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Home My WebLink About0061 POWDERHORN WAY - Health G1 POWDERHORN WAY, CENTERVILLE A= 190 005 mom C No.-1153LOR HASTINGS,MN No. D Fee TIE COMMONWEALTH OF MASSACHUSETTS Entered ui comp er: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplit tion for Bizipo8al 6pstem Construction Permit Application for a Permit to Construct( ) Repair(+�Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No.&j Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 801a U Installer's Name,Address,and Tel.No. aaSr•SIo78- a,c- I1�signer's ame,A ess,and Tel.No.6-BV— c oo?-115 �alrSlrtC'ons�rtr}�cy t�:S7jY�t�S <sd' N �1'3 j lLl�✓l� MA. 420n Type of Building: Dwelling No.of Bedrooms 3 Lot Size /7, R5 0 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures P Design Flow(min.required) 30 gpd Design flow provided 3 7 9 gpd Plan Date fie.. '�}ah wig Number of sheets Revision Date Title—LA S - jj" 0aj Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 C and to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ne e.._. Date 4 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. "� Date Issued TOWN OF BARNSTABLE LOCATION 0&--i SEWAGE# -AOl6 -0`1+ VILLAGES t¢ /i�� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C. I . 5 771- 36tj� SEPTIC TANK CAPACITY "71ld LEACHING FACILITY. (type) -:717� ., C_(,(— (size) I 1�- NO.OF BEDROOMS 3 -I-- Sao 4.Arc OWNERt � PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHEDBY /Ji ej �� ii � 7��,V (.:. a �- ��b y��r �� t # No: Fee T E COMMONWEALTH OF MASSACHUSETTS 'Entered in comp er. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppF Iication for : osaZ 6pstrut construction 3permit . , Application for a Permit to Construct( ) Repair(✓� Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. '.rt C � Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. V,,,)$- $�%aZ,,G� Designer's Name,Address,and Tel.No.�r--a i{- 3,oR Type of Building: Dwelling No.of Bedrooms J Lot Size �y �5 ± sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) _,330 gpd Design flow provided 3 y 9 gpd Plan Date U 4 7 0l. Number of sheets �� f9 � Revision Date Titl ) _a 1 ( / Size of Septic Tank � c,4,,, �tyyOc,_.,,Q Type of S.A.S., Description of Soil Nature of Repairs or Alterations.(Answer when applicable) _ +r Late last inspected: r 'Agreement: The undersigned agrees to ensure the construction and main_teenn-an�cee of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envir714-- C ane'' d afto place the system in operation until a Certificate of t , Compliance has been issued by this Board of Health. e � Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by Z&v-1vA� ( �A(Z4i6�ZoZ at ��, l�rE�1/�r has been constructed in acco74,4 ce with the provisions of Title 5 and the for Disposal System Construction Permit No. / ted Installer ' ��, ��j,,K_ke�� -T�[_ Designer y n , ,, #bedrooms �j Approved design flow D gpd ..r The issuance of this permit sha3 not be co trued as a guarantee that the syst will functi as es' ed. Date Inspecto - No: 0 6 Fee �✓ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstent Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at (v! i 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:Constrq1tion mu be eo pleted within three years of the date of this permit. j b proved A Date � / P Y � -04-2019 22:33 From: To:15087906304 Pa9e:1/1 Town ®f Barnstable Regulatory Services ' Thomas F.Geiler,Director 'enY six rublic Health Division MABE� r ' 'Thomas McKean,)Di rector 2001VU[n Street,Hyannis,MA 02601 Office: 508-862-4644 F= 508-790-6304 Installer&Besig er Certification Forms Date! Sewage PerwIO a01? 09 51 .Assessor's MV\Pareel q4 5- IDesigner: �D UN hsta&r: ��LOVTI� ON - - - Ad&eaq: q32 mRdN �►�aarea�: . 45 [ L D On was issued a permit to install a (date) (xn er) septic system at LLE based on a design drawnby (addresby IWIEL A.QJArLA._PE;F� dated 2-12 21 t q (desi ) r—� X cry that the septic system referenced above was installed substantially according to the design,which may iml;ude minor approved changes such as lateral relocation of the distribution box and/or septic tank. Y 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 t in accordance with State&Local Regulations. Plan revision or cued as- signer to follow. �3t%or DANK. OJA, "= mstauees ignatl�Te) " CIV. 0 No.46, �°��ForsT .• '.��'fSt engner's Signature r Designer s Stamp Here) P.LEP'ASE RETURN TO k4EWrASLEE PUTS [C BEAM DHVI I()N. CERT (LATE OF CONOMANCE WiOzNOT E 7MD UNTIL WOR TEHL9 FO AND AS-R CARD AM nonTD BY IW BAAMAEB EE MLIC HEAL EI E-0-N- THAKKli'O Q:Hca WSgtic/Uos per Cut ficadon Form 3 26-04.doc ' �(2 �2" DIA. BOLTS ,!ASHERS AT 24° O.C. 2�SCH SIDE OF � iECTED —STEEL14 PLATE PER PLAN Nq �.4 4_x P' 9f D ICM�C ELPP &AN (,+)t7Az j j� L, ST14bs TLITCH BEAM DETAIL 0 r (t F&O-PJ6 MINI ex 04�cy M1Ca�El cu9llo -A 0 sTRucTURAL 0 No 34774 o e �FQIsi Goa a ADDENDUM ell S• R, , cN� MICHIELE C UDILdting . P.E eer 123 Cottonwood Lane. Centervige, Massachusetts 02632 Drawn By: MC Date: L D r a,wi n g Gbw ko- ° scale: AS NOTED Rev. o p Fite Name: Project No.: �G 0 D`V H { k: }Uw- MEMBER REPORT PASSED level 2ND,Floor:Flush Beam 3 plem(s)1 3/4"x 14 2•BE Micrellaral®LVL Overalll?ngth:16' '} T 0 0 d R 16, i 2 , o a All locations are measured from the outside face of left support(or left cantilever ends All dimensions are horizontal Design ltest!