HomeMy WebLinkAbout0023 PINE CREST ROAD - Health (2) 23 Fine Crest Road
Centerville
"A. =245 - 151
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UPC 12534
.2.153L
�wo�arr
2 TOWN OF BARNSTABLE .
LOCATION SEWAGE #
VILLAGE � ASSESSOR'S MAP & LOT2UIS I
INSTALLER'S NAME&PHONE NO(.,,
SEPTIC TANK CAPACITY V
C �IV
LEACHING FACILITY: (type) � � �_�I�I(size) �fJ
NO. OF BEDROOMS Z``
BUILDER OR OWNERJ rOCLk)
PERIvIITDATE: COMPLIANCE DATE:
Separation Distance Between the:.
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility. (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) r ���� ��. Feet
Fu.:ushed by
0 P�Ic
AA �A
AB
f _
oFIVA
Town of B arnsiable 1 a 716
6
Departinent of Regulatory Services
BARN,�tr = Public Health Division ?
Q MA't A`b� 200 Main Street,Hyannis MA 02601 Date b
Date Scheduled
Time Fee Pd, U 0
Soil Suitability !Assessment or Sewage isposal
Performed By: r'JAuel PiNIe l t?1 i. G5E
Witnessed By: , S
7
LOCATION & GENERAL INFb
Location Address 2- 3 �, RMATION
/I ®��','e+.I5,,1 � Owner's Name �Os
v`'r.l'""'l uc Address
Assessor's Map/Parcel: a q'7l i,5' f i -t
Engineer's Name
NEW CONSTRUCTION
REPAIR �`r
Telephoned# "[ s '16 ZV
Land Use _�5�e `a'1Ylity / la �ltn�
Slopes(%) t`z. Surface Stones
Distances from: Open Water Body _ft possible Wet.Area 4J1_ft Drinking Water Well AIM
Drainage Way ft
ft Property Line > io
Other f[
STCII:(Street name,dimensions of lot,exact locations of test holes&pere tests,]oe5te wetlands in
Proximity to holes)
See_ al�c r e(cri
Parent material(geologic) Co4(ILyQs(A
Depth to Bedrock. 7 12-y ('s 5.
Depth to Groundwater. Standin Water in Hole:
g ----7 I Weeping from Pit Fnee 7 (2(4(osy
Estimated Seasonal High Groundwater -7 12Y�b5s
DETERMINATION FOR Gtp SEASONAL NI
Method Used: care GH WATER TABLE
t!- �UQbjvj
Depth Observed standing in obs.hole: '7 t 2 Y
Depth to weeping from side of obs.hole: f 24 �n' Deptll to Boll mottles: 7 r2 tf
Index Welld# ariiundwalerAdJtistment ln'
Reading Date: Index Well level
- Adj.factor_ Adj,(3ruundwater Level
Observation PERCOLATION TEST bate it tz o9
Holed# ( _ - - 'll#lt 1�_A h
Depth Time at 9" -
p of Perc '2� `/(oTime at at 6" _
Start Pre-soak Time @' 11120-Af( -
Time(9°-6„)
End Pre-soakI 33 A H
Rate Min./inch < Z -
Site Suitability Assessment: Site Passed V
Site Failed:_ Additional Testing Needed(YIN) N
Original: Public Health Division
Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 10
Barnstable Co 0' of wetland, you Must first notify the
nservation Division atleast one (1) week prior to beginning.
Q:\SF-PTIC\PERCPORM-ObC
DEE,P-OBSERVATION HOLE LOG Hole# — 1�
Depth from Soil Horizon Soil Texture
Surface(in.) Soil Color Soil Other
(USDA) (Munsell) Mottling (Structure,Stones;Boulders,
oti istenc % ,rnvel
2�3'12y G MS 2.5i�'llo r
Ga05 e_
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil
Surface(in.) (USDA) Other
(Munsell) Mottling (Structure,Stones,.Boulders.
Consistent %Gravel)
r S�6 —
y8-r2y
L e'ose-
z
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil
Surface(in.) (USDA) Other
(Munsell) Mottling (Structure,Stones,Boulders.
onai2tency,3' Gravel
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones,Boulders.
Consi ten I
e
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes ._ ✓_
Within 500 year boundary No ✓ Yee—
Within 100 year flood boundary No✓ Yes .
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? `Pe5
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on !e_2. -44 (date)I have passed the soil evaluator examination approved by the
Department of.Environmental Protection and that the above analysis was performed by me consistent with
the required training,ex ertise d experience described in 310 CMR 15.017,
Signature �-�'— Date 1j'13 D
;z
r
Q:4S.BPTIC\PBRCFORM.DOC
r
No. d—''6 �TO a Fee �V v
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplitation for ]Disposal *pstrm Construction 3pErmit
Application for a Permit to Construct( ) Repair Vj Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 2� Qi�k Lc-e6..r (L c Owner's Name,Address,and Tel.No. 6 e m M A d T05--ph 7W eS
Assessor's Map/Parcel 7--�t-1 1� �
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.°S L_Cn,tLan.i
1�u 2t�3 ZQ L 6 �4
c
TI pe of Building:
Dwelling No.of Bedrooms Lot Size —7 ± sq.ft. Garbage Grinder( )
Other Type of Building � ,� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.r quired) Q) gpd Design flow provided 3 q(p. gpd
Plan Date I ( 1311.4101 Number of sheets 1 Revision Date
Title `Z Ytl,#_ T
Size of Septic Tank 15140 SIJA- Type of S.A.S.
