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HomeMy WebLinkAbout0235 PRINCE HINCKLEY ROAD - Health 235 Prince Hinckley Road / Centerville P A = 171 114 1 I i 1 J . TOWN OF BARNSTABLE LOCATION051 f%1y c W Q Jd<CEY SEWAGE#g)a) 1 -CkOl VILLAGE CENTCRUI(1-P-_ .-ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SIG L.�If���YL 7S SEPTIC TANK CAPACITYK1�f lt��►3Cj �A{ a LEACHING FACILITY.(type)�$�K��j�t �' �-0 (size) NO.OF BEDROOMS Ic ue v ��3eS OWNER PERMIT DATE: g' C�^ COMPLIANCE DATE: Q @l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and L.aching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY � K i iLi Q TOWN OF BARNSTABLE L4YATION a35 Gt�(-jAcL bL,1JJ21 SEWAGE # VILLAGE Cfo! �V+�� ASSESSOR'S MAP & LOT INtTXLLER'S NAME& PHONE NO. SEPTIC TANK CAPACITY �OVp LEACHING FACILITY: (type) P1 7 VX(o� (size) ST✓t� NO. OF BEDROOMS_3� I BUILDER OR OWNER PERMITDATE: COMPLIAN DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leacg facility) Feet Furnished by SrJCGTIO� �O� A ► - 3- 53 (3.3 a a Ay- as y f ; No. 6q 00 t9 t ` Fee .��,/ THE COMMONWEALT14 OF MASSACHUSETTS Entered in computer: t/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Misposal 6pstrm (tonstrUttion 3pPrmit Application for a Permit to Construct( ) Repair V) Upgrade( ) Abandon( ) ❑Complete System ;1_n__d`ividualComponents Location Address or Lot No. p_�'W f M` (;.tAty/tv Owner's Name,Address,and Tel.No.ti;`Ilrrw C�'I'e�Z �1� Assessor's Map/Parcel Y' r,&t_ t �Ki°,, L A2, 5a R nstaller' Name,Address,and Tel.No.ImscA p :�el� Des i er's Nam me,Address,and Tel.No.CN-QQ to I`5ae�iti�'l a@ ?+� PC)Vt t cV6k Type of Building: Dwelling No.of Bedrooms .S Lot Size y y$�Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 110 gpd Design flow provided gpd Plan Date `b l lc 11 01 Number of sheets 'Z Revision Date Title Size of Septic Tank 1&tb !qt~i(,;.y,S Type of S.A.S. 614(, Tr V Description of Soil 0" +o 11°1 �-,���,�i �� � �0 � `t �� rd.l 1 pkr.� �(r" `fie 1411.1" 04.�,d 5a_-j j Nature of Repairs or Alterations(Answer when applicable) f-4 j'5-." 100- 7.4t. 1-1c-41 L.1) wle �� t:i�-i1' LI�� f 3� (l �' ( ) t��.�-S j dS ►3i� '� -4-le a-n`t r A,)Cz S�CVNz,., ca�tivl c�y ti'rd► cJl o,-y Lol C.QA 0%)AAA k&�- 'es 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"Health i d Date 1 Application Approved by Date f? Application Disapproved Date for the following reasons Permit No. a00 -2C_ Date Issued cI No. Ova -S � ' � � ," i"rt°r Fee _� THE COMMONWEALTW ,M SSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for -MispoBal 6pstem Construction Permit Application for a Permit to Construct( ) Repair V Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No.la M"AG Q %A;"'Q`I X�A Owner's Name,Address,and Tel.No.k_)Nc�,n �ct'f'o ZZ C_ A�c�ty i ale- s Assessor's Map/Parcel R Installer's Name,Address,and Tel.No.1'ca5o,n 12oy-e/LS Designer's Name,Address,and Tel.No.1NQ\z-,1 4we�iu��Z SaQ�,� Obb4 1f46b + W. 0- en °��e6 N2 3 2�-t�, �.. 4 ���..���:��., Mr _.5.0 34-2.Z'122 Type of Building: Dwelling No.of Bedrooms Lot Size ? .FLI%0 sq.ft. Garbage Grinder( ) ,Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 1/0 gpd Design flow provided ® gpd Plan Date `�j 10 p q Number of sheets Revision Date Title t 2 Size of Septic Tank J p(ob Type of S.A.S. (,,4 L g);+. Description of Soil0" i0 pill ex.. 1 .I.o Z(c" Su-1a.1 10► 3Ge" `(0 IWLI„ k4-ecA $.. A Nature of Repairs or Alterations(Answer when applicable) (tl kYe o %4-10 Of (7) QCLIJ% o4 (5) ltcr' LA5, Lit� t1 ��5�✓t ' +i=_ 3 00,i!S--At o 5 A , cA-A a fe y+-k Aa Q cal 0,'7 S LO Date last inspected: Agreement: 1'` 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 B and of Heal riged Date �A-1 Application Approved by r/ Date �17 d 9 Application Disapproved Date for the following reasons Permit No. �60 C1 — 2 Date Issued ( 7 o � '- - ` - -- --- ---------------------------- ---------------------- THE COMMONWEALTH OF MASSACHUSETTS c._..