(t,S AOuat 0 0,0000 Allowed Result LPF P cad Combiaa0ort(Pattem) :Floor Member Reaction Obs) 7836 0 2" 7809(3.50") Passed(100%) — 1.0 D+1.0 t(All Spans) Hwdw Type Rush Searn Shear(1bs) 6407 @ 1'S 1/2" 13%5 Passed(46%) 1.00 1.0 D+1.0 L(All Spans) SWAin Use,Residential Bugg Code IBC 2015 Moment(R-lbs) 300SO 0 8' 36387 Passed(W%) 1.00 ,1.0 D+1.0 L(All Spans) oesign methodology.Aso Live Load Deli.(in) 0.391 @ 8' 0.392 Paced(L/481) — 1.0 D+1.0 L(All Spans) Tote)Load Defl.(in) 0.600 @ V 0,783 Passed(V313) -- 1.0 D+1.0 L(Ali Spans) f (� •Demon criteria:LL(LJ480)and TL(ts240). .\r •Top Edge Bradrag(Lu):Top compression must tr he braced at 6"sic un�ss detailed otherva>se. C� �t,J j�� J �2 ` r •Bottom.Edge Bracing(Lu):Bohan compression edge must be braced at 16 sic unless detained ottrersvae. a ring, etfptlr adsft$uRP¢R (lbg) _.. i7 TOWAraiXakTe � Arad F(PvrLivra T AeoessQ.¢refi 1=stud wall-SPF 3.S0" 3.s0" 3.51" 2736 S10D 7M 8loc" 2-Stud wall-SPF 3.S0" 3.SW 3Si" 2736 S100 7836 Biocidng •Bbddng Panels are assumed to carry no bads applied directly above Vm&Qjpdtw hd bad is applied to the membw being designed. P444 F1,a0r lfve Lt d rocatrom(Side) 170Hdcarylaridth (M"2) (F•Oo.) Commettts; 0-Self A 21.s to 6 ti/ Weight(PUF) 1-Uniform(PSF) 0 to 16'(Front) 12'9" 12.0 30.0 Default Load 2-Uniform(PLF) 0 to 16'(F W) N/A 4010 3-Uniform(PSF) 0 to 16'(Front) 12.9" 10.0 MO rMember Notes HS.. E SPAN SEAM fffferhaeuser Note Weyewhaeuser vwrants that the s Wng of its p►oducts will be in accordance with Weyerhaeuser product design criteria and pad demon value&Wejerhaeuser expressly disclaims any other warranties related to the soitviane.Use of this ware is not intended to atcvm wk the need for a design professional as defermiirled by the authority having PerisdiQtbn.The designer of record,buitdet or framer Is responsible to assure that this caladation is compatible with the overall project Accessories(Rim Board,Boating Panels and Squash Mocks)are not designed by this sd ware.Products manufkti ned at Weyerhaeuser facilities are third-party cwdNed to sustainable forestry stamtards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC-ES undw evaluation reports ESR-1153 and ESR-1387 andlor tested in acco"Wee with applicable ASTM standards.For atirent code evauation reports,weyerhaeum product literature and IrMllation details refer to www.vieeae�e►.eortVwoodproducWdocvmert bury. The preduct application,input design bads,dimensions and support information have been provided by A.BRAGA A AI AR SUSTAINAB E FORESTRY HTtATnfE � f' +i W,S • �M�GN�p �� G �� D f FaftWED Sa tware operator lab Rates p� 1/30/2019 2:07:5i PM UTC MICHELE CUDILO,P.E. RES[DEHCE MODIFICATIONS MICHM CUOILO CONSULTIMG STRUCTURAL 4 POWDERHt>RN FortieWEB v1.5,Engine:V7.3.1.294,Data:V7.2.0.2 90GI -TNG tt� t vtLLE,MA 737-852i File Name:2019-39BRAGAPowdeehom (SO8)737 mcvddot@comcMnet A :e 1.4 joy �vl vi o _. � oWy C Gje '.Sr y /z�`q-31 yiC i 40 1 } j E � 2 Alba ` t Town.of Barnstable P# iHE o Department of Regulatory Services " Public Health Division * DA MASS.LE, * .Date I MASS. 94jA 16g9• ,�� 200.Main Street,Hyannis MA 02601 i l �a r I/ FD a . Date Scheduled ; Time Fee Pd. j' pd Soil /Suitability Assessment for Se e Disposal" Performed By: .J�6,-e �0, �Ve s Witnessed By: LO.CATION:&,.GENERAL;INFURIVIAT ON w d Location Address / ��""" n t0 f u� �o ✓� W Owner's Name ) �X / /J Address •' ef Assessor's Map/Parcel: qo/ooS Engineer's Name. NEW CONSTRUCTION REPAIR Telephone#.,`(fas-3 ,3L Land Use P,0_ Slopes(%) r. � Surface Stones A// Distances from: Open Water Body (n00 ft Possible Wet Area '-> l/0�ft Drinking Water Well� ft ` Drainage Way y t/ ft Property Line w ft Other ft SKETCH:(Street name,dimensions of lot,exact to ations of test holes&perc tests,locate wetlands in proximity to holes) Paws e,- Harr) way 1IS O/ r Ex Sfin� D+vell;/!� c 0 r T � Parent material(geologic) jV`c(Gl u4walk A` Depth to Bedrock Z O Depth to Groundwater: Standing Water in Hole: /V / Weeping from Pit Face Estimated Seasonal High Groundwater 01//A I� ERM NATION FOR'SEASONAL HIGH WATER TABLE Method Used: //1�6 16V Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST. Date Time Observation Hole# Time at 9" Depth of Perc 7 7 Time at 6" Start Pre-soak Time cr Time(9"-6") End Pre-soak Rate Min./inch G Z 9"7r�✓ , h Site Suitability Assessment: Site Passed Site.Failed: Additional Testing Needed(YIN) /V Original: Public Health Division Observation Hole Data To Be Completed on Back----------- *"If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTICTERCFORM.DOC'- i 4 DEEP OBSERVATION HOLE LOG Hole#._� Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel �0/0 Greve DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Snil, Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. �f Consistency.Y_o Gravel) V ` 9 �i /( �- 39 SL I K50 39-132- C 10 `! DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. ` Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No Yes 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? y e S If not,what is the depth of naturally occurring pervious material? Certification / I certify that on S�� / 12 (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,expertise and experience described in 310 CMR 15.017. Signature �/� �%' � '..