Description of Soil
a C
Nature of Repairs or Alterations(Answer when applicable) 7 —` Z r
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of ealt
Signf awcDate
Application Approved by Date N90
Application Disapproved by Date
for the following reasons
Permit No. ( Date Issued
�-66`� -3�� f V V
No. .._ -,.... ( Fee
THE COMMONWEALTH OF MASSACHUSETTS" ' Entered in computer.
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftpYication for ]Disposal-6potenn Construction 3Perrnit
° Application for a Permit to Construct( ) Repair(+16 U grade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 2.3 �,,,Q rST (2.o4 Owner's Name,Address,and Tel.No. G e,.n M,q e 5- -y TOi eS
Assessor's Map/Parcel Zy-I
C�rt..w:tile �
Installer's Name,Address,and Tel.No.Cgp i, W-V0,5e3 Designer's Name,Address,and Tel.No.
(A A-`(oii Q�-2U3 J k- 2^t3-v37� ZQT1.1 CJahb✓�!
C �vG�,n.✓1 �.�, ,art{, V�✓a
Type of Building:
Dwelling No..of Bedrooms @ Lot Size -7_J sq.ft. Garbage Grinder( )
Other Type of Building �j i 1 i t kt No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) Q gpd Design flow provided gpd
Plan Date (I t 3��ug Number of sheets I Revision Date
Title 2 3 Q�1�C,J'e ST
Size of Septic Tank I �J 60 5,14. Type of S.A.S(7--� �U- ���•+5�3-�, tr�)
Description of Soil
p ✓. + C Z�
Nature of Repairs or Alterations(Answer when applicable) ^4� {N t�-to 5-r. jo 1J) - 'jo r
Date last inspected:
v
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 ealt}.
� .
Signed Date ( I Zi�j
Application Approved by Date _ f �6 0
Application Disapproved by Date
for the following reasons
Permit No. I Date Issued b - 6
l
-- -, �= - -- ___- - -- - - - -------- -- - - - --- - - - _ - - --- _ -------------------=--_----_
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO/C�ERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by (-AP"%6G G r P{ S t S 1.(,(
at 2 3 Q'vw-(-J eye (Z d,,-,l ee, , <<-e has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.1T ooq-331 t dated `f d
Installer ( ,_ , 1 �{�/ t>� Designer
#bedrooms i l-i B-o-t
oZ Approved design flow ,2 o gpd
The issuance of this ermit shall not be construed as a guarantee that the system willinc on as desi01 ed.
Date �r� ()�—i Inspector 1 /�V � 1 /
No. c)-04� _.. 370 Fee tbl) - - -'
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
3Disposal bpstem Construction permit
Permission is hereby granted to Construct( ) Repair qpgrade( ) Abandon( )
System located at Z 3 P%AgU. eN r 6 6A J
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit---- -
0
'
Date ��`�
i Approved by hn�l
Town of Barnstable
Regulatory Services
Thomas F. Geiler, Director
1 RARNBfABI,1S, ' Public Health Division
MAN,
te'9�s Thomas McKean, Director
200 Whin Street, Hynnnis, MA 02601
Office: 508-8624644 Fax; 51)h�:'Q��-i�tr-
.}
Date: v i V2 t"U —_ Sewage Permitti ` �`� '3'1� Assessor's Map/1'arcel J "p 24_7
Lai I % l
Installer & Designer Certification form
De9i6t141': �..c.i'n..( _.:...Y �)-C:..._.. Installer-,
Address: dt'51 Lcclvt ccr ............ Address: (20 7,>I„
r wy\ W t+r e�t�vn t•t A U 2 ,3 �' ��,,� 1�1
on �� Z f 1�aoc, - C4w j - I.0 -4et _._.._. was issued a permit to .nstall a
date) (installer)
septic sstone 2- ,n e, C.r va at r Z o a.cl
p •y�• ___-....,_.�-.._.� ( based on a d4si�;t1 drawn by
(,address)
C: Y\�LK� .�.SiJ�`� , ` '�)c:... dated
(designer') ._..----------------•---•_,,,.....-...__._
I certify that the septic system referenced above was installed substantially according to
the design, which trtay include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Stripout (if required) was insp-w- ted and the sails
were found satisfactary,
r �
I certify that the septic system referenced above was installed with major changes (i.a.
greater than 10' lateral relocation ol'the SAS or any vertical relocation of any component
i of the septic system) but in accordance with State & Local Regulations, Plan revision or
certif ed as-built by desi8ner to follow. Stripout (if required) ' I 'Iected and till sock
were found satin tort'.
CJ0 N L.,
HUkCt11L'..
JR
(ll le' s leg iltllC��_...___..._..,... IVIL
o� 41&Q
esTrier s Signalur (Affix e g rhy Here)
P "jjSE RETURN -I'() ARNSTABLE PUBLIC HEALT DIVISION, CERTIF.ICA'I'E;
OF C NTPLIANCE WILL NOT IIE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE, RECI.LVED BY THE BAR.NS'JABLE PUBLIC Hr6�L"tH DIVISION.
