0
� v
C2 5�
MIN EFFECTIVE DIAMETER
(NO T TO EXCEED 3 TIMES EFFE C Tl VE DEPTH)
�-v WATER TABL E
ti1U tit r- c-:COVk.-jTl=gei-)
r I tiJ SOIL A ND PE/iC. DATA GENERAL NOTES
PERC. RATE : 2 MIN. /IN . I` 10)4o5 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM
T e)w_UG I µ l Lp �,�,� SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD
. EST BYE _ � M,�,vAl2�.c.Ji4 {� � A55oL. )
PRECAST REINFORCED CONCRETE UNITS.
WITNESSED BY: Ja'4 tiJ J 4, Gae 1 03. 1?, it ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE
TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE ,
TEST PIT GR EL. '� DATE ' S f���� MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF
TEST PIT NO. 1 TEST PIT NO. 2 SANITARY SEWAGE EFFECTIVE I JULY 1977.
0' 0" ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE
ToF / 5UD501L
�' _ BOARD OF HEALTH.
.=OAGZhE 5 AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE
7, AAJD �o.R/.VrcL
BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION.
to MF_D. 5 AN D PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED
1=1n1E EL 20
I2, OTHERWISE.
DESIGN DATA
BEDROOMS 3 DISPOSAL
EST. TOTAL DAILY EFF. � 19 GALS.
L EGEND — SEPTIC TANK I o o o GAL.
SIDEWALL AREA z,5 GAL./SO. FT.
BOTTOM AREA L GAL./SQ. FT.
Oxoo EXISTING GRADE LEACHING REQUIRED SQ.FT SEWAGE DISPOSAL SYSTEM
ZONE'.' a. o0 FINISHED GRADE ACTUAL LEACHING AREA Z51 • "22- SQ.FT. J FOR
DOMESTIC WATER SOURCE U \,Q LiA 7L 0- 0-OS INVERT ELEVATION , �� {._ p-r 4e) p Ita I r.I!`► C-`j' S L /a r.d
-- —-- — --
PROPERTY LINE " , y `.µD}`Ater `E t.IT �►'��/ I l.l, 1S , WA (2►-IAi'f A 131.. e1 MA 6,
PLAN REFERENCE : — E s' �'":� . ! fiy
—• ------- µ,
7
SCALE' AS INDICATED DATE :HIGH WATER j
WAR
BENCH MARK DATUM _ y h U Tor' w i= MARSH s . �,t ' ,� 3• WM. M WARWICK B ASSOCIATES
BOX 80l - NORTH FALMOUTH
r= L oocp wrulf �-J 0NJ L 4z b, rzQ >Wr.SSACHUSETTs 02556