�'BARNSTABLE MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired({sue) Upgraded( ) Abandoned/( )by )jiSvn Q04,A,1'L-5 C w v t*C- at "� }�(L,1^ 1A rT1"`_C*_! VL&t has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.1�ove,___v dated Installer't-,5 n {��g e n c (��,7 a�n 3i`�;Q 2 Designer&AVI.e m4 q #bedrooms "' Approved design flow A ID gpd The issuance of this "qermij shall not be construed as a guarantee that the system will c"on as der signid. Date Inspector ' / Gl 1 No. d 0� - Fee /66+^ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS ]Disposal bpStem Construction J)ermit Permission is hereby granted to Construct( ) Repair(v) Upgrade( ) Abandon( ) System located at ;� Z5� lA K_P 1AC40"I%Q-4 (L CA 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'pe it. Date ( -7 ��} `} Approved by )A �� Rug 26 09 03: 10p p. 1 Town of Barnstable Regulatory Services Thomas F. Ceiler, Director ' uAA1vMA818 .9 MA9B �. Public Health Division TRo Thomas McKean, Director 200 (Nhin Street, Hyannis,MA 02601 Office: 508-362-4644 Fax: jO;i-90-h304 (nst:,ller & Designer C:ertifieati4n F4rrn Date: 421(01p� Sew:tre Permit# lletiigne.r: I r✓�✓� Installer: W � Address: IQx lb —_- Address: 1„L 02537 vv, �a�t� 02623 ���� On 17 D`� --..-._�4SOAP01. QRS BIyewQI Inns issued a permit to install a (date) (installer) s("ptic system at _J_Z11..✓_L' based on 1 de,ign drawn by (addre,$) . k dated .. D 1� �. I �;cnlfy that rho: septic system referenced above wtis installed subst-ntially according to the design. which may include minor apprcw(,d chac�ges such as !:'te:al reiocarua ;; t;�C distribution box an&or septic tank. __— 1 certify that the se ti major system referenced above was installed with major chans�cs I.C. P _� greater than lU lateral relocation of the SAS or am vertical relocation o` any COtllP011CLlt of the septic system) but in accordance with Statc lie Local Regulations. Plan revision or certified as-bef' designer to t,�Ilow. of C , s� DARREN M. s o, MEl'ER (Install•r". ."is;tls `� No. 1140 I - IA NITA��p� (Designer's Signature} (Affix Desi.gner's Stamp Here) PLE,,kSF: R1•:TI1RN TO BARNSTABI'F: 11IM11C HEALTH DIVISION. CE:11TIF'IC'A'CE OF COiyUILIANC E WILL NOT BF. ISSUED UNT11, ROTH THIS FORNI AND AS-B111i.*I*CARD ARE RECr.IVFD BY TFIr. IIARNST:\BLE PUIt1.,IC HF_ALT I DIVISION. TIJANK YOU. — Q'..I lealth/Scp6cfDesigncr Ccrtitication Form 3.26-t➢i 0C I � ��Y_Town of 1BAi astable. P# Department of Regulatory Services ? j Public Health Division Date-7 4s e� 200 Main Stree4'Hyannis MA 02601 " •ssv . Date Scheduled Time ` Fee Pd. Soil Suitability Assessment fop Sewage Dispo al Performed By: L'^ t" t P��l t7�_ I Witnessed By: LOCATION &G)ENERAL INI4'ORMATION Location Address .R35 P12J tQl&F_ t 1 l J6 / RD Gw 's Name CfroZZ I o �Q.v 1 t L r-- NSA �Address aorEe V)L L e N�c Assessor's Map/Parcel: I.7 /�` I s-Engineer's Name Din MG NEW CONSIIZUt�I70N REPAIR ' FTelephone# �( Land Use t✓ � Slopes(%) �' Surface Stones .2'S D ��p0 ft Drinking Water Well ?7� ft Distances from: 1 Open Water Body ft Possible Wee Area___ . Drainage Way ®� ft. Property Line l D. ft Other ft I , I 0 SIOTCH:(street name,dimensiods'of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) _ _ _._ ........ te°dir4 --- .n � Eyis ,910) r VED'�QR_c pA (Note I -I a49• F- 0 ---- --�---\ r N/ATER LINE...... ,, \ n� / • I ` I — son � 11 in LL Ln ° I o i Property ltn� \ I \ w (U LLJ \ I� pV 09 �0� a C.� i I Q0 � St A- I Existin9LL t0k�� 2a$S o TortSeptic P I w Q __------�-5 o LJ Parent material(geologic) Depth to Bedrock ' Depth to Groundwaldr. Standing Water in Hole:' i Weeping from Pit Pace Estimated Seasonal li jigh Groundwater i -- •- DtTERMINATION FOR SEASONAL I3IGII WATER TADLE Method Used: I. I _ Depth Cibserved standing in obs.hole: in._ Depth to Sall tnA98, in. Depth toiweeping from side of obs.hole: i in. ©foundwoter AdJ It usttdent Index Well#-----__ Reading Date Index Well level!