THANK YOU,
I 4.111'c Ibrruti•.Iietiit:ne.rce.rlt'c:.UIn ruin Jn,: '
7 L 1 T C L 1 7 1 1•` 1-1 N C 4-• M T L f:,fT 7—T 7—A r 1 A I
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TRANS. NO.:
CITY/TOWN: Centerville
APPLICANT: Capewide Enterprises
ADDRESS: 23 Pine Crest Road, Centerville, MA
DESIGN FLOW: 330 gpd
REVIEWED BY: DATE:
N/A OK NO
GEN ''RAL
Legal boundaries denoted [310 CMR 15.220(4)(a)] X
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)] X
Locus Provided [310 CMR 15.2204(t)] X
Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for
components) [310 CMR 15.220(4)] X
Easements shown 310 CMR 15.220(4)(b)] X
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is required [310 CMR 15.412(4)] X
Location of impervious surfaces (driveways,parking areas etc.)
[310 CMR 15.220(4)(d)] X
Location all buildings existing and proposed 310 CMR
15.220(4)(c)] X
Location and dimensions of system components and reserve areas.
[310 CMR 15.220(4)(e)] X
System Calculations [310 CMR 15.220(4)(0] X
daily flow X
septic tank capacity (required andprovided) X
soil absorption system (required andprovided) X
whether system designed for garbage grinder X
North arrow [310 CMR 15.220(4)(g)] X
Existing and ro osed contours [310 CMR 15.220(4)(g)] X
Location and log of deep observation holes (existing grade el. on
each test) [310 CMR 15.220(4)(h)] X
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and i ] X
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(i)] X
Percolation test results match loading rate? [310 CMR 15.242] X
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] X
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)] X
Address 23 Pine Crest Road Centerville MA Sheet 1 of 7
N/A OK NO
Location of every water supply, public and private, [310 CMR
15.220(4) k X
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water supply X
within 250 feet of the proposed system location in the case X
within 150 feet of the proposed system location in the case
of private water supply wells. X
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR. 15.211 and any catch basins
located within 50 ft. [310 CMR 15.220(4)(1)] X
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] if water line cross see 310 CMR 15.211 1 [1] X
Profile of system showing invert elevations of all system
components and the bottom of the SAS [310 CMR15.220 4 (o)] X
Stamp of designer [310 CMR 15.220 1 and 310 CMR 15.220(2)] X
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)] X
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 310 CMR 15.405 1) k ] X
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103(4)] X
Test Holes adequate to confirm adequate groundwater separation?
[310 CMR 15.103(3)] X
Benchmark within 50-75' of system 310 CMR 15.220(4)(g)] X
Materials specifications noted? [various sections of 310 CMR
15.0001 X
System components not> 36" deep (unless Local Upgrade
Approval or LUA requested) [310 CMR. 15.405 1 b)] X
Address 23 Pine Crest Road, Centerville,MA Sheet 2 of 7
R
N/A OK NO
E"PTNC
Size OK? [310 CMR 15.223(1)] X
Inlet tee located ten inches below flow line [310 CMR 15.227(6)] X
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR
15.227(6)] X
Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X
Note regarding installation on stable compacted base [310 CMR
15.228(l)] X
Separation between inlet and outlet tees (no less than liquid
depth) [310 CMR 15.227(2)] X
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5)) or permitted for
upgrades under LUA [310 CMR 15.405 1 k ] X
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3)(0] X
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" by 7/07 [310 CMR 15.228(2)] X
Access to within 6 " of grade - one port for systems<1 000gpd,
two for systems>1000 gpd [310 CMR 15.228(2)] X
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)] j X
> 10 ft from building foundation [310 CMR 15.211 GA X
Buoyancy calculation Required/Done [310 CMR 15.221(8)] X
H-20 Where appropriate? [310 CMR 15.226(3)] X
Setbacks from resources [310 CMR 15.2111 X
Multi Compartment Tanks W 1�'�_""�v f
Required when other than single-family dwelling or flow>1000
d [310 CMR 15.223(1) b ] X
First compartment 200% daily flow; Second compartment 100%
daily flow [310 CMR 15.224(2) and 3 ] X
"U" pipe through or over baffle, outlet of each compartment with
gas baffle or approved filter [310 CMR 15.224(4)] X
Address 23 Pine Crest Road. Centerville MA Sheet 3 of 7
a
@ a _S K' f
N/A OK NO
B AFL y TeI�iGS WE12 ANDyOTHIR
. �.,.. .,
Located at least ten feet from any water line? [310 CMR
15.222(2)] X
Disposal piping at least 18" below water line (when water and
sewer cross, see 310 CMR 15.211(1)[1] X
Cleanouts required/provided ? [310 CMR 15.222(8)] X
Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] X
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
[310 CMR 15.222(6)] X
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] X
Siphonproblem/ leachfield below pump chamber) X
Endca s or vent manifoldspecified? X
Size and orientation of discharge holes specified? (not smaller
than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310
CMR 15.252(2)(h)] X
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed) X
DISTRIPBIITION"BOX � ' ' ,'. � � mot
. F
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a)] X
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323(3)(a)] X
Riser if deeper than 9" [310 CMR 15.232(3)(f)] X
Inside minimum dimension 12" [310 CMR 15.232(2)(b)] X
Minimum sum 6" [310 CMR15.232 3 (e)] X
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
[310 CMR 15.232(3)(d)] X
y
Capacity(emergency storage above working=design flow) [310
CMR 231(2)] X
Proper setbacks [310 CMR 15.211 same as septic tanks)] X
Watertight 20-in minium access manhole at least 20" MUST BE
TO GRADE [310 CMR 15.231(5)] X
Service components accessible (not too deep with piping,
disconnects accessible) X
Alarm floats - alarm on circuit separate from pumps specified? X
Exceeds two units must have two pumps operating in lead-lag
mode. [310 CMR 15.231(6) and(8)] X
Stable Compacted Base [310 CMR 15.221(2)] X
Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)] X
Address 23 Pine Crest Road, Centerville,MA Sheet 4 of 7
OII�ABSORPTI'ONSYST L1IS` SA GE�N � �
N/A OK NO
Calculations correct? X
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)1 X
Required separation to groundwater? [310 CMR 15.212)] X
Aggregatespecified as double washed [310 CMR 15.247(2)] X
System Venting required/provided? (system under driveway or
>36" deep) [310 CMR 15.241] X
Inspection ports specified and within 3"final grade? [310 CMR
15.240(13)] X
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document] X
GALL �FS;PI� �GgERS3y10 C ? 51 . ,`� NO
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. [310 CMR 15.253(6)] X
Each structure with one inspection manhole (if>2000 gpd must
be to grade) [310 CMR 15.253(2)] X
Aggregate 1' minimum- 4' maximum. [310 CMR 15.253 1 b ] X
2' sidewall credit maximum [310 CMR 15.253 1 a ] X
In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] X
..