`_' - Date Q:\SEPTIC\PERCFORM.DOC tHE 7 Town of Barnstable Barnstable ° Regulatory Services Department AgAmeiicaC j nnenrsrneM 6'9. ,��' Public Health Division ""�� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 5787 August 23, 2018 CIVITARESE, STEPHEN L & TARA L 61-POWDERHORN WAY CENTERVILLE, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 61 Powderhorn Way, Centerville, MA was inspected on 08/14/2018 by James D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOA OF HEALTH ho , . ., CH Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\61 Powderhorn Way Centerville.doc i THE r w Town of Barnstable t w + BARNSI'AHM 9�P 6 9 a Regulatory Services Department rED MA't Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc 190- Dos Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments h,"l w 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name f' Information is Centerville (/ � required for every MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection 17) Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. %A OP raid-*I Important:When A. Inspector Information -�- filling out forms •' ••� ••-'. cy� on the computer, G' !'- use only the tab James O.Sears JAM E S m key to move your Name of Inspector cursor-do not ; 12 Capswide Enterprises use the return c 0,=Q. r key. Company Name ,� Z 153 Commercial Street lea IMSp�Gp�� Company Address Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector In full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails B-14-18 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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, r5insp.doc•rev.7/26f2o1e Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 a6ed Xed dH £SZZ 860Z 91l• 611V Commonwealth of Massachusetts (p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ow 61 Powderhorn Way Property Acdress Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of and 6. 1) 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: Failed System leaching. The system is a 1000 Gal. Tank D Box and pit 2) 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): t5insp.doc-rev.7/261M18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 E 96ed XeJ dH £gZZ 860E 51• 6ntf Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspectlon C. Inspection Summary (cost.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational, System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level In the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) 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. a. 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: t5insp.doc•rev.V2612018 Title 5 Official Inspection Form:Subsurface Sewage Oisposal System•Page 3 of 18 £ a5ed xeJ dH £SZZ ME 91, brtV f" Commonwealth of Massachusetts e Title 5 Official Inspection Form nsp Subsurface Sewage Disposal System Form -Not for Voluntary Assessments vi 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. C4ilrown State Zip Code Date of Inspection C. Inspection Summary (cunt.) ❑ 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 b. 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: I '*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. c, Other: 4) 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 t5insp.doc-rev.7/26/2018 Title 5 OfAcial Inspection Form:Subsurface Sewage Disposal Systern-Page d of 18 abed xeJ dH £S:ZZ 860Z S6 bnf Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,v r 61 Powderhom Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in 40MOM is less than G" below invert or available volume is less than '/2 day now Pi'm ❑ ® 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 water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® 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. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surf ace drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply I 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 t5insp.cloc-rev.72612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-page 5 0116 g a6ed xeH dH EgZZ 860Z gl• 6nV commonwealth of Massachusetts Title 5 Official Inspection Form rg Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered :'yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section C.4 shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no" for each of the following for all inspections: 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 wat er been Introduced to the system recently or as part of this inspection? ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank Inspected for the condition of the baffles or tees,material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t6insp.doc-rev.7126f2018 Title 5 Official Inspection form:Subsurface Sewage Disposal S•,rstem-Page 6 of 18 9 a5ed xe:I dH bS:ZZ 860E 96 5nb' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-1 B page. Cityffown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): - 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage2016-104,000Gal g ( y (gpd))' 2017-33,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NA Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 a5ed xeJ dH t,S:ZZ 81,0Z 91, 6171b' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. CommerciallIndustrial 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 Water treatment unit present? ❑ Yes ❑ No If yes,discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: dons How was quantity pumped determined? Reason for pumping: l5insp.doc•rev.7126MIR Title 5 Official Inspection Form:Subsurface Sewage Oispcsal System-Page a of 18 8 a6ed xed dH 99ZZ 860Z 9I• 6nV Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 4. Type of System: ® Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of informatlon: 1990-90-504. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 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.): Pipeing is 4" PVC SCH -40. I5insp.doc-rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 6 a5ed xed dH 99ZZ 860E 56 5nV Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhom Way Property Address Fannie Mae Owner Owner's Name equired don Is r for every Centerville MA 02632 8-14-18 requir page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 6. Septic Tank(locate on site plan): Depth below grade: 18"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: 1000 Gal. Precast H-10 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Tank Full W/Solids Scum thickness To Covers 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.): Note: Tank full w/solids -Not been pumped in many years. Inlet solids up to cover. t5lnspAoc-rev.WW2016 Title 5 Official Inspection FDfm:Subsurface Sewage Disposal System•Page 10 of 18 o f abed xed dH Wee 8 60Z 91, find Commonwealth of Massachusetts Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form •Not for Voluntary Assessments F 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Syslem•Page 11 of 18 1.6 abed xe� dH 99:Z2 2 60Z 9 6 5nV r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhom Way Property Address Fannie Mae Owner owner's Name information is required for every Centerville MA 02632 8-14-18 page. CityiTown State Zip Code Date of Inspection D. System Information (cunt.) B. Tight or Holding Tank(cont.) 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 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert NA Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box, etc.): D Box located on site. t5'rnsp.doc•rev.7i2812018 Title 5 Ofridal Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Z abed xezI dH 9WE 860Z 91• 5nV I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Powderhorn Way Property Address - Fannie Mae Owner Owners Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Irupection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7126/2018 Title 6 Ofrdel Inspection Form:Subsurface Sewage Disposal System-page 13 of 18 £6 a5ed xe� dH 99ZZ 860E 56 find , cf',N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments E05 61 Powderhorn Way Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil,signs of hydraulic failure,level of ponding, damp soil, condition of vegetation, etc.): Leaching is a 1000 Gal.precast pit. Pit and cover at 14". Pit has been full to cover. Pit has solid carry over.Wall's are covered w/solid's on top of inlet line. Need to replace system. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5insp.doc•rev.7126=18 Title 5 official Inspection Form:Sut•surface Sewage Disposal System•Page 14 of 18 {,6 abed xed did LW� 8 60Z 91, 6n'd Commonwealth of Massachusetts ,p Title 5 Official s Inspection Form Subsurface Sewage p y for Voluntary Assessments 61 Powderhorn Way v Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of I gi, abed )(e:1 dH LgZZ 860Z 51. 5rb Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 61 Powderhorn Way Property Address Fannie Mae Owner Owners Name information Is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 tO o , r � lwi 13 t5irlsp.doc•rev.712af201 a Title 5 Official Inspeclim Form:Subs irface Sewage Disposal Svstem•Page 16 of 16 96 a5ed xe:1 dH LSZZ 860E 51• 611d Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Powderhom Way Property Address Fannie Mae Owner Owner's Name information Is required for every Centerville MA 02632 8-14-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12' 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: Cl Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Auger T.H. 12' no G.M. Bottom of pit at T below grade. Bottom of pit at S above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5inspAcc•rev.712612018 Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 19 a6ed xe� dH 85:ZZ 81,0Z 91, 6rTV Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form • Not for Voluntary Assessments 61 Powderhorn Way y Property Address Fannie Mae Owner Owner's Name information is required for every Centerville MA 02632 8-14-18 page City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1,2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 151nsp.doc•rev.726/2018 Trlle 5 Officiai nspectiorn Form:Subsurface Sewage Olsposal System•Page 10 of 18 g abed xe� dH 89:Z2 8OZ 96 6nV VE Town of Barnstable Barnstable Regulatory Services Department ;ericaC ay aaxuvsrar�». t1,,9.i63S/, Public Health Division Gb `� m AT�D M 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO SECOND NOTICE CERTIFIED MAIL#7015 1730 0001 4987 9170 September 24, 2018 FEDERAL NATIONAL MORTGAGE ASSC 8950 CYPRESS WATERS BLVD COPPELL, TX 75019 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 61 Powderhorn Way, Centerville, MA was inspected on 08/14/2018 by James D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\61 Powderhorn Way Centerville- Second Notice.doc V Commonwealth of Massachusetts Executive Office of Environmental Affairs Dept. of Environmental Protection AN I One winter Street,Boston,Ma. 02108 John Grad D.E.P. Title V Septic Inspector P.O. Box 2119 Teaticket, MA 02536 WILUAM F.WELD (508)564-6813 Governor ARGEO PAUL CELLUCCI 1 U.