�.' A4 Actor,,,.--- Adj.Crt7undwnter Level I PERCOLATION TEST . Date 'rime . Observation , 3 Hole# Tune fit 9" i • Depth of Pere Time at 6" ....._•_,._� .�.-..-- Start Pre-soak me.(} ®G �s Time(9"-G') Ti A)2 J I End Pre-soak V rr�� Rite MinJlnch L \ I I Site Suitability Assessment: Site Passed X Site Failed:: Additional Testing Needed(YIN) Original:.Public Halth Division Observation Hole Data To Be Completed on Back---------- ***If percola#6n test is to be conducted within 100' of wetland,,you must first notify the Barnstable C44servation Di-,zsion at least one (I weak prior to beginning. 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 r ® q''- 3 `' B LoA x d e-s 3 i 2' G Flt•e _ Me 2AG�(l SA-V V . 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) S�K ' DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. o 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. Flood Insurance Rate May: Above 500 year flood boundary No Within 500 year boundary No X i,Yes Within 100 year flood boundary No k Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? WS If not,what is the depth of naturally occurring pe vious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection and that the above analysis was performed by me consistent with the requirpd-tr ,expertise and experience described in 3.10 CMR 15.017. Signature Date �� C2 g ` COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS ul DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 235 Prince Hinckley Road Centerville, MA 02632 Owner's Name: Chris Leary Owner's Address: 40 Vernon Street Medford, MA 02155 Date of Inspection: December 6, 2001 FRECEIVED Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford 2ooZ Mailing Address: P.O. Box 49 : Osterville,MA 02655-0049 TOWN OF BARNSTABLE Telephone Number: (508) 862-9400 HEALTH DEPT. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs her Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: December 18, 2001 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 235 Prince Hinckley Road Centerville, AM Owner: Chris Leary Date of Inspection: December 6, 2001 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined", please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 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 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 • Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_ ✓ Any portion of the SAS, cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area- IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 235 Prince Hinckley Road Centerville, AM Owner: Chris Leary Date of Inspection: December 6, 2001 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ _ Were as built plans of the system obtained and examined?(if they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6. 2001 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 1 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): No Water meter readings, if available(last 2 years usage(gpd)): 2000-10,000 gals; 1999- 11,000 gals. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): pd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None on file-per treatment plant Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: Qallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Mar. 25181 -per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron 40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 2' Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs of leakage. Recommend installing risers on the covers. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 ` Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. Roots were QrowinQ inside and the D-box was broken down structurally. A new D-box was installed(see permit#2001-736). PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): 8 . 