r
Width 2'minimum 3'maximum [310 CMR 15.251 1)(b)] X
100 feet -maximum length [310 CMR 15.251 1) a ] X
Minimum separation 2x effective depth or width whichever
greater 3x if reserve between trenches [310 CMR 251(1)(d ] X
Situated along contours [310 CMR 15.251(2)] X
Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] X
�BSEDr�SAS�(1Vlaximum size o�f�b �dorfiel, 5000 gd) �" � f�� � ��e
minimum 2 distribution lines [310 CMR 15.252(2)(a)] X
Maximum separation between lines 6' [310 CM R15.252 2 d ] X
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)] X
Aggregate depth below discharge pipes 6" minimum, 12"
maximum. [310 CMR 15.252(2)(g)] X
Separation between beds 10' minimum. [310 CMR 15.252(2)(0] X
Bottom area used in calculations only [310 CMR 15.252(2)(i)] X
Address 23 Pine Crest Road,Centerville,MA Sheet 5 of 7
N/A OK NO
Pressure Dosed System ? Provided pump and piping
calculations as required [310 CMR 15.220(4)(r)] X
Pressure dosing required on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and I/A
Remedial Use Approvals] X
If used in gravelless system- make sure jet is directed as not to
scour soil interface [Guidance Document] X
Inspections once per year(systems<2000 gpd) or quarterly
>2000 d good to note on plan [310 CMR 15.254(2)(d)] X
Construction in fill - Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255(3)? X
Impervious barrier and/or retaining wall ? [Guidance Document] X
Impervious barrier installation must be supervised by
designer [310 CMR 15.255(2)(b ] X
Retaining wall must be designed by Registered Professional
Engineer [310 CMR 15.255(2)(a)] X
Side slope not exceed 3:1 ? [310 CMR 15.255(2)] X
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document] X
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended) [310 CMR 15.255 (2)(e)] X
G�a'velCess,Syst m �pirovaetters w ,x .,
Check DEP Approval letters for credits and design conditions X
If used with pressure dosing do not allow pressure discharge
to scour soil interface X
A51t'e nativee ttc£Sstem I%A A r aZl erg
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions? X
Is the technology being properly applied and does it meet all
DEP Approval Conditions? X
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement? X
Any alarms involved on separate circuits X
Did the applicant submit an operation and maintenance
manual? X
Has applicant submitted a copy of a maintenance X
4 Are the variances listed on the plan ? [310 CMR 15.220
(4)( )] X
RLS Stamp necessary on plan if a component is within five
feet of property line [310 CMR 15.412(4)] X
New construction or increased flow proposed - [Refer to 310
CMR 15.414] X
Address 23 Pine Crest Road, Centerville,MA Sheet 6 of 7
f
Bogen,Sensitive Areas `` x '° �� �� N/A �M OK NO
Is the system in a Designated Nitrogen Sensitive Area(Zone II for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems] X
Is the system proposed on the same lot as served by private well ?
310 CMR 15.214 2 X
[ ]
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1)] X
11Nliscellano§us,
.Pumping to septic tank ? [ 310 CMR 15.229] X
Shared System [310 CMR 15.290] X
Address 23 Pine Crest Road, Centerville, MA Sheet 7 of 7
Health Complaints
22-Nov-05
Time: 11:05:00 AM Date: 11/21/2005 Complaint Number: 18552
Referred To: DONNA MIORANDI Taken By: ELLEN WADLINGTON
Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH
Article X Detail: UNSANITARY CONDITIONS
Business Name:
Number: 23 Street: Pine Crest
Village: CENTERVILLE Assessors Map_Parcel:
Complaint Description: 55 gallon drums, scrap wood with nails sticking
out, and rodent population with children playing
around
Actions Taken/Results: DZM investigated and found no 55 gallon
drums except one filled with old metal. This
problem looks more like a building dept.
problem with the unfinished building and all the
trailers/campers on the property. They do have
a lot of tires which DZM will send a warning
notice .
Investigation Date: 11/21/2005 Investigation Time:
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COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
z
DEPARTMENT OF ENVIRONMENTAL PROTECTION
�M rev
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUisTARY ASSE EVE®
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION MAY 1 0 2002
TOWN OF BARNSTABLE
Property Address: 23 PINECREST RD HYANNIS PORT, MA 02647 Z� I�� HEALTH DEPT.