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO / ly b PART A CERTIFICATION �S tit4), /�,� t� Property Address: 61�owderHorn Nay Centerville Lo LA' p Address of Owner: p 6 ` Date of Inspection. 5f4198 ! (if different) OyyN 1 t Name of Inspector: John Grad Mike Web y�a�gq I am a DEP approved system Inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) !Ty FpjTgB� Company Name,Address and Telephone Number: <d 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 This Inspection to based on criteria dented In Title V _ Conditions y P SCS code 310 CMR 16.303.My findings are of how the system is performing etthe time of the Inspection.My Inspection does _ Needs Fu he valuation By the Local Approving Authority not Impyanywarrantyor guarantee of the longevity ofthe Fails Ifseptic system and any of Its components useful life. Inspector's Signature: Date: 5/41g8 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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. INSPECTION SUMMARY: Check A, B,C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank Is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Co hpliance(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 conforming septic tank as approved by the Board of Health. (revised M7197) One Winter Street 9 Boston,Massachusetts 02108 • FAX(617)556-1049 0 Telephone(617)292-5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 61 Powder Horn way Centerville Owner: Mike Web Date of Inspection:514199 _ Sewaae backup or.breakout or hiah.static water level observed.in.the distribution box is due to a broken, or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced —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 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS Is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must Indicate either"Yes"or"No"as to each of the following: — I have determined that the system violates one or more of the following failure criteria as defined 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 — Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Diachorge or ponding of offluent to the surfac@ of th@ ground or mirfac@ wal@r§flue to on ov@rlo@ded or cloyp(I cesspool. SAS Is In hydraulic failure. (revised 04127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 61 Powder Ham Way Centerville Owner: Mike Web Date of Inspection:514198 D]SYSTEM FAILS(continued) Yes No 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 V2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. 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"as to each of the following: The following criteria apply to large systems in addition to the criteria: 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: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revleed 0427)87► SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM S PART B CHECLIST Property Address: 61 Powder Horn Way Centerville Owner: Mike Web Date of Inspection:514rea Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: _c_ — Pumping information was requested of the owner,occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the 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. _ — . 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. x The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, If different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x _ Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is — — unacceptable)[15.302(3)(b)) (revised 04/27197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 61 Powder Horn Way Centerville Owner: Mike Web Date of Inspection:514109 FLOW CONDITIONS RESIDENTIAL: d./bedroom for S.A.S. Design flow: 3w g p Number of bedrooms: J Number of current residents: 4 Garbage grinder(yes or no): Yea Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available:(last two(2)year usage(gpd): da Sump Pump(yes or no): No Last date of occupancy: nla COMMERCIAL/INDUSTRIAL: Type of establishment: nis Design flow:0 gallons/day Grease trap present: (yes or no) Ne 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: rds Last date of occupancy: Na OTHER:(Describe) rda Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System was pumped two years ago. System pumped as part of inspection:(yes or no)Ne If yes,volume pumped:0 gallons Reason for pumping: Na TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) I/A Technology etc.Copy of up to date contract? Other: APPROXIMATE AGE of all components,date Installed(if known)and source Information: 1968 Sewage odors detected when arriving at the site: (yes or no) No (revlsed 04)27)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 81 Powder Ham way Centerville