'Page 9 of i l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 6'x 6'with]'stone(per design plans) leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): The pit had 1'ofwater on the bottom. The scum line was T up from the bottom. There were no signs of failure The cover was Y below grade. The bottom to grade was approximately 96". Recommend installing risers CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 Map: 171 Parcel: 114 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. • So (v 41- as k Aa- s/ A3- $3 a3- a� L a Ay- as y 13q- (o 10 f . 'Page I 1 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Prince Hinckley Road Centerville, MA Owner: Chris Leary Date of Inspection: December 6, 2001 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate (check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: The bottom of the leach pit to grade was approximately 96". Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 25'+/-to ground water at this site. Using the Cape Cod Commission Technical Bulletin, the high ground water adjustment for this site(SDW 252, Zone D 11/01)was 5.0'. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 s GrA d 2. CEO. b 1-�iq� Grovndw/a'�ei �eVe _ S � _ �C�SUST'Me✓��- S Dw a.Sa of a S. 0 A G rove C�L wATe r l eve I P� TOWN OF BAR!NSTABLE LOCATION a3s Pr/1ce n(ilC SEWAGE #0ni --73W VILLAGE &A-Terv.lt ASSESSOR'S MAP & LOT /-7 fly I,I - 3 INST.,LLER'S NAME&PHONE NO. GQr�a^� etjs SEPTIC TANK CAPACITY 4 e w Ib"GOX LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER C rt S J,tAr PERMITDATE: COMPL CE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ao ; Aa- Sl All r A3- 5.3 O 133- a8 Ay- a� a No. 2Vp Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �V Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Migpogar *pgtem Cow5truction 3permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. -� .3$ Jp/iA1-E Owner's Name,A dress and Tel.No. C CN 0-,� �� Cho /s 1,4,A el Assessor's Map/Parcel /r// — //// �3S' / /J�/GF �'fi /[y Installer's Name,Address,and Tel.No. '�/ Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations( swer hen applic ble) "7 A�l� Date last inspected: Agreement: The undersigned agrees o 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 Certifi- cate of Compliance has been issu y this Board of Health. Signed Date /al '* C Application Approved by °�'`= Date d �l Application Disapproved for the following reasons Permit No. �U y �'7 7 Date Issued C o G -7J No. � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �/ ✓ Yes PU LIC HEALTH DIVISION, TOWN OF BARNSTABLE, MASSACHUSETTS ZIpphratfon for �Dfgpogal *pgtem Congtructfon Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. a 3.5 �in ` Owner's Name,A dress and Tel.No. c�rvr�l�, ��€� Ch�e �s Arlqay/ r Assessor's Map/Parcel / l/ 3S ✓A/GF M`kLf(1F 1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: -,Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date ' Title , Y Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations( swer when applicable) Date last inspected: Agreement: � 4 �v The undersigned agrees to ensure the construction and maintenance off 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 Certifi- cate of Compliance has beenrissu y this Board of ealth. Signed �� Date /off / CJ Application Approved by &17 2 °n= Date i LN Application Disapproved for the following reasons Permit No. T a o 717 Date Issued f G 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 ' at 23 S Ai ti c1,11C C iv 494,;J1 Q has been constructed}'n accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. )D u /- �3G dated /0 71 Installer Designer The issuance of this permit shall not be construed as a guarantee that the syste will function as designed. tzlDate t Inspector R ..