Owner's Name: JIM CASHMAN
Owner's Address: 14 ASHWORTH DR3N.OXFORD MA 01537
Date of inspection: 4/16/02
Name of Inspector: (please print):; JOHN GRACI
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O. BOX 2119 TEATICKET, MA. 02536
Telephone Number: 508-564-6813 FAX 5.08-564-7270
CERTIFICATION STATEMENT
1 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 syst.,ms. I am a DEP approved system
inspector pursuant to Section 15.340 of.Title 5(310 CMR 15.000). The system`
X Passes'
_ Conditionally yasses
_ Needs Furt Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Date: 4/16/02
The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within
30 days of completing this inspect on. 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 slubmit the report to the appropriate regional office of the DEP. The original should be
sent to the system owner and copies-sent to the buyer, if applicable,and the approving authority.
Notes and Comments
SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERT' TWO YEARS TO PROLONG THE
SYSTEM'S USEFUL LIFE.
****This report only describes cundilioiis'ul the time of Inspection 1uu1 ufldcl Ills' c11111IIIIll114 III 1141' III 111111 IIn1P, 11114
inspection does not address how the system will perform in the future under fac Same or different conditions of use.
Page 2 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM ItdrSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 23 PINECREST'RD HYANNIS PORT,MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
,rr•
X 1 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:
SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EV 11Y TWO YEARS TO PROLONG THE
SYSTEM'S USEFUL LIFE.
B. System Conditionally Passes:
_ One or more system components as described in the"Conditional Pass"section n,�:d to be replaced or repaired. The system,
upon completion of the replacement or repair, as approved by the Board of Health,wid pass.
Answer yes,no or not determined(Y,N,ND) in the for the following statemen-L' If"not determined"please explain.
n/a 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 exfrltration 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 ol&is"available.
ND explain: n/a
n/a Observation of sewage backup'or break out or high static water level in the distribution box due to broken or obstructed
pipe(s)or due to a broken,settled`or'uneven distribution box. System will pass inspection if(with approval of Board of
Health):
_ broken pipe(s)are replaced
_ obstruction is removed
_ distribution box is leveled or replaced
ND explain: n/a
n/a The system required pumping more than 4 times a year due to broken or obst,=,t:d pipe(s). The system will pass
inspection if(with approval of the Board of'Health):
_broken pipe(s)are replaced
_obstruction is removed
ND explain: n/a
Page 3 of I
y,
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 23 PINECREST RD HY,ANNIS PORT, MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
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
u
2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the
system is functioning•in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water
supply or tributary to a surface water supply.
_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water
supply well**. Method used to determine distance n/a
**This system passes if the welil'water analysis,performed at a DEP certified laboratory, for coliform bacteria and
volatile organic compounds indicates�that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy
of the analysis must be'attached to this form.
i
3. Other:
n/a
is
1.
1}
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i
Page 4 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT, MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
D. System Failure Criteria applicable to all systems:
You nwst indicate"yes"or"no"to each of the following for all-inspections:
Yes No
X Backup of sewage int61fac,ility or°system component due to 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 '/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 nia.
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of 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 1 of a public well.
X Any portion of a cesspool or 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. IThis system passes if the well water analysis, performed at a DEP
certified laboratory,for colifoi•m bacteria and volatile organic compounds indicates that the well is free
from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.I
(Yes/No)The system fails. l 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: t ,2
To be considered a large system th'e'system must serve a facility with a design now of 10,000 gpd to 15,000 gpd.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
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—I W PA)or a mapped
Zone 11 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 Itpitge y��(enl 11 failed. The Owner Or nperalor of on;' I�t; e sysl?Ill (nI1S1(Ieft(I *j sipilifif11)l iIli-4
under Section E or failed under Section 1)shall upgrade the system in accordance wills 1 I II t WW 1'• 41 'I
should contact the appropriate regional 611ice of the DcpparUnait.
7
t
Page 5 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 23 PINECREST RD HYANNIS PORT,MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
Check if the following have been done. You must indicate"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 Were any of the system components.pumped out in the previous two weeks`?
X Has the system received normal flows in the previous two week period ?
X Have large volumes of water been introduced to the system recently or as part of this inspection '?
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out'?
X _ Were all system components,excluding the SAS, located on site'?
X _ Were the septic tank.Aanho'les uncovered,opened,and the interior of the tank inspected for the condition of the
baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ?
X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance
of subsurface sewage disposal systems'?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
X _ Existing information. For example,a plan at the Board of Health.
X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is
unacceptable)[310 CMR 15.302(3)(b)]
i .
y4
' Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 23 PINECREST RD H.YANNIS PORT, MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 2 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220
Number of current residents: 0
Does residence have a garbage grinder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): NO
Seasonal use: (yes or no): YES
Water meter readings, if available(last 2 years usage(gpd)): nfa ZOOLj — LA -7 cp00
Sump pump(yes or no): NO l- 11 1 O a U
Last date of occupancy: n/a
COMMERCIAL/INDUSTRIAL
Type of establishment: n/a
Design flow(based on 310 CMR.1 a 203').: n/agpd
Basis of design flow(seats/persons/sgftetc.): 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/use: n/a
OTHER(describe): n/a
GENERAL INFORMATION
, ,a
Pumping Records e.