Owner: Mike Web Date of Inspection:5f4198 SEPTIC TANK: x (locate on site plan) Depth below grade: V Material of construction:x concreate_metal_FRP_Polyethylene_other(explain) If tank is metal,list age nia . Is age confirmed by Certificate of Compliance Ho (Yes/No) Dimensions: L8'6"H57w4•10~ Sludge depth:3" Distance from top of sludge to bottom of outlet tee or baffle:24" Scum thickness:3" Distance from top of scum to top of outlet tee or baffle:e" Distance form bottom of scum to bottom of outlet tee or baffle:te" 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.) Septic tank and all components us ativcburally sound and functioning properly.Recommend pumping now,then every year. GREASE TRAP: (locate on site plan) Depth below grade: rda Material of construction: _concrete_metal_FRP_Polyethylene_other(explain) Dimensions:rda Scum thickness:rda Distance from top of scum to top of outlet tee or baffle:rds Distance from bottom of scum to bottom of outlet tee or baffle:nla Date of last pumping'. 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.) nfa BUILDING SEWER: (Locate on site plan) Depth below grade: yr Material of construction: cast iron x 40 PVC_other(explain) Distance from private water supply well or suction line? Diameter: 4•_ Qi�mments:(conditions of joints,venting,evidence of leakage,etc.) (revised U27W) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 61 Powder Ham Way Centerville Owner: Mike Web Date of Inspection:514108 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: da Material of construction:_concrete_m eta l_FRP_Polyethylene_other(explain) Dimensions: ne Capacity: da gallons Design flow: da allons/day Alarm level:_da larm In working order? Yes_No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) da DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: n1a Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box etc.) da PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)Yea Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) da pev1eed00127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 61 Powder Ham Way Centerville Owner: Mike Web Date of Inspection:stares SOIL ABSORPTION SYSTEM(SAS):x (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Na Type: leaching pits,number: ons1000gellonleachpit leaching chambers,number:Na leaching galleries,number: n1a leaching trenches,number,length: Na leaching fields,number,dimensions:nla overflow cesspool,number:Na Alternate system: Na Name of Technology:_Na Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.) Leach ptt and all components are structurally sound and lunctiontng properly.System has V of leaching lelt CESSPOOLS: (locate on site plan) Number and configuration: Na Depth-top of liquid to inlet invert: Na Depth of solids layer: Na Depth of scum layer: Na Dimensions of cesspool: Na Materials of construction: Na Indication of groundwater: n1a inflow(cesspool must be pumped as part of inspection) Na Comments:(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) Na PRIVY: (locate on site plan) Materials of construction: Na Dimensions: Na Depth of solids: Na Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Na (revised 04127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 01 Powder Hom Way Centerville Mike Web 514198 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) I 1� Uo C VD Uq (nvio•dOWNT) Page ! of 10 . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 61 Powder Ham Way Centerville Mike Web 514198 Depth of groundwater 12 Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. v Observation of Site(Abutting property,observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators,installers X Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS maps and charts (nv1e.d04WA7) sage 19 of 19 TOWN OF BARNSTABLE �LOCATION p� �� 3 VA SEWAGE # VILLAG V(Ll Ce,i ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE N SEPTIC TANK CAPACITY j DC e LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PU iC-W.&TER BUILDER OR OWNER Mkt-\ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No AN� A^ V o, �^ 35 a TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE �e�'�'ew, I I� ASSESSOR'S MAP & LOT /70 —UCfs INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type)�, DD 0 (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No vy2Ms gy rice �wSO-c1 .� 1�u5 -� 2,. �00 0 9a � � Gf2S3�a�.��,S 3� �.�� ' t \ .. ,� � /I �(. ,D u ar;�l�ot✓ �4�y� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH. TOWN OF BARNSTABLE Appliration for Disposal Works Tonotrurtio rruti# Appli tion is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: --...(4---- - ----------------- .. -- --------------- ._......_....----..--_----. ocation- d e .bot No. lLr1Z- ------------ ------------- ------------- I o -----------A�d .-•------- .... .................. Owner --••------- ----- ` -- nsler ddresstal d Type of Building Size Lot___________________________S q. feet U Dwelling—No. of Bedrooms........___________________________Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building ____________________________ No. of persons............................. Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------=-•-••- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity_._.