`,1 4A) e `�- V No. 200 71 Fee y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lfgpogal 6pgtem Congtructfon Permit Permission is hereby granted to Construct( )Repair( Upgrade( )Abando (- ) ,/ System located at 3`S !7,'/✓LGf ii✓c /��s� ��`ifiOE/Z ti✓�T and as described in the above Application for Disposal System Construction Permit.The applicant recognizes 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. N Date: 11 V 7 10t Approved by r - a3� LO,CAT ION� SEWAGE PERMIT NO. V1-1:L AG E I N S T kLLER'S NAME i ADDRESS C C) �.. qakw ck- B UILDER OR OWNER -fay F5m��1 .DA`,T E" PERMIT ISSUED DATE COMPLIANCE ISSUED L 2�� . � fir` Y�' � :� .� W_ Y44 No.._ ............ .. Fim$.......- e......... THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HEALTH ?rt.......0 F.............. ........................................................................ Applirativit for Dhipos al Works Tonstrurtivit ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....../ ... .. ........................................ ---------------- ---___--•--.._.._..._.....--•--........... Location- dre s .. .................. ... ... ................................................................ ............. ... ........ ......................................... W Owe nfr ,Address .............. .... ........ .......•..... -----............___....._.__................... ............... ----------.__ •-•-----•------- ..__... ' Installer Address Type of Building Size Lot-----Z-U{___�_'_-Sq. feet Dwelling—No. of Bedrooms.............#_..............._..........Expansion Attic ( Ar4 Garbage Grinder (^o aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) elOtherfixtures .----•-----••-•-••------•------•-•-----.....--•-----•-••-----••-•--•------•-••-•••-•-------� W Design Flow___________4..2 S G-AQ_____gallons per person per day. Total daily flow____-______3__3...¢..................gallons. WSeptic Tank—Liquid capacity/O.Mgallons Length................ Width................ Diameter---_............ Depth................ x Disposal Trench—No_ .................... Width_.__...�__.__... Total Length._._.._____ Total leaching area__._______._________sq. ft. ` Seepage Pit No....�47�._.. Diameter..... Depth below inlet_________.____ Total leaching area.__c2:.Q/_sq. ft. Z Other Distribution box (,,4-- Dosing t ~' Percolation Test Results Performed by___________ __ _ ?..._..... Date.__�.�_... - _'?�- a . --------•-- Test Pit No. 1___�/� minutes per inch epth of Test Pit____________________ Depth to ground water.____._.__.__._.__._.__. rTf Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ......_ Description of Soil. .`.... .,�----- . -- , & ��' g L.� =........................ W •--•••--•••-••-•-•••-••-----•----•-•-•----'--------------------•--______•------------------'-•'----•...--------•'••••-----'--------------•----...----•-•'•---_________.__....._......_._..t--..__...... W ---•-------------------------------•--•---------•-•-----••------•--•--------------••---•-----••--•------------••------------•------•-------•--------•---------------------....______....------'--_...:•- V Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------•------•-----------'••---•----------•-----•--•---•--•----------••-----•'•••-•-------•'--•-•---------------------------------•----•----•------------•-•••-----------._................--•- Agreement: The undersigned agrees to install, the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersign d further agrees not to place the system in operation until a Certificate of Compliance has been iss e by the boar f health. Sig d.._.._ J �lr' Date Application Approved By........ -•-• _._.. _ .. ..................... '/d.:- Date Application Disapproved for the following reasons:.........-..............---••----••----------------............................................................. .................