Source of information: n/a
Was system pumped as part of the inspection(yes or no): NO
If yes,volume pumped: n/agallons--How was.quantity pumped determined? n/a
Reason for pumping: n/a
TYPE OF SYSTEM
X Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool f
_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
t
system owner)
_Tight tank Attach a copy of the DEP approval
Other(describe): n/a
Approximate age of all components,date installed(if known)and source of information:
1969 IIY OWNE11
Were sewage odors detected when arriving at the site(yes or no): NO
Page 7 of 1 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT,MA 02647
Owner: 31M CASHMAN
Date of Inspection: 4/16/02
BUILDING SEWER(locate on site plan) .
Depth below grade: 0"
Materials of construction:_cast iron _40.PVC Xother(explain): ORANGEBURG
Distance from private water supply well or suction line: n/a
Comments(on condition of joints,venting,evidence of leakage,etc.):
TOWN WATER
SEPTIC TANK: X(locate on site plan)
Depth below grade: 0"
Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explaiii)n/a
If tank is metal list age: n/a Is.age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate)
Dimensions: 6' X 6' BLOCK CESSPOOL"
Sludge depth: n/a
Distance from top of sludge to bottom of outlet tee or baffle: 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
How were dimensions determined: MEASURED
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related
to outlet invert,evidence of leakage,,etc.):
CESSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.
CESSPOOL WAS EMPTY AT TIME OF INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO
PROLONG THE SYSTEM'S USEFUL LIFE.
l:
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(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related
to outlet invert,evidence of leakage,etc.):
n/a
tit
• Page 8 of I l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT, MA 02647
Owner: 31M CASHMAN
Date of Inspection: 4/16/02
TIGHT or HOLDING TANK: (tank'musf be pumped at time of inspection)(locate on site plan)
Depth below grade: n/a
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(yes or no): N/A
Alarm level: N/A Alarm in working order(yes or no): NO
Date of last pumping: n/a
Comments(condition of alarm and float switches,etc.):
n/a
DISTRIBUTION BOX:_(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: n/a
Comments(note if box is level and distribution Ito outlets equal,any evidence of solids carryover,any evidence of leakage into
or out of box,etc.):
n/a E
PUMP CHAMBER: _(locate on site plan)
Pumps in working order(yes or no): NO
Alarms in working order(yes or no):NO
Comments(note condition.of pump chamber,condition of pumps and appurtenances,etc.):
n/a
4
' Page 9 of
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT,MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
SOIL ABSORPTION SYSTEM-(9'. S): X (locate on site plan,excavation not required)
If SAS not located explain why:
n/a
Type
n/a leaching pits, number: n/a
n/a 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: n/a
6' X 6' BLOCK CESSPOOL overflow cesspool, number:
n/a F innovative/alternative system
Type/name of technology: n/a
Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.):
OVERFLOW CESSPOOL IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO
SIGNS OF FAILURE.OVERFLOW HASD NEVER BEEN MORE THAN HALF FULL. BOTTOM IS AT 8'6".
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: n/a
Depth—top of liquid to inlet invert: o/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 inflow(yes or n6)': NO
Comments(note condition of soil,signs of'hydraulic failure, level of ponding,condition of vegetation,etc.):
n/a
PRIVY: (locate on site plan)
Materials of construction: n/a
Dimensions: n/a
Depth of solids: n/a
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
n/a
n
Page 10 of I I ;
OFFICIAL INSPECTION. FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT, MA 02647
Owner: 31M CASHMAN
Date of Inspection: 4/16/02
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.
Locate all wells within 100 feet. Locate where public water supply enters the building.
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Page I I of l I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
-SYSTEM INFORMATION(continued)
Property Address: 23 PINECREST RD HYANNIS PORT, MA 02647
Owner: JIM CASHMAN
Date of Inspection: 4/16/02
SITE EXAM
_Slope
_Surface water
_Check cellar
Shallow wells r .
Estimated depth to ground water 12`+feet
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record- If checked,date of design plan reviewed: n/a
YES Observed site(abutting propc�'y-observation hole within 150 feet of SAS)
NO Checked with local Board of Health-explain: n/a
NO Checked with local excavators, installers-(attach documentation)
NO Accessed USGS database-explain: n/a
You must describe how you established the high ground water elevation:
HAND AUGER- 12+ FT. NO WATER ENCOUNTERED.
cd�
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1 I 4
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-S f
TOP OF FOUNDATION = 31 .7'± INISH GRADE OVER D-BOX= 29.4 ± o GENERAL NOTES
PROVIDE CONC. RISER WITH 4"SCHEDULE 40 PVC MIN. SLOPE 1 /o FINISHED GRADE OVER BIODIFFUSERS - 29,2' - 29,5'
COVER OVER INLET&OUTLET FINISH GRADE OVER TANK EL.= REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISHED GRADE TO WITHIN 6" OF F.G. 30,0�± RISER TO WITHIN 6"OF FINISHED GRADE INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
@ FOUNDATION = 30.0'± BOX TO WITHIN 3"OF F.G. CODE AND ANY APPLICABLE LOCAL RULES.
�-5' DIA. OUTLET(S) _ (ONE PER TRENCH)
20"MIN.ACCESS 9"MIN. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
COVER(3 TYP.)_
YP.) 36"MAX. - i DESIGN ENGINEER.
PROP. 4"SCH. 40 i
9" MIN. 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
PVC SEWER PIPE PROP.4"SCH. 40 36"MAX. 9" MIN.
SYSTEM UNLESS OTHERWISE NOTED.