________gallons Length________________ Width................ Diameter---------------- Depth____................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ fT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-----•------••--------------••-•-•--••--•-••-•---•----•-•...-------•--------•••--------------------......................................................... 0 Description of Soil................................................I-•----•--•-------•---•--•----•---••-••-••---•••----•----•-••••----------•--••-••-------------------•----•._......._...... x U ..._..•••------•--------------------------------------------------------------------•---------------•--------•---•--•----•----------------------•-•-•----•------------Z!�-------------_------------- W ---------------------------------- ---- ----------- w U t e of Repairs or Alteratio Answer app !j!! _ _____ - ------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not 'to place the system in operation until a Certificate of Co plia as iss d by the board of health. igne --------- ----- ---. ..-- -------- - -- ------------------------------ .... - Application Approved B ........ ... ....... . .....^'�� ll-r - ----- Dare Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------- -- ------------------------- ................................I-------------- - - ---- �} Dace Permit No. �/ �.l� 9. �------------- ---- --------- Issued 1./. - . 4- -- b----------_---- ...:.......... r ITHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Allp iration for Dispniitt1 Works Tonstrnrtinn .ermit Application is hereby made for a Permit to Construct ( ) or Repair ( Il)an Individual Sewage Disposal System at: ! W ..... ...__..�....�. ......................r < ..�. . - ----..._.........1.. ---1- ........ ••.+.�.r ......................................... r\� — !!aation-�dd�s� 1 ....----•--. , ±• s _ ----------- ......................... ? ............... ...................... AddlesC -----` -- ' - �^`�� ln(I lain l .�AN� ..I ?�'`!. ,Z .Y � nstaller , dress Type of Building Size Lot............................Sq. feet �-t Dwelling—No. of Bedrooms............. •---.------ Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No: of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----------•-•-------------------------------------•--••---•••---••••••-•••••••••••••-•--•••••••••••••-••-••••-•-•••-••••............._.............. W Design Flow...............;............................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter__-__ _-_-_._ Depth................ x Disposal Trench—N'o..................... Width................._..,Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___--__.�_'___._ Diam'ete`r_==`::_-___.._'Depth below inlet............ ..... Total leaching area..................sq. ft. Other Distribution box ( ) } Dosing tank ( ) aPercolation Test Results Performed by•-•--------•----•---•••••--------------•-•-•--•--•-•----•••---------•-•- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth\to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ................................................O Description of Soil------------•-•------------------•.............-----.......--•---------------------------------------•-------•-------•-•--......-----------•--••••......-----------•_.. x U ----------------- -------------------------------------------- ••-•------------------- •-------------------------------------------- -••----------- ---------- U Nature of Repairs or Alteration —Answer when applicabe �PC)cam- �t�,c /��"X�r �- i �.= ��r �r�� s Y C--------•--- r.�. ---•---- � � � :� b � � —.........................................- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees,not,to place the system in operation until a Certificate of Corn l"lan e'has been issued by the board of health`. ``r Signed � � do/6 -�--- Application Approved BY , .. 1.......7 f/ ...---- ................. ................ ....../ fl�w � Dare Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- -------------------------I....-•--- ------------••. .......------------------------.................................................................... ........................................ PermitNo. /)-"?�A Issued al...�....l .✓..--.J..v........................................ ............ .._.................te....-. -/ - - /• Date 6 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE a Gextifirate of (gontylianre IS r! 0 CE TIF`; That the Individual Sewage Disposal System constructed ( ) or Repaired by ..2 i x ,...._........ ....--------^------------ -------................ .... ... .. ............................................. Installer : -r.....-.-.. :. Q �... r -- . has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application fo`r DisposaltWorks Construction Permit No. ..-.... . ..' /. --........ dated�.��i /?�Qd.................. . i THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONST,6E, AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. . DATE---- l... .... 6.... ....................... ... - ..... Inspector : +r/• ..--:..::. �.. _...... p rLu�v V THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH � TOWN OF BARNSTABLE �! 