•---'------------•--------•-•-•••----•--•-•--------_._...-------__...--•--'-•-----______---•••--•---------'-•-••----••---"------------••-•---'--•-••--''----•-----•-••----------_..... Date. PermitNo......................................................... Issued........................................................ Date No. ....... .--.... Fizz.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F..................:........--..........--------•-------......•----._......_............... Allp iraa#ion for Disposal Works Tontrnrtion ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................----....--...................................................................... .............-•-•--••-•--••••-------•--.....-•••••----•-•---•-•-••-----•--•--.........._..-••••--• Location-Address or Lot No. .............................................................•.............._._........._.__._.... ...__......_.__.......:_...._...._....__.......__..................._........_.........._.......•. W Owner Address a .......... ........ Installer Address Type of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin a YP g ------------------•--------- No. of persons............................ Showers ( ) — Cafeteria ( ) d Other 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—No...................: Width �.__.. ..._.... Total Length_..__....__ ...... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-__-- t.. ..... Depth below inlet..... ...... Total leaching area_..�.:.Q_/.sq. ft. Z Other Distribution box ( Dosing t �e Percolation Test Results Perf rmed by........ __ i_._...... ... 1. ........... Date...j_ �"/ _--------------- Test a Pit No. I.... minutes per inch e-pth of Test Pit.................... Depth to ground water____..........__._____.. L� Test Pit No. 2................minutes per inch Depth of Test Pit..........:......... Depth to ground water............_........... •------------------------ Description of Soil------.... ......A. � _ �/��¢!�1��•_.... U ••••-•-•-•-••••.....•-•••••••--•••••-•-•-••••-•.........-••••--•••-••...•--•-•••-•••-••---......••-•••----••---•-••-••---•••---•-•••••--••-•••••...•••••••••.............•••---..................•..... W x ••-•-•--••••-----••••••--•-•••-••••-••••••--•-•-•••-•-••-•..............•-•••-••------•-••••--•---••----••••----••------•-----•-----••••••--•••----•••••••-•...-•••••••-•-•••.........••._...---••--•--- U Nature of Repairs or Alterations—Answer when applicable------------------------------------------_.................................................... •................•------...-------•--•-----...-----.......------------------------------••••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. 4Sig Date --..................... ................................ Application Approved B Date � Application Disapproved for the following reasons-....................... ---•-•--------•---••-•--••...•-••-••--••-•••••••-•••••-•••••-•••- Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .': . ... Tatifiratr of (Somplittnre T S rS T iCER I Y, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by . 4� •..... 49°? •••••. stall 77-71 has been installed in accordance with the pr isions of T ; ` of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__ .... ... ,r................ dated..... .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FICTION SAT4SF TORY,. DATE -----•--•--•--•---. Inspector.---•-------•------.... ..:.:::.............. THE COMMONWEALTH OF MASSACHUSETTS \ BOARD�dF HEALTH No...... `---tl " FEE�e.�.......... t ro r ons#r ion ami# Per miss on ' hereby granted- .....•..._.. '------•-•----------------------------------------------------- -- ------------ ------ to Constr or Rep 'r�( ) an Individual Sew g Dispos Syst. ' at No.. ` w T treet as shown on the application for Disposal �orks Constru �on �P�e-� t No r�.. -_ � ...........