FPVC SEWER PIPE 36"MAX. TOP OF SAS/ B.O. = 26.93'
2" DROP MIN.
MIN.SLOPE @1%1'*6 ' " 3"J14"
PROVIDE WATERTIGHT ! 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
3 DROP MAX. MIN.SLOPE@,r JOINTS (TYP.) ELEVATION = 26.93' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
4" PVC IN FROM41 �f
40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
' SEPTIC TANK 4" PVC OUT TO 1.33' nITYP
THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
26.80 � 6 TYPEXIST. PIPr LEACHING FACILITY 0 90, 1 E I I E (TYP.) 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
27.05' 12" 6" I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
48" OUTLET TEE 26.77 MIN. 26.60 I
26.50' 25.60' (LAID FLAT) 2.875' (34.5")�i- 5.75'� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
22"ZABEL FILTER MODEL#A1801 4x22 6" CRUSHED STONE S O� (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
-�-
(GAS BAFFLE ON BOTTOM) OVER MECHANICALLY TYP. 11.50' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
-20.7'TO B.H.
COMPACTED BASE 5' MIN. AND DESIGN ENGINEER.
6" CRUSHED STONE 5 OUTLET DISTRIBUTION BOX 30.0' (TYP FOR BOTH TRENCHES) 8. ELEVATIONS BASED ON AN ASSUMED DATUM OF 30.00' ESTABLISHED ON A
OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE NAIL SET IN FENCE POST AS SHOWN ON PLAN.
COMPACTED BASE C, C, ( Ci BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 18.87' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
LENGTH 10' 6" WIDTH 5' 8" DEPTH 5 8" (Dimensions per Wiggin CROSS SECTION VIEW BIODIFFUSER (PROFILE) BIODIFFUSER (END VIEW) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
SEPTIC TANK PROFILE Precast Corp., Pocasset, MA) 12 - ARC 36HC #3616BD1 BIODIFFUSERS TO THE DESIGN ENGINEER.
'CONTRACTOR TO VERIFY THIS ELEVATION& DISTRIBUTION BOX DETAIL ` / 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
REPORT TO ENGINEER IF DIFFERENT NOT TO SCALE NOT TO SCALE NOT TO SCALE
- 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
" • ` TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
HC-1 EXISTING#23s 0* •• • ' PERC NO. 12756 APPROPRIATE AUTHORITY.
3-BEDROOM • w +• w �- . • ♦ INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
DWELLING • EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE
TOF = 31.7'±
THEY SHALL WITHSTAND H-20 LOADING.
C.S.E. APPROVAL DATE: Oct. 1999
\FO EXIST. • ' . 4� November 12, 2009 i 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
DATE:
O�y/ CFOF 6 DECK •� �� •• // . ••• TEST PIT#: 1 114. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
• MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
Aq�F/Ll ( B.H. HC- ' ' • ' + a ZONE 2 •• ELEV TOP = 29.20' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
O'ti'w NT r • ; ' • i • �!wt• • ELEV WATER- < 18.87' I FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
\ • • : • • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
\ A/� • PERC RATE _ < 2 min./inch
` . • •• • • , SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
LO F • • 0 °
o 0��� �40- c�F . • * -�E 28"-46" 16. PROPOSED PROJECT IS LOCATED WITHIN:
DEPTH OF PERC =
•
a g \ /O�'A s� (5 ' s ,� 'CI• r '• • � -l�• TEXTURAL CLASS: 1 ASSESSOR'S MAP 247 PARCEL 151
�e4,c�0�0 3) •' ` "' • + • ` s• ` OWNER OF RECORD: GEMMA&JOSEPH JONES
p , '' ' �` y i• •° • • to " ADDRESS: PO BOX 461
CaO�y� . ..• , 0 29.20'
g / _ �3 2) � W ;, .# LOCUS ' •
- s •� .(C� • •�•. �� Fill 28 8T WEST HYANNISPORT, MA 02672
O� \ 37 4
r' '. • • • ,� .•• - �'"' •r .,� �. • . B Loamy Sand FEMA FLOOD ZONE C
o �O �� O�y\ 4) .• ! two .,_ "` :` • . COMMUNITY PANEL# 250001 0008 D
• • . ... ; • .• 10Yr 5/6
� CAP \ via. �< ♦!ll-: •♦ • w
30 � ♦ , : .• t • 28" 26.87'
17. DEED REFERENCE: BOOK 17401, PAGE 110
\ Perc
18. PLAN REFERENCE: PLAN BOOK 139, PAGE 5
Qy O S �� '�• " • . * • + I ; :r' ✓ 46" 25.37'
\ Q� SWING-TIES (SCALE: 1 =10 ) tl la` _' 'T
-• • • �� •` 19. ALL DISTURB�U AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
it oil it it • • •
DESCRIPTION HC-1 HC-2 f o QN it r �w • •..• "`°� Medium Sailo 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
MAP 247 \ vv \ �\ it f 7 • : FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
/' � \ 9� . ,.
SEPTIC COVER IN (1) 43.8' 29.4 C FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
LOT 152 \ 2.5Y 6/6
SEPTIC COVER OUT(2) 38.4' 31.5' 1 •
<t o PS \ �y,� 21. IN ACCORDANCE WITH 310 CMR 15.401 - 15.404, THE FOLLOWING LOCAL UPGRADE
�\ APPROVAL IS REQUESTED FROM 31 MR 1 11:
BIODIFFUSER CORNER(3) 29.3' 29.3' Q 0 C 5 2
1). A 3.0'VARIANCE (20.0' - 17.0') FOR THE SETBACK FROM THE PROPOSED LEACHING
ti-4v\ BIODIFFUSER CORNER(4) 38.9' 38.9' LOCUS PLAN FACILITY TO THE FOUNDATION WALL.