7 Disposal orks-�nstrnrtinn "prrmit Permission is hereby granted :........... - �:. ................... . ............................................................. to Construct ( )-or Repair ( ) a Individual Sewage Disposal Systyetn (K[I�L. at No y "r'" ........---•--......--•-••-----•........... ...�r ' ......_. :..., ....................................................... �Streeb � / as shown on the application for Disposal Works Construction Permit No.65. 712-rO�V. Dated..... ............................. ..............................................�� i �....L.,//,..,,_....... -- .;.. . Board of-,Health / DATE......&./ .................................................. GJ v J FORM 36108 HOBBS&YiARREN.INC..PUBLISHERS ALL SHALL TE SYSTEM PROFILE MARK DS WITHC MAGNETIC TTAPE OR BE NOTES (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. PROVIDE MIN. 20" DIAM. WATERTIGHT 1. DATUM IS NAVD 88 Cl- ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE o� �a TOP FOUND. EL. 47.3' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING eta / s 7 45.9' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. ot�e o MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 43.0 Q I PRECAST H-10 THICKNESS REQUIRED BLOCKS OR UNITS STO BE O ADASHO OR 10LL PROPOSED PRECAST 5e�r chQ�pQ RISERS (TYP.) , MORTAR ALL PRECAST RISERS o U .. . 44.7 6" MIN. SUMP 4"OSCH40 PVC H-10 12" MIN. INT. DIM. PIPES LEVEL 1ST 2' COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. 4' INV'S EL. 39.2 4' a INSTALL TEE (TYP•) ENDS SIDES 40.03 ** ➢;p o;o�;p o;�0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE Locus 10" EXISTING 14" °o°° o0000000° a y. TEE SEPTIC TANK TEE * �QQ�QQ O 0�l°'� Do Mo Mo Eo_!__0 �Eo Lo 0 °o°a°o° WITH 310 CMR 15.000 (TITLE 5.) �3 EXISTING 43.4 f ��[��®�� 0�0�0 ° Sywia °o°o°o°o°o°o WATERTEHT D'BQX O ;°o°o°o°o o 0 0 0 0 0 0 ,°o°o°o°o ,1. o°o°o°o°o°o° ,°°°°°°°° o o o o o 0 0 0 0 0 0 0 o 0 0 0 0 0 0 ;°°°°°°°° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND d. GAS BAFFLE ::; _o�o�o o°o_ FOR LEVELNESS c� ,°°°°°°°° oa�oo�000aa aoa�aaooaoo °°°°°°°° c Z8 Iler R ,°°°°°°° NOT TO BE USED FOR LOT LINE STAKING OR ANY ate Fu 39.47' ° °°°°°°°° 37.2 R° 39.3 °°°°°°°° OTHER PURPOSE. •"•• . � 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. LH-10 500GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED ALL AROUND PRECAST STRUCTURES 9. COMPONENTS NOT TO BE BACKFILLED OR 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 [2]) HEALTH AND PERMISSION OBTAINED FROM BOARD �o CO OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR ( 15.1 % SLOPE) ( 1 SLOPE) CALLING VERIFYING ITHE LOCATION OF ALL UNDERGROUND & LOCUS MAP 31.5' BOTTOM TH-2 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000'f LEACHING NO GROUNDWATER FOUND FOUNDATION-EXISTING SEPTIC TANK 26' D BOX 12 FACILITY ' WORK. *THE INSTALLER SHALL VERIFY THE LOCATIONS OF **INSTALLER SHALL CONFIRM MINIMUM SEPTIC 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 190 PARCEL 5 ALL UTILITIES AND ALL BUILDING SEWER OUTLETS TANK SIZE AT 1000 GALLONS AND ITS BE REMOVED BENEATH AND 5' AROUND THE AND ELEVATIONS PRIOR TO INSTALLING ANY SUITABILITY FOR RE-USE. REPLACE WITH 1500 PROPOSED LEACHING FACILITY. LOCUS IS WITHIN FEMA FLOOD ZONE X PORTION OF SEPTIC SYSTEM GALLON SEPTIC TANK APPROPRIATE TO SITE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED (AREA OF MINIMAL FLOOD HAZARD) AS CONDITIONS IF NOT SUITABLE AND REMOVED OR PUMPED AND FILLED WITH CLEAN SHOWN ON COMMUNITY PANEL #25001CO561J LE G E^ ' D SAND. DATED 7/16/2014 y � 44� 99- EXISTING CONTOUR X 99•1 EXIST. SPOT ELEV. A� -[99]- PROPOSED CONTOUR O�Z� 198.41 PROPOSED SPOT EL. q5 TH 1 P0�� TEST HOLE SLOPE OF GROUND s�z� oo, SYSTEM DESIGN: 115 UTILITY POLE F PAVED GARBAGE DISPOSER IS NOT ALLOWED 45 � FIRE HYDRANT DRIVE EXISTING 3 BEDROOM DWELLING NOTE' NOT ALL SYMBOLS MAY APPEAR IN DRAWING q5 °tip LOT AREA 6 DESIGN FLOW: 3_ BEDROOMS 0 110 GPD = 330 GPD 14,950± S.F. USE A 330 GPD DESIGN FLOW TEST HOLE LOGS SEPTIC TANK: 330 GPD (2) = 660 �46 _�, **RE-USE EXISTING 1000 GAL. SEPTIC TANK ENGINEER: DANIEL E. GONSALVES, SE #13587 °tip EXISTING 41 SIDES:LEACHING: 25 + 12.83 2 .74 = 112 GPD WITNESS: DAVID STANTON, RS / DWELLING \ ( ) ( ) DATE: 2/15/19 TOF - 47.3 BOTTOM 25 x 12.83 (.74) = 237 GPD PERC. RATE MIN 2 INCH BENCHMARK: _ < / CORNER BULKHEAD TOTAL: 472 S.F. 349 GPD CLASS I SOILS P# 15895 = 47.0' NAVD88 / N USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) ELEV. ELEV. �� 46 WITH 4' STONE ALL AROUND p» 42.5' p„ 42.5' O \�� _-��--- 454�� FILL FILL o PO\0 APPROVED DATE BOARD OF HEALTH// MA 3» 8" O TH2 ' B B �} TITLE 5 SITE PLAN ) SL UNSUITABLE SOIL 3, k�� TH1 ,< OF 10YR 5/6 , 10YR 5/6 o 36" 39 5 �� 38 39.3 61 POWDERHORN WAY �Z CENTERVILLE, MA C c PERC 6 X 5 0' PREPARED FOR M/CS M/CS ,� � 11 k� BORTOLOTTI CONSTRUCTION DATE: FEBRUARY 22, 2019 1OYR 4 1 4 / 45 7/ OYR 7 \ N of V,ASSq� � off 508-362-4541 fax 508-362-9880 DANlELA. c�PAy s� DANIEL �, _M downcape.com R r� �� . 4 OJAU� A. " " CIVIL !�' lGtALAI • • • 132 31 .5' ,32" <a1 No.46502 I o �0 r00 v 00WO cope eag1neering, 1/!c 31.5 � � i46� , < �h of o� civil engineers Scale: 1"= 20' �Fssf_ a�,t t s yo lQ'nC� Serve O/'S NO GROUNDWATER ENCOUNTERED ��Z-Z�-r'� �n� E IRv �"� y � w J 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 C� � , �_®2 , 0 10 20 30 40 50 FEET 19-021 BORTO-BRAGA.DWG