•••. - ard DATE...... .. 3 ,� Hea -V4 •-•--••••...••••-•••••••............•-•••••-•-FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ,a, S►UGI.b c.otin►��! - 3 ��eao� - ln GAS � �V iJ� C'f `�, Li' tr��E•{�. UO 6.rzi r L>&t t-'14 F'LOw -- 110 -4 -S • 33o 6.P•D. w. CEQF -IC T -1K = :S30f lriC %. • 4,957 6.P.D. USA- I OOp 6A L-. , �ISPoS,�.� PiT - l�sE I ono <.-At , �I I��n SF � � �..5 • 3'7S G.P.D. �' _ APT .� sue. :: ► .o So �.p�. �, m M " TOTAL T>rSIGr.1 = 425 &.pD• ? rw o ? N ToTo L t.-,( Pc-:oCDL&T%o Q O.&TE 1"ui I-M I u•o¢ ,4 .: FAID. 7?�i9�76 MeST 99 Top Fw L Iao.o G'L: 9rr 6a,4M •. �"Ppe 1000 tuv• 97.0 s tj X)tlr. Iw. Z' "Bo sepnc •_ lOpp 9G•o �, � J 4 &AL. 94 Z. �� LEgcN A FIT ? •,� WAS+IED "4 STONE 90,0 • C SQ-TIFIEID PLOT uv S�AL.+E=-1 SCI.0 ( ILA bAT>± rz,z 0 1 CMlz-rl =lf T�4AT TNrE 1ouaoQTroW 514owW PZ-A,Q Rol=� �►.toE t 1F.�:Gn�,1 Gc LPL�fS W ITk TOG: 51DE.L(WF-- - �.� aua SEY�,nc1� 1~c4�tcEti�G►-ITS of TNr~ �v�- S� ~row►.! OF' �$A!?►JS�" �1 �tr.• ���C ?,C3,°.n (?fir. , '1..�;RcGlSrc.r:�D "Wo 5u2vcYols TI-AIS FLAW IS LJOT 'LASeo vN AN OSTE�'V1t,.l.0 o LASS. u.lsr�c.».�c.t�iT -`C 5 Y-, 51aWtr� 4: Kb, r at- urL-o To t)c:rczMo-4 .:: ,LOT Lli�tL.•.'s .. .tl.. I I LEGEND \ \ \ PROPOSED CONTOUR ® PROPOSED SPOT GRADE- EXISTING CONTOUR 54 4` 3; �••T, + 96.52 EXISTING SPOT GRADE xc 1�/ 4 /j // �?36 7\ rt W— EXISTING WATER SERVICE TEST PIT `$ x �` QExisting Leaching ____--- \`� , , ��j : (Note 10) \ LOCUS MAP N.T.S. Q C) ftp Port y \� GENERAL NOTES: Q / fig. L. \ 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ BOARD OF HEALTH AND THE DESIGN ENGINEER. 2 OF THE STAT WORK E ENVIRONMENRIALS TAL CODE. TITLE NFORM TO ANY LE LOCAL RULES AND REGULATIONS. \\ 3. TOEINSPECTION ANDS APPROVAL SYSTEM BY THEHALL "BOOARD OFF HEALTH AND TE BACKFILLED HE to A11-0 y �r // ' 20 rl ` ` AVER\��RJ� DESIGN`--� 4. ANY CONDITIONS ENCOUNTEREDDURING CONSTRUCTION DIFFERING Y j FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN W q ENGINEER BEFORE CONSTRUCTION CONTINUES. i i r o J T Z ( / 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. Li I jl Z 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF LL 00Wq rE I THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. �TH-1 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 1 Q _� _ 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 0 1 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 0 1 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY r \\ 1 [v I �/ THE LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO BEGINNING \ \ CONSTRUCTION. 10. EXISTING LEACHING TO BE PUMPED AND REMOVED. FILL WITH CLEAN MEDIUM SAND PER TITLE V. BENCH MARK ,`\ Existin �� OO 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION g '4 g 1 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PAINT SPOT ON 154•�.. Septic Tank\\ i AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY CONCRETE STEP 40 l 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING ELEVATION = 55.42 to / 14. ALL PIPING TO BE 4" SCH 40 0 1/8-/FT (UNLESS SPEC. OTHERWISE) s4 8 \ o / 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW BARNSTABLE GIS DATUM eft` \ �`� `�\ LOT 8 0 / %Z '---V -16. NORW USEHETLANDS WRHINGARBAGE 00 FT. OFINDER PROPOSED LEACHING AREA = 24880 S f — / / z ( ) 17. PROPERTY IS IN ZONE 11 OR NITROGEN SENSITIVE AREA. OF DAR M. ✓� — l C� M ! % 0 No. 114 55 cIS1 PROPOSED SEPTIC. SYSTEM UPGRADE PLAN ZH I TAR\t` .235 PRINCE HINCKLEY ROAD, CENTERVILLE, MA MAP:171 Prepared for: Blue Water Septic LOT' 114 Engineering by: Surveying by: SCALE DRAWN JOB. NO. SURVEY REFERENCE: DEED BOOK.,15091 DARREN M.MEYER,R.S. Posoxmi Boo—Tech Bavlrnnmeata! 1"=20' DMM PLAN OF LAND BY ALLEN SMALL, INC. SURVEYORS DEED PAGE.