BIODIFFUSER CORNER (5) 36.2' 59.4'
3�\ ` MAP 247 -32_� BIODIFFUSER CORNER (6) 25.6' 53.6' SCALE: 1" = 1000' 124" 18.87'
� \ LOT 151 No Mottling, Standing or Weeping Observed
7,500 S.F.
DESIGN DATA TEST PIT DATA LEGEND
#23 ---- -31- - PERC NO. 12756
50x0 EXISTING SPOT GRADE
EXISTING INSPECTOR: David W. Stanton, R.S. _ -
NUMBER OF BEDROOMS (DESIGN) 3 - 50 - EXISTING CONTOUR
\ 3-BEDROOM / EVALUATOR: Michael Pimentel, E.I.T.
DWELLING DESIGN FLOW 110 GAU C.S.E. APPROVAL DATE:
DAY/BEDROOM Oct. 1999 -� 50 PROPOSED CONTOUR
/ TOF = 31.7'± / TOTAL DESIGN FLOW 330 GAL/DAY November 12, 2009
PROPOSED 40 MIL. IMPERVIOUS �� 660 GAL/DAY DATE: ❑/H/V EXISTING UNDERGROUND UTILITIES
GEOMEMBRANE LINER \ / G DESIGN FLOW X 200 % =
TEST PIT#: 2 GAS - EXISTING GAS LINE
Z9x2 \ ' INV=27 8'± /}� USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP - 29.20'
EXIST. W_W _ EXISTING WATER LINE
Benchmark r /�� ELEV WATER=
Nail Set in Fence 60- DECK < 18.87'
TEST PIT LOCATION
Elev. = 30.00' \ /B.H. '� PERC RATE _
.�
Approx. M.S.L. cb \ '� INSTALL 12 - ARC 36HC (#3616BD) BIODIFFUSERS LP EXISTING LEACHING PIT
DEPTH OF PERC =
TP 3 ` 30 /�/ ^o SYSTEM CAPACITY TEXTURAL CLASS: 1 CP EXISTING CESSPOOL
/ o°, 29.2 \ J o
9x2 ,�� oo LOT 150 MAP 247
h / 1• 1 / �`L ^ (TOTAL L.F. OF BIODIFFLISERS)(7.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD O O O PROPOSED 1,500 GALLON SEPTIC TANK
TP 2 ,� '� /� (60.0')(7.8 SF/LF) (0.74 GAUSQ.FT.)= 346.3 GAL. LEACHING/DAY 0" 29.20'
-I'"I Fill
�X �0 29,2' PROP. C/O / 4� 28.8T PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE
TOTALS: B Loamy Sand 13 PROPOSED DISTRIBUTION BOX
28x9 LP 10Yr 5/6
k ~ (PROPOSED INSPECTION PORT (TYP OF 2) 28.. 26 87'
TOTAL NUMBER OF BIODIFFUSERS: 12 PROPOSED ARC 36HC (#3616BD) BIODIFFUSER
TOTAL NUMBER OF COUPLINGS: 0
0 TOTAL LEACHING AREA: 468.0 SQ.FT.
PROP. TOTAL 12 ARC 36HC BIODIFFUSERS `.` 29x2
/
(6 BIODIFFUSERS EACH TRENCH) �-� / O p1 /-'� TOTAL LEACHING CAPACITY: 346.3 GAL./DAY Rom• DATE _ BY APP'D. DESCRIPTION
PROPOSED SEPTIC SYSTEM UPGRADE
/ EXISTING CESSPOOL TO BE PUMPED, FILLED
29x0 �`� IV /�/ WITH CLEAN SAND AND ABANDONED NOTE: PREPARED FOR:
\ ^
EXISTING LEACHING PIT TO BE REMOVED i}EXIST. EFFECTIVE LEACHING AREA OF 7.80 SF/LF OBTAINED FROM THE Medium Sand
AND REPLACED WITH CLEAN COARSE SAND - r �. SHED DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER C
A� 2.5Y 6/6 CAPEWIDE ENTERPRISES
"MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO
PROPOSED DISTRIBUTION BOX '���� ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003 (LAST
MODIFIED JUNE 30, 2008). TRANSMITTAL NUMBER=W000052. LOCATED AT
23 PINE CREST ROAD
PROPOSED 1,500tis042, NOTES:
GALLON SEPTIC TANK- 25., CENTERVILLE, MA
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF SCALE: 1 INCH = 10 FT. DATE: NOVEMBER 13, 2009
C/� EACH SEPTIC SYSTEM COMPONENT. No Mottling, Standing or Weeping Observed 0 5 10 20 40 FEET
<t�YH OF b(�� Mod
�'FiQ 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF JOHNL. c'a PREPARED BY:
THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST RESERVED FOR BOARD OF HEALTH USE I CHU'RHCH�LL JC ENGINEERING, INC.
F PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL CINA 2854 CRANBERRY HIGHWAY
BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. No o�
� EAST WAREHAM, MA 02538
SITE PLAN 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. 508.273.0377
SCALE: 1" = 10' Drawn By: MCP Designed By:MCP Checked By: JLC JOB No. 1721