• 032 EASTSWDWCK AAA 02637 (508) 364-0894 DATE: CHECKED SHEET NO. f 508-W,2022 08/15/09 OMM 1 of 2 r� NOTE: TO PREVENT BREAKOUT, THE PROPOSED to NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:51.99 -,! FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S.' SEPTIC TANK PROPOSED 0-809 PROPOSED S.A.S. OF T.O.F. EL.=55.87 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 1� s OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. F.G. EL=55.Of F.G. EL.=55.25t F.G. EL: 54.40f F.G: EL: 54.60(MAX.) DA E M. I N No. 1140 L - 10'"tf96'"MINN C� L - 40' 7NV 0'( INSTALL TWO INSPECTION PORTS (MIN.) O S-IX (MIN.) • S-IX (MIN.) X (MIN.) 4"SCH40 PVC 4'SCH40 PVC TEE40 PvcNITA4�*� a11.3" TOINV.a 52.594B'uouro 14 INVERT �� INV.=52.34 . 1.74 GAS BAFFLE D-80X 3 ROWS OF 5 UNITS AT 6.25'/UNIT + 0.75' WEDGE = 32.0'/ROW INV.=51.94 D8-3 H-101 INV.= 51.60 SOIL ABSORPTION SYSTEM (PROFILE) - EXISTING 1.000 GALLON SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING SEWER OUTLET TOP MATH CLEAN PERC SAND � 75" TO TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING t•,•:••,• . ;. :. PIPE INVERTS PRIOR TO CONSTRUCTION 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BREAKOUT=TOP ELEV.=51.99 GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 51.60 INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 50.66 EXISTING SUITABLE 310 CMR 15.221(2) 2.83' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF rL 76" - TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.83' = 8.49' IF FAILED, DAMAGED, OR LESS THAN 1,000G IN CAPACITY. (7.10' PROVIDED) USE 3 ROWS OF 5-HIGH CAPACITY PROFILE _ - T 4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM OF TESTHOLE EL.-43.56 - ADS BIODIFFUSER UNITS NO STONE _ W/ CONTOURED WEDGE SEPTIC SYSTEM PROFILE TYPICAL SECTION T 16" N.T.S. r►ta 12w DESIGN CRITERIA SOIL LOGP#- 12664 NUMBER OF BEDROOMS: 3 BR DESIGN DATE: AUGUST 13, 2009 1 34" ►I SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: DARKEN M. MEYER, R.S., CSE. SECTION END CAP WITNESS: DAVE STANTON, BARNS B.O.H. DESIGN PERCOLATION RATE: <2 MIN/IN Elev. TP-1 Depth Elev. � 16"" HIGH CAPACITY H-20 BIODIFFUSER UNIT DAILY FLOW: 330 G.P.D. TP-2 Depth 54.56 0" 54.68 0" DESIGN FLOW: 330 G.P.D. A A SANDY LOAM SANDY LOAM MODEL 16" HICAP GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 10YR 3/2 10YR 3/2 LENGTH 76" 9" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT PROPOSED SEPTIC TANK: USE EXISTING 1,000 GALLON CAPACITY 53.81 e 53.93 a 9" EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY SANDY LOAM DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330) = 445.94 S.F.. SANDY LOAM SIDE WALL HEIGHT 11.2" .74 1DYR 5/8 10YR 5/8 OVERALL HEIGHT 16" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) 51.64 35" 51.68 36" OVERALL WIDTH 34" 4640 TRUEMAN BLVD PRIMARY S.A.S. c1 . CI 13.6 CF HILLIARD, OHIO 43026 11,11106 USE 3 ROWS OF 5 - 16" ADS BIODIFFUSER H-20 UNITS-NO STONE MEDIUM SAND sly MEDIUM SAND CAPACITY (101.7 GAL) AOVANcm oR wai: sYsfEMs, iNc. AND EXTENDED 0,75' W/ CONTOURED WEDGES 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM. SITE PLAN BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIODUFUSER) (BIODIFFUSERS) 15 UNITS x 6.25 LF x 4.70 SF/LF = 440.63 SF 43.56 132" 43.68 144" 235 PRINCE H I N C K LEY ROAD, C ENTE RVI LLE, MA (CONTOURED WEDGE) 3 ROWS x 0.75' x 4.70 SF/LF = 10.58 SF PERC RATE <2 MIN/IN. ("C" HORIZON) TOTAL AREA = 451.21 SF Prepared for: Blue Water Septic DESIGN FLOW PROVIDED: 0.74GPD/SF(451.21 SF) = 333.89 GPD > 330 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN JOB. NO. DARRENM.MEYER,R.S. Bao-Teak A rinaamem&I NTS D.M.M. • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 p08C1XA81 (508) 364-0894 to conduct soil evaluations and that the above analysis has been performed by me consistent with the DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Sail Evol. Exam in October. 1999. EAST S4NOW/CH,A4102597 508-W-29= 08/15